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WHICH DR. KNOWS BEST?

No, it isn't the title of a TV reality show; it's a serious question.  In a Social Security disability case, there are often several doctors who give their medical opinions.  Usually, there is at least some disagreement or inconsistencies in the doctor's opinions.  For instance, Social Security's consultative doctor will generally find very little medical evidence supporting disability.  Your "family doctor" or primary care doctor may document more serious problems in the claimant's medical condition.  Which doctor goes to the top of the "pecking order" with Social Security?  Here's the order, in terms of which doctor's opinion is given the most weight:
  1. A treating doctor - especially one who has treated the claimant over a lengthy period of time - His/her opinion is given the most weight.
  2. A specialist, offering an opinion within his/her area of specialty, is given more weight than a non-specialist (assuming both are treating doctors). 
  3. An examining doctor is given more weight than a non-examining doctor.
  4. The opinion of a non-examining doctor (consulting doctor) should have the least amount of weight on the Social Security decision.  Problem is, at the initial level, this is usually not the case.  The consulting doctor is generally the one Social Security listens to.  Hence, most disability claims are lost at the initial level.
Does the claimant have the right to choose which doctor examines him/her for Social Security?  In some cases, yes.  First, you should always have all of your treating physicians submit their records to Social Security.  Second, ask your treating doctor to submit a "Medical Source Statement" about your ability to do work-related activities. (Some doctors will; some won't).  Third, if Social Security asks you to attend a consultative exam (which they pay for), ask if your treating physician can perform the exam?  Under federal regulations, opinions from your treating physician should be given more weight than an examination by a non-treating Social Security consulting doctor.  Note:  You have to be assertive to get your doctor to perform the examination.  Social Security will almost never recommend it.  Here's is what needs to happen:
  • Contact your doctor and ask if he/she will agree to do the exam.
  • Contact the disability examiner who is requesting the exam and insist that your doctor be allowed to perform the examination needed.
 I do not have any official research on this but "I'll betcha" that claimants who receive examinations by their own doctors are awarded benefits much more often than claimants who get examined by a "doc in the box."  That's not because your doctor will lie for you; it's because your doctor knows more about you than one of Social Security's doctors.

In the appeal stage, administrative law judges will get it right:  they will always give the proper weight to the proper doctor, as the regulations require.  This is because judges know the law and take time to sort it out in their decisions.  This is also why you have a much better chance on appeal than with the initial application.
  


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