The Treating Physician Rule
Plaintiff argues that the ALJ erred in rejecting the diagnosis of fibromyalgia based
on the lack of objective medical evidence, that the ALJ failed to give weight to the
opinions of Plaintiff’s treating physicians, and that the ALJ misstated Dr. Goldfarb’s
opinion. These are all essentially contentions that the ALJ erred in rejecting the
assessments of Plaintiff’s treating physicians.
The Ninth Circuit distinguishes among the opinions of three types of physicians:
(1) those who treat the claimant (treating physicians); (2) those who examine but do not
treat the claimant (examining physicians); and (3) those who neither examine nor treat
the claimant (nonexamining physicians). Lester v. Chater, 81 F.3d 821, 830 (9th Cir.
1995), as amended (Apr. 9, 1996). “The ALJ must consider all medical opinion evidence.” Tommasetti v. Astrue, 533 F.3d 1035, 1041 (9th Cir. 2008) (citing 20 C.F.R. § 404.1527(b)).
“By rule, the SocialSecurity Administration favors the opinion of a treating physician over non-treating physicians.” Orn v. Astrue, 495 F.3d 625, 631 (9th Cir.2007) (citing C.F.R. §404.1527).”Generally, a treating physician’s opinion carries more weight than an
examining physician’s, and an examining physician’s opinion carries more weight than a
reviewing physician’s.” Holohan v. Massanari, 246 F.3d 1195, 1202 (9th Cir. 2001)
(citing Lester, 81 F.3d at 830; 20 C.F.R. § 404.1527(d). In addition, the regulations give
more weight to opinions that are explained than to those that are not and more weight to
the opinions of specialists concerning matters relating to their specialty over that of nonspecialists. Holohan, 246 F.3d at 1202 (citing 20 C.F.R. §§ 404.1527(d)(5) and
404.1527(d)(3)). “As such, the ALJ may only reject a treating or examining physician’s
uncontradicted medical opinion based on ‘clear and convincing’ reasons.’ ” Carmickle v.
Commissioner, 533 F.3d 1155, 1164 (9th Cir. 2008) (citing Lester, 81 F.3d at 830-31).
Where such an opinion is contradicted, it may be rejected for specific and legitimate
reasons that are supported by substantial evidence in the record. Id. When rejecting the
opinion of a treating physician, the ALJ can meet her ” ‘burden by setting out a detailed
and thorough summary of the facts and conflicting clinical evidence, stating [her]
interpretation thereof, and making findings.’ ” Tommasetti, 533 F.3d at 1041 (quoting
Magallanes, 881 F.2d 747, 751 (9th Cir. 1989)).
The opinion of a nonexamining physician cannot by itself constitute substantial evidence that justifies the rejection of the opinion of either an examining physician or a treating physician. Lester, 81 F.3d at 831 (citations omitted). The Ninth Circuit has consistently rejected ALJ’s findings that are vague or conclusory. “To say that medical opinions are not supported by sufficient objective findings or are contrary to the preponderant conclusions mandated by the objective findings does not achieve the level of specificity our prior cases have required…. The ALJ must do more than offer his own conclusions. He must set forth his own interpretations and explain why they, rather than the doctors’, are correct.” Embrey
v. Bowen, 849 F.2d 418, 421-22 (9th Cir. 1988).
The Social Security Administration has explained that an ALJ’s finding that a
treating source medical opinion is not well-supported by medically acceptable evidence
or is inconsistent with substantial evidence in the record means only that the opinion is
not entitled to controlling weight, not that the opinion should be rejected. Orn, 495 F.3d
at 632 (citing § 404.1527). Treating source medical opinions are still entitled to deference
and, in many cases, will be entitled to the greatest weight and should be adopted, even if
it does not meet the test for controlling weight.” Orn, 495 F.3d at 632; see also Murray v.
Heckler, 722 F.2d 499, 502 (9th Cir.1983) (“If the ALJ wishes to disregard the opinion of
the treating physician, he or she must make findings setting forth specific, legitimate reasons for doing so that are based on substantial evidence in the record.”)
In addition, the Ninth Circuit has highlighted the importance of the “subjective
judgments of treating physicians” because they “properly play a part in their medical
evaluations.” Embrey, 849 F.2d at 421-22; see Green-Younger v. Barnhart, 355 F.3d 99,
107 (2nd Cir. 2003)(noting that a treating physician’s reliance on a claimant’s reported
symptoms “hardly undermines his opinions as to her functional limitations, as a patient’s
report of complaints, or history, is an essential diagnostic tool” (internal quotation marks,
brackets, ad citation omitted); Lester, 81 F.3d at 832 (“The Secretary may not assume that doctors routinely lie in order to help their patients collect disability benefits.”).