Nurse and therapist records in Social Security cases
Social Security has regulations on which medical providers can provide evidence and opinions about an individual’s diagnosis and limitations. For a long time, evidence from nurses, chiropractors, therapists, and psychologists was not considered by Social Security because these professionals were not considered “acceptable medical sources.”
The term “medical sources” refers to both “acceptable medical sources” and other health care providers who are not “acceptable medical sources.” See 20 CFR 404.1502 and 416.902.
Under our current regulations, “acceptable medical sources” are:
Licensed physicians (medical or osteopathic doctors);
Licensed or certified psychologists. Included are school psychologists, or other licensed or certified individuals with other titles who perform the same function as a school psychologist in a school setting, for purposes of establishing mental retardation, learning disabilities, and borderline intellectual functioning only;
Licensed optometrists, for the measurement of visual acuity and visual fields (for claims under title II, we may need a report from a physician to determine other aspects of eye disease);
Licensed podiatrists, for purposes of establishing impairments of the foot, or foot and ankle only, depending on whether the State in which the podiatrist practices permits the practice of podiatry on the foot only, or the foot and ankle; and
Qualified speech-language pathologists, for purposes of establishing speech or language impairments only.
See 20 CFR 404.1513(a) and 416.913(a).
Basically, a medical provider had to have MD (or DO, or PhD) after their name to qualify as a medical source. This left nurses, therapists, chiropractors, teachers, counselors, among other providers out in the cold as far as having their evidence conisidered by Social Security.
Social Security Ruling (SSR) 06-03p changed that by creating a new class: “other sources.”
Reducing income below SGA levels: Impairment Related Work Expenses (IRWE)
If your work is performed at a Substantial Gainful Activity (SGA) level you may be denied Social Security disability benefits. However, you may be able to reduce the amount Social Security considers to bring your gross income below SGA levels.
One way to do this is through Impairment Related Work Expenses (IRWEs). Here is what Social Security describes IRWEs:
An IRWE means an expense for an item or service which is directly related to enabling an impaired individual to work and which is necessarily incurred by that individual because of a physical or mental impairment. Such an expense may involve payment for the purchase, installation, maintenance and repair of an impairment-related item or payment for an impairment-related service. Any medically necessary expenses related to your impairment which are necessary to allow you to work are deducted from your gross income.
If you are disabled, but some type of medical care or service allows you to be able to work, the cost of that care or services may be deducted from your gross income.
