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Illinois disability hearing attorney physician opinionIn Social Security disability cases, agency officials will look at two types of medical evidence: The information provided by an applicant’s own treating physicians, and testimony from outside reviewers and consultative examiners, who typically look at an applicant’s medical records but do not necessarily examine them in person. When one’s own doctor's medical opinions are supported by appropriate treatment records, Social Security is expected to afford such views substantial weight, even if they conflict with the opinions of the outside consultants.

Magistrate Orders New Hearing After Social Security Ignores Evidence from Applicant's Psychiatrist

In far too many disability cases, Social Security does not provide the proper weight to the opinions of an applicant’s own physician. A Social Security administrative law judge (ALJ) will often credit the views of the outside experts–who often believe the applicant is not disabled–and ignore the contrary opinions of the treating physician. While this is not necessarily against regulations, the ALJ cannot simply ignore evidence.

Consider a recent decision by a federal magistrate judge here in Illinois, Sartin v. Berryhill. The plaintiff in this case is a woman who first applied for disability benefits nearly five years ago. At a hearing, the ALJ accepted evidence that the plaintiff suffered from a number of severe impairments, including depression, bipolar disorder, generalized anxiety disorder, and post-traumatic stress disorder. Nevertheless, the ALJ found these impairments “do not meet or medically equal” a legally recognized disability.

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Chicago social security disability lawyersIn a Social Security Disability case, your most important ally is often your treating physician, the person who understands your medical history the best. While a treating physician’s expert opinion is not enough, in and of itself, to qualify you for disability benefits, it is almost impossible to prevail before Social Security without such medical evidence. And even if your doctor can attest as to your medical impairments and how they render you unable to work, Social Security may still choose to ignore that evidence in favor of analysis by doctors who never even examine you at all.

Social Security Ordered to Reconsider Case After Giving “No Weight” to Treating Physician

In any Social Security disability case, state agency doctors will review your medical records and present their analysis to the administrative law judge (ALJ) in charge of deciding the applicant’s claim. It is not uncommon for the state agency doctors to reach a different conclusion about the applicant’s medical condition than his or her treating physician. While the ALJ has the discretion to decide which opinions to accept or reject, Social Security officials cannot simply refuse to consider a treating physician’s opinion just because it happens to conflict with that of the state agency doctor.

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Social Security regulations provide that treating physicians' opinions are generally given more weight than other medical sources. A treating physician would typically have spent more time with you and gotten to know your condition much better than any other medical professional. However, there are a number of circumstances where a treating physician's opinion will not be given more weight in a Social Security disability claim, whether for SSDI or SSI benefits. The following are several factors Social Security will evaluate when reviewing a treating doctor's opinion:

1) How often have you been treated by your doctor?

Have you seen your doctor only three times in two years or do you see him or her every month?

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