Frequently Asked Questions

Either. Firms usually advance the fee as a case cost. If the claimant pays, they pay by card and I send the receipt to both of you. The fee and who paid it are disclosed inside the opinion.

No. That finding is reserved to the Commissioner and stating it would reduce the weight of everything else in the document. The opinion states functional limitations, their basis, onset and duration.

Yes. I complete your form and attach the narrative. Every box I tick on the form is explained in the narrative with citations.

I tell you at the pre-screen, at no charge. Sometimes the record supports a different set of limitations than the ones you asked about, and I say which.

Some adjudicators still do, and you should know the objection exists. The regulation does not rank credentials; it tells the judge to weigh supportability and consistency, and the published decisions that discount nurse practitioner opinions do so because the opinion was unexplained or contradicted by the source's own notes, not because of the credential. My answer to the objection is on every page of the opinion: the findings, the citations, the contrary evidence addressed, and three years of VA disability examinations behind the reasoning.

Yes, and it is why the pre-screen comes first. A completed opinion must be submitted whether or not it helps (20 CFR 404.1512). So I do not write anything until the pre-screen tells you what the record supports and you approve. The pre-screen is a consultation, delivered by phone or in a short email at your preference.

Before you file, yes, free and without limit: citations, format, your form, wording, and anything I missed in the record. What I do not do is change a conclusion on request. Under the all-evidence rule a completed opinion must be filed, so a second version with different conclusions would sit next to the first one and damage both. That is why the substantive discussion happens at the pre-screen, before anything is signed.

Under 20 CFR 404.1520c the two factors the judge must articulate are supportability and consistency, not the examining relationship. An examining relationship is one of the other factors the judge may consider. My opinions are built so that the two required factors are answered on the page: every limitation cites the records that support it, and the contrary evidence is addressed rather than ignored. I also state plainly that I did not examine the claimant, so the judge is never surprised by it.

Yes. For claims filed on or after March 27, 2017, licensed advanced practice registered nurses are acceptable medical sources for impairments within their licensed scope of practice under 20 CFR 404.1502(a)(7), and their medical opinions are evaluated under the same rules as a physician's.

What drew scrutiny there was the pattern: identical pre-filled forms signed without a record review, paid per signature by the representative. Everything about my practice is built against that pattern. Each opinion is individually written from a complete record review, I decline files the record cannot support, the fee is flat and disclosed inside the opinion, and I pay and accept no referral fees.

Pre-screen within 24 hours of receipt. Signed opinion within 24 hours of your go-ahead on a complete file. If your hearing is inside the five-day window, call me when you send the file and I tell you the same day whether I can make it.

Written interrogatory responses are included at no charge, returned within 24 hours. Telephone testimony at the judge's request is available; ask when you send the file.