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Simple English definitions for legal terms
treating-physician rule
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A quick definition of treating-physician rule:
The treating-physician rule is a principle that says the doctor who is treating a person's medical condition has the most important opinion about how severe the condition is. This means that if someone is applying for social security benefits because of their medical condition, the judge who decides their case must listen to what their doctor says about how much the condition affects their ability to work. The judge can only disagree with the doctor if there is strong evidence that the doctor is wrong.
A more thorough explanation:
Treating-Physician Rule
The treating-physician rule is a principle that states that the diagnoses and findings of a claimant's treating physician regarding the severity of their impairment are given more weight than other medical opinions. This rule is binding on an administrative-law judge unless there is substantial evidence to the contrary.
For example, if a person has a back injury and their treating physician determines that they are unable to work, the administrative-law judge will consider this opinion when making a decision about the person's eligibility for disability benefits. If there is no substantial evidence to contradict the treating physician's opinion, the judge will likely approve the claim.
Another example is if a person has a mental health condition and their treating psychiatrist determines that they are unable to work due to their symptoms, the administrative-law judge will give more weight to this opinion than to the opinion of a non-treating physician who may have only seen the person once or twice.
The treating-physician rule is important because it recognizes the value of the relationship between a patient and their treating physician. The treating physician has often seen the patient over a long period of time and has a better understanding of their medical history and current condition. By giving more weight to the treating physician's opinion, the rule helps ensure that people with disabilities receive the benefits they need to support themselves and their families.