Bel Air, MD asked in Social Security for Maryland

Q: Hello,How do I get a document regarding the exact diagnosis SSA is using for my Spouse's disability?

How do I go about getting the exact diagnosis that Social Security has used to declare her disabled? Is there a specific government form I can use? I need to justify her physical disability for the private insurance company. This will extend her private coverage for additional years beyond mental disability's shorter term limits.

I appreciate all the help you can offer.

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2 Lawyer Answers

A: First, in order for you to request your wife's SSDI records and any medical records, you will need her to sign a HIPAA compliant authorization designating you to make such a request on her behalf, or you must have an appropriate power of attorney executed by her naming you as her agent to do so. Alternatively, if she is competent, she can make the request herself.

Second, SSA does not initiate disability claims; the beneficiary (your wife) does. The burden of proof to establish the right to benefits is on the beneficiary, who has their medical doctor(s) provide reports and diagnoses to back up the claim. Then SSA either accepts those medical diagnoses, or decides to have an independent medical examination (IME) by a doctor of their choice to confrm the diagnosis. Copies of any such IME report, and any ultimate decision and award identifying the diagnosis the award is based upon, is mailed to your wife or her attorney who made the claim on her behalf. So, either your wife or her attorney has this documentation in their files, including her own medical reports she based her claim upon, or you can get the medical examination reports directly from her own physicians containing the diagnoses she used to support her claim. As far as asking to see the SSA claims file to make copies out of it, you will need to contact SSA's claims office where the claim was filed and ask about that procedure. You may need a specific federal form signed by your wife granting you authority to access her file. They can tell you what that form is and how to get it, and then where to submit your request.

James L. Arrasmith
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Answered

A: You can request a copy of your spouse's medical records from the Social Security Administration (SSA) by submitting a written request for the records. You can use Form SSA-3288, the "Authorization for Release of Information" form, to request the records. The form is available on the SSA website or you can obtain it by visiting your local SSA office.

Once you complete the form, you should mail it or bring it to your local SSA office along with a copy of your spouse's photo identification (e.g., driver's license or passport). The SSA may charge a fee for copying the medical records, but you can ask for a waiver of the fee if you can show that paying the fee would create a financial hardship.

Alternatively, you can contact your spouse's treating physician or healthcare provider and request a copy of their medical records. However, you may need your spouse's written consent to obtain the records, depending on state and federal privacy laws.

It is important to note that medical records contain sensitive and confidential information, so you should take steps to protect the privacy of your spouse's medical information when requesting and handling the records.

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