This rule used to mean that the doctor’s opinion was the most important opinion on how severe a patient’s condition was. Until January of 2017, doctor’s opinions had a huge impact on whether someone won their disability benefits case when a medical condition was involved.
Social Security now equally weighs the opinion of all medical providers involved, instead of just the patients’ physician. This means treating providers and independent medical examiners are equally evaluated to determine persuasiveness in a case. Social Security looks at supportability and consistency in a disability case.
A social security adjudicator will consider medical opinions that have evidence to back up observable medical signs, symptoms, blood tests and imaging. On the other hand, medical opinions are tested for consistency based on the rest of the evidence that is taken into account, including the patient’s medical records and the patient’s own statements on the matter. The physicians claim has to match up with the patient’s own claim, or consistency will be in doubt.
This rule used to be considered when the option was on the table to approve or deny a person’s eligibility for disability benefits based on just the physician’s account of the patient’s condition.
Now Social Security will more strongly look at the length and purpose of a patient’s relationship with their doctor and what field the medical provider is in to treat the patient. Finally, a doctor who has a strong understanding of social security policy will benefit the case of their patient by having a convincing understanding of social security’s policy and the patient’s entire file.
The new rule change applies to cases filed after March 27th of 2017. Many workers in the field of disability have a concern for their clients. They believe the rule change will allow social security to deny more disability claims where the client realistically needs social security benefits. Disability workers also believe that not all clients they work with have less of a long-term relationship with their physician which was originally needed to make a case. This means if physicians could still prove the importance of a long-term relationship with a patient, there would likely be a more positive outcome.
In the past, a judge would take into account the treating physician’s opinion on the matter and disagree if there wasn’t evidence to discount the doctor’s opinion. Now patients are denied more often regardless of how much proof is provided to social security for the existence of a long-term relationship with their doctor. The old rule was very beneficial to patients that were unable to work due to a mental health concern. Now a psychiatrist who has regularly seen and treated a patient is no longer seen at face value by a judge when considering a decision.
People seeking disabilities benefits see a much more in-depth screening process by social security. Social security also pays for their own doctors called consultative examiners who are looked at equally with other parties for their persuasiveness on the matter.
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