How Far Back Does Social Security Look at Medical Records

Learn how far back they examine medical records, the factors influencing their decision, and why maintaining comprehensive records matters.

Suppose you or a loved one have become disabled and unable to work. In that case, you may wonder about one of the crucial elements of proving a Social Security Disability case- which is medical records. Read on to find out more about the guidelines the Social Security Administration has for reviewing medical records.

The Social Security Administration will review your past relevant medical history records. They consider the past twelve months as the most pertinent medical history. You should care about the Look-back period that the Social Security Administration uses because it will help strengthen your disability claim- but it also has the potential to hurt your claim.

Do I Need to Maintain Consistent Medical Records For Social Security?

Yes, you must maintain consistent and updated medical records for the Social Security Administration’s review for both your SSI or SSDI claim and your continued disability reports after you have received benefits.

Social Security Administration’s Acceptable Medical Sources

The Social Security Administration states that “Documentation of the existence of a claimant’s impairment must come from medical professionals defined by SSA’s regulation as “acceptable medical sources.” Once the existence of an impairment is established, all of the medical and non-medical evidence is considered in assessing impairment severity.”

The following are considered “approved medical sources”:

  • A licensed physician, either a medical doctor or osteopathic doctor.
  • Licensed psychologists, which includes:
    • Licensed or certified psychologists at the independent practice level.
    • Licensed or certified school psychologists or other licensed or insured individuals with a similar role as a school psychologist in a school setting. This is applicable only for impairments related to intellectual disability, learning disabilities, and borderline intellectual functioning.
  • Licensed optometrists, specifically for impairments concerning visual disorders or measurement of visual acuity and visual fields. This depends on the scope of practice in the state where the optometrist practices.
  • Licensed podiatrists, but only for impairments related to the foot or foot and ankle. This depends on whether the state permits the practice of podiatry on the foot only or the foot and ankle.
  • Qualified speech-language pathologists, for impairments related to speech or language. “Qualified” refers to being licensed by the State professional licensing agency or fully certified by the State education agency or holding a Certificate of Clinical Competence in Speech-Language Pathology from the American Speech-Language-Hearing Association.
  • Licensed audiologists, limited to impairments involving hearing loss, auditory processing disorders, and balance disorders within their licensed scope of practice. However, certain balance impairments involving multiple body systems outside the scope of practice for audiologists, such as muscles, bones, joints, vision, nerves, heart, and blood vessels, are not covered.
  • Licensed advanced practice registered nurses (APRNs), known as advanced practice nurses (APNs) or advanced registered nurse practitioners (ARNPs) in some states, for impairments within their licensed scope of practice. This includes:
    • Certified nurse midwives (CNM).
    • Nurse practitioners (NP).
    • Certified registered nurse anesthetists (CRNA).
    • Clinical nurse specialists (CNS).
  • Licensed physician assistants, but only for impairments within their licensed scope of practice.

Read our Social Security Disability Benefits Pay Chart post for the latest COLA increases.

What Are Some Common Problems With Medical Records in Disability Cases

Some common problems with medical records in disability cases include that they have become outdated, like your disability has developed into a worse condition, or you have improved.

Other common problems may include that you did not accurately share your medical symptoms with your medical team, including your doctor, so then, in turn, this results in medical documentation that doesn’t fully describe your disability symptoms and how it affects your day-to-day life.

Factors Influencing the Social Security Administration’s Look-Back Period

Several factors can potentially influence the Social Security Administration Look-Back Period, which includes the length of your disability, whether your disability is expected to become better over time, the standards of care for your specific symptoms, and when your records were last requested.

Why You Should Care About the Look-Back Period

The Social Security Administration states that under both the Title II and Title XVI programs, medical evidence is the cornerstone for the determination of disability. This means that they must evaluate your medical disability with the most up-to-date information about the disability that you are applying with. The look-back period depends on which disability you have, as some may take years to manifest symptoms and others may appear overnight.

Tips for Preparing Your Disability Claim

You will want to gather all of the medical disability records that you can, which may include consulting your doctors and past medical teams for the relevant records.

You can also call for a free consultation with the knowledgeable Social Security Disability attorneys at Evans Disability, who have a track record of proven success in Social Security Disability cases. Call them today at 855-360-1010.

How Far Back Social Security Looks at Medical Records FAQs

How many years of medical history does Social Security review?

The Social Security Administration will “look back” at the past twelve months of Medical History when deciding on your disability case, whether it’s SSI or SSDI.

Can I submit medical records from more than the required period?

Indeed, it is recommended to provide medical records covering a period longer than what is strictly required. Submitting additional records beyond the requested timeframe, even including records from years preceding your most recent medical appointment, can offer the Social Security Administration a comprehensive view of your case.

What happens if my medical records are incomplete?

It is always better to submit fully complete medical records. However, your medical team and your attorney can help assist you in gathering your complete medical records so that you can submit your best case forward to the Social Security Administration so that they can review a complete picture of your disability.