The Social Security Administration (“SSA”) denied my claim even though my treating physician says that I am disabled. Why doesn’t the Social Security Administration listen to my doctor? The short answer is that the Commissioner of Social Security is responsible for deciding whether a claimant is disabled under Social Security rules. In other words, the SSA will make that decision and it does not want anybody else telling it what to do. That has been the case for many years.
However, Social Security rules required that the SSA give the most weight to treating physicians’ opinions about the nature and severity of the impairments and the resulitng limitations. A recent rule change allows the SSA to give an opinion from a doctor who reviewed medical records, but never even saw the claimant, greater weight than an opinion from the treating physician. This change will make obtaining disability benefits increasingly difficult.
Disability is an issue reserved for the Commissioner. and the SSA “will not give any special significance to the soruce of an opinion on issues reserved to the Commissioner ” (20 CFR 404.1527). Therefore, the SSA routinely dismissed opinions from treating physicians that the claimant is disabled because that is an issue reserved to the Commissioner.
It used to be that Social Security rules required that the SSA give the most weight to treating physicians’ opinions about the nature and severity of the impairments and limitations. The prior rules recognized that the treatment relationship put a treating physician in a better position to give medical opinions. The Code of Federal Regulations explained, “Generally, we give more weight to opinions from your treating sources, since these sources are likely to be the medical professionals most able to provide a detailed, longitudinal picture of your medical impairment(s) and may bring a unique perspective to the medical evidence that cannot be obtained from the objective medical findings alone or from reports of individual examinations, such as consultative examinations or brief hospitalizations. If we find that a treating source’s opinion on the issue(s) of the nature and severity of your impairment(s) is well-supported by medically acceptable clinical and laboratory diagnostic techniques and is not inconsistent with the other substantial evidence in your case record, we will give it controlling weight.” (20 CFR 404.1527).
Earlier this year, the SSA eliminated the rule that greater weight be given to opinions from the treating physician. The revisions to the rules regarding the evaluation of medical evidence was published in the Federal Register on January 18, 2017, and applies to all claims filed on or after March 27, 2017. Now there is no inherent persuasiveness to evidence from the claimant’s treating physician over medical evidence from other medical sources.
Statements from your physician that you are disabled are not persuasive to the SSA, so do not ask your doctor to make such statements. Instead, you should make sure that your doctor is fully aware of your symptoms and resulting limitations. That way, your doctor can verify your specific limtiations which provide the basis for disability. For example, many people are not able to sustain activities for 8 hours per day, 5 days per week, 50 weeks per year. If you are one of those people who would need more breaks or absences than typically allowed, your physician can explain that reason for your disability.
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