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IL disability attorneyWhen seeking Social Security disability benefits, the opinions of your treating physicians will often provide crucial evidence in support of your case. But not all treating-physician opinions are treated equally. For instance, if your doctor simply confirms your own subjective reports regarding certain symptoms–such as chronic pain–without providing any further analysis, that may be of limited value to a Social Security administrative law judge (ALJ) reviewing your application.

Seventh Circuit Dismisses Appeal Brought by Illinois Woman with Fibromyalgia

A recent decision from the Chicago-based U.S. Seventh Circuit Court of Appeals, Apke v. Saul, helps to illustrate this point. In this case, a 37-year-old woman applied for disability benefits, citing a number of impairments, including fibromyalgia. Fibromyalgia is a pain disorder that is notoriously difficult to diagnose using objective tests. As a result, Social Security often views disability claims based on fibromyalgia with increased skepticism.

This case proved to be no different. Although the plaintiff submitted expert reports from three of her treating physicians, the ALJ overseeing the case decided after holding a hearing to solicit the views of a third-party rheumatologist. Based on the rheumatologist's findings, the ALJ ultimately denied the plaintiff's application for disability benefits.

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IL disability lawyerIn Social Security disability cases filed before March 27, 2017, agency officials are normally required to give “controlling weight” to the medical opinions of your treating physicians when assessing your claim for benefits. A Social Security administrative law judge (ALJ) may only depart from this controlling-weight rule by giving specific reasons, based on the available medical evidence, why the treating physician's views are contradicted by other evidence or are someone internally inconsistent.

Judge Rules ALJ Failed to Properly Follow Pre-2017 Regulations

Even though the pre-2017 rule is well understood, it is not always correctly applied. Take this recent decision from an Illinois federal judge, Rosalinda G. v. Saul. In this case, the judge ordered Social Security to conduct a new disability hearing after finding the ALJ failed to properly follow the treating-source rule.

The plaintiff here applied for disability in 2013 based primarily on her fibromyalgia. Three of the plaintiff's treating physicians presented medical evidence for her disability hearing. The ALJ assigned to the case ultimately gave “little weight” to the views of two of these doctors, and only assigned “great weight” to “aspects” of the third doctor's opinions. As you might expect, the ALJ found the plaintiff did not qualify as disabled and denied her application for benefits.

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IL disability attorneyA Social Security disability hearing is not a criminal trial. The role of the Social Security administrative law judge (ALJ) is not to assess your honesty, character, or credibility as a person. The ALJ's responsibility is to assess the medical evidence presented and make a fact-based determination as to whether or not you meet the listed requirements for disability benefits.

Federal Court Criticizes Social Security ALJ for Relying “Too Heavily” on Judgments About Applicant's Character

Although Social Security's own regulations instruct ALJs to avoid making statements regarding a disability applicant's “overall character or truthfulness,” this principle is not always followed in practice. When that happens, a federal court may decide an unsuccessful applicant is entitled to a new hearing.

To give a recent example, in a June 2020 decision, Dawn K. v. Saul, an Illinois federal magistrate judge found an ALJ relied “too heavily on character-doubting inconsistencies” in denying the plaintiff's application for disability benefits. The plaintiff is a woman in her mid-40s who applied for disability more than four years ago based on a number of impairments, notably problems with her right arm.

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