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Changes in Social Security Evidence Rules and How They Impact Your Claim

On Behalf of | Jan 6, 2020 | Social Security Disability (SSD)

In recent years, the Social Security Administration revised several important Social Security evidence rules. The impact of evidence on a disability claim cannot be overstated, so it can be helpful to understand a little bit about these rules and what impact they might have as you consider your particular case and circumstances.

As you might already realize, medical evidence is an important and critical component of qualifying for disability benefits from Social Security. In fact, the Social Security Administration frequently refers to medical evidence as the cornerstone of the disability determination process. In the last few years, the Social Security Administration has made some significant changes to the Social Security evidence rules. Let’s take a look at those changes and the effects that they might have on disability claims:

  • Redefining the weight of medical opinion as evidence: Typically, when a Social Security disability claim is filed, claim reviewers, and eventually an Administrative Law Judge will review the medical evidence that you present in order to draw conclusions about your condition, your level of impairment, and how this might impact your ability to work. Typically, medical evidence includes professional opinions from the physicians that treat you, as well as other medical specialists. In the past, the Social Security Administration gave more weight and importance to the opinions from treating physicians as opposed to the opinion of a physician or specialist who may have only seen you once to conduct an evaluation, or otherwise very rarely. The new rule now indicates that an Administrative Law Judge can no longer give special weight to a medical opinion from a doctor just because that doctor is the treating doctor. Instead, all medical opinions and findings must be viewed equally. This rule was intended to recognize the fact that patients today may see many doctors and healthcare providers.
  • No Longer Giving Weight to Findings by Other Administrative Agencies: Prior to the new evidence rules, an Administrative Law Judge could give special weight or importance to a finding from another government agency with regard to whether or not a claimant was disabled. For example, if a claimant was a veteran, and the VA had made a determination that the claimant was disabled, an Administrative Law Judge in a Social Security claim could give that opinion extra weight. Today, that is no longer the case. Under the new rules, an Administrative Law Judge can only review and evaluate the medical evidence as submitted in the claim as it pertains to that particular claim, and will not apply special weight to the findings of another agency.
  • Expanding the List of Acceptable Medical Sources: To support a claim for disability benefits, claimants submit evidence from medical service providers. These are typically doctors and other healthcare professionals who have treated or evaluated the claimant in some way. In the past, the list of acceptable medical sources included licensed physicians, psychologists, podiatrists, and speech-language pathologists. Now, however, under the new rules, the list also includes physician’s assistants, APRNs, and licensed audiologists and optometrists. Even under the new rules, however, registered nurses, chiropractors, and licensed social workers are still not considered as acceptable medical sources. This change was intended to more accurately reflect the wide variety of care that today’s claimants receive, and to allow those providing treatment to give opinions on the conditions of the patients they treat.

Ultimately, each of these changes was intended to reflect the ever-changing nature of healthcare in modern times. The goal is to allow claimants to present a more diverse variety of evidence to support their claims. As with any legal matter, the effect and impact of evidentiary changes will vary depending upon your particular case, and as a result, consulting with an attorney is always wise.

The Law Offices of Daniel Berger is Here for You

At The Law Office of Daniel Berger, our attorneys and representatives understand Social Security law very well. Because we do, we know that to those who are unfamiliar with the process of applying for and receiving benefits, it can often seem very overwhelming and complex. This can be particularly true when the rules change, and you aren’t sure what impact that might have on your claim. Our New York disability representatives can alleviate that stress for you, so that you can focus on what’s most important – treating your condition and maintaining your health so that you can continue to live a full and happy life. If you are in the midst of applying for benefits and aren’t sure how these rules might affect you, or if you are contemplating filing a claim for the first time, we’re here for you. We encourage you to visit our website at Law Offices of Daniel Berger