By Elliott Andalman, Esq. and Peter Casciano, Esq.
eandalman@a-f.net
pcasciano@a-f.net
The Social Security Administration (SSA) provides the major safety net for workers who become disabled by either accident or illness. The Disability Insurance Benefit (DIB) program was adopted in the 1930s as part of the New Deal to protect workers from poverty. The program protects millions of disabled Americans and their families.
Sadly, the SSA has been under pressure from Congress to cut costs and pay fewer claims. In 2016, SSA adopted major changes to the regulations governing the administration of the DIB program that went into effect with all applications filed after March 17, 2017.
Possibly the most damaging of these changes was the abolition of the “treating physician rule.” That rule, which arose out of federal court decisions, gave deference to the opinions of the claimant’s treating physician over the opinions of medical reviewers hired by SSA to review claims. The treating physician rule also required the SSA to defer to treating physicians over one-time examiners such as the consultative examiners (CEs) hired by SSA to examine the claimant.
Giving deference to treating physicians under most circumstances is only fair and reasonable. The treating physician normally has seen the patient multiple times and is more familiar with the patient than any one-time examiner or reviewer of medical records possibly could be.
So, why is the treating physician rule abolished? SSA has not put forth any credible reason. Sadly, although SSA does not admit it, the most likely reason the SSA is doing this is to give the administration, and particularly the administrative law judges (ALJs) who hear these cases more latitude to deny claims. In addition, the treating physician rule has been a significant factor in claimants being able to overturn denial decisions in federal court.
The abolition of the treating physician rule is a serious loss for American workers who become disabled. This rule and other recent changes will make it harder for disabled American workers get disability benefits to which they should be entitled. This rule and other recent changes will create more holes in our country’s social safety net.
Individuals and organizations on behalf of disabled Americans should appeal to Congress and go out to vote for candidates that will support reinstating the treating physician rule.
The disability team at Andalman and Flynn has the experience, the knowledge, and the passion to assist with the filing, processing and winning of disability benefit claims. We help workers win claims including short– and long-term disability insurance, FERS disability retirement, State of Maryland disability retirement, and social security disability applications, among others. Contact us online now for a disability law consultation in Maryland.
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