If you are filing a Social Security disability application, you need to be aware of the rules and laws applicable to SSI and SSDI disability claims. In the past couple of years, changes in the rules used to evaluate Social Security disability claims have made it more difficult for some individuals to receive disability benefits. If you have questions, you may want to contact a New York Social Security disability claims lawyer to discuss how the changes in rules impact your claim.
1. Rule for Submitting Evidence
Claimants must now submit evidence they want an ALJ to consider at least five business days before the scheduled hearing or inform the judge of the evidence. The rule permits an ALJ to disregard any evidence submitted after the deadline. If a judge adopts a hard deadline under the five-day rule, the ALJ may deny an individual’s claim for Social Security disability benefits even though the person has sufficient evidence to support the claim. An ALJ may permit an exception to the five-day rule for good cause, but what constitutes good cause can vary greatly for different judges and jurisdictions.
2. No Deference for Treating Physician’s Opinions
A new change in the rules eliminates the weight an ALJ gives to a treating physician’s medical opinion regarding a claimant’s limitations. Under the old rule, an ALJ considered a treating physician’s opinion as controlling if the opinion was consistent with other medical evidence in the case. Under the new rule, an ALJ has much more flexibility in deciding whether to accept a treating physician’s medical opinion regarding his patient’s limitations or whether to dismiss the treating physician’s opinion altogether.
3. Must Include Adverse Evidence in Disclosures
Under the old rules, an attorney or claimant only had to submit evidence to the ALJ that was “material” to the issue of whether the claimant’s condition met the SSA’s definition of disability. Claimants and their attorneys must now disclose all evidence to the ALJ regarding the claimant’s disability, including evidence that might be harmful to the claimant’s application for Social Security disability benefits. Attorney work product rules no longer protect residual functional capacity evaluations (RFCs) that an attorney drafts to send to a doctor. Attorneys must disclose RFCs to the ALJ under the new rules.
4. Disclosing Referrals to Doctors
An attorney is now required to disclose whether the attorney or the law firm referred the claimant to a doctor for an evaluation of the claimant’s limitations and abilities. The new rule is applicable when an attorney has referred a client to a doctor regarding a personal injury or workers’ compensation claim.
Unfortunately, the referral of a client to a specific doctor to obtain an opinion related to the claimant’s abilities and limitations could lead the ALJ to question whether the attorney’s referral influenced the doctor’s final opinion. Many clients rely on their lawyers to help them locate a physician to provide treatment and opinions related to a Social Security disability claim. The new rule could substantially impact how attorneys handle referrals to physicians in the future.
Filing a Social Security disability claim or appealing a denial of an SSI or SSDI claim can be complicated. If you are unaware of the Social Security rules, your claim may be denied even though you are disabled. Schedule a consult with our New York Social Security disability claims lawyers to help you avoid making mistakes that could result in a denial of your disability claim.