ALJs or administrative law judges and disability claims examiners appointed by the Social Security Administration, SSA, can sometimes disregard the medical opinions of doctors for many different reasons. This is particularly true if an SSA-appointed doctor examined you but didn’t find sufficient proof of your disability.
In this case, insufficient proof might be enough to disregard the opinion of your doctor. But before reaching out to disability insurance lawyers in Los Angeles, try to find out why SSA examiners might ignore doctors’ opinions.
Insufficient Medical Proof
It is the job of your doctor to provide the SSA with sufficient medical proof of your disability, complete with details regarding your limitations and capacities. For instance, if your doctor writes a comprehensive report detailing your capacity to walk, sit and stand.
It includes the amount of weight you can carry and lift, and so on. And you have sufficient proof in your medical records to back up the report; then the SSA must take into account your doctor’s report. However, your physician may just give his opinion regarding your limitations and capacities based solely on your complaints instead of objective proof. The SSA will likely disregard his advice.
Contradictory Medical Proof
The SSA will most likely reject your doctor’s opinion if it finds conflicting proof in your case records. To illustrate, let’s say that your doctor stated that you’re not capable of lifting things over 20 pounds so you can’t possibly continue working.
However, if the SSA examiner sees proof in your records that you applied for disability benefits while you were a part-time worker at a job that entailed lifting things over 30 pounds, then the examiner has a valid reason for ignoring the opinion of your doctor.
How SSA Examiners Determine the “Weight” of Doctors’ Opinions
If an examiner discounts doctors’ opinions, it would then have to take into account certain considerations. He or she will try and determine how much weight an opinion has with regards to a disability claim. Below are certain factors that might be considered when figuring out how a doctor’s opinion might influence a disability claim:
- You’ve only seen your doctor a couple of times or haven’t been seeing him for a more extended period.
- You last visited your doctor more than six months ago.
- Your doctor doesn’t have the necessary or specialized training or knowledge to give opinions about your specific impairment.
- Your doctor doesn’t seem familiar or knowledgeable about your case even if he was the one who diagnosed your condition.
- Your doctor gave inadequate objective medical proof of your disability.
- Your case records proof that directly contradicts the opinion given by your doctor.
Otherwise, if your doctor has treated you consistently and for a long while, supports your claim, has extensive knowledge and experience on your specific disability, and gave the SSA medical records that justify your claim, then the SSA must assign significant weight to the opinion of your doctor.
With that said, it is within your right to take legal action and consult a disability insurance attorney if the SSA discounted your doctor’s opinion even if it has valuable evidence to support your disability claim.