SSD Hearings - What Makes a Doctor's Opinion "Persuasive" to an ALJ

The Social Security Administration has recently updated its regulations with regard to how judges weigh the evidence when issuing decisions. The "Treating Physician Rule" has been replaced with a series of factors that a judge must use to decide how persuasive a doctor's opinion is.


Supportability means the extent that a medical opinion is supported by the relevant objective medical evidence and the explanations provided by the medical source. The more relevant the objective medical evidence and supporting explanations presented by a medical source are to support his or her medical opinions or prior administrative medical findings, the more persuasive the medical opinions or prior administrative medical finding(s) will be.


Consistency means the extent a medical opinion is consistent with the evidence from other medical and nonmedical sources. This also includes considering internal conflicts within the evidence from the same source. The more consistent a medical opinion or prior administrative medical finding is with the evidence from other medical and nonmedical sources in the claim, the more persuasive the medical opinion or prior administrative medical finding.


Relationship with the claimant includes the combined consideration of the following five issues:

  • Length of the treatment relationship. The length of time the medical source treated the claimant may help demonstrate whether the medical source has a longitudinal understanding of the claimant’s impairments.

  • Frequency of examinations. The frequency of the claimant’s visits with the medical source may help demonstrate whether the medical source has a longitudinal understanding of the claimant’s impairments.

  • Purpose of treatment relationship. The purpose for treatment the claimant received from the medical source may help demonstrate the level of knowledge the medical source has of the claimant’s impairments.

  • Extent of the treatment relationship. The kinds and extent of examinations and testing the medical source has performed or ordered from specialists or independent laboratories may help demonstrate the level of knowledge the medical source has of the claimant’s impairments.

  • Examining relationship. A medical source may have a better understanding of the claimant’s impairments if he or she examined the claimant than if the medical source only reviewed evidence.

Specialization. The medical opinion or prior administrative medical finding of a medical source who received advanced education and training to become a specialist may be more persuasive about medical issues related to his or her area of specialty than the medical opinion or prior administrative medical finding of a medical source who is not a specialist.


Other factors. Consider any other factors that tend to support or contradict a medical opinion or prior administrative medical finding. This includes, but is not limited to, evidence showing a medical source has: familiarity with the other evidence in the claim, or an understanding of our disability program’s policies and evidentiary requirements.


An adjudicator must also consider if any new evidence receive after the source made the medical opinion or prior administrative medical finding makes it more or less persuasive.


We remind our clients that maintaining a relationship with your physicians, and consistently documenting and treating your symptoms, is essential to a successful outcome. Knowing what your judge will be looking for to approve your application should help you throughout the process.


If you have any questions about what you should be doing to best support your SSD case, please call our office at (212) 766-5800.

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© 2020 by UNGARO CIFUNI & JAFFE, Attorneys at Law LLP. 

Disclaimer: Prior results do not guarantee a similar outcome.

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