As we've talked about here on this blog, the Social Security Administration often sends and pays for claimants to be evaluated by doctors and/or psychologists when evaluating a claim. This can be done at the initial level, that is, when you initially file your claim. It is also often done when your claim gets to the Administrative Law Judge. This is something I see often, especially in claims where a specialized evaluation is needed. For example, you may file for benefits and the disability determination specialist may send you to see an internal medicine or family doctor to get an idea of your medical problems. To be honest, many of these opinions aren't really that helpful. For example, if you have a specific orthopedic problem such as a herniated disc or multi-level degenerative disc disease, a generalized exam may not really provide much insight into your problems. Therefore, when you get to your hearing before the Administrative Law Judge, he or she may send you out to see an orthopedic specialist, possibly with x-rays, who will give a specialized opinion on what you can and can't do. But what happens if this exam isn't really that helpful to or is, in fact, harmful to your case?
Well, the answer to the question is complex but it comes down to needing evidence to rebut, or contradict, what that doctor has said. This brings up an issue that I had in a recent case. Our firm represented a claimant who had worked for many years as a certified nursing assistant and assistant to the activities coordinator at a nursing facility. Due to an on-the-job injury, she had severe back pain with radicular symptoms (tingling, numbness, and pain) in her left arm and leg. She had MRI's showing multiple bulging cervical discs and degenerative disc disease of the lumbar spine. Her treating nurse practitioner had also filled out a form stating that the claimant's pain was severe and would prevent her from working. However, when the claimant went to see the orthopedist, he opined that she had significantly greater abilities, such as the ability to stand and walk for 8 hours in an 8-hour workday. Because we were able to show that the orthopedist's report was not consistent with the other medical records in the file, the Administrative Law Judge assigned less weight to the orthopedist's opinion and we were able to win the claimant's case.
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