In certain circumstances, the SSA will deny social security disability insurance applications. If this occurs, the person will have the option to request a social security disability hearing. A social security disability hearing is an informal meeting with an administrative law judge (ALJ). Furthermore, an ALJ will review your claims, ask you for additional information, and potentially overrule the initial decision. However, the ALJ may choose to interview your doctor yet choose to ignore their opinion.
Reasons Why an ALJ Rejects Your Doctors Claims
Below is a list of the most common reasons why an ALJ will ignore your doctor’s opinion.
Lack of Medical Evidence
If your medical records do not contain test results that contain strong evidence for your claim, the SSA is more likely to ignore your doctor. For example, overwhelmed or inexperienced doctors may simply write a letter to the SSA stating that you are totally disabled and can’t work. However, the physician didn’t include evidence or an explanation of what your limitations are and how long they will persist. Additionally, the SSA may disregard your doctor’s opinion because their statements are made from your subjective complaints rather than medical evidence of issues.
Your Last Doctors Visit was Over Six Months Ago
To receive disability benefits, you must provide documentation supporting your stated medical condition. The main way that you prove this is through documentation that you receive from your doctors or specialists you see.
Furthermore, to receive disability benefits, you must consistently visit a doctor. Thus, if you stop visiting a physician for a period of time, your chances of receiving benefits drastically decrease. Additionally, not only do you need to consistently visit a doctor, however, you must also have medical records establishing the long term existence of your conditions. This is also important if you want to try and receive backdated disability benefits.
While past medical issues should be documented, the ALJ only considers your recent medical records when determining your ability to receive disability benefits. The reason for this is because a determination of disability is based on a person’s current ability to work.
Your Doctor Did Not Provide A Good Explanation for Why You Have Certain Limitations
If your doctor testified on your behalf yet did not state the reasons for your limitations, it is likely that you will be denied access to disability benefits. The reason for this is that an ALJ needs to understand how long your disability is likely to last. Thus, if your doctor simply checks off a box that you have a certain disability rather than discussing the disability and why it means that you cannot secure meaningful employment, the ALJ will likely not place as much weight on your doctor’s statements.
Contradictory Evidence
If your initial claim lists contradictory evidence to your doctor’s opinion, the ALJ will likely place less emphasis on your doctor’s opinion. The most common example of this is when your file states that you can only stand for 2 hours at a time or can only lift 25 pounds. Furthermore, issues occur if your doctor is called by the ALJ and states that you can only stand for 1 hour at a time or can only lift 10 pounds. If this occurs, the ALJ will assume that your doctor is not familiar with your case so cannot make specific claims regarding the specific physical or mental limitations you are suffering from.
Factors Determining Weight Given to Doctors Opinions
Here are additional examples of factors ALJs may consider when deciding that your doctor’s opinion is not very persuasive.
- You have seen the doctor only a few times.
- The doctor does not have specialized knowledge or training about your specific impairment.
- Your last visit to the doctor was over six months ago.
- You have not been seeing the doctor for long.
- There is evidence in the file that contradicts your doctor’s opinion
- The doctor is not that familiar with your case even though he diagnosed your illness.
- The doctor provided little objective evidence of your impairment.
- Your doctor didn’t provide a good explanation for why you have certain limitations.
Final Thoughts
If the ALJ does not rely on your doctor’s testimony, having an experienced and knowledgeable attorney is even more important. Just because the ALJ does not listen to your doctor’s statements does not mean that will not receive benefits. However, as the medical records and doctors’ testimony are the most important pieces of evidence for the ALJ, winning your case without convincing testimony is extremely difficult. At Antonoplos & Associates, our attorneys have been working with clients on their social security claims for over 20 years. With this knowledge, we can provide guidance on any social security claim in the District of Columbia, Maryland, and Virginia.
Contact Our Law Office for More Information
For more information on why an administrative law judge may not rely on your doctor’s opinion, contact us at 202-803-5676. You can also directly schedule a consultation with one of our attorneys. Additionally, for general information on social security law, check out our blog.