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'Treating physician rule' rescinded by the SSA

When an individual applies for disability benefits, the first stop for their application is the Social Security Administration, which will determine if they meet certain baseline criteria concerning everything from work-related activities to work history.

If their application passes this preliminary examination, it will then be forwarded to the Disability Determination Services office in their state, where agency employees, including physicians and disability specialists, will complete the initial disability determination decision.

In doing this, the state agency will consider all the facts of the applicant's case, including medical evidence from doctors, hospitals, or other medical institutions regarding the condition and their treatment.

In fact, under the "treating physician rule," both claims examiners and other adjudicators are required to give the opinions of an applicant's treating physician "controlling weight" provided that they are 1) well supported by medically acceptable clinical or laboratory diagnostic techniques, and 2) not inconsistent with other medical evidence in their case file.

As it turns out, the SSA effectively rescinded this treating physician rule as of March 27, meaning physician reports, as well as disability determinations made by other agencies, are no longer given added weight by benefits adjudicators.

As for the reason why the SSA decided to pursue such a controversial rule change, it merely indicated that it was necessary to "reflect modern healthcare delivery."

While the real impact of the elimination of the treating physician rule on applications for disability benefits has yet to be seen, experts have indicated that it's not likely going to make the process any easier, and will only help continue an otherwise discouraging trend.

Indeed, the SSA has determined that the percentage of claim approvals has declined in recent years, while the number of people actually receiving disability benefits has fallen for the first in nearly three decades.

What all of this really serves to underscore is that now more than ever, those seeking disability benefits must seriously consider consulting with a skilled legal professional who can protect their rights and best interests throughout the entire process.

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