Can My Doctor’s Opinion Be Used to Help My Disability Claim?

docDisability attorneys often look to a claimant’s primary doctor or treating physician for a medical opinion as to the client’s impairment. This might be the most important evidence presented in your case, especially because under the SSA rules and regulations, the doctor’s opinion might be “controlling”—that is, the SSA will automatically adopt the doctor’s opinion in its decision.

For this to happen, there are several requirements that must be met:

Your doctor must be an “acceptable medical source”.
Not all doctors qualify as an “acceptable medical source.” An acceptable medical source might include a physician, such as a medical or osteopathic doctor; a psychologist; an optometrist; or a pathologist. Other professionals tend to be labeled as “other sources,” and their opinions do not carry the same weight as those which are “acceptable” by the SSA. Examples of these sources include chiropractors, nurse practitioners, therapists, and audiologists. The SSA regulations state that opinions from other sources may be taken into account and given some weight, but that they cannot be given controlling weight. For that, you have to turn to a more credible source as described.

Your doctor must be a “treating source”.
The doctor whose opinion you submit must be someone who is actually treating you in some capacity. Your disability attorney cannot just send you to a known doctor for a quick one-time evaluation, and expect that this doctor’s opinion will get controlling weight in your case. Under the SSA regulations, the agency will not consider a source to be your treating source if your relationship with that source is based “solely on your need to obtain a report in support of your claim for disability.” Your relationship with the source must be based on your medical need for evaluation and treatment to be considered for controlling weight.

Your doctor’s opinion must be well-supported
The final requirement is that your treating doctor’s opinion be supported by current medically acceptable diagnostic techniques. If your doctor’s opinion is 1) found to be well-supported by acceptable clinical and laboratory diagnostic techniques, and 2) is not inconsistent with any other significant evidence in your case record, then it must be given controlling weight, and the agency will adopt your doctor’s opinion as its own.

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