The social security administration has announced drastic changes making it harder to get disability benefits, so a disability lawyer is needed now more than ever. It is no surprise that social security has changed one of the best rules that was helpful to disability claimants.
Social Security Disability Abolishes the Treating Physician Rule
The treating doctor rule has long been established in Court decision and by rule. This rule was codified in SSR 96-2p. The direction was that a treating doctor’s opinion was entitled to controlling weight as to the nature and severity of the medical impairment if certain conditions were met. In a nut shell these were:
- It must be an acceptable medical source
- The opinion must be well supported by acceptable clinical and laboratory techniques
- It is not inconsistent with other substantial evidence of record
The judges would often attempt to write around this rule. But it was a cause for many reversals when the judges tried to do so. The administrative federal Court judges also had to give good and specific reasons why they adopted the opinion or did not adopt it.
In a recent Court case it was found that conflict with a social security non-examining doctor was not enough to defeat the treating doctor rule. Gayheart v Commisioner of Social Security This probably put more fuel on the fire to change the rule. It made it more difficult to write around the rule and thus more people won their case. With social security as a big piece of the federal budget there is pressure to decrease the benefits awarded.
What Takes The Place of The Treating Physician Rule?
So what takes the place of the old doctor rule. and how will social security attorneys handle it. The new rules emphasize consistency and supportability. Is the opinion of the treating doctor consistent and supportable. Many commentators are concerned that this will open the door to reliance on the social security doctors that never even examined the claimant. Some Judges tend to do that already. These non-treating non-examining social security doctors have limited evidence and never even examine the claimant. The treating doctor rule developed in recognition that doctors that had seen the patient over a significant period of time were in the best position to render opinions about their patients.
Why SSI SSDI Claimants Need Attorneys Now More Than Ever
With the recent changes, an attorney is your best hope for getting a clear and supportable medical opinion. Comprehensive reports from treating doctors and specialists will be critical. The doctor must explain the opinion and what it is based on in clear, consistent and understandable terms. A lawyer can give the doctor what he needs in terms of the rules to follow and what the report should contain.
Also obtaining affidavits from former coworkers and friends about the claimants restrictions will be of paramount importance. These lay medical witnesses support the treating doctor’s opinion.
In my experience the strongest cases have significant objective evidence including an MRI, CT scan, blood testing. Anything that takes the restrictions out of the realm of the patient’s own words. is critical. When coupled with written restrictions from the doctor and the doctor’s clinical basis for the restriction the lay medical witness can me powerful.
For more about Anthony Castelli and his practice of social security disability in Cincinnati and throughout Ohio go here
Law Office of Anthony D. Castelli
8170 Corporate Park Drive #220
Cincinnati, Ohio 45242
602 Main Street #707
Cincinnati, Ohio 45202