Can my doctor help me with my Alaska Social Security disability claim?

Alaska Social Security attorneys will frequently look to a client’s own treating physician to provide a medical opinion regarding the client’s disability. Some of the most important evidence at the hearing before the Administrative Law Judge includes your doctor’s opinion along with your medical records.

Obviously, your medical records are important. Indeed, your case may be won just because your attorney tracks down all of your records. But, if your case is like many others, presenting medical opinion evidence may be even more crucial to winning your Social Security benefits.

The opinion of your doctor may be controlling in your Alaska Social Security disability case

If I represent you, one of the most important things I may need to do is get a useful opinion from your doctor about the nature and severity of your impairments—your symptoms, diagnosis, prognosis and what you can still do despite these impairments and your physical or mental restrictions. Indeed, under the Social Security rulings and regulations, the claimant’s doctor provides the most important medical opinion evidence in the case. Furthermore, the doctor’s opinion may be given “controlling weight” in the case. That is, the Social Security Administration will adopt the doctor’s opinion as its own.

Requirements for your doctor’s opinion to be controlling

The Social Security Administration imposes several requirements to get to the point where a doctor’s opinion is given controlling weight.

Doctor must be an “acceptable medical source”

For your doctor’s opinion to be given controlling weight, the first requirement is that your doctor must qualify as an “acceptable medical source.” Not all doctors qualify. Acceptable medical sources are a physician (a medical or osteopathic doctor), psychologist (including a school psychologist), podiatrist, optometrist, and qualified speech-language pathologist. Other medical professionals fall into the category of “other sources,” whose opinions do not carry the same weight as those professionals deemed “acceptable” by the Social Security Administration. These include, among others, chiropractors, nurse practitioners, audiologists and therapists. According to the Social Security rulings, opinions from other sources may be considered and be given some weight, but can never be given controlling weight.

Doctor must be a “treating source”

For a doctor’s opinion to be given controlling weight, the doctor must be a claimant’s “treating source.” Thus, the claimant’s lawyer cannot send the claimant to be evaluated by a doctor one time and expect that the doctor’s opinion will be given controlling weight. Under the regulations, the Social Security Administration “will not consider an acceptable medical source to be your treating source if your relationship with the source is not based on your medical need for treatment or evaluation, but solely on your need to obtain a report in support of your claim for disability.”

Opinion must be well supported

To be given controlling weight, the treating doctor’s opinion must be well supported by medically acceptable clinical and laboratory diagnostic techniques. If a treating doctor’s opinion (1) is well-supported by medically acceptable clinical and laboratory diagnostic techniques, and (2) is not inconsistent with other substantial evidence in the case record, it must be given controlling weight.

Use of opinion, even if not considered controlling

Even if a treating doctor’s opinion is not controlling, it doesn’t mean that the opinion must be rejected. It may still be entitled to deference and may be adopted by the decision maker. As a rule, more weight is given to a treating doctor’s opinion that explains reasons for conclusions rather than simply asserting that the patient is disabled. Indeed, a statement from a treating doctor that a patient is disabled, without more, is not worth much.

The Social Security Administration evaluates the weight to be given a treating source’s opinion by considering:

  • Nature and extent of the treatment relationship
  • How well the treating source knows the claimant
  • Number of times the treating source has seen the claimant
  • Whether the treating source has obtained a detailed longitudinal picture of the claimant’s impairment
  • Treating source’s specialization
  • Kinds and extent of examinations and testing performed by or ordered by the treating source
  • Quality of the treating source’s explanation
  • Degree to which the opinion is supported by relevant evidence, particularly medically acceptable clinical and laboratory diagnostic techniques
  • Its consistency with other evidence

Veterans Administration doctors

If your treating doctor is employed by the Veterans Administration, do not let anyone tell you that VA doctors are prohibited from completing reports for use in Social Security disability cases. Although the VA had such a policy at one time, it is current VA policy that VA doctors are expected to complete such reports at the request of claimants. However, in a stunning example of non-cooperation between government agencies, VA doctors may not complete reports at the request of the Social Security Administration.

Nurse practitioners

If you are treated by both a physician and a nurse practitioner, I will probably want to get a separate opinion from the physician or have the opinion from the nurse practitioner counter-signed by the physician. Even if the physician saw you only once but supervised additional treatment by the nurse practitioner, the physician’s opinion ought to be treated as from a “treating source.”

Obtaining and presenting the treating doctor’s opinion

Presenting live testimony of your treating doctor at the hearing may be the most effective way to get the treating doctor to address all the issues and win your case. Unfortunately, most doctors have difficulty fitting an appearance at a hearing into their busy schedules. And it may be hard to justify the expense of paying the doctor to appear at the hearing. Thus, in the usual case, it is necessary to seek a more economical way of obtaining the doctor’s opinion. Indeed, treating doctors testify in only a tiny percentage of disability cases.

There is no single way to obtain the opinion of a treating source. Some options include:

  • Taking the doctor’s deposition
  • Written questions (in a letter or in a set of interrogatories) for the doctor to answer in writing
  • Request for a medical report that addresses particular topics
  • Use of pre-printed medical opinion forms, customized for particular impairments

It doesn’t matter whether the doctor’s opinion is called a medical source statement, a Residual Functional Capacity opinion, or a medical assessment. No matter how it is obtained and presented, a treating doctor’s opinion must be considered by the Social Security Administration and, under appropriate circumstances, given controlling weight.

Help from a knowledgeable Alaska disability attorney

Some of the most important parts of your Alaska disability attorney’s job include educating your treating doctor about the doctor’s role in your Social Security case, and obtaining and presenting the doctor’s opinion so that it provides the greatest possible support for your claim.

If you are applying for Social Security disability benefits, having the assistance of an experienced Social Security disability lawyer may be indispensable. If you live in Fairbanks, Juneau, Anchorage or in any other part of Alaska, you are not already represented by a disability attorney and you want my evaluation, briefly describe your claim using the form to the right. If you have questions, you may contact me at:

Paul Eaglin of the Eaglin Law Office
Alaska Social Security disability attorney
E-mail me
907-374-4744

Fairbanks, Alaska