THE MEDICAL OPINION OF YOUR DOCTOR
HOW DOES THE SSA WEIGH THE MEDICAL OPINION OF YOUR DOCTOR?
The medical opinion of your doctor should matter more than the opinion of SSA’s doctors. Most people submit a letter or progress notes from their doctor that states they cannot work. Sometimes, they even file for SSD benefits on the advice of their doctor
Did your treating doctor tell you that you have a medical condition that prevents you from working? Have you been off work for more than 12 months? If so, then the SSA should accept the opinion of your doctor.
But, will the Judge at the hearing adopt what your doctor said and grant you SSDI and SSI benefits?
You would think that the medical opinion of your doctor would matter a lot to the judge in your case. However, SSA’s approach toward treating doctors is not what you might expect.
SSA’S OLD APPROACH TO THE MEDICAL OPINION OF YOUR DOCTOR
Prior to March 27, 2017, the treating doctor opinion of your doctor as to whether you could work was given the most weight. Especially, if the medical evidence supported the opinion. If the medical tests support the opinion given by your doctor, then the judge would adopt the opinion in his decision. For example, the judge would give the most weight to your doctor if her opinion didn’t conflict with the medical evidence.
In the past, greater weight was given to the opinion of the treating doctor over that of a doctor who never met you. SSA defines a treating source as a doctor, psychologist, or psychiatrist, who has had an ongoing treatment relationship with you. This does not mean three visits over the course of a year. Instead, it means a relationship where you are getting the type of treatment your need for your medical condition.
There are other factors the Judge could consider. For example, the judge considered the length, nature, and extent of the treating relationship. The judge also looks at whether the progress notes support her opinion. The judge looks at whether or not the medical opinion changes over time. Additionally, the judge will consider if your doctor is an expert in the medical field.
SSA’S CURRENT APPROACH TO THE MEDICAL OPINION OF YOUR DOCTOR
For claims filed on or after March 27, 2017, the SSA issued new rules. The new rules state the Judge will not give any specific weight, including the most weight, to the opinion of any medical doctor. This includes the medical opinions from treating doctors.
However, SSA’s rules state that for claims filed after March 27, 2017, when two medical opinions are equal in weight, then other factors will be taken into account. The other factors include things such as whether or not the medical records support the medical opinion of your doctor. Additionally, the SSA will look at whether the medical opinion remains the same. Also, the SSA will look at the length of your relationship with the doctor. In addition, the Judge will look at how often you visit the doctor and have exams. Another important factor is whether or not your doctor is an expert in the area of your illness.
Even though the Judge doesn’t give most weight to the medical opinion of your doctor, it is still important to get that opinion. Your doctor should support you in winning benefits. She should write a letter about the symptoms of your medical condition. She should also explain why you cannot work due to your illness.
Additionally, your doctor should write about your limits. For example, if you have a spinal condition then she could write about your limits with lifting, sitting, standing, and walking. She could also explain why you cannot work a 40 hour work week. This type of medical opinion is an explanation of your RFC.
DO YOU NEED A MEDICAL OPINION FROM A DOCTOR IF YOU HAVE A MENTAL CONDITION?
In the past, the SSA did not accept the medical opinion of treating counselors or nurses, because they were not doctors. They did this, even though most people with mental conditions see a counselor. The SSA has now changed the rules and they will accept the medical opinion of your treating counselor or nurse. For those who need to find a counselor, please see our list of mental health professionals.
If you have a mental condition, then you should see the counselor for weekly visits. The SSA can also send you to see one of their doctors. For example, if you need a mental exam, then you will visit the SSA psychologist. The psychologist will interview you to see if you suffer from anxiety, PTSD, or another mental condition. You may also be given an IQ test. Find out more information about the WAIS IV IQ test here.
You should see the exam as an opportunity to explain your mental problems and how they affect you on a daily basis. For example, if you have anxiety, you could discuss how you can’t sleep at night, have panic attacks, or how you can no longer concentrate. You should make sure to describe all of your mental issues with the doctor. If you need to know more about how to prepare for the mental exam, read here.
OBTAIN MEDICAL EVIDENCE FOR FREE OR LOW COST
If you are missing a medical opinion in your case, then you can make an appointment with your doctor. Your doctor can order tests, like an MRI or CT scan. This evidence helps you win your case. Your doctor can give the SSA her medical opinion. However, what happens if you don’t have a doctor? Don’t worry. If you can’t afford to see a doctor, then you still have options.
For those who live in Utah, we have a list of free and low cost health resources you can contact for medical treatment. Likewise, if you live in Nevada, we provide a list of Nevada’s free and low cost health resources to help you find a doctor. Read her for the list of Idaho clinics. Additionally, if you live in Colorado, learn more about free health resources.
Additionally, if you cannot afford treatment, you can request that SSA send you to one of their doctors. You can visit one of SSA’s doctors for free. They will write a report about your medical condition. You can learn further information on our website about your free SSA doctor exam.
If the SSA sends you to a free exam with one of their doctors, make sure that you bring the things that you use to help you walk or sit. For example, bring your cane or walker to the exam. Also, if you use a brace for your back or other part of your body, then wear it. Finally, remember that at the exam you could be under SSA investigation.
WHAT OUR LAW FIRM DOES FOR YOU
You do not have to obtain SSD benefits on your own. We can help file your SSD application on Social Security’s website. Also, we can help you through each of the appeal stages during the Social Security process.
When you leave that up to us, you can focus on your health. Our attorneys and staff can:
- Help you file your application for SSD and SSI benefits
- File an appeal if you receive an initial denial from DDS
- Collect your medical records
- Help you confirm your SSA doctor exam
- Request a Hearing with an Administrative Law Judge
- Prepare you to testify at your ALJ hearing
- Represent you at your hearing
- Question the expert witnesses
- Read more about job experts here
- Learn more about medical expert testimony here
- Request review of a decision with the Appeals Council
- Request review of an Appeals Council denial in Federal Court
If you file your SSD application online at Social Security’s website, then you have 6 months to complete the application. It is best to complete the application quickly. You don’t want to run out the 6 month time limit. You can always file your application by yourself. But if you need help, then give us a call.
OUR EXPERT ATTORNEYS & LEGAL STAFF
If you need help winning your SSD benefits, then you have found the right law firm. You can learn more about the attorneys at our law firm on our About Us page.
For example, you may want to know that Dianna Cannon has been helping her clients win Social Security benefits for over thirty years. Additionally, Brett Bunkall and Andria Summers have also won thousands of SSDI and SSI cases.
Together, over the past 30 years, we have won over 20,000 SSDI and SSI cases for our clients. Our experts can help you file for SSI benefits using the SSA’s website. However, we will need your help to apply for SSI benefits. Because only you know your personal financial information. Also, when filing for SSD benefits, we need you to give us your medical information, like the name, address and phone number of your doctor.
If you are tat the point where need an appeal, then we can help you do that too. There are also many forms that will need to be filled out. If you have questions about these forms, then we will answer them. You can learn more about SSA’s appeal forms here. Call us today for help winning your Social Security benefits.
THE MEDICAL OPINION OF YOUR TREATING DOCTOR IS THE MOST CREDIBLE
Once you have the medical opinion of your doctor, then your attorney should argue it should be given greater weight than other opinions. The reason for this argument must be based upon the fact that the medical opinion of your doctor is more reliable than the opinion of other doctors. At our law firm, we make this argument to the judge whenever we can. We want the judge to listen to what your doctor has to say. We believe the medical opinion of your treating doctor should matter more than a doctor who has only seen you one time.
If you need help with your SSDI and SSI case, then contact Cannon Disability Law. We have won over 20,000 SSD cases in the last 30 years. Also, we have the legal experience you need to win your benefits. Finally, if you follow our advice, you can find a doctor who can help you by giving the SSA the medical opinion that you cannot work.
Give us a call today. We can often tell you over the phone if you have a good case. It is free to call and talk to us. Additionally, there are no attorneys fees unless we win your case. If we don’t win, then you do not pay an attorney fee. Therefore, you have nothing to lose by calling to discuss your benefits today.