The Value of Treating Source Opinions

Posted June 8, 2018 by Premier Disability Services, LLC®

If you’re applying for Social Security disability benefits, your chances of success improve if your case is supported by your treating doctor. However, in 2017, the Social Security Administration (SSA) eliminated its longstanding rule that treating physicians’ opinions are entitled to special consideration.

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.”

In 2017, 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 were published in the Federal Register on January 18, 2017, and apply 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. Social Security’s new rule states that the consistency and supportability of the medical evidence should be the most important factors in deciding how much weight to give to a medical opinion.

Statements from your physician that you are disabled are not persuasive to the SSA, so do not ask your doctor to make such statements. The question of whether you are “disabled” is for Social Security to decide, not physicians. “Disability” is a legal term rather than a medical term, and physicians’ opinions on this matter are not given any special consideration. 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 limitations 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. Conversely, even if your doctor does not consider you disabled, this does not necessarily mean that you are not eligible for benefits. Remember that disability is a legal term and that your doctor may not be aware of Social Security’s rules for what it means to be disabled.

If you or someone you know is unable to work due to a medical condition, please contact us for a free evaluation of your claim!

Opinion evidence for claims filed before 03/27/2017:

By: Joyce Trudeau of Premier Disability Services, LLC®