Omaha disability lawyer discusses your doctor’s role in proving your Social Security disability claim

As an Omaha disability lawyer, one of my most important tasks is to get an opinion from a client’s doctor about the client’s symptoms, diagnosis, prognosis, and what work-related activities the client can and cannot still do. Although some cases are won on the basis of medical records alone, in many others, presenting medical opinion evidence is even more crucial to winning Social Security disability benefits.

Under the Social Security rulings and regulations, the claimant’s doctor provides the most important medical opinion evidence in the case. Furthermore, the doctor’s opinion may be given “controlling weight” in the case. That is, the Social Security Administration will adopt the doctor’s opinion as its own.

Requirements for your doctor’s opinion to be controlling

Your doctor’s opinion will be controlling if it meets three requirements:

• The doctor must be an acceptable medical source.
• The doctor must be a treating source.
• The opinion must be well supported.

Who are “acceptable medical sources”

Not all doctors qualify as acceptable medical sources. Acceptable medical sources are:

• Physicians (medical or osteopathic doctors);
• Psychologists (including a school psychologists);
• Podiatrists;
• Optometrists; and
• Qualified speech-language pathologists.

All other medical professionals are “other sources,” whose opinions do not carry the same weight as “acceptable medical sources.” These “other sources” include, among others, chiropractors, nurse practitioners, audiologists, and therapists. The Social Security Administration will give opinions from other sources some weight, but they can never be given controlling weight.

Who are “treating sources”

Your doctor’s opinion is entitled to controlling weight only if the doctor is a “treating source.” This means your relationship with the doctor must be based on your need for medical treatment or evaluation. A doctor will not be a “treating source” if the only reason you visit him or her is to obtain a report in support of your claim for disability. Thus, if you see a doctor one time just to be evaluated, whether the visit is arranged by the Social Security Administration or your Omaha disability lawyer, that the doctor’s opinion will not be given controlling weight, although it will be considered.

When is an opinion “well supported”

To be given controlling weight, your treating doctor’s opinion must be both:

• Well-supported by medically acceptable clinical and laboratory diagnostic techniques; and
• Not inconsistent with other substantial evidence in the case record.

If your treating doctor’s opinion satisfies both these requirements, it must be given controlling weight.

Diagnostic techniques are “medically acceptable” if they follow the standards that are generally accepted within the medical community as appropriate for establishing the existence and severity of an impairment. The purpose of this requirement is to ensure that your doctor’s opinion has a sound medical basis.

A well-supported treating source medical opinion does not have to be consistent with all the other evidence in your case as long as no other substantial evidence contradicts or conflicts with the opinion.

Use of doctor’s opinion even if it is not controlling

Even if your treating doctor’s opinion does not satisfy the requirements to be controlling, it isn’t necessarily rejected by the Social Security Administration. It may still be entitled to deference and may be adopted by the decision maker.

The Social Security Administration evaluates the weight to be given your doctor’s opinion by considering the following factors:

• Nature and extent of the treatment relationship.
• How well the doctor knows you.
• Number of times the doctor has seen you.
• Whether the doctor has obtained a detailed picture of how your impairment has developed over time.
• Your doctor’s specialization.
• The kinds and extent of examinations and testing performed by or ordered by your doctor.
• The quality of your doctor’s explanation of his or her opinion.
• The degree to which the opinion is supported by relevant evidence, particularly medically acceptable clinical and laboratory diagnostic techniques.
• The consistency of the opinion with other evidence.

As a rule, more weight will be given to your doctor’s opinion if it explains reasons for conclusions rather than simply asserting that you are disabled. Indeed, a statement from your treating doctor that you are disabled, without more, is not worth much.

Obtaining and presenting your treating doctor’s opinion

The most effective way to present your treating doctor’s opinion may be by live testimony at your Omaha disability hearing. But most doctors find it hard to schedule an appearance at a hearing and the expense of paying the doctor may be prohibitive. In the usual case, a more convenient and cost-effective method of obtaining the doctor’s opinion is needed.

There are several option for obtaining a written opinion from your treating doctor that can then be submitted into evidence. Your Omaha disability lawyer will decide which is the best based on the specific facts of your case. Some options include:

• Pre-printed medical opinion forms that the doctor completes. Your disability attorney can customize these for your particular impairment.
• A request to the doctor for a written medical report that addresses particular topics. Your disability attorney can inform your doctor which specific topics ought to be addressed in your disability case.
• Written questions (in a letter or in a set of interrogatories) for the doctor to answer in writing. Again, your disability attorney can custom-draft a set of questions that are appropriate to your particular condition.
• A deposition (questioning the doctor in person or on the phone and making a video or audio recording that can be transcribed). Your disability attorney will prepare the questions and make the appropriate arrangements to record the doctor’s answers so that they can be submitted to the Social Security Administration for consideration.

Knowledgeable Omaha disability lawyer offers assistance

Obtaining and presenting your doctor’s opinion so that it provides the greatest possible support for your claim is an important aspect of your Omaha disability lawyer’s job. If you live in Omaha, eastern Nebraska or southwestern Iowa, you are not already represented by a Nebraska disability lawyer, and you want my evaluation, briefly describe your claim using the form to the right. Or you may contact me at:

Timothy J. Cuddigan
Omaha disability attorney

E-mail me
Phone: 402-397-2000
Toll-free: 877-550-8593
Fax: 402-397-0803

10855 West Dodge Road, Suite 100
Omaha, Nebraska 68154-2666

My offices are located near the Social Security district office in the Old Mill area in Omaha, right off of Dodge Street.




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We can travel to your home if you are unable to visit my offices.