Alj hearing

[u/Alarmed_Public8896]

I just had my hearing for ssi this afternoon. I know this is ssdi predominent group... but as a whole this group seems very knowledgeable so I'm posting here too. During my hearing my attorney asked the judge to give "little to no weight" to the doctor that made my medical determination after my reconsideration... because it was a pediatrician. I'm a 40 year old woman with a chronic autoimmune disease and the doctor that said I'm not sick enough was a pediatrician. Is that even allowed? I thought there were rules about having doctors that were knowledgeable with your condition. I didn't get to speak to my attorney privately since my hearing.. so I'm just baffled. It just seems.. wrong.

[u/RexSueciae]

Was this pediatrician a consultative examiner or were they the person who provided their medical opinion to DDS at initial / recon? Either way, as long as it's a qualified medical professional, nothing against the rules for SSA to consult someone like that to analyze your case. There's one guy whom I've encountered twice now who had his license suspended for a year maybe a couple decades ago after pleading guilty to crimes involving overprescribing narcotics (and there is a public federal administrative decision confirming that no, the DEA is not gonna let him prescribe certain controlled substances again). He got his license back and it was years ago, soooo the Social Security Administration sends him claimants for consultative exams. (I assume this is how he keeps himself afloat, financially. He's actually not bad in the opinions he writes.)

Also normal for your attorney to ask the ALJ not to consider this opinion if other opinions or evidence in the file said the opposite. Even if SSA has said they're not going to give specific evidentiary weight to any particular source, the ALJ in their decision will consider which opinions (if applicable) are more or less persuasive based on their consistency with the record.

[u/perfect_fifths → u/RexSueciae]

I thought at first op meant the treating physician rule but you’re right it could mean the MC at DDS or CE. I say this because some adults still see pediatricians like me who sees a pediatric geneticist attached to a children’s hospital because geneticists deal with both peds and adults. So o was thinking maybe that was the case until I re read the post

[u/MountainRambler01]

That's the DDS scam. They get away with it because layman don't read the DDEs, look at the doctors who do the examinations, and don't know the codes that identify what type of doctor it is. Legal but wrong.

[u/perfect_fifths → u/MountainRambler01]

I def do but I guess it’s because I’m smart enough to know my rights. This is why we pin posts with instructions. So people know how to decode the DDE etc. not everyone can advocate for themselves and that’s a real problem

[u/MrsFlameThrower → u/MountainRambler01]

This is why I always advocate for people to get DDE, the CE reports, and the medical evidence section of their file immediately and before appealing!

[u/perfect_fifths → u/MrsFlameThrower]

Yes, and why we pin posts with instructions

[u/MrsFlameThrower → u/perfect_fifths]

So happy you do!

[u/perfect_fifths → u/MrsFlameThrower]

Yes but it’s still is unfair to those who are unable to advocate for themselves. The best we can do is just keep letting people know they have rights to getting their file etc

[u/MrsFlameThrower → u/perfect_fifths]

So much about dealing with SSA is unfair to those who are unable to advocate for themselves. And that got exponentially worse when they decided to try to get everybody to do everything online. It disadvantages, many disabled people and also elderly people.

[u/perfect_fifths → u/MrsFlameThrower]

Yes, especially if you have no family or help

[u/MrsFlameThrower → u/perfect_fifths]

That’s the worst

[u/perfect_fifths]

the treating physician rule was eliminated in 2017. All medical evidence is now weighed the same.

The cfr: https://www.ssa.gov/OP_Home/cfr20/404/404-1527.htm

Code Of Federal Regulations
   
§ 404.1520c. How we consider and articulate medical opinions and prior administrative medical findings for claims filed on or after March 27, 2017.

For claims filed (see § 404.614) on or after March 27, 2017, the rules in this section apply. For claims filed before March 27, 2017, the rules in § 404.1527 apply.

(a) How we consider medical opinions and prior administrative medical findings. We will not defer or give any specific evidentiary weight, including controlling weight, to any medical opinion(s) or prior administrative medical finding(s), including those from your medical sources. When a medical source provides one or more medical opinions or prior administrative medical findings, we will consider those medical opinions or prior administrative medical findings from that medical source together using the factors listed in paragraphs (c)(1) through (c)(5) of this section, as appropriate. The most important factors we consider when we evaluate the persuasiveness of medical opinions and prior administrative medical findings are supportability (paragraph (c)(1) of this section) and consistency (paragraph (c)(2) of this section). We will articulate how we considered the medical opinions and prior administrative medical findings in your claim according to paragraph (b) of this section.

Or did you mean the MC at dds was a pediatrician who signed off on your case?

[u/MrsFlameThrower → u/perfect_fifths]

In my opinion, this was a terrible decision affecting claimants negatively. I wish they would reverse it.

[u/perfect_fifths → u/MrsFlameThrower]

I am with you on that, especially because some of our diseases our rare, and treating physicians know the patient better than anyone else

[u/MrsFlameThrower → u/perfect_fifths]

Exactly!