Question: I have a quick question about disability for back pain. Does it matter if one goes to a chiropractor for tests and diagnosis in comparison to a regular doctor? What’s better?
Answer: I wish I had a quick answer, but I don’t. (I’m assuming your question has to do only with what’s more likely to get you approved for disability benefits, not whether you’ll get better treatment from a chiropractor or M.D.)
Disability claims examiners and judges who work for Social Security are required to give weight to medical opinions from “acceptable medical sources.” This means doctors and osteopaths with a medical degree. Social Security must also accept records from licensed psychologists, but only for disability claims related to intellectual or learning disabilities. (In all other cases involving mental impairments, only a psychiatrist is an acceptable medical source.) In short, Social Security requires that a medical doctor diagnose and evaluate your impairments before you can get disability benefits.
As a result, if the only medical records you have in relation to your back pain are from a chiropractor’s office, you will likely be sent to a consultative exam with a doctor paid for by Social Security. Such an assessment is not likely to help your claim, as a doctor who only sees you once for a few minutes isn’t going to understand your limitations as well as a heath care provider who has seen you over a long period of time.
That said, Social Security should take a chiropractor’s records into account when looking at the severity of your back pain and how it limits your abilities. While a claims examiner or judge doesn’t have to rely on a chiropractor’s diagnosis and prognosis since chiropractors aren’t acceptable sources, if you have a long treating relationship with your chiropractor, the examiner or judge should evaluate a chiropractor’s records for information on your limitations.
Are there exceptions to the acceptable medical source rule? Yes, there have been numerous federal court rulings on whether chiropractors and nurse practitioners can be considered acceptable medical sources. Some federal courts have said that the opinion of a chiropractor who regularly treats a patient should be given the same weight as a medical doctor, and others have said that when a disability applicant lives in a rural area with no access to an M.D., a nurse practitioner’s opinion is entitled to consideration. Social Security has not changed its rule, however, that says that a chiropractor is not an acceptable medical source, so while you could end up winning your case in federal court after several appeals, it’s a much better idea to get an M.D.’s opinion from the get-go.
Getting a medical doctor’s detailed opinion about your diagnosis, prognosis, and how your medical condition limits your abilities and activities is the most important thing you can do to win your disability case, since Social Security must give controlling or substantial weight to the opinion of your treating doctor — unless it’s inconsistent with other evidence in your file.