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What Happens If Social Security Ignores My Treating Physician's Diagnosis?

Posted on in Social Security Disability

Chicago disability benefits lawyer, physician diagnosis, disability cases, disability applicant, Social Security regulationsBefore you can receive Social Security Disability Insurance benefits, agency officials must first determine what jobs you might still be capable of performing. This requires a thorough review of your medical record, including any work-related limitations noted by your treating doctors and the state agency physicians who assist the Social Security Administration's administrative law judge (ALJ) in assessing your claim.

Keep in mind, however, that the ALJ's job is not to “play doctor” herself, but rather to weigh all of the credible medical evidence—including your own testimony regarding your symptoms—and to determine whether you qualify as disabled under Social Security regulations.

Judge Finds SSA Official Improperly Ignored Applicant's “Prolonged Standing” Restriction

As we have noted many, many times, some ALJs not only decide to play doctor—they selectively ignore diagnoses and symptoms that conflict with their preordained decision to reject a disability claimant's application. Such conduct is illegal and frequently leads reviewing courts to order new hearings. This has a significant, negative impact on applicants and their families, as they are often forced to wait years just to receive an accurate assessment of their disability cases.

Here is yet another Illinois case on point. The plaintiff is a former roofer in his 50s. His medical impairments largely revolve around a broken left knee. The plaintiff's treating physician wrote in a 2014 letter that the plaintiff's condition meant he could no longer perform any jobs that required “climbing, prolonged standing, kneeling, squatting, or lifting greater than twenty pounds.”

But in reviewing the plaintiff's disability claim at a 2014 hearing, the ALJ assigned to the case simply chose to ignore the “prolonged standing” limitation. The ALJ offered no explanation for this decision, except to say she discredited the treating physician's diagnoses to the extent it conflicted with her conclusions. The ALJ also alleged the doctor “did not provide a definition for prolonged standing.”

On appeal, a federal district judge found the ALJ's reasoning insufficient as a matter of law. More to the point, the judge said the ALJ's “post-hoc statement is deficient and contrary to the Regulations.” She was not allowed to reject a medical expert's testimony regarding a disability applicant's limitations simply because it was “not in accord with her own lay opinion.”

Indeed, the judge said the ALJ never bothered to assess whether the treating physician's assessment of the plaintiff's “prolonged standing” capacity was consistent with the assessment of the state agency doctors or the plaintiff's own testimony. Ultimately, the judge said the “ALJ's exclusion of the prolonged standing restriction … was prejudicial to Plaintiff” and justified a new hearing.

A Cook County Social Security Disability Attorney Can Help You

Social Security has a legal, ethical, and moral obligation to consider a disability applicant's entire medical record in good faith. But for too many Illinois residents, Social Security ALJs fall well short of this ideal. This is where having a qualified Chicago disability benefits lawyer by your side can prove invaluable. If you need help dealing with Social Security, call Pearson Disability Law, LLC, at 312-999-0999 today.



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