Comment from Miller, David, organization

The value of a longitudinal treatment relationship, and what should be a natural presumption of lack of bias or complicity on the part of providers, could not be overstated. My personal experience reveals that most of them would rather not be putting forth opinions that their patients are in fact highly impaired and of significantly limited functioning in cases where it is not appropriate. Implicit in this movement is an assumption that a treating source is naturally inclined to help otherwise unworthy patient-claimants get benefits, and I see over and over and over again that that is simply not the case. If a person can work despite their health problems, their practitioner simply does not offer the opinion that they cannot work. I have never seen this done, not once. In fact the opposite is true and rather proves the point. Many very large providers- including Acadia Hospital, Kennebec Behavioral Health, and Mayo Regional, for example- who are huge sources of health care in central Maine, refuse to provide opinion evidence despite the fact that they are aware that a significant number of their patients have health problems that would or may preclude work, and many of those patients pay for their services using disability Mainecare. Once the disability case is lost, such providers lose the patient and thus stops getting paid. Anecdotal as it is, this is strong evidence that profit motive or collusion of any sort just doesn’t happen. Given the lack of bias, one is left to wonder, why wouldn’t an appropriately credentialed provider with a treatment relationship over time be the preferred source for evidence at each stage of the process?