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IL disability lawyerThose who suffer from physical or mental conditions that make it difficult or impossible to work will often be concerned about their ability to support themselves financially. Fortunately, Social Security disability benefits are available in many cases. However, the process of applying for Social Security disability can be complicated, and disability claims are often denied for a variety of reasons. While it is possible to appeal the decision to deny disability benefits, it is important to understand the procedures followed when doing so and the types of evidence that may be considered in an appeal.

Appeals Court Upholds Decision to Deny Benefits and Refuses to Reweigh Evidence

If a disability claim is denied, an applicant will usually need to file a request for reconsideration, and if benefits are once again denied, they may request a hearing before an Administrative Law Judge (ALJ). Both sides will present evidence at this hearing, and the ALJ will follow specific procedures to determine whether the applicant is disabled and whether they should be able to find work that fits within their physical or mental limitations. If an ALJ rules that a person is not disabled, the applicant can appeal this decision. However, an appeal must be based on the claim that the ALJ committed errors, and an applicant cannot introduce new evidence or ask the appeals court to reconsider or reinterpret previous evidence.

A recent Illinois case illustrates the types of arguments that can and cannot be made in a Social Security disability appeal. In the case of Angela H. v. Commissioner of Social Security, the plaintiff was a 43-year-old woman who suffered from impairments including obesity, degenerative disc disease, depression, and personality disorder. After considering the evidence presented at her hearing, the ALJ found that the plaintiff could perform light work, including sitting and standing at a light exertional level and pushing and pulling at a sedentary level. A vocational expert testified that these limitations would allow the plaintiff to perform jobs such as a production worker or cleaner, and because of this, the ALJ determined that the plaintiff was not disabled and denied disability benefits.

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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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