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IL disabilityIf you suffer from injuries or illnesses that make it difficult or impossible for you to continue working and earning an income, you may be able to receive Social Security disability benefits. However, the process of applying for disability benefits can be complicated, and applications are often denied. When appealing a disability denial, it is important to understand the factors that will be reviewed to determine whether you are disabled and eligible to receive benefits.

Analysis of Whether a Person Is Disabled

When reviewing a plaintiff’s appeal of the denial of Social Security disability benefits, an Administrative Law Judge (ALJ) is required to perform a five-step analysis in which the following questions are considered, in order:

  • Is the plaintiff currently unemployed?
  • Do the plaintiff’s medical issues constitute a severe impairment?
  • Is the plaintiff’s impairment one of the specific impairments listed in Social Security regulations, or is it equal to one of these impairments?
  • Is the plaintiff unable to perform work in their former job?
  • Is the plaintiff unable to perform work in another occupation?

An answer of “yes” to either step three or step five will result in a finding that the plaintiff is disabled. If the plaintiff can meet the requirements of step four and show that they are unable to perform work they have done in the past, the Commissioner of Social Security has the burden of proof to show that the plaintiff should be able to find work based on the available jobs in the national economy that meet their physical limitations.

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IL disability lawyerWhen applying for Social Security disability benefits, a person will need to provide evidence to show that they have severe physical or mental impairments that affect their ability to find gainful employment. If disability benefits are denied, a person can appeal this decision, and their case will be heard by an Administrative Law Judge (ALJ). In these types of hearings, the ALJ must base their decision on evidence provided by both sides, as well as the opinions of medical and vocational experts. Any additional evidence considered by the ALJ is known as “extra-record evidence,” and certain rules apply regarding when this type of evidence can be used.

Magistrate Reverses ALJ’s Decision Based on Reliance on Extra-Record Evidence

A recent case in Illinois, Elizabeth D. v. Commissioner of Social Security, illustrates when extra-record evidence can and cannot be used by an ALJ. In this case, a woman had been found disabled in 2003 after receiving kidney and pancreas transplants. In 2011, Social Security determined that she was no longer disabled, and she appealed this decision, stating that in addition to her prior medical issues, she also suffered from extreme fatigue, depression, anxiety, migraines, and personality disorder.

When reviewing the evidence, the ALJ chose to give limited weight to the opinions of a doctor who had been treating the plaintiff since 2003, since this doctor’s opinions relied heavily on the plaintiff’s subjective complaints. Instead, the ALJ gave great weight to the opinion of a doctor who saw the plaintiff twice in preparation for hysterectomy surgery. This doctor stated that the plaintiff had an exercise capacity of 10 METs.

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IL disability lawyerTo receive Social Security disability benefits, you will not only need to show that your physical or mental conditions have caused you to be unable to work in jobs you have previously done, but you will also need to demonstrate that you are unable to find gainful employment in positions that are available in the United States economy. In many cases, Social Security disability claims are denied because a vocational expert (VE) testifies that a person should be able to work in certain jobs that fit their physical or mental limitations. However, these denials may be made based on an improper consideration of the complexity of the work a person is able to perform.

Magistrate Overrules Denial of Benefits Based on Limitations Regarding One-to-Two Step Tasks

One recent case in Illinois courts addressed work limitations and the improper denial of benefits. In the case of Michael S. v. Commissioner of Social Security, the plaintiff had applied for Social Security disability benefits based on cognitive impairments such as memory loss, attention deficit disorder, and depression. After disability benefits were denied, the plaintiff appealed this decision, and the court ruled in his favor and remanded the case to the Commissioner of Social Security for reconsideration. After considering new evidence, an Administrative Law Judge (ALJ) again denied benefits, and the plaintiff appealed this decision as well.

The key issue in this appeal involved the opinions of two state agency psychologists stating that the plaintiff should be limited to one-to-two step tasks while at work. Based on the testimony of a medical expert, the ALJ rejected this limitation and found that the plaintiff could perform light work while being limited to tasks that involved simple decision-making.

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