How Should a Treating Source Physician’s Opinions Be Considered in a Disability Claim?

 Posted on September 30, 2020 in Social Security Disability Medical Conditions

When a person makes a Social Security disability claim, the decision about whether to award benefits will usually depend on the medical examinations they receive, as well as evaluations that are meant to determine whether they have the ability to work. In these cases, the opinions of a person’s regular doctor, who is known as a “treating source physician,” are given a great deal of weight. This is because a treating physician will have established a relationship with the patient that gives them a better understanding of their physical condition and their capabilities to perform work. However, in some cases, disability claims are improperly denied because Social Security does not properly consider the opinions of a treating source physician.

Appeals Court Vacates Denial of Benefits Based on Failure to Give Weight to Treating Physician’s Opinion

One recent case in Illinois demonstrates how Social Security may deny benefits without properly considering the opinions of a treating source physician. In Hargett v. Commissioner of Social Security, the United States Court of Appeals considered a situation in which an applicant had been denied benefits by an administrative law judge (ALJ), and this decision was upheld by a federal magistrate judge.

The plaintiff applied for disability benefits based on a number of impairments, including type 2 diabetes, chronic obstructive pulmonary disease, curvature of the spine, and high blood pressure. He had been receiving treatment from his primary care physician, who referred him to a physical therapist for a functional capacity evaluation (FCE). This evaluation found that while he had the lifting capacity to perform “medium-strength” work, he was unable to stand for more than five minutes, could not walk for more than a tenth of a mile, could not balance well while walking or standing, and could not crouch or stoop. The primary care physician signed off on the results of this evaluation.

While the FCE found that the plaintiff could only perform work at a light capacity, a later examination found that he had the ability to sit, stand, or walk for at least six hours during an eight-hour workday and lift 25-50 pounds. The plaintiff’s disability claim was denied based on the determination that he had the capacity to adjust to working within his abilities.

When making this decision, the ALJ gave great weight to the opinion of the doctor that performed the second evaluation, but only partial weight to the initial FCE. The plaintiff claimed that more weight should have been given to the FCE since his treating physician signed off on these results. The appeals court agreed, finding that the ALJ did not provide good reasons for assigning weight to the different opinions. The decision stated that since the FCE was performed upon referral from the plaintiff’s physician, and the physician co-signed the results of the FCE, it should be considered a treating-source opinion and given more weight when making decisions about whether the plaintiff was disabled. For these reasons, the judgment against the plaintiff was vacated, and the case was returned to the Commissioner of Social Security to be reconsidered.

Contact Our Chicago Social Security Disability Appeals Attorney

The denial of a disability claim does not necessarily mean that you cannot receive benefits, but to appeal a denial, you should be sure to work with an attorney who is experienced in these types of cases. Pearson Disability Law, LLC will help you determine the best ways to demonstrate why you should receive the disability benefits you need. Contact our Cook County Social Security disability claim lawyer today at 312-999-0999 to schedule your free consultation.

Source:

https://scholar.google.com/scholar_case?case=12095242758482643309