Can Social Security Ignore My Medical Diagnosis Due to My Doctor’s Specialty?

 Posted on July 12, 2016 in Need to Apply for Social Security Disability

Supplemental Security Income (SSI) is a program administered by the Social Security Administration that is intended to assist disabled individuals with little or no income. SSI is not the same thing as Social Security Disability Insurance (SSDI). SSDI is, as the name implies, an insurance program into which workers pay. In contrast, SSI is a welfare program funded by general tax revenues. SSI is similar to SSDI, however, in that both programs require Social Security to assess whether an applicant is “disabled” and therefore unable to work.

Applicant Suffering From Fibromyalgia Entitled to New SSI Hearing

SSI applicants often face hostility from Social Security officials who choose to ignore medical evidence of disability in order to justify denying benefits. Recently the U.S. Seventh Circuit Court of Appeals in Chicago ordered Social Security to reconsider one SSI applicant’s claim for benefits after an administrative law judge simply disregarded medical evidence. This particular SSI case has been pending for more than five years, and this appears to be at least the third time that Social Security will have to review the matter.

The applicant suffers from Graves’ disease, an autoimmune disorder. Among other physical ailments, the applicant suffers from fibromyalgia, a chronic pain disorder. The applicant’s doctors had diagnosed with her fibromyalgia, and one doctor had certified to a local community college where the applicant was taking classes that she required special accommodations due to her disability.

The Social Security administrative law judge (ALJ) who reviewed the applicant’s SSI claim, however, decided she did not really have fibromyalgia because her doctors were not specialists in rheumatology. Instead, the ALJ relied on the testimony of two state agency doctors who reviewed the patient’s medical records—which were prepared before her fibromyalgia diagnosis—and did not personally examine her. The state doctors opined the applicant’s other medical conditions, which include Graves’ disease, a serious autoimmune disorder, did not render her disabled.

The Seventh Circuit said the ALJ was wrong to simply throw out the applicant’s fibromyalgia diagnosis due to her doctors’ “lack of specialization.” While a rheumatologist’s medical opinion might be afforded “more weight than that of a non-specialist,” any medical testimony offered by an applicant is entitled to consideration—especially when, as in this case, there was no contrary expert opinion to contradict the diagnosis. And while a physician’s diagnosis is not sufficient, in and of itself, to establish a disability claim based on fibromyalgia, there was additional medical evidence that the ALJ simply failed to consider.

Get Help From a Chicago Social Security Disability Attorney

Dealing with Social Security is rarely quick or easy. It may take several rounds of hearings and appeals just to get a Social Security ALJ to properly consider all of the available medical evidence in support of your SSDI or SSI claim. An experienced Chicago disability benefits lawyer is therefore an indispensable resource. If you are considering applying for federal disability benefits and require assistance, contact Pearson Disability Law, LLC, today.

Sources:

https://www.ssa.gov/ssi/

https://scholar.google.com/scholar_case?case=14600454623731740617