Social Security Claims—What's in YOUR file?

by Alan Harder

Social Security disability decisions have an air of mystery about them, don't they? Especially when claims are denied, the first question is: "How could they possibly turn me down?"

The answer will become more clear if you look at the records SSA relied on to decide your claim. You have a right to view this information, and getting it is easier than you might think.

What Your "Folder" Probably Looks Like

SSA maintains nearly every claim in electronic folders.  There is actually section on SSA’s computer where your information is stored, not a collection of paper. When you ask for a copy, the information is put on a CD that can be read on your computer. There are rare exceptions where paper folders are still created, but not many. (In those few cases a copy is still created the old way—on a photocopier.)

What You Will Find in Your Folder

Your folder will contain: The written decision and supporting documents; notices to you; the forms you completed when you applied; requests for medical records; and medical records.

Do I Really Have a Right to See My Medical Records?

YES. YES. YES!!! Under provisions of the Privacy Act, you are entitled to have copies of your records held by the agency. SSA might not release a record directly to you if it is labeled "Sensitive". This is pretty rare, and even those records can still be released to your Doctor or other representative.

What Does it Cost?

If you need the records for a "program use" (that is, to help you understand or appeal your decision) there is no charge.

Some Good Times to Ask For a Copy

1.    If your claim is denied, it's important to know the basis for that denial before filing an appeal. The denial may have been because of missing, incomplete or incorrect information. With the folder in front of you, it's lots easier to spot problems in the records SSA used, and to argue intelligently with the decision if it was wrong.
2.    After an award, SSA reviews your case periodically to see if you have improved, or if medical science has advanced treatments to the point that your condition doesn't keep you from working anymore. It can be useful to have a copy of your prior records as this review begins.
3.    While your claim is being processed, SSA may ask you to go to a Dr. for an examination. They do that if there isn't enough information in hand to make a decision. That isn't unusual for 'ordinary' folks, but PH'ers often have TONS of records. Getting a request to go for an exam may be an indication that SSA didn't receive records from one or more of your Dr's. The most direct way to explore this would be to call the Disability Determination Service and ask if anything is missing. However you can also ask for a copy of your folder and see for yourself what records have been requested and which ones are or aren't there.
 

So How Do I Get a Copy?

Getting a copy of an electronic disability folder (or a paper one, for that matter) shouldn't be hard.

To get the CD, contact your local Social Security District Office and ask for it.

How to contact SSA? The surest method is to go to an office and ask in person. Alternately, you can write or call and ask for a copy, but that may take much longer. You absolutely do not want to let the 60-day time limit for filing an appeal expire. 

If you go to an office you can usually take the CD with you as you leave.

A look at SSA's Operating Manual:

Your right to see your records:

1. Click here: This is the introduction to your right to see your records explained in SSA's operation manual.

Read Alan Harder's other articles:
Social Security Claims—Making Your Efforts Count
Alphabet Soup Spelled Out—(Where Your Disability Claim Goes After it's Filed.)
Work and Social Security: (Yes! You Can!)
 

Have a Question?  Ask the PHC Action Desk
If you're looking for information about Social Security/Disability, we may be able to help. Alan Harder is here to answer your questions.
Submit a Social Security/Disability Question to Alan Harder

Ed. Note:
Alan Harder worked for Social Security for many years. To learn more about the author, visit his bio on the PHC Staff Page.