604.Independent Determinations Under the Social Security Act

604.1How are disability determinations made?

We make independent disability determinations. Our determination is based on all of the facts in your individual case.

604.2Do disability decisions by other agencies affect SSA's determination of disability?

A decision made by another governmental or non-governmental agency that you are or are not disabled does not mean that you have met the disability requirements of the Social Security Act. A decision made by another agency that you are or are not disabled is not binding on SSA. However, the evidence used to make these decisions, may provide insight into your mental and physical impairment(s). We consider opinion evidence included in your case record from medical sources, as well as “non-medical sources,” used by other agencies, which have had contact with you in their professional capacity, as required by our rules.

604.3Do medical opinions from a treating source affect SSA's determination of disability?

Generally, we give more weight to opinions from your treating sources, since these sources are likely to be the medical professionals most able to provide a detailed, longitudinal picture of your medical impairment.

If we find that the medical opinion from a treating source is well supported by objective medical evidence and it is not inconsistent with other substantial evidence in your case record, we will give it controlling weight. We rely substantially on it to support our decision of disability.

Note that under our rules, “medical opinions” are statements from physicians and psychologists or other acceptable medical sources (see 615.1) that reflect judgments about the nature and severity of your impairment(s), including your symptoms, diagnosis and prognosis, what you can still do despite impairment(s), and your physical or mental restrictions.

604.4What if the medical opinion from a treating source is not given controlling weight?

A finding that your treating source's medical opinion is not entitled to controlling weight does not mean that the opinion is rejected. Treating source medical opinions are still entitled to deference and must be weighed using certain factors. These factors include:

  • the examining relationship between you and your treating source;

  • the treatment relationship between you and your treating source, including its length, nature, extent, and frequency of evaluation;

  • how well the medical opinion is supported by the relevant evidence;

  • how consistent the medical opinion is with the record as a whole;

  • whether your treating source is a specialist; and

  • any other factors brought to our attention, or of which we are aware, which tend to support or contradict the opinion.

Last Revised: Aug. 1, 2011