Wednesday, October 28, 2009

Will Social Security Disability Pay For X-rays and a MRI to Evaluate My Case?

The Social Security system does not pay for testing unless it is essential to make a Social Security disability or SSI determination. Most disability determinations are made with the evidence provided (by treating physicians and/or consultative examinations reports) without the benefit of x-rays or MRIs. But...if the disability examiner handling a particular case feels that x-rays are needed to make a determination, or that the consultative examining physician will need imaging to make their report, they may schedule an appointment for one or more x-rays.

However, when it comes to imaging studies, x-rays are the end of the line. Social Security never pays for MRIs or more advanced imaging techniques for their decisions. Fortunately, many individuals who have been receiving ongoing treatment have this type of information in their medical record documentation. Unfortunately, if an individual has no medical treatment, or no current medical treatment, the most they can hope for is that social security will pay for an x-ray of the affected area.

Why does SSA draw the line at x-rays? Well, the cost of obtaining more advanced imaging would be considered prohibitive. Each year, Social Security receives more than two million disability cases...and that number is climbing steadily (by some reports, the total number will exceed 2.5 million for this year). So, its not likely that social security will ever pay for MRIs, CT scans, bone scans, or, for that matter, even x-rays every time a claimant makes an allegation regarding back pain.

Note: if an individual wants to be approved for Social Security disability it's typically best to be under the care of a treating physician. If an applicant is unable to provide any information (no medical records at all, or no recent medical records), Social Security will get "medical information" of a sort in the form of consultative exams, which may or may not include sending a claimant out for x-rays.

Return to the Social Security Disability SSI Benefits Blog

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