Opinion ID: 711197
Heading Depth: 2
Heading Rank: 2

Heading: The Commissioner's Treatment of the Nurse Practitioner's Opinion

Text: 11 According to the ALJ, the observations of Dr. Kincade and NP Blaker indicated that Gomez was not disabled. The ALJ then concluded that these observations were entitled to greater weight than Dr. Aho's conclusion that Gomez was disabled and should be awarded benefits. Gomez argues that the ALJ erred in failing to distinguish between the opinions of Dr. Kincade and NP Blaker, and thus accorded NP Blaker's opinion more weight than was warranted. Gomez contends that Social Security regulations require the opinions of nurse practitioners to receive less weight than those of treating physicians or examining psychologists. 12 The Code of Federal Regulations distinguishes between those opinions coming from acceptable medical sources and those coming from other sources. 20 C.F.R. Secs. 404.1513(a) and (e), 416.913(a) and (e). From this, 20 C.F.R. Secs. 404.1527 and 416.927 each set forth similar guidelines for the Commissioner to follow when weighing conflicting opinions from acceptable medical sources, while containing no specific guidelines for the weighing of opinions from other sources. This permits the Commissioner to accord opinions from other sources less weight than opinions from acceptable medical sources. 13 Acceptable medical sources specifically include licensed physicians and licensed psychologists, but not nurse practitioners. 20 C.F.R. Secs. 404.1513(a)(1) and (3); 416.913(a)(1) and (3). Thus, Gomez argues that NP Blaker's opinions should be separated from those of Dr. Kincade, and not given as much weight as the opinion of Dr. Aho, an acceptable medical source. 14 Chart notes indicate that although Dr. Kincade did not personally examine Gomez any time after July, 1990, NP Blaker consulted with Dr. Kincade regarding Gomez's treatment numerous times over the course of her relationship with Gomez. NP Blaker worked closely under the supervision of Dr. Kincade and she was acting as an agent of Dr. Kincade in her relationship with Gomez. Her opinion was properly considered as part of the opinion of Dr. Kincade, an acceptable medical source. Thus, the ALJ did accord it appropriate weight and consideration under 20 C.F.R. Secs. 404.1527 and 416.927, as against the opinion of Dr. Aho, an examining, nontreating source. 15 Moreover, 20 C.F.R. Sec. 416.913(a)(6) states that [a] report of an interdisciplinary team that contains the evaluation and signature of an acceptable medical source is also considered acceptable medical evidence, while later in that section the statute designates nurse practitioners as an other source. Sec. 416.913(e)(3). While nowhere in the regulations is the term interdisciplinary team expressly defined, a plain reading of these sections taken together indicates that a nurse practitioner working in conjunction with a physician constitutes an acceptable medical source, while a nurse practitioner working on his or her own does not. 16