How far back does Social Security look at medical records?

Asked by: Miss Eula Kulas Sr.  |  Last update: May 19, 2025
Score: 4.9/5 (51 votes)

These records paint a picture of your health and help the SSA decide. To ensure a thorough evaluation, the SSA prefers to have a 12-month medical history of an individual. This means they look at your medical records from the past year. For records to be considered current, they should be less than 90 days old.

What does Social Security look for in medical records?

Once the existence of an impairment is established, SSA considers all evidence from all medical and nonmedical sources to assess the extent to which a claimant's impairment(s) affects his or her ability to function in a work setting; or in the case of a child, the ability to function compared to that of children the ...

How far back does my medical history go?

How long are medical records kept? The answer varies depending on the state. In California, the retention period can be anywhere from two to ten years, depending on the type of procedure or healthcare provider. However, an insurance claim medical report should only look as far back as the injury in question.

How far back does SSA go to determine benefits?

You may be entitled to monthly benefits retroactively for months before the month you filed an application for benefits. For example, full retirement age claims and survivor claims may be paid for up to six months retroactively. In certain cases, benefits involving disability up to 12 months may be paid retroactively.

What illness automatically qualifies for disability?

It includes:
  • Musculoskeletal Disorders, such as arthritis, fibromyalgia, and back pain.
  • Special Senses and Speech, such as blindness and hearing loss.
  • Respiratory Disorders, such as cystic fibrosis and respiratory failure.
  • Cardiovascular System, such as hypertension and heart disease.

The SSDI Podcast - EP10: How far back does Social Security disability look at medical records

42 related questions found

What is the easiest diagnosis to get disability?

What Is the Most Approved Disability? Arthritis and other musculoskeletal system disabilities make up the most commonly approved conditions for social security disability benefits. This is because arthritis is so common. In the United States, over 58 million people suffer from arthritis.

What gives 100% disability?

What Is a 100% Disability Rating? A 100 percent disability rating, or total disability rating, is the highest rating VA can assign for service-connected compensation purposes. VA reserves this rating for veterans with extremely debilitating service-connected conditions.

What is the disability 5 year rule?

There's no official “five-year rule,” but the phrase refers to a process called “expedited reinstatement,” or EXR. You can file for EXR if you received disability benefits within the past five years, stopped collecting those benefits and need to apply for disability benefits again.

How far back does Social Security look at your work history?

How Many Years of Job History Does the SSA Look At? With your initial SSDI application, the SSA generally does not look further than 10 years back. However, if the SSA requires additional documentation for your application, they might want to look at 15 years of your work background.

How far back does a medical background check go?

Under this act, most information can only be reported for seven years. However, the limits do not apply for jobs that pay salaries of at least $75,000. Many states also have laws that restrict the reporting period for certain types of information.

Do all doctors see your medical history?

Medical records are typically shared electronically between all healthcare providers, including doctors, hospitals, healthcare organisation systems, pharmacies, laboratories, clinics, medical imaging facilities, and any other health care provider who might benefit from seeing patient records.

What medical records are kept indefinitely?

immunization records, which should be kept indefinitely; records of significant health events or conditions and interventions that could be expected to have a bearing on the patient's future health care needs, such as records of chemotherapy.

How far back does Social Security disability look at medical records?

According to SSA regulations, the analyst reviewing your claim will review the alleged onset date of your disability and request all medical records that cover the period from the 12 months prior to the alleged onset date. These records include hospital records, doctor's notes, laboratory tests, and therapy reports.

What are red flags on a disability update report?

Some red flags on the Social Security disability update report include: Checking the box that states your doctor told you that you can work. Checking the box that says your health is better now than when you were approved for benefits.

What shows up on health records?

What's in a Medical Record?
  • age, gender, and ethnicity.
  • height and weight.
  • medical problems (such as asthma, epilepsy, or diabetes)
  • mental health issues (such as anxiety or depression)
  • medical test results (from lab tests, X-rays, etc.)
  • medicines, including doses and how often the medicine is taken.

What is the 5 year rule in Social Security?

The Social Security 5-year rule refers specifically to disability benefits. It requires that you must have worked five out of the last ten years immediately before your disability onset to qualify for Social Security Disability Insurance (SSDI).

How many years does Social Security look back?

Social Security benefits are typically computed using "average indexed monthly earnings." This average summarizes up to 35 years of a worker's indexed earnings. We apply a formula to this average to compute the primary insurance amount (PIA).

How far back does Social Security keep records?

To ensure a thorough evaluation, the SSA prefers to have a 12-month medical history of an individual. This means they look at your medical records from the past year.

What is the 10 year rule for disability?

The ten-year rule says that the VA cannot revoke a veteran's disability rating if they have had it for a decade or more. That means that the VA has to offer the vet some level of benefits, although there are limited exceptions.

What is the maximum back pay for SSDI?

How Far Back Will SSDI Cover? Minus the five-month waiting period, you should receive back payments for any delays. The maximum SSDI will provide in back payments is 12 months. Your disability would have to start 12 months before you applied to receive the maximum in SSDI benefits.

What is the highest disability payment?

In 2024, the maximum Social Security disability benefit for a disabled worker receiving Social Security Disability Insurance (SSDI) is $3,822 per month, according to the Social Security Administration (SSA).

How much a month is 100% disability?

Those with total disability get the 100 VA disability benefits, where 100 is 100%, which is the maximum VA benefit/rate. Today, the 100% VA disability payment ranges between $3,700 and $4,200 based on a veteran's specific condition and factors like the number of children, spouse, and age of the children.

What is a nexus letter?

A NEXUS letter is the medical evidence a doctor prepares for a veteran that explains how and why the veteran's current medical condition is related to his military service or secondary to an established service connected disability.