Social Security Attorney Boise -- Doctors Opinions

Medical Source Statements – Part IV

This the is the fourth part of an article entitled Medical Source Statements, which discusses how your Boise Social Security Attorney can use statements from your doctors get you your disability benefits.  You may read this article from the beginning, starting with “Medical Source Statements — Part I”.  You may also want to contact a Social Security Attorney in our Boise Idaho office.

This article covers SSR 96-2p, which is entitled “Giving Controlling Weight to Treating Source Medical Opinions” and provides your Boise Social Security attorney  with the criteria judges must use to evaluate the opinions of your doctors.

 Controlling Weight

If the opinion of your doctor is entitled to controlling weight, the ALJ must use the limitations your doctor provides in determining your disability.  Not all opinions from your doctor are entitled to controlling weight and not every treatment provider qualifies to provide a controlling weight opinion.  In order to be entitled to controlling weight,

1.   The opinion must come from a treating source;

2.   The opinion must be a medical opinion;

3.   The adjudicator must find that the treating source’s medical opinion is well-supported by medically acceptable clinical and laboratory diagnostic techniques; and

4.   The treating source’s medical opinion must be not inconsistent with the other substantial evidence in the individual’s case record.

Number four above should make it clear to you that having a Social Security attorney at the initial levels of application is very important.  Many of the forms that Social Security disability claimants are asked to complete require details of your daily activities.  There are many common mistakes that claimants are prone to making that miscommunicate their actual abilities.  In order to effectively communicate your disability to Social Security, make sure you get advice for an experienced Boise Social Security attorney on completing function reports, work history reports and other forms sent to you by Social Security.  By correctly completing these forms, it is more likely that your doctor’s opinions will be found not inconsistent with the record.

In addition, if you suffer from both mental and physical impairments, it is important that your Social Security disability lawyer distinguish between the opinions of your doctors, which should take into account both your physical and mental limitations, and the opinions of Social Security doctors, which frequently only account for either physical or mental limitations, but not both.  Your disability must be evaluated in light of ALL of your conditions/limitations and it is improper to say that a medical opinion or other evidence that conflicts with your doctor’s opinion is inconsistent with it unless it takes into account all of the same conditions that your doctor’s opinion does.

Ruling 06-03p has significantly increased the value of nonmedical evidence, including the testimony of lay persons such as your family members, friends, chiropractors, clergy etc., so it is important that none of this testimony conflict with the opinion of your doctor.  Be sure to send such letters to your disability attorney and do not submit them directly to Social Security.

You judge may need to consult a medical expert to gain more insight into what the clinical signs and laboratory findings signify in order to decide whether a medical opinion is well-supported or whether it is not inconsistent with other substantial evidence in the case record.  Your disability lawyer may seek clarification from your doctors if your doctor is willing to produce it.

Controlling Weight Versus Greatest Weight

older-coupleIf a judge finds that your doctors’ opinions are not entitled to controlling weight, that does not mean he or she does not have to take them into account.  SSR 96-2p indicates that even though your treating source’s medical opinion may not be entitled to controlling weight, it may, nevertheless, be entitled to the greatest weight of any opinion in the record and should be adopted.  SSR 96-2p  states as follows:

“Adjudicators must remember that a finding that a treating source medical opinion is not well-supported by medically acceptable clinical and laboratory diagnostic techniques or is inconsistent with the other substantial evidence in the case record means only that the opinion is not entitled to controlling weight, not that the opinion should be rejected. Treating source medical opinions are still entitled to deference and must be weighed using all of the factors provided in 20 C.F.R. ßß 404.1527 and 416.927. In many cases, a treating source’s medical opinion will be entitled to the greatest weight and should be adopted, even if it does not meet the test for controlling weight.”

The Court of Appeals has pointed out the differences between controlling weight, some deference, and no weight:

“The initial determination the ALJ must make with respect to a treating physician’s medical opinion is whether it is conclusive, i.e., is to be accorded controlling weight on the matter to which it relates . . ..  But finding such deficiencies to resolve the controlling-weight question against a claimant does not end the inquiry. Even if a treating opinion is not given controlling weight, it is still entitled to deference; at the second step in the analysis, the ALJ must make clear how much weight the opinion is being given (including whether it is being rejected outright) and give good reasons, tied to the factors specified in the cited regulations for this particular purpose, for the weight assigned.

Thus, a deficiency as to the conditions for controlling weight raises the question of how much weight to give the opinion; it does not resolve the latter, distinct inquiry. This second inquiry is governed by its own set of factors, summarized as follows:  (1) the length of the treatment relationship and the frequency of examination; (2) the nature and extent of the treatment relationship, including the treatment provided and the kind of examination or testing performed; (3) the degree to which the physician’s opinion is supported by relevant evidence; (4) consistency between the opinion and the record as a whole; (5) whether or not the physician is a specialist in the area upon which an opinion is rendered; and (6) other factors brought to the ALJ’s attention which tend to support or contradict the opinion. In applying these factors, the ALJ’s findings must be sufficiently specific to make clear to any subsequent reviewers the weight [he] gave to the treating source’s medical opinion and the reason for that weight.  (Krauser v. Astrue, 638 F.3d 1324, 1330-1331 (10th Cir. 2011))

Be sure to ask a Boise Social Security Attorney in our office about getting a medical source statement to your doctors.  To continue with this article, please click the link below.

 

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Originally posted 2014-09-05 18:06:30.