Penn. Court Rules Social Security Must Consider Physician’s Opinion When Determining Disability Eligibility

On Monday, a memorandum opinion was filed in a Middle District of Pennsylvania case against the Commissioner of Social Security. The case was remanded for further review by the Commissioner, due to failure to adequately explain the weight given to one of the plaintiff’s treating doctors in deciding both her disability status and her residual functional capacity (RFC).

When assessing if a claimant is medically or mentally disabled and qualified to receive Social Security Disability (SSD), the Administrative Law Judge (ALJ) is required to review and give weight to the often contradictory evidence presented by the claimant and by the government. However, the opinion said one of the “cardinal” principles in guiding these determinations is that the opinions of the treating physicians, as opposed to those performing limited evaluations, should be given great weight, especially when the opinion is formed over a long course of treatment. If the opinion of the treating physician is not given controlling weight in the decision, the ALJ is supposed to give an analysis of the factors regarding the length of treatment, frequency of treatment, and the consistency of the opinion with the medical records to explain the lesser weight that was given to the treating physician’s opinion.

In the plaintiff’s case, the court said, the government did not dispute that one of the physicians could be considered a treating physician. However, the analysis provided by the ALJ regarding that physician’s opinion indicated specifically that it was given little weight in the evaluation of evidence. While the ALJ’s decision did state that the treating physician’s evidence was contrary to a portion of the medical record, the segment that the ALJ cited was not contradictory to that treating physician’s opinion and at no point did the ALJ cite a portion of the medical record that was contradictory to that treating physician’s opinion. Therefore the case was remanded for further review and assessment of the weight that should be given to that portion of the evidence.

The plaintiff was represented by Buzgon Davis Law Offices