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Treating Physician's Role Diluted at Disability Hearings

April 1, 2020

An important part of disability law - and your own health needs - is reliance upon the advice of your physician. Their medical opinions are vital, both personally and from a legal standpoint. Until recently, your doctor's medical opinion on your limitations and abilities was given high priority, or a presumption of validity in legal jurisprudence. More recently however, the current administration and the Social Security Administration have reduced the value of your treating physician's opinions. SSA now can substitute the opinion of a consulting doctor who may examine you once, or perform a simple paper review of your medical records.

The traditional case law is as follows, but will change: "If treating physician opinions are “well supported by medically acceptable clinical and laboratory diagnostic techniques" and "not inconsistent with the other substantial evidence in [the] case record," then they must receive "controlling" weight. 20 C.F.R. § 404.1527(d)(2); Rogers v. Comm'r of Soc. Sec. , 486 F.3d 234, 241 (6th Cir. 2007). Good reasons must exist for not affording controlling weight to a treating physician's opinion in the context of a disability determination. Wilson v. Comm'r of Soc. Sec. , 378 F.3d 541, 544 (6th Cir. 2004). If the treating physician opinion is not entitled to controlling weight, the ALJ must determine what weight the opinion should receive consistent with 20 CFR § 404.1527(d)(2); Gayheart v. Comm’r of Soc. Sec ., 710 F.3d 365, 375-377 (2013)." Now, special weight will no longer be accorded to your treating physician's opinion. Case law is developing about how current treating physician's opinions are interpreted.

MMA continues to fight the negative effect of this new rule. We feel our clients' physicians are to be supported, and are in the best position to opine on the health of our clients/their patients.

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