Monday, November 7, 2016

Letter to Commissioner Colvin Re: Proposal to Change Treating Physician Rule

November 7, 2016

Carolyn ColvinActing Commissioner
Social Security Administration

   6401 Security Boulevard
   Baltimore, MD  21235-6401

Submitted on

Re:  Notice of Proposed Rulemaking on Revisions to Rules Regarding the Evaluation of Medical Evidence, 81 Fed. Reg. 62559 (September 9, 2016), Docket No. SSA-2012-0035

Dear Acting Commissioner Colvin:

Thank you for the opportunity to comment on the proposed regulations contained in above referenced Notice of Proposed Rulemaking (NPRM).  I am writing to express my strong opposition to the SSA’s proposal to eliminate the treating physician rule and the 9th circuit’s credit-as-true doctrine. 

I believe that the proposed rules would unduly burden our Federal Court system and the legal staff at the U.S. Attorney’s Office.  Moreover, claimants and your staff at the SSA will also be adversely affected as a result the likely delays caused by these revisions.  As proposed, the new rules will lead to more federal court appeals, more delays and substantially more remands for a new hearing. 

It is no secret that the proposed rules are part of your administration’s strong anti-claimant stance.  This proposal shows once again, that you have acquiesced to the Republicans’ pressure to “tighten up the rules” to make it harder for claimants to qualify for disability benefits.  However, I would like to point out your agency’s current proposal will not achieve the results intended by its drafters.  Instead of leading to lower allowance rates, the proposed changes will lead to chaos, waste, and unnecessary delays in the adjudication process.  Moreover, the new rules will foster confusion at the Federal Court level, resulting in an even bigger backlog and far more EAJA fee awards.

The proposed rule removes the responsibility of adjudicators to explain how they weigh medical evidence and how they weight prior determinations made by other administrative agencies.  If enacted, adjudicators will have to weight medical evidence without guidelines or legal standards. The vagueness and uncertainty created by the proposed rules will lead to more prolonged federal court challenges and not, to the “quick and easy unfavorable decisions” wished for by its proponents. 

It is a well accepted legal axiom that specificity and preciseness in legal standards, lead to less challenges at the appellate level.  The vague rules proposed by your agency violate this legal axiom.  In fact, the proposed changes are an outright invitation to lawyers and jurists to develop new case law to fill up the legal void left by the absence of clear regulatory guidelines.

In my experience as a disability lawyer, I have witnessed how the absence of guidelines to evaluate medical evidence can lead to a significant number of remands by the federal courts.  Besides practicing in the area of Social Security Disability, I also represent claimants who have been denied disability benefits under insurance contracts governed by the Employee Retirement Income Security Act of 1974 (ERISA).  In disability insurance cases covered by ERISA, the treating physician rule does not apply and there are no clear guidelines for evaluating medical evidence.  Due to the absence of clear guidelines to evaluate medical evidence in ERISA cases, federal judges are often unable to issue a decision and are forced to issue a remand back to the insurance company for further consideration. 

For the above mentioned reasons, I urge you to withdraw the proposal to change the way that the SSA evaluates medical evidence.


Iván A. Ramos