Evaluation Of Medical Evidence Regulations Sent To OMB

     The Social Security Administration has sent proposed final rules on the evaluation of medical evidence to the Office of Management and Budget (OMB) for approval. To come into effect before the change of administrations, the regulations would have to be approved by OMB and published in the Federal Register by December 20.
     Here's what I picked out of the proposed regulations when they appeared in the Federal Register on September 9:

• We propose to revise our rules in 20 CFR 404.1504 and 416.904 to state that we will not provide any analysis in our determinations and decisions about how we consider decisions made by other governmental agencies or nongovernmental entities that an individual is disabled, blind, or unemployable in any claim for disability or blindness under titles II and XVI of the Act , and that we are not bound by those decisions. Although we would categorize decisions made by other governmental agencies or nongovernmental entities within the other medical evidence category if made by a medical source or a statement if made by a nonmedical source, we propose to state in 20 CFR 404.1520b and 416.920b that these decisions are inherently neither valuable nor persuasive to our disability and blindness determinations. ...
• [W]e propose to state in 20 CFR 404.1520b(c)(2) and 416.920b(c)( 2 ) that we will not provide any analysis about how we considered disability examiner findings from a prior level of adjudication ...
• Consistent with our goals to better define and organize our evidence regulations to produce more accurate and consistent determinations and decisions, we propose to define a statement on an issue reserved to the Commissioner as a statement that would direct the determination or decision of disability. ... Although a statement on an issue reserved to the Commissioner would be categorized within other medical evidence if made by a medical source or a statement if made by a nonmedical source, we would not provide any analysis about how we considered such statements at all in our determinations and decisions . ...
• To help adjudicators, representatives, and courts identify statements on issues reserved to the Commissioner, we propose to include the following in 20 CFR 404.1520b(c)(3) and 416.920b(c)(3) :

• statements that an individual is or is not disabled, blind, able to work, or able to perform regular or continuing work;  
• statements about whether or not an individual’s impairment(s) meets the duration requirement for disability; statements about whether or not an individual’s impairment(s) meets or equals any listing in the Listing of Impairments; 
• in title XVI child claims, statements about whether or not an individual’s impairment(s) functionally equals the Listings; 
• in adult claims, statements about what an individual’s RFC is using our programmatic terms about the functional exertional levels in Part 404, Subpart P, Appendix 2, Rule 200.00 in stead of descriptions about his or her functional abilities and limitations ; 
• in adult claims, statements about whether or not a n individual’s RFC prevents him or her from doing past relevant work; 
• in adult claims, statements that an individual does or does not meet the requirements of a medical-vocational rule in Part 404, Subpart P, Appendix 2; and  statements about whether or not a n individual's disability continues or ends when we conduct a continuing disability review (CDR) . ...

• In order to assist representatives and our adjudicators in interpreting our rules, we propose to revise our rules to state affirmatively our current policy that we will not use a diagnosis, medical opinion, or an individual's statement of symptoms to establish the existence of an impairment(s). We would clarify our rules to state that a physical or mental impairment must be established by objective medical evidence from an AMS. We would continue to follow our current policy if we have objective medical evidence from an AMS that a claimant has a severe impairment(s) at step 2, we will consider all evidence to determine the severity of the impairment(s) and all other findings in the sequential evaluation process. ...
• [W]e propose several revisions to how we consider medical opinions and prior administrative medical findings. First, we would no longer give a specific weight to medical opinions and prior administrative medical findings; this includes giving controlling weight to medical opinions from treating sources. Instead, we would consider the persuasiveness of medical opinions and prior administrative medical findings using the factors described below. Second, we propose to consider supportability and consistency as the most important factors. Finally, we propose to reorganize the factors to: (1) list the supportability and consistency factors first, (2) include a "relationship with the claimant" factor that combines the content of the current examining relationship and treatment relationship factors, (3) list individually the three different factors currently combined as other factors, and (4) restate the factors using consistent sentence structure. ...