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SSA rules Nurse Practitioner - Not a valid medical source?

Why did the SSA Administrative Law Judge not accept the Nurse Practitioner’s Medical Opinion?

Nurse practitioners are used by hospitals and medical facilities to treat and diagnose patients, much like a physician. The nurse practitioners are paid less than a physician and can be a revenue producer, adding efficiency to patient care while keeping the costs of medical care down.
Monroe County Nurse Practitioner

To be a nurse practitioner you must have a bachelor’s degree in nursing, complete a master's degree from a nurse practitioner program, and have a nursing license. Nurse practitioners will also generally specialize in a particular medical field of study (i.e. cardiology, Gerontology, Pediatrics, Obstetrics, Gynecology, or Oncology). Most nurse practitioners have also spent time working as a licensed or registered nurse. Most nurse practitioners are given greater clinical independence and autonomy than other nurses.

Critics of the practice of substituting the nurse practitioner for a full-fledged doctor argue that the nurse practitioner, while helping to meet the demand of the physician shortage, does not have the same educational training or education that a doctor has nor have they spent years honing their skills in a residency training program before they diagnose and treat patients. Others argue that they are necessary to meet the growing demand.

Does the nurse practitioner work with a doctor?

State laws vary. In some states the nurse practitioner has almost total autonomy and can write prescriptions and diagnose patients at will. Other states require a doctor to oversee the nurse practitioner’s work and monitor all of the decisions they make, including prescribing medication and diagnosing patients.

What training does a doctor have?

Doctors have completed 11 to 15 years of medical training. This includes four years getting a bachelors degree (preferably one focused on a science or biology), four years of medical school (2 years of classroom studies and 2 years of clinical training) and a 3 to 7 year residency program.

They also must pass the MCAT which is a five hour exam which tests theirknowledge of the physical and biological sciences and verbal reasoning, and “the Boards” which are a series of exams given by the National Board of Medical Examiners. Finally, the individual must get licensed to practice medicine in their state. Requirements vary by state.

Why would the SSA Administrative Judge refuse to accept the medical evidence of the nurse practitioner?

According to the Social Security Administration (SSA), “Medical evidence is the cornerstone for the determination of disability for both Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI).” They list the following as acceptable medical sources:

  1. licensed physicians (medical or osteopathic doctors);

  2. licensed or certified psychologists including school psychologists

  3. licensed optometrists only for purposes of establishing visual disorders

  4. licensed podiatrists

  5. Qualified speech-language pathologists only for purposes of establishing speech or language impairments.

The majority of your medical evidence to win SSDI or SSI benefits should be from these sources. Additional information can be provided from what the SSA terms “treating sources,” (for example, nurse-practitioners, physicians' assistants, naturopaths, chiropractors, audiologists, and therapists) but medical evidence from a treating source should not be all the medical evidence in your file. If it is, it is likely the judge will rule the evidence as insufficient.
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