This is particularly true when the use of diagnostic tests was either minimal or non-existent at the time the medical report was completed. Ogozalek , supra . A physician's letter diagnosing total disability for the first time cannot be considered documented by the physician's twenty year old medical report. The quality standards found at Section 718.104 are not mandatory for medical evidence considered by the administrative law judge. Section 718.104 does not preclude a medical report merely because it lacks objective testing.
Quality standards are mandatory quides.
A physician's opinion in a supplemental letter written three years after the physician's examination of claimant, was properly accorded little weight when it contained no indication as to what documentation the opinion was based on. The administrative law judge may discredit an opinion as lacking reliable documentation because it is based on a pulmonary function study which does not meet applicable quality standards or because it is based on a pulmonary function study with values disparately lower than subsequent studies.