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Attorney for Denied Social Security Disability Claims in Illinois

Cook County Lawyer for the Treating Physician’s Opinion in Social Security Disability Claims Denials

Did the judge deny your case? Not all cases are approved by Administrative Law Judges, in fact, the majority of Social Security disability benefits claims are denied. Friends and family routinely tell claimants that it is always wise to promptly appeal a disability denial. For claims that are denied before the hearing level that can be good advice. However, once a judge denies a claim it is not always the right decision to appeal to the Appeals Council.

The Social Security Administration used to allow people who have been denied by an Administrative Law Judge to file both a new application and appeal the judge’s decision. For claims denied by an Administrative Law Judge after July 2011 however, the laws have changed and force claimants to choose between the two. The choice to complete a new application or appeal the judge’s decision can be a difficult one and can depend on a number of things including: the claimant’s financial situation, age, changes in medical condition, and probably the most important factor the judge’s written decision.

Cases that can be legitimately appealed to the Appeals Council must contain some kind of legal error made by the judge in his or her written decision. It is highly recommended if you are at this stage to seek out a Social Security disability lawyer who handles Appeals Council claims.

One common error made by judges is to not properly weigh medical opinions. In general, a judge must give more weight to a treating physician than he would a non-treating physician. The rationale for this should be pretty straightforward. A doctor that has seen you for an extensive period of time will typically know more about your condition and limitations than a medical examiner that you may have only seen for a half an hour at a consultative examination.

The rule regarding the proper weight of medical opinions can be found at 20 C.F.R. Section 404.1527(d). 20 C.F.R. Section 404.1527(d)(2) provides in pertinent part:

Generally, we give more weight to opinions from your treating sources, since these sources are likely to be the medical professionals most able to provide a detailed, longitudinal picture of your medical impairment(s) and may bring a unique perspective to the medical evidence that cannot be obtained from the objective medical findings alone or from reports of individual examinations, such as consultative examinations or brief hospitalizations. If we find that a treating source’s opinion on the issue(s) of the nature and severity of your impairment(s) is well-supported by medically acceptable clinical and laboratory diagnostic techniques and is not inconsistent with the other substantial evidence in your case record, we will give it controlling weight. When we do not give the treating source’s opinion controlling weight, we apply the factors listed in paragraphs (d)(2)(i) and (d)(2)(ii) of this section, as well as the factors in paragraphs (d)(3) through (d)(6) of this section in determining the weight to give the opinion. We will always give good reasons in our notice of determination or decision for the weight we give your treating source’s opinion.

In other words, as long as the treating physician’s opinion meets certain criteria, the judge must afford more weight to that doctor’s opinion. Some of the criteria considered includes: length of treatment, specialization, nature and extent of treatment, consistency, and supportability. Since a treating physician’s opinion can play such a heavy role in a judge’s decision, it is very important that a person try to have the doctor complete a residual functional capacity form for his or her case. Many RFC forms can be found and printed right off of this website.

If you would like help navigating the appeal process after you’ve been denied Social Security disability benefits, contact our office today at 312-999-0999.

You are not alone. Call us now for a FREE consultation 312-999-0999

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