The Treating Physician Rule as a Factor in Qualifying for SSD

Many factors are considered by the Social Security Administration (SSA) in its determination of a claimant’s disability. The medical records documenting the treatment history are examined to understand the nature of the impairment, but, as a San Jose disability attorney can explain, the “treating physician rule” is a critical factor in the SSA’s evaluation.

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Treating physicians are important in SSA determinations because they can provide the best detailed evidence of the longitudinal history of your medical problems. Importantly, SSA policy requires that significant weight be provided to the findings and opinions of a treating physician as to the nature and severity of your medical impairments. In addition, SSA policy provides that only the treating physician’s opinion of impairment can be given controlling weight when consistent with objective medical evidence and not contradicted by other significant medical data. Basically, your treating physician’s records and reports can “trump” the contrary opinion of the one-time consultative examiner, or the medical chart-reviewing doctor used by SSA.

Because of the treating physician rule, it is not wise for a claimant to jump from one treating doctor to another, because SSA policy requires that an established treating history be in place before the opinions of the treating doctor will be accorded greater weight. SSA policy also provides that the findings of the treating doctor are accepted, depending on factors which include:

  • length of the treating relationship
  • frequency of the examination by the doctor
  • specialization of the treating doctor
  • clinical and laboratory findings provided by the doctor
  • the extent to which the doctor is knowledgeable about other case record information

In addition, your treating doctor must be an “acceptable medical source”. Under SSA policy, chiropractors and naturopaths cannot be treating doctors. Only MDs, osteopaths and psychologists; as well as podiatrists (ankle and feet), optometrists (vision) and speech pathologists (speech and language) can be an acceptable medical source whose reports are entitled to special consideration under the treating physician rule.

A good treating physician can provide the documentation of your medical problems from your medical records. Equally important, a treating physician can also provide opinions on the criteria for disability used by SSA. Since most doctors do not know the SSA standards of disability, your San Jose disability lawyer can assist in obtaining from your doctor(s) a “medical source statement” which is often essential to the approval of your disability application or appeal.

Contact a San Jose Disability Lawyer
The SSA disability process is complex, and denials are often the initial result. However, a San Jose disability attorney can protect your rights and provide the best opportunity for a positive result. Call LaPorte Law Firm, at 800-735-3425.