Jan 6, 2017

Regulations On Evaluation Of Medical Evidence Advance

     The Office of Management and Budget (OMB) has cleared Social Security's proposed final regulations on evaluation of medical evidence. Here is the agency's summary of the regulations:
We are proposing several revisions to our medical evidence rules. The proposals include redefining several key terms related to evidence, revising our list of acceptable medical sources (AMS), revising how we consider and articulate our consideration of medical opinions and prior administrative medical findings, revising who can be a medical consultant (MC) and psychological consultant (PC), revising our rules about treating sources, and reorganizing our evidence regulations for ease of use. These proposed revisions would conform our rules with the requirements of the Bipartisan Budget Act of 2015 (BBA), reflect changes in the national healthcare workforce and in the manner that individuals receive primary medical care, simplify and reorganize our rules to make them easier to understand and apply, allow us to continue to make accurate and consistent decisions, and emphasize the need for objective medical evidence in disability and blindness claims.
      These may now be published in the Federal Register. However, the Administrative Procedure Act provides that the regulations cannot come into effect for at least 30 days after publication. There will be a new President by then. We do not know for sure what the new President will do but it's a good bet that all regulations which have been approved but which have not yet come into effect will be put on hold pending review by the new administration and that review may not be complete until there's a new Commissioner. It's not that these new regulations are likely to be unpopular with the new administration but it may still take months before they come into effect and they might be modified. But, then again, who knows what to expect out of the Trump Administration?


Anonymous said...

Finally a new rule from the agency that is beneficial to claimants as opposed to detrimental. The reality is that NPs, although not medically acceptable sources, are used by many major hospital systems in place of MDs for primary care services.

Anonymous said...

That's a good point. You don't need a medical degree to arbitrarily check boxes or write "Patient is totally disabled." Nurses can do that too.

Anonymous said...

The proposed rule has a whole section on statements on issues reserved to the commissioner...2:38, those statements are already and are even more likely under the proposed rule to be ignored.

Anonymous said...


ALJs lack medical degrees and do the reverse on a regular basis.


Not if they come from the new nurse practitioner consultative examiner or medical consultant.

Apu Mridha said...

Thank you for sharing such an amazing and informative post. Really enjoyed reading it. :)



Medical Claims Management