Why Medical Evidence Matters

SSA doesn't approve claims based on a diagnosis alone. They need to see how your condition limits your ability to function, both at work and in daily life. The goal is to demonstrate that your disability:

• Is medically determinable (verified through tests or clinical evidence)
• Is expected to last at least 12 months or result in death
• Prevents you from performing substantial gainful activity (SGA)

Key Types of Medical Evidence to Include

1. Medical Records From Treating Physicians

Your main source of evidence should be your long-term healthcare providers, such as:

• Primary care doctors
• Specialists (e.g., neurologists, psychiatrists, cardiologists)
• Therapists or counselors (for mental health claims)

Include:

• Clinical notes
• Diagnosis history
• Progress reports
• Surgery or treatment summaries

2. Test Results and Imaging

Objective test results help prove the existence and severity of your condition. Examples include:

• MRI, CT scans, or X-rays
• Blood tests and lab work
• Pulmonary function tests
• Cardiac stress tests or EKGs
• Neuropsychological evaluations

3. Hospital and Emergency Room Records

Include any:

• Admission and discharge summaries
• Emergency treatment documentation
• Notes related to urgent complications of your condition

4. Prescription History

A full list of:

• Current and past medications
• Dosage, frequency, and duration
• Side effects that impair your ability to function (e.g., fatigue, confusion)

5. Statements From Your Doctors (Medical Source Statements)

Ask your physician for a detailed written statement explaining:

• Your diagnosis and prognosis
• Functional limitations (e.g., how long you can sit, stand, or concentrate)
• How your condition affects your ability to work full-time
• Whether your condition is expected to improve

SSA gives extra weight to evidence from treating doctors who have a long-term history with you.

6. Mental Health Records (if applicable)

If your disability involves anxiety, depression, PTSD, bipolar disorder, or other mental health conditions, provide:

• Psychiatric or therapy notes
• Psychological evaluations
• Mental status exams
• Statements from licensed mental health professionals

Common Mistakes to Avoid

• Submitting incomplete or outdated records
• Failing to include evidence from all treating providers
• Relying only on diagnosis without functional impact
• Not continuing treatment (SSA looks for ongoing care)