How Inconsistent Medical Records Can Seriously Harm Your SSDI Claim

What Counts as an Inconsistency

An inconsistency is any conflict between different parts of your medical evidence — or between your medical evidence and your own statements.

Some inconsistencies are obvious: One doctor’s notes say you can walk for 30 minutes while another’s say you can barely stand. Some are subtler: Your treatment records describe moderate pain, but your function report describes pain so severe you can’t dress yourself.

Other common inconsistencies include:

• Gaps in treatment that suggest your condition isn’t as severe as you claim
• Emergency room visits that contradict what you reported to your primary care doctor
• Imaging results that don’t support the level of limitation your doctors describe
• Mental health records that show improvement while you’re reporting worsening symptoms.

Many inconsistencies aren’t actually contradictions. Instead, they’re the result of how medical records are created. Doctors may write notes quickly, nurses may paraphrase what patients say, and different providers may document the same symptoms using different language.

Unfortunately, the SSA is specifically trained to look for these discrepancies and doesn’t always make those distinctions. In fact, disability examiners and administrative law judges routinely compare your records against your statements, your function reports against your treatment notes, and one doctor’s findings against another’s.

Any inconsistency can become a reason to question your claim, and what reads as an inconsistency on paper can overshadow the reality of your condition.

Treatment Gaps Are a Particularly Damaging Inconsistency

Gaps in your treatment history are one of the most harmful patterns SSA looks for.

If you claim you’re disabled by chronic pain but your records show you went six months without seeing a doctor, SSA may conclude your condition isn’t as limiting as you describe. If you were prescribed medication but stopped filling the prescription, SSA may question whether you’re making a good-faith effort to follow a treatment plan.

Of course, in the real world, treatment gaps often have explanations that have nothing to do with how severe your condition is. You may have lost health insurance. You may not have been able to afford copays or transportation to appointments. You may have been dealing with depression or anxiety that made it difficult to seek care.

These are all legitimate reasons for treatment gaps, but they need to be documented and explained. Otherwise, SSA may draw its own conclusions that aren’t favorable to your case.

That’s why it’s essential to address any treatment gaps proactively rather than hoping SSA won’t notice. An experienced disability attorney at Chermol & Fishman can help you present these gaps in context and can work to obtain supporting statements from experts that explain the reasons for any interruptions in care.