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Illinois Social Security disability claim lawyerThere is a common misunderstanding with respect to disability insurance. When considering your application for disability benefits, Social Security does not just evaluate whether or not you are medically able to perform your past work. It must decide whether you are capable of performing any type of sustained work. This distinction is often used as reasoning to deny benefits to an applicant.

Judge Orders Social Security to Reconsider Disabled Truck Driver's Claim

An applicant's failure to completely understand the law, however, does not in and of itself justify denying disability benefits. This point was hit home by a recent decision from a federal judge here in Illinois. In this case, King v. Berryhill, the plaintiff previously worked as a truck driver. He stopped working in 2008 due to chronic back pain, for which he did not seek treatment until six years later. In 2014, the plaintiff's treating physician diagnosed him with “severe lumbar degeneration” and several related conditions. 

At a 2016 hearing before a Social Security administrative law judge (ALJ), the plaintiff testified that he continued to suffer from chronic pain, and that therapy and ibuprofen provided only a modest amount of temporary relief. The ALJ nevertheless ruled that the plaintiff did not qualify as legally disabled.

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Chicago disability claim denial lawyerSocial Security disability applicants who suffer from chronic pain often face a difficult choice. If they stop treatment that is no longer effective, Social Security may cite that as proof the pain is not that bad. But if the treatment continues, the agency may say that shows the applicant can effectively “manage” their pain. Either way, Social Security may decide that the applicant is not disabled.

Fortunately, the federal courts often see through this “heads I win, tails you lose” logic. The reality is that a disability applicant may need to stop treatment for a number of valid reasons. This does not, in and of itself, mean they are able to work full-time in spite of their chronic pain and other ailments.

Social Security Criticized for Inaccurate Description of Disability Applicant's Pain, Treatment Options

Here is a recent example from here in Illinois: the plaintiff in this case–a woman now in her mid-60s–lost her job in 2009 because she required “too much time off” to deal with her existing medical problems. Later that same year, she was diagnosed with lupus, which only further aggravated her existing back pain problems.

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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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