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Only SSA can pay a testifying medical expert or consultative examiner in the Claimant’s case. There are rare instances where a medical expert is willing to do an individual assessment, for a fee, but this is usually very expensive. Under certain circumstances, it makes sense to pay a medical expert for an individual assessment to rebut an adverse medical opinion or to submit additional evidence with an appeal.

What Medical Evidence Do I Need To Win My Disability Claim?

Regular, ongoing medical care is absolutely necessary to prove a disability case. The types of medical evidence needed to depend on the Claimant’s medical impairments. A Claimant who suffers from a severe mental disorder should be inactive mental health treatment with mental health professionals. Simply receiving psychotropic medications from a primary care physician is not enough. There should be regular therapy sessions and medication management with a mental health professional. There are some exceptions, of course, such as a Claimant who lives in a rural area where there is no affordable mental health care in the area. The same applies to physical impairments; simply going to a general practitioner or the emergency room a few times a year is not enough. There should be referrals to specialists, physical therapy or aquatic therapy sessions, imaging studies, pain management, and other laboratory and diagnostic techniques.

When it comes to Claimants with Learning Disorders or Intellectual Disabilities, school records can be extremely useful. Sometimes, records from employers can be helpful as well. Fit Bit computer-generated printouts are an excellent way to track disrupted sleep patterns. For people with seizure disorders, the frequency, duration, and description of seizures can be easily documented for free at Statements from witnesses about the seizures can also be helpful. For people who are in recovery from substance abuse, letters from their sponsors and attendance logs from meetings are great examples of the Claimant’s efforts to remain abstinent.

Why Is An Applicant’s Medical Evidence Sometimes Lacking?

There are many reasons why a Claimant’s medical evidence may be lacking. The two primary factors are the cost and availability of affordable health care. Transportation issues can also be a major factor. Some Claimants live in rural areas, where free or low-cost medical care is unavailable, and this can provide a justifiable excuse for little or lack of regular medical treatment. However, this must be demonstrated by documentation.

Even for Claimants with private insurance, the cost of co-pays, deductibles, and out-of-pocket expenses can be financially overwhelming, especially when they have no income or are reduced to a single-income budget. These factors come into play when deciding how much medical or psychiatric care they can receive and from whom. These issues should be taken into account by the Administrative Law Judge and should not be held against the Claimant. Claimants should make reasonable efforts to obtain medical care, make sure they are medically-compliant with their doctors’ orders, and refrain from abusing alcohol or illegal substances, or abusing prescription medications. Abusing substances, frequent no-shows to doctors’ appointments, and not following doctors’ orders can hurt a case and lead to a denial of benefits.

What Are Some Things I Can Do To Make My Case As Strong As Possible, Regardless Of The Medical Expert’s Testimony?

The most important thing to do for your case is to establish a good rapport with a long-time treating doctor or psychologist. The more they see you, the more they know about you. When it comes time for the judge to weigh your doctor’s opinion, a longitudinal record will exist to back up your doctor’s familiarity with your medical conditions and the effect they have on you.

It’s also important to maintain regular appointments and remain 100% compliant with doctors’ recommendations. Your doctor’s opinions are extremely important in supporting your case. Also, report the side effects of any medications to your doctor. Don’t assume the doctor already knows about the side effects. It is important for the doctor to document the side effects in his or her treatment notes. Under the regulations, the Administrative Law Judge must consider the side effects of your medications when determining whether you are disabled. Tell your doctors how your impairments impact your daily activities, socialization, and what you do on your own to find relief for your symptoms, other than taking medications and seeing doctors.

For more information on Paying A Medical Expert In Texas, a free initial consultation is your next best step. Get the information and legal answers you are seeking by calling (214) 373-3761 today.

Morgan & Weisbrod LLP

by Paul B. Burkhalter
Managing Partner of Morgan & Weisbrod, Board Certified in Social Security Disability Law.


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