What happens when you apply for Social Security Disability (“SSD”) benefits, and your doctor says you cannot work, but the Social Security Administration (“SSA”) doctor says you can? If the medical records support your doctor’s opinion, then your SSD application should be approved. Unfortunately, all too often the State agency ignores that rule, which requires appealing the denial to an administrative law judge (“ALJ”).
I represent a 48 year old truck driver with back problems, whose SSD application was approved today by an ALJ. The ALJ’s decision exemplifies how medical opinions should be weighed.
The ALJ gave great weight to the opinion of the claimant’s orthopedist because “he has treated claimant on a regular basis." He is familiar with claimant's medical condition due to the regularity of treatment provided to him, and therefore in the best position to report on claimant's physical condition as well as its impact in his ability to perform work activities.”
On the other hand, the ALJ gave little weight to the opinion of the SSA doctor because, “He evaluated the claimant one time and his examination lasted a short period, as per the claimant's testimony at the hearing, and thus he is not familiar with the claimant's functioning."
The State agency knows that the opinion of a claimant’s doctor is supposed to supercede that of the SSA doctor, yet the State agency regularly does the opposite. The result is that the State agency costs the SSA millions of dollars in having to review unnecessary appeals, and delays claimant’s receipt of SSD benefits.