The Social Security Administration (SSA) has issued a new ruling dealing with two separate issues that frequently arise in disability determinations: 1) the consideration of evidence from other than “acceptable medical sources” and 2) the consideration of disability determinations by others, including determinations by the Department of Veterans Affairs. SSR 06-03p.; “Titles II and XVI: Considering Opinions and Other Evidence From Sources Who Are Not ‘Acceptable Medical Sources’ in Disability Claims; Considering Decisions on Disability by Other Governmental and Nongovernmental Agencies.” 71 Fed. Reg. 45593 (Aug. 9, 2006).
– The Ruling refers to the increasing role in the context of managed health care of medical sources who are not “acceptable medical sources” as defined by SSA regulations. These other medical sources include nurse practitioners, physician assistants, licensed clinical social workers and therapists. The Ruling stresses that opinions from these other medical sources “are important and should be evaluated on key issues such as impairment severity and functional effects.” 71 Fed. Reg. at 45595. The ruling goes on to state that “‘Non-medical sources’ who have had contact with the individual in their professional capacity, such as teachers, school counselors, and social welfare agency personnel” are “valuable sources of evidence for assessing impairment severity and functioning.” It also refers to the need to consider evidence provided by others such as “spouses, other relatives, friends, employers and neighbors.”
In considering the weight to be given to opinion evidence from these other sources, the ruling clarifies that the factors set forth in the regulations as factors to be considered in determining the weight to be assigned to opinion evidence from an “acceptable medical source” represent basic principles and can be applied to opinion evidence from other sources as well. It goes on to state that “the adjudicator generally should explain the weight given to opinions from these ‘other sources.’” Finally, if the adjudicator gives greater weight to an opinion from one of these other sources, the reasons must be explained in the notice of decision in hearing cases and in the notice of determination at the initial and reconsideration levels if the decision is less than fully favorable.
Other Disability Determinations
– The last part of the Ruling deals with the separate issue of the treatment of decisions on disability by other governmental and nongovernmental agencies. This part of the Ruling simply states that such decisions cannot be ignored and must be considered, although the Commissioner is not bound by such determinations. However, in this regard, the Ruling would appear to be weaker than the case law already existing in several circuits, at least with respect to decisions by the Department of Veterans Affairs. See, e.g. McCartey v. Massanari, 298 F.3d 1072 (9th Cir. 2002) (VA decision entitled to “great weight.”)(citing decisions from other Circuits). For further information contact Gerald McIntyre in the NSCLC Los Angeles office.