Monday, December 12, 2016

The "Co-Signature" of a Physician in a Social Security Disability Medical Opinion

In social security disability cases, the opinion of a treating doctor is given controlling weight unless it is contradicted by substantial evidence in the record.  Social security lawyers know that many doctors do not actually complete the medical opinions that are submitted in support of a claim.  Very often, they simply co-sign the questionnaires which are completed and signed by nurses or PA's in their offices.  (Obviously, it is always better when the treating doctor is the one who actually writes the opinion and signs the paperwork.) 

Given these circumstances, it is somewhat unclear what weight is given to medical opinions that are co-signed by an M.D.  Should these opinions be given "controlling weight" even when the physician did not examine the claimant?

A case recently decided in the Connecticut District Court addressed this question.  In Baldwin v. Colvin, 2016 U.S. Dist. LEXIS 165596 * (D. Conn. Dec. 1, 2016), Magistrate Judge Joan Margolis ruled that Hartford ALJ Peter Borre  erred in ignoring the "co-signature" of a physician.  The case was remanded for a new hearing with the following instructions:
[U]pon remand, the ALJ shall consider "whether . . . [the co-signed] opinion[] [is that] of an acceptable medical source[.]" and "explicitly consider the treating physician factors so that [the ALJ] may comprehensively set forth [his] reasons for deciding whether to give the opinion[] controlling weight[.]" Johnson, 2016 U.S. Dist. LEXIS 19515, 2016 WL 659664, at *3-4, and if the ALJ does not assign controlling weight to the opinion of the treating provider, explain the weight given to the opinions of the State agency consultant by considering the relevant factors set forth in the Regulations. 20 C.F.R. §§ 404.1527 and 416.927.
Ignoring the co-signature of a physician is is a legal error even when the doctor who co-signs a form has not treated a claimant.  In accordance with social security disability regulations, the ALJ must make specific findings explaining the weight given to the opinion.

Monday, December 5, 2016

December 2016 Social Security Disability Briefing

Here are some of the top stories and issues affecting Social Security Disability Lawyers and their clients:

  • New HIV Listing:  The Social Security Administration has published a new listing for claimants who suffer from HIV / AIDS.  The revisions in the HIV listing reflect the great medical advances in treating this condition.  This new rule becomes effective on January 17, 2017.  For a complete version of the new listing click here.
  • Congressman Larson Might Become the Ranking Democrat in the House Social Security Subcommittee:  Just a few days ago Congressman Xavier Becerra, the top democrat on the House SSA subcommittee, announced that he was leaving Congress to become California's Attorney General.  Connecticut's John Larson is the second ranking member on the Committee. However, it is not clear yet if he will become the ranking member on the next Congress. Congressman Larson's office is just a few doors down from RamosLaw.   We will keep you posted .  We want him to take the job!  Our Congressman is the person that we need protecting Social Security.
  • The National Organization of of Social Security Claimant's Representatives (NOSSCR) is interested in any stories about the five day rule and good cause exception harming Region I claimants: for example, situations where the ALJ did not find there was good cause for late submission of probative evidence, and the case needed to be appealed causing delays for the claimant or the claimant lost back benefits by reapplying.  Please send your stories (without any personally identifiable information about the claimant) to by noon on Thursday Dec. 8th.
  • Commissioner Colvin and Other Top SSA Officials Expected to Resign on Inauguration Day: According to the "ALJ Discussion Forum" Acting Commissioner Colvin has informed SSA employees that she will be stepping down on inauguration day.  According to the rumors "many other" SSA employees will follow her.  This has not happened before.  Anyway, expect more backlogs and more staff reductions in the next administration.  Thanks Republicans!