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Importance of Medical Record Review in Connection with OTR Review Request

Author: Medical Record
by Medical Record
Posted: Jan 19, 2016

Any social security disability claim hinges on a patient’s medical records. Since the claim application and appeal processes can be lengthy and complicated, many applicants prefer to have a social security disability lawyer assist them. Disability lawyers find the support of an experienced medical record review company invaluable when it comes to reviewing the medical evidence and determining the legitimacy of a disability claim. Medical record review for attorneys focuses on developing medical evidence from the claimant’s medical records that may often run into hundreds of pages with many of them not even relevant to the case. A complete review helps identify the pertinent medical records and use them appropriately.

Medical Evidence Most Important for OTR Review Approval

Medical record review services become very helpful for the lawyer requesting an on-the-record (OTR) review. An OTR review is available to an SSD applicant who is appealing a denial of his/her benefits based on their written disability application. An attorney who is convinced that the medical evidence supports his/her client’s disability application may request for this type of review. The OTR review is a process wherein an administrative law judge (ALJ) will review all the claimant’s medical records and issue a decision without a hearing. The attorney usually decides to request an OTR review after the claimant has submitted a request for a hearing and a judge has been assigned to his/her case. However, it will be before a hearing date has been scheduled. The applicant must submit a request for a hearing within 60 days from the date he/she receives a notice regarding the denial of their claim.

  • An OTR review is beneficial because it may result in a favorable decision before the claimant’s hearing date.
  • If the review is negative or the claimant is not granted disability benefits, the case will proceed on to a disability hearing.
  • Medical evidence is the most important factor with regard to an OTR review request. With the able support of the partnering medical review company, an attorney can determine whether the medical evidence is compelling enough to request an OTR review.

    Disability Lawyers Speed up the OTR Review Request Process

    An OTR review request has to be made to the claimant’s nearest Office of Disability Adjudication and Review (ODAR). The ALJ reviewing the request will approve it, deny it or call the applicant for more information. It is when the request is denied that the case proceeds to a hearing.

  • Social security disability attorneys help applicants prepare the brief that has to be submitted along with the request, which is a summary of the claim with a clear argument as to why the claimant’s medical condition qualifies him/her for benefits.
  • The attorney will collect all necessary medical evidence and clearly demonstrate how the claimant qualifies for the SSA’s disability requirements.
  • The attorney will represent the claimant in all matters before the judge and also negotiate on his/her behalf if necessary.
  • An OTR request is considered a great way to speed up the disability appeal process, though it may not be the right option for all disability claimants. The attorney is the best person to determine if the claimant should request an OTR, once he/she has reviewed all available medical documentation associated with the disability claim. An experienced lawyer will request an OTR only if the medical records can prove to the ALJ that the claimant is truly disabled and should be approved benefits without the need for a disability hearing.

    About the Author

    Managed Outsource Solutions (Mos) has providing value-added medical record review services for the medico-legal industries.

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    Author: Medical Record

    Medical Record

    Member since: Jun 17, 2015
    Published articles: 31

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