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IL disability lawyerMany Social Security disability applicants often get tripped up by the process. They may assume they qualify as “disabled” based on a prior doctor's diagnosis or state-agency decision. But Social Security has its own standards for assessing disability. And if you proceed without fully developing the record in support of your claim, you are likely to be denied benefits, even if your case has merit.

Appeals Court Upholds Social Security Decision Despite ALJ's Failure to Fully Develop the Record

A recent decision from the U.S. Seventh Circuit Court of Appeals, Elder v. Berryhill, helps illustrate the hurdles that disability applicants face. The plaintiff in this case applied for disability benefits in 2012, alleging he had been unable to work since 2010 due to a number of physical impairment.

The plaintiff presented his own case to an administrative law judge (ALJ) without the assistance of a qualified disability attorney. At the hearing, the plaintiff said the Illinois Department of Human Services “deemed him disabled and provided him with a home-care assistant.” The plaintiff further testified he suffered from “excessive pain” and required constant medication.

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IL disability lawyerLast year, we discussed a case that was pending before the U.S. Supreme Court involving Social Security regulations for compensating lawyers who successfully pursue disability claims on behalf of their clients. On January 8, 2019, the Court issued its decision, which provided important clarification of the law in this area.

Justices: Caps for Agency, Court Representation Are Separate

To briefly review what this case, Culbertson v. Berryhill, was about: A Social Security attorney from Florida represented a woman who was seeking disability benefits. After going through the lengthy administrative review process, Social Security denied the woman's application. The woman then decided to challenge that decision by suing the Social Security Administration in federal court.

As part of the lawsuit, the woman signed a contingency-fee agreement with her attorney, which provided he would receive 25 percent of any past-due disability benefits she received if the court action proved successful. And in fact, the lawsuit did succeed. Social Security awarded past-due benefits and the agency withheld 25 percent of that amount to pay the attorney's fees.

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Illinois Social Security disability application lawyerOne of the cardinal rules of Social Security disability cases is that agency officials are not allowed to “play doctor.” In other words, when a Social Security administrative law judge (ALJ) holds a hearing to decide whether or not an applicant is legally disabled, the ALJ must rely on medical testimony presented by qualified experts. The ALJ is not supposed to rely solely on their own interpretation of medical evidence, since, after all, they are not doctors themselves.

Federal Court Orders New Disability Hearing After ALJ Ignores Medical Evidence

Here is a recent disability case in which Social Security forgot this basic rule. This is taken from a decision by the U.S. Seventh Circuit Court of Appeals, which has jurisdiction over Illinois, although this particular case originated in Indiana. The plaintiff was a 49-year-old woman who formerly worked as a hairstylist. She stopped working in 2009 due to a variety of ailments, notably degenerative disc disease, fibromyalgia, and depression.

The degenerative disc disease–the plaintiff's chronic back pain–was the main focus of a hearing before a Social Security ALJ. At the hearing, the plaintiff's treating physician testified that her degenerative disc disease had progressed to the point where she qualifies as disabled under Social Security regulations. Although the doctor based his findings on examinations conducted during 2014, he nevertheless concluded that the plaintiff had been disabled since at least June 2011.

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