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Weighing Doctor’s Opinion In Benefits Decision
Posted in: Benefits on February 15th, 2012

disability benefitsThere are many factors that go into the decision process of Social Security Disability claims. While the process is riddled with documentation requirements and waiting periods, many applicants are informed about what all goes into the final decision. Besides extensive work history verification and income requirement needs, one of the biggest factors if the medical diagnosis and report from the doctor.

A Weighty Issue

It seems natural to assume that a doctor’s opinion would hold a lot of weight in the decision over whether an applicant meets medical condition guidelines necessary for disability insurance. However, disability claim applications are also being weighed heavily by one time medical record and single case reviewers, an issue that has sparked much debate among applicants.

A treating doctor’s opinion is supposed to be given more weight than the one-time application examiner or medical records reviewer. Because neither of these individuals knows the case history or current medical status of an applicant, it is questioned as to whether they can adequately judge the necessity of the claim. A recent decision handed down by a Federal Administrative Law Judge rejected the treating doctor’s opinion, leaving one claim applicant denied for benefits.

Luckily for the applicant, the judge’s decision was reversed. By law a judge must provide evidence to support his decision to reject a treating doctor’s opinion if the claim is to be denied according to regulation. Since the judge failed to provide adequate evidence of the denial, the ruling was overturned.

 

 

 

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