I represent a 55 year old cement truck driver with neck and back problems whose application for Social Security Disability (“SSD”) benefits was approved today without a hearing. The interesting thing about this case is that it was approved based largely on the opinion of the claimant’s primary care physician (“PCP”).
In general, the rules provide that the opinion of a generalist is entitled to less weight than a specialist. Many Administrative Law Judges misapply that rule, and reject the opinion of a PCP on the grounds that he or she is not a specialist. However, when a PCP’s opinion is well supported by clinical and diagnostic findings, it may be entitled to significant or even controlling weight.
In this case, the PCP’s opinion was supported by several MRI reports as well as exam findings by numerous other orthopedic and pain management specialists. Accordingly, there was more ample grounds for approving SSD benefits based upon the PCP’s opinion.
There have been many times where clients have neglected to provide their PCP’s information, or were reluctant to ask them to provide reports because they were not the specialist treating the disabling impairment. This case is a perfect example demonstrating why supportive information should not be disregarded just because the source is not a specialist.