Creative Strategies for Tracking Down Medical Evidence: SOAR Team Tips
Tracking down medical evidence can be very challenging, especially if the treating source is unknown. Case managers must develop creative strategies and become good detectives!
Tracking Down Medical Evidence
The qualities of a good clinical detective include curiosity, persistence, and creativity. You constantly need to assess whether the information gathered creates a complete picture of the individual’s life in a way that supports the disability claim. While this process can be challenging, nothing is more rewarding than getting an approval in less than 90 days! Here are some tips and strategies from the SOAR team to help you track down needed medical evidence.
Useful Medical Evidence
Obtain as much information as possible about health care providers an applicant has accessed, including provider name, location, services provided, and the dates of service provision to applicant.
- Be aware of the many types of useful evidence for making disability determinations. Keep a "cheat sheet" of where to find useful records.
- Some of these records are signed by physicians or psychologists and serve as medical evidence. However, information recorded by social workers, nurses, or other professionals is very relevant.
- Look carefully at progress notes. Sometimes you can tease out functional information and get a better sense of the course of a person’s illness and how they have or have not responded to treatment.
- Don’t forget collateral information. Friends, family, and associates may have very pertinent and valuable functional information. An outreach worker or other service volunteer may help as well. Be sure to have signed releases to talk with these providers.
Types of Evidence |
Where to Look |
What to Look For |
Psychiatric evaluations & records |
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Physical health evaluations |
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Substance use |
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Other |
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Dates of Treatment
It may be difficult for people to recall when they received services.
- It is helpful to provide a context for people. For example, you might ask, “Was that before you left high school or after?"
- Work out a timeline from my conversations with applicants and then get the details filled in by carefully reviewing the medical records once they’re received.
Where Was Treatment Received?
It can be difficult for people to identify where they received treatment, especially those who have accessed only acute care and those who have cognitive impairments.
- Develop a list over time of local places where people frequently receive services.
- Search the internet for local shelters or service providers that you can call for suggestions of frequently used facilities near where the applicant has lived.
- Sometimes you just have to send releases to places where you think the person would have received services. This can be useful particularly for local services.
- Use the Federal Treatment Facility locator on the SAMHSA website.
Keeping It All Organized
Be sure to keep the requests and replies organized.
SOAR Tool
Details
- Type:
- Adult Course
- Date:
- September, 2012
Other Details
- Topic
- Medical Records and HIPAA