The Treating Physician Rule

The “treating physician rule” provides that an ALJ is required to give “controlling weight” to the medical opinion of a treating source, as compared to the medical opinion of a non-treating source, if the opinion of the treating source is “well-supported by medically acceptable clinical and laboratory diagnostic techniques and is not inconsistent with the other substantial evidence in [the] case record.” 20 CFR 416.927(c)(2).  Citing: Tilley v. Comm’r of Soc. Sec., 394 Fed.Appx. 216, 222 (6th Cir. Aug. 31, 2010);  Hensley v. Astrue, 573 F.3d 263, 266 (6th Cir. 2009); SSR 96-2p; Wilson v. Comm’r of Soc. Sec., 378 F.3d 541, 544 (6th Cir. 2004).  If the ALJ does not give the treating source medical opinion controlling weight, said opinion is “still entitled to deference. . . .”  SSR 96-2p.  The ALJ must consider the following factors outlined in 20 CFR 404.1527(c)(2)-(6):

(1) the length of the treatment relationship and the frequency of examination;

(2) the nature and extent of the treatment relationship;

(3) the supportability of the opinion with respect to relevant evidence such as medical signs and laboratory findings;

(4) the consistency of the opinion with the record as a whole; (5) the specialization of the physician rendering the opinion; and

(6) any other factor raised by the applicant.

Once the above factors are considered, the ALJ must also provide “good reasons” for the resulting weight given to the treating source.  SSR 96-2p.   The “good reasons” must be “sufficiently specific to make clear to any subsequent reviewers the weight the adjudicator gave to the treating source’s medical opinion and the reasons for that weight.” Meece v. Barnhart, 291 Fed. Appx. 456, 461 (6th Cir. 2006).  If the ALJ fails to adhere to follow these procedural rules, the case should be remanded for clarification.  Wilson v. Comm’r of Soc. Sec., 378 F.3d 541, 544-45 (6th Cir. 2004).



About tngainjurylawyer
Serious Injury Lawyer in Tennessee and Georgia.

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