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Chicago social security disability appeal lawyerSocial Security officials often try to discredit or discount the expert opinions of a disability applicant's treating physicians. In many cases, a Social Security administrative law judge (ALJ)–who is not a doctor–will attempt to substitute their own judgment for that of the medical professionals. Such actions are inconsistent with Social Security's own regulations and can lead to significant problems for the agency if a rejected applicant seeks judicial review in the courts. 

Federal Appeals Court Orders SSA to Reconsider Disability Applicant's Case

For example, the U.S. Seventh Circuit Court of Appeals here in Chicago recently ordered Social Security to conduct a new hearing in the case of a disability applicant who was previously denied benefits. The main problem identified by the appeals court was the ALJ's failure to properly explain her reasons for largely ignoring the medical testimony of the plaintiff's treating physicians. Although the Court did not rule that the plaintiff was legally disabled, it did hold that Social Security owed him a better explanation for denying his application.

Here is briefly what happened: the plaintiff is a former maintenance mechanic who is now in his mid-50s. He underwent two spinal surgeries in 2005 and 2006 but continues to suffer from chronic back pain. For this reason, he initially applied for Social Security disability benefits in 2012. At a subsequent hearing on the application before a Social Security ALJ, the plaintiff presented expert evidence from his primary care doctor and neurosurgeon, who both agreed that he was medically “unable to work” in his former job due to his ongoing back pain. The neurosurgeon further explained that the plaintiff was limited to “sedentary work.”

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Illinois social security disability attorney medical examWhen applying for Social Security disability benefits, the medical records provided by your own treating physicians are rarely taken at face value. Social Security will also seek one or more consultative medical examinations. These are exams conducted by doctors hired by the government to supplement the existing medical records in your case. In many cases, consultative physicians only do a quick exam, yet their views are often afforded great weight by Social Security administrative law judges (ALJs) when deciding whether to grant or deny a disability application.

Appeals Court Rejects Disability Applicant's Interpretation of Doctors' Opinions

When dealing with consultative physicians, it is important to be honest. Do not exaggerate or downplay any symptoms you are experiencing. Similarly, you need to be accurate when citing or discussing any findings presented by the consultative physicians.

Recently, the U.S. Seventh Circuit Court of Appeals here in Chicago rejected a Social Security disability appeal centered on the views of two consultative physicians. The plaintiff, a woman in her 50s suffering from a variety of mental and physical impairments, applied for disability benefits four years ago. Two consultative physicians–a medical doctor and a psychologist–conducted brief exams of the plaintiff on the same day in 2014. 

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Chicago disability benefits denial attorneyInconsistency is often a major factor in Social Security denying disability claims. If the agency feels your doctor's opinions are inconsistent with the other medical evidence available, your claim can be denied. Similarly, if an administrative law judge (ALJ) feels your own testimony with respect to your symptoms–especially with respect to subjective matters like pain–is inconsistent, that may also form the basis for denying a claim.

Appeals Court Sides With Social Security Despite Problems With ALJ's Reasoning

Consider a recent decision by the U.S. Seventh Circuit Court of Appeals here in Chicago. The plaintiff in this case unsuccessfully applied for disability benefits. He previously worked for a chemical company, and while loading chemicals onto a truck at work one day, he “felt pain in his low back.” The pain persisted, so he eventually saw a specialist, who determined the plaintiff had a large disc herniation “that was pinching a spinal nerve root.”

Although doctors initially advised a conservative course of treatment–i.e., physical therapy–the plaintiff ultimately needed back surgery. This led him to stop working in 2007. In 2008, a physical therapist suggested the plaintiff could resume performing “light” work. However, the plaintiff did not return to work and instead applied for disability benefits in 2012.

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