How Does Social Security Give Weight to Different Medical Opinions?

 Posted on January 25, 2021 in Social Security disability

If you or a loved one have suffered physical or mental impairments that have affected your ability to work, you may rely on public benefits to meet your needs. Social Security disability benefits can provide you with much-needed financial assistance, and depending on your age, your work history, and other factors, you may qualify for either Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI). Unfortunately, the majority of Social Security disability applications are denied. You can appeal the denial of a disability claim, but when doing so, you should be sure to understand the types of evidence that may play a role in your case, including opinions from your doctor or other medical experts.

How Are Opinions from Different Medical Sources Evaluated?

During a Social Security disability case, multiple different forms of medical evidence may be considered. In addition to reports made by one or more doctors or medical professionals that you see regularly, you may also be examined by other medical experts. Physicians, psychologists, optometrists, podiatrists, speech-language pathologists, audiologists, advanced practice registered nurses, and physician assistants may be considered acceptable medical sources that may provide opinions about your condition. The Administrative Law Judge (ALJ) who hears your case will need to weigh the evidence provided by different sources to determine whether you meet the qualifications for disability.

An ALJ will look at several different factors when determining the amount of weight to give to the opinions of medical sources. The most important factors are:

• Supportability - A source’s opinions are more likely to be considered persuasive if they are backed up by evidence, including medical tests such as blood work or MRI scans and clinical findings such as the results of physical or psychological examinations.

• Consistency - A medical opinion will be considered more persuasive if it is consistent with the evidence provided by other medical sources, as well as nonmedical evidence such as your statements about your daily activities.

In the past, a medical opinion would be given greater weight if it came from a “treating source,” or a doctor who had an established relationship with a patient. For Social Security disability claims filed on or after March 27, 2017, treating source opinions are no longer given special weight. However, if two sources that both meet the standards of supportability and consistency offer different opinions, a source’s relationship with a patient may also be considered. An ALJ may look at the length of time you received treatment from a provider, how often you visited with them, and the extent of the examinations and testing that a doctor performed. An opinion may also be given greater weight if it came from a source who specializes in an area of medicine that is relevant to your case.

Contact a Milwaukee, WI Social Security Disability Attorney

If you are planning to apply for Social Security disability, or if your disability claim has been denied, Pearson Disability Law, LLC can provide the legal help you need. Attorney Jonathan Pearson will work with you to make sure you meet the requirements to show that you are disabled, and he will help you gather the necessary evidence to demonstrate that you qualify to receive benefits. Contact our accomplished Waukesha County Social Security disability appeals lawyer today at 414-240-4801 to schedule a free consultation.

Sources:

https://www.ssa.gov/OP_Home/cfr20/404/404-1520c.htm

https://www.ssa.gov/OP_Home/cfr20/404/404-1502.htm

https://www.ssa.gov/disability/professionals/greenbook/ce-evidence.htm