New regulations regarding Social Security Disability (SSD) applications took effect March 27, 2017, which will make it more difficult to file a disability claim. Most significantly, the so-called “treating-physician rule” has been eliminated. Administrative Law Judges (ALJs) and others making decisions on claims will no longer put significant weight on reports from claimants’ physicians, including agencies such as the Department of Veterans Affairs.
“This is disturbing, but it doesn’t mean more people who deserve SSD will be eliminated from qualifying,” said Kevin J. Bambury, attorney, Jeffrey Freedman Attorneys, PLLC. “Truly disabled workers will get their benefits if their case is prepared well and the decision-makers have all the necessary facts to support the claim.”
A brief summary of the rules follows:
- The definition of “signs” and “laboratory findings” has been revised to clarify one or more signs, one or more laboratory findings, or a combination of both are needed to provide sufficient medical evidence.
- Audiologists who are licensed for hearing impairments, auditory processing disorders, and balancing disorders are considered acceptable medical sources within the limits of their licensing practice area. The agency requires audiometric testing be performed by, or under direct supervision of a licensed audiologist or otolaryngologist.
- Evidence from physicians assistants will be recognized.
- The term “evidence from nonmedical sources” has been revised to “statements from nonmedical sources.” This evidence can be provided to ODAR either directly or through forms and administrative records.
- The agency clarified that although it would consider all evidence received in a case, there are specific articulation requirements regarding medical opinions and prior administrative medical findings.
- Adjudicators will be required to state how they have considered the medical evidence provided, regardless of whether the source of the evidence is an acceptable medical source.
- The agency states it will consider a medical source’s longstanding treatment relationship with a claimant equally to evidence from MCs, PCs, or CE.
“The Social Security Administration (SSA) believes these changes bring the rules into line with modern healthcare practices, and will be easier to use and understand,” Bambury said. “We’ll have to see how they work out for claimants in real cases. As a claimants’ representative, I question that the changes will simplify the collection of medical evidence for our clients.”
The SSA reports the number of people receiving benefits has declined for the first time in 30 years, however, during the same time period, the percentage of claim approvals also declined.
“The reality is it is becoming more and more difficult for claimants to obtain benefits,” Bambury said. “That is why it’s critical claimants retain an attorney who is experienced in the area of SSD law right from their initial application.”