Can I Pick Any Health Care Provider When Applying for SSDI Benefits?

Are you planning to apply for Social Security Disability Insurance (SSDI) benefits, you will need strong medical evidence to support your claim. You may be wondering about the particulars of the medical evidence that you will need to provide to the Social Security Administration (SSA) when you submit your application for benefits, and whether you need to see a specific doctor or have the SSA provide you with options for health care providers. In other words, you may be wondering: can I pick any health care provider when applying for SSDI benefits?

In short, you can always choose your own health care provider who will provide medical evidence for your SSDI application, but you will only be eligible for benefits if the health care provider you have chosen is considered to be an “Acceptable Medical Source,” or AMS, under federal law. Our SSDI eligibility attorneys can explain in more detail.

Finding an Acceptable Medical Source

The type of health care provider that you will need to see for diagnosis and treatment of your disabling medical condition will depend on the type of medical condition and symptoms. In order to be medically eligible for SSDI benefits, you will need to provide the SSA with medical evidence that shows you have a medical condition that is expected to last for a year or longer (or to result in your death), and that the condition is severe enough that it prevents you from engaging in substantial gainful activity (SGA).

If you have a disabling mental health condition, you will likely seek a diagnosis and treatment from a mental health specialist, for example, whereas a person with terminal cancer will likely supply medical evidence from various health care providers that include an oncologist. Yet the SSA cannot tell you whether a particular health care provider is acceptable based on their particular experiences, the geographic area of practice, or similar. What the SSA does require, however, is that the health care provider of your choice be considered an AMS.

What is an Acceptable Medical Source?

Under CFR 404.1502, 404.1513, 416.902, and 416.913, the following health care providers are considered to be acceptable medical sources:

• Licensed physicians (with a degree in medicine or osteopathic medicine);
• Licensed or certified psychologist;
• School psychologist if the impairment is an intellectual disability, learning disability, or borderline intellectual functioning;
• Licensed optometrist if your impairment is related to your vision;
• Licensed podiatrist if your impairment concerns your foot or ankle;
• Qualified speech-language pathologist (SLP) if your condition is a speech or language impairment;
• Licensed physician assistant for impairments within their scope of practice;
• Licensed audiologists for impairments related to hearing loss, auditory processing, or balance disorders; or
• Licensed Advanced Practice Registered Nurses (APRNs) for impairments within their scope of practice.

Contact Our National SSD Eligibility Attorneys for Assistance with Your Application or Appeal

Whether you are just beginning to work on your application for SSDI benefits, or if you were denied upon your initial application for medical reasons and need to appeal, our firm can help you to gather the necessary medical evidence you need to support your application or appeal. An experienced social security disability lawyer at the Law Offices of Stephen Barszcz can speak with you today about the medical evidence and records you currently have, and whether there is a need to obtain additional information from one or more acceptable medical sources. Contact our firm to discuss your SSDI application and any eligibility or appeals questions you have.

Source:

secure.ssa.gov/poms.nsf/lnx/0422505003