A typical disability claim contains several disability evaluations from doctors who consult for the Social Security Administration (SSA). Some of these physicians or psychologists evaluate your claim based on a review of your medical records, while others will evaluate your limitations during a consultative examination. But because these doctors only see you once—if at all—their opinions don't often provide significant insight into your impairments.
The most valuable opinions are from doctors who you've seen multiple times over the course of a year (or more). In Social Security terms, these opinions are known as "medical source statements from treating doctors." Medical source statements can be especially persuasive to disability claims examiners and administrative law judges—as long as they're not at odds with the rest of the medical records.
Social Security likes to see evidence of an ongoing relationship you've established with your doctors. While claims examiners and judges work closely with medical professionals, they aren't doctors. So they need extra help in order to determine whether a health condition is severe enough to be disabling.
It's likely your regular doctors have a good understanding of important factors relating to your disability claim, such as which treatment options you've tried and whether they've helped you feel better. In the eyes of the SSA, their opinions will be better informed and more representative of your medical history than a doctor whom you've only seen once.
You can have multiple treating doctors. For example, you might have a psychiatrist who treats you for depression and a neurologist who treats you for spinal stenosis. Their opinions can be helpful in their respective fields of practice, but your psychiatrist shouldn't be providing an opinion on how long you can sit, stand, or walk for, and your neurologist shouldn't provide an assessment of your mental health.
Social Security can't completely ignore your doctor's evaluation, but the agency no longer has to take every treating doctor's opinion as the gospel truth. However, treating source statements can still be a powerful tool to help win your claim for disability benefits.
Now, instead of reflexively adopting your treating doctor's opinion, the SSA looks at the opinion within the context of your broader medical records and then decides whether your doctor's statement has "earned" special consideration (a process called giving the opinion "more weight.")
Social Security gives the most weight to medical opinions that are supported by and consistent with the medical evidence as a whole. (20 CFR § 404.1520c.) Doctors' opinions that appear to be outliers—like saying that somebody with paraplegia can walk for miles—are given little weight.
Social Security is more likely to ignore the opinion of your physician if you're missing objective evidence, such as blood tests or X-rays. For example, if your doctor wrote an opinion saying that you can't type or hold small objects due to carpal tunnel syndrome but you never had a nerve conduction study, the SSA is likely to be skeptical of your doctor's conclusion and can disregard the opinion.
Similarly, the SSA can ignore doctors' opinions based solely on subjective criteria. Any medical source statements that appear to be a "rubber stamp" on self-reported symptoms rather than a doctor's considered professional opinion won't play a large role in the agency's decision.
If your disability file contains evidence that contradicts your doctor's opinion (what disability lawyers sometimes call "bad facts"), Social Security is likely to dismiss the opinion. For example, if your doctor said that you're unable to lift over 10 pounds due to shoulder impingement but your records show you recently worked at a part-time job where you lifted 25 pounds, the SSA won't give your doctor's statement much weight.
Doctors' opinions can also be discounted when they conflict with the doctor's own clinical notes. So if your doctor writes a statement limiting you to sit-down jobs because of lower back pain, but none of the doctor's treatment notes from your physical examinations show evidence of pain, like a reduced range of motion or positive straight-leg raising signs, the SSA is more likely to give that opinion less weight.
Even if your doctor's opinion is supported by your medical records, the SSA still might not find that the statement is very persuasive. Some factors that disability examiners and judges consider when deciding not to give much weight to your doctor's opinion include the following:
Social Security is required to explain why they gave your treating doctor's opinion little weight in your disability determination notice. You should be able to find a discussion of these factors either in your personalized disability explanation or in the judge's written decision.
If you were denied benefits because Social Security didn't give much weight to your doctor's opinion—even though they've treated you regularly for a while and have extensively documented your medical condition—you should consider an appeal with the help of a disability lawyer.
Having an attorney on your side who can fix any issues with your medical source statements can be an invaluable resource. Your representative can help by:
Updated March 7, 2023