New Rules on Acceptable Medical Evidence

Here are a few Social Security disability rule changes set to go into effect in the next few weeks.

• Acceptable medical sources.
Under the new medical evidence rules, the list of acceptable medical sources has been expanded to include: advance practice registered nurses (APRNs), licensed audiologists, licensed optometrists and physician assistants (PAs). While this change has been welcomed by many representatives, others have argued that licensed clinical social workers (LCSWs) should have also been added to the list of accepted medical sources, as many of our clients rely on social workers to provide mental health treatment.
• No treating physician rule.
Another troubling development that claimants’ representatives opposed during the public comment period is the abolishment of the treating physician rule. Previously, opinions of a claimant’s treating doctors were to be given additional weight, and in some cases controlling weight, as compared to nontreating medical sources. The new rule affords ALJs more deference to weigh evidence as they see fit. Specifically, starting with claims filed on or after March 27, SSA will no longer give controlling weight to any one class of providers. Instead, ALJs are to weigh medical evidence based on “persuasiveness” and “consistency” with the other medical evidence of record.
• Unsuccessful work attempt regulations.
The new rules also make it slightly easier for claimants and representatives to establish unsuccessful work attempts. The final rules at 20 CFR 404.1574(c), 404.1575(d), 416.974(c), and 416.975(d) remove the additional conditions that claimants previously had to meet when a work attempt had lasted between three and six months. Under the new rules, SSA will use the current three-month standard for all work attempts that are six months or less. Thus, work a claimant has performed will not be used as evidence of “substantial gainful activity” (SGA) during a period of six months or less if the work was stopped due to one’s impairments or the work was reduced to below the SGA threshold due to one’s impairments, without requiring verification of the specific reason work ended or was reduced.
More detail: