Medical Sources

Tuesday, April 24th, 2018

Recently, the Social Security Administration (“SSA”) enacted new rules concerning evidence from medical providers. The bad news is that the new rules were designed to make it more difficult for a claimant to obtain Social Security Disability (“SSD”) benefits. The rules achieve that goal by eliminating the requirement that controlling weight be given to treating source opinions that are well supported. The bad news is tempered somewhat by allowing more weight to be given treating sources that are not considered acceptable ones, primarily MDs.

For claims filed after March 27, 2017, the new rules state that all medical sources, not just acceptable medical sources, can provide evidence that the SSA will consider as medical opinions.

I represent a 25 year old with mental impairments whose SSD application was approved after the Administrative Law Judge (“ALJ”) gave even greater weight to the opinion of the claimant’s certified social worker (“CSW”) than the treating psychiatrist. The rationale was that the CSW had extensive face to face interactions with the claimant and reviewed the claimant’s medical records.

While the new rules eliminate the concept of controlling weight, there is nothing to prevent an ALJ from giving greater weight to a treating doctor after considering all the factors for evaluating medical opinions. Nonetheless, no doubt that those ALJ’s with high denial rates will see the new rules as justification to deny more claims.

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