SSA Publishes Changes to Medical Evidence Evaluation
By Christina March 8, 2017

SSA Publishes Changes to Medical Evidence Evaluation

As the Social Security Administration (SSA) continues to work on ways to reduce spending and decrease the SSDI claims backlog, we are closely monitoring any decisions made and actions taken towards these goals. In January, the SSA published a final rule in the Federal Register in which they made numerous revisions regarding how they will interpret medical evidence in SSDI claims.  The most significant changes outlined in this new ruling include:

 

  • Physician’s Assistants, Nurse Practitioners, audiologists, and optometrists will now be considered Acceptable Medical Sources for determining whether or not an individual applying for SSDI has a medically determinable impairment.
    • This will place even more important on clear and consistent medical treatment and provider records, as we will need to thoroughly request records, and possibly letters/ testimonies, from the individuals most familiar/qualified to speak to the impact that your condition(s) has on your daily activities.

 

  • SSA has eliminated the Treating Source Rule, meaning the opinion of treating sources (i.e. a letter from a doctor testifying to the severity of one’s condition) will no longer be given controlling weight in deciding whether to award someone SSDI benefits.
    • These letters and statements of opinion will still be valuable evidence, but these opinion will be given equal weight to the opinion of all medical sources, including the opinions of consultative examiners (doctors who SSA assigns to evaluate your condition) and medical experts (also appointed by SSA, individuals who simply review the record and do not examine the claimant).

 

  • SSA will no longer consider disability determinations from other government and non-government entities (such as the Veteran’s Administration, Workers Comp. claims, long-term disability claims, etc.).

 

The new rules only apply to applications filed after March 27, 2017, so it is going to be several years before claims to make their way through the administrative review process and into the courts (as it can take anywhere from 6-18 months to reach the hearing level of the SSDI application process if your claim is denied at the initial and reconsideration stages).

 

In light of this, we encourage you not to worry about this ruling, and to simply continue to keep track of your treating providers and determine who might provide you with letters of opinion supporting your claim that your condition(s) prevent you from working.

 

Nothing in this post is intended as advice or a suggestion to elect or not elect to claim benefits of any kind, including Social Security benefits, nor is it intended as financial advice in any way.  The decision to claim benefits is a personal one that is contingent upon each individual’s unique circumstances.

Need help applying for SSDI?

The Advocator Group can help you better understand and take advantage of the many benefits of Social Security Disability, to help maximize your financial well-being during your period of disability.