Claimants who applied for Social Security Disability benefits after March 27, 2017 will have their medical evidence evaluated according to new rules established by the Social Security Administration.  These new rules may improve the likelihood that disability claimants in Southern Illinois are approved for benefits.

The Social Security Administration has revised their medical evidence rules for Social Security Disability claimants.

A statement on the Social Security explains, “We revised how we consider medical opinions to reflect modern healthcare delivery and to address adjudicative issues resulting from the current rules.”

The most relevant changes for Southern Illinois disability claimants are related to evidence and rules about which medical sources are accepted as evidence.

Three new sources for medical evidence are now being accepted by the SSA.

According to the Social Security Administration website, three new kinds of medical sources have been added to the acceptable medical sources list for disability claims.  

Medical evidence from the following sources is now acceptable*:

  • Advanced Practice Registered Nurses (APRN)
  • Physician’s Assistants (PA)
  • Audiologists

*within their licensed scope of practice.

Several different titles fall under the scope of Advanced Practice Registered Nurses, including:

  • Advanced Practice Nurse (APN)
  • Certified Nurse Midwife (CNM)
  • Nurse Practitioner (NP)
  • Certified Registered Nurse Anesthetist (CRNA)
  • Clinical Nurse Specialist (CNS)

According to the SSA’s Medical Evidence Regulation Public Desk Guide, all of these practitioners are now acceptable sources for Social Security disability evidence.

The new rules are beneficial for rural disability claimants, who rely more on physician’s assistants and nurse practitioners for healthcare.

According to a 2009 study on rural health in the United States, researchers found that survey participants from rural locations were more likely to use the services of physician’s assistants and nurse practitioners than those who lived in urban areas.

Researchers also discovered that survey participants without insurance (or with public insurance other than Medicare) were more likely to use the services of PAs and NPs than people with private insurance.

This trend is expected to grow as many doctors in rural areas retire.  It is more likely that a retiring rural doctor will be replaced by a physician’s assistant or a nurse practitioner, because these jobs do not require as many years of schooling, and new doctors are more likely to seek better pay in urban areas.

The Social Security Administration has factored this trend into their updated rules in an effort to better serve rural areas like Southern Illinois.  Going forward, an evaluation from a physician’s assistant or nurse practitioner will be just as valid for a disability case as one from a licensed physician.

What other sources are currently accepted by Social Security?

These sources were accepted prior to March 27, 2017 and continue to be accepted:

  • Physicians (medical or osteopathic doctors)
  • Psychologists (at the independent practice level)
  • School psychologists (for impairments of intellectual disability, learning disabilities, and borderline intellectual functioning only)
  • Optometrists (for impairments of visual disorders, or measurement of visual acuity and visual fields only)
  • Podiatrists (for impairments of the foot, or foot and ankle only)
  • Speech-language pathologists (for speech or language impairments only)

Why doesn’t Social Security accept my chiropractor as a source?

Despite the fact that those relying on physician’s assistants and nurse practitioners were found to be more likely to visit a chiropractor as well, chiropractors are not required to earn a medical degree to perform chiropractic adjustments.  Therefore, they are not considered an acceptable medical source.

The Social Security administration’s FAQ explains:  “We will continue to monitor licensure requirements for the medical sources that public commenters suggested that we add to the AMS list.  At this time, however, we decided to add only APRNs, audiologists, and PAs as AMSs.  Upon investigation of licensing requirements for other medical sources, we did not find a similar level of national consistency or rigor in terms of education, training, certification, and scope of practice.”

 Joni Beth Bailey is a Southern Illinois disability attorney.