In order to be found disabled under the Social Security regulations, it must be determined that you have a condition or combination of conditions that severely impairs your ability to perform work related activities for at least a year. This finding by Social Security cannot be based solely upon your complaints of pain or limitations. In other words, you must be diagnosed with a severe impairment by the medical community in order for Social Security to consider your impairment. So the simple answer to the question is Yes.
As a result, many Social Security Disability claimants find themselves in the following Catch-22 situation:
(1) The claimant lacks medical insurance because they are not working due to their disability
(2) The claimant cannot treat with a doctor because they do not have medical insurance or money to pay for a doctor because they are not working
(3) The claimant cannot prove that they are disabled because they have no medical evidence to prove that they are disabled
On the other hand, I am often asked by my clients whether or not they should treat for a certain condition. Although is it important to have medical evidence of your claim, it is more important to be forthright in your presentation to Social Security. Social Security considers medical evidence provided by claimants in large part because the medical evidence represents a true sense of what the claimant is experiencing when they go to their doctor’s office. If the claimant is going to the doctor for a secondary purpose, such as bolstering their claim for Social Security, this system breaks down with potential negative consequences for the claimant for both his/her efforts to obtain both future medical treatment and Social Security Disability Benefits.
The medical community is interested in treating people with an actual desire to improve their condition. They are generally not interested in treating people who primary goal in seeking treatment is to support some secondary claim such as a Social Security Disability or SSI claim. If Social Security reads in your medical evidence or suspects that you are seeking out medical care solely to support your Social Security claim (doctors will make these observations and put them in your medical records!), they will likely find you not credible and this may result in the denial your claim.
A rule of thumb to use when deciding whether to treat for a certain condition: Ask yourself, if you had unlimited free access to healthcare and were not applying for Social Security Disability benefits, would you treat for your condition? If the answer is yes, then by all means treat for the condition if you can.
In my next blog post I am going to discuss the implications of not treating for conditions and the circumstances surrounding when Social Security can use this decision against you in your claim and when Social Security is not permitted to use this decision against you.