Changes in Social Security Evidence Rules and How They Impact Your Claim

Social Security has recently amended its regulations to require that claimants and their representatives in a Social Security disability claim must submit all evidence, whether helpful or not, that relates to whether a person may or may not be disabled. This rule is an attempt to clarify Agency regulations on the submission of evidence regarding disability claims.

The Changes, Explained

Prior to this change, regulations presiding over the administrative review process for SSDI and SSI claims, including 20 CFR § 404.900 and 416.1400 stated “you may present any information you feel is helpful to your case.” The ambiguous wording of the regulations allowed claimants to choose not to submit certain evidence that was irrelevant in their opinion, or even harmful to their claim for benefits.  This section of the regulations was removed as of April 19, 2015, which means that claimants and their representatives now must inform the Agency of all evidence that relates to whether they are or are not disabled.

Understanding The New Rules

The new rules do have exceptions: duplicate records and advocate work product. If medical or other evidence has already been submitted to the Agency, claimants and their representatives do not have to resubmit such evidence, even though it may be “relevant.” More importantly, evidence which falls under ‘advocate work product’ is not encompassed by this new rule. Advocate work product means any analysis, notes, or strategy created by a representative in preparing a claimant’s case, as well as any oral or written communication between the representative and the claimant. While the advocate work product exception does cover notes taken by an advocate when speaking with the claimant’s doctors, it would not cover a medical source statement prepared and signed by that doctor.

How Will This Affect My SSDI or SSI Claim?

The SSA, representatives, and claimants are still endeavoring to understand the full implications of the new rule. Representatives will now submit every single medical record or other evidence which they receive on behalf of a client, even if many of those records are not relevant or useful in determining whether an individual is disabled. For instance, a representative may receive a 500 page medical record documenting a claimant’s treatment history, but only a few dozen pages might be important in evaluating whether that claimant is disabled. The new rule removes any discretion the representative may have had to submit only those records they determined were relevant. This will inevitably result in much larger files that the Agency and claimant representatives must review. Representatives may also hesitate to request medical opinions on behalf of their clients, which can often be a key piece of evidence in a disability determination.

If you have any questions about what evidence you, as a claimant, are obligated to submit to the Agency when filing for disability benefit, please consult with an experienced disability advocate.

About Citizens Disability, LLC:

Since 2010, Citizens Disability has been America’s premier Social Security Disability institution. Our services include helping people in applying for SSDI benefits, managing the process through Reconsideration, and representing people in person at their Hearing, and if necessary, bringing their case to the Appeals Council. Our mission is to give a voice to the millions of Americans who are disabled and unable to work, helping them receive the Social Security Disability benefits to which they may be entitled. Learn more about us and disability benefits like SSDI & SSI or give us a call (800)492-3260.

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