Treating Doctors

Monday, May 2nd, 2011

The Social Security regulations require a treating doctor’s opinion that a patient cannot work to be given controlling weight if it is supported by clinical and test findings, and is consistent with the record as a whole. When such a treating opinion exists Social Security is supposed to approve an application for Social Security Disability (“SSD”) benefits. However, especially prior to a hearing, having another treating doctor to corroborate the disability opinion is frequently needed.

I represent a 58 year old former security manager with rheumatoid and osteoarthritis whose SSD application was approved today without a hearing. After the claimant’s application was denied, but before a hearing was scheduled, I submitted a report from the claimant’s orthopedist that corroborated the disability opinion of the claimant’s rheumatologist.

The State agency had denied the SSD application on the grounds that a consultative examination (“CE”) was needed because there supposedly was insufficient evidence to support the claimant’s disability. However, the attorney advisor found that it was unnecessary for a CE.

It is not unusual for the State agency, attorney advisors, or Administrative Law Judges to reject an SSD application when there is only one treating opinion. However, when there are two treating opinions that conclude the claimant cannot work it is much more difficult to conclude the disability opinions are not consistent with the record as a whole.

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