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Social Security Changes: Treating Physician Rule and Acceptable Medical Source

March 21, 2017

The Social Security Administration recently announced the repeal of the well-known and long standing treating physician rule. The treating physician rule offered certain procedural safeguards to individuals applying for disability benefits under any of Social Security’s programs.

What was the treating physician rule under Social Security?

Put simply, the treating physician rule required a Social Security Administrative Law Judge (ALJ) to defer to the medical opinions of your doctor, so long as the opinion was supported by objective medical evidence and not inconsistent with the rest of your medical record. If the ALJ wished to discount the opinion of your doctor, they were required to provide “good reasons,” supported by the record, for discounting a treating physician’s opinion.

What was the purpose of the treating physician rule?

The policy and purpose behind the treating physician rule was the recognition that your doctors are the medical professionals who are in the best position to provide a detailed picture of your medical impairments over time due to their close relationship with their patients.

What is Social Security changing under the treating physician rule?

Effective March 27, 2017, Social Security will no longer give special consideration to the opinions of your doctors. Instead, the opinions of your doctors will be placed on the same footing as the doctors who perform a one-time consultative examination of you, if any, and Social Security’s doctors who issue opinions as to your functioning after reviewing your medical records.

The National Organization of Social Security Claimants’ Representatives, or NOSSCR, of which Balin Law is a sustaining member, staunchly opposed the changes to the treating physician rule. In a November 1, 2016 letter to then Acting Commissioner of Social Security Carolyn Colvin, NOSSCR’s Executive Director Barbara Silverstone wrote that the elimination of the treating physician rule is premised on the idea that individuals no longer have long-standing or strong relationships with their doctors.

“NOSSCR disagrees with that premise. Many disability claimants and beneficiaries have important relationships with their treating providers … It is NOSCCR’s position that the relationship a claimant has with a treating source means treating source opinions deserve more weight than the opinions of an individual who performs a single examination or reviews a claimant’s paper file.” The undersigned agrees.

Other Changes by the Social Security Administration: “Acceptable Medical Source”

One bit of positive news is that Social Security has changed the definition of “Acceptable Medical Source.” The change is to include Physicians Assistants (PA) and Advance Practice Registered Nurses (APRN).

What are Acceptable Medical Sources?

Acceptable Medical Sources defined by the Social Security Administration are sources who can provide evidence to establish an impairment. The Social Security Administration needs Acceptable Medical Sources to establish if you have a medically determinable impairment(s).

Team of Medical Professionals

An opinion from an “Acceptable Medical Source” must be taken seriously and weighed according to a variety of factors. Prior to this change, only M.D.’s, D.O.’s, licensed or certified psychologists, licensed optometrists, licensed podiatrists, and qualified speech-language pathologists were considered “Acceptable Medical Sources.”

Who are not considered “Acceptable Medical Sources” under SSA?

Chiropractors (D.C.), Licensed Social Workers (LCSW or LISW), and Registered Nurses (RN) are still not “Acceptable Medical Sources.”

What do these changes mean for disability claimants?

These changes underscore the need for competent, informed legal counsel by your side at your disability hearing. Although it remains to be seen whether the elimination of the treating physician rule will make it more difficult to be approved for disability, Balin Law is here to assist you. We have eight convenient locations in Mentor, Cleveland, Cuyahoga Falls, Ashtabula, Sheffield Village, Canton, Youngstown, and Toledo. Call today toll free with any questions you have 866-492-2546