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IL disability lawyerDecisions regarding Social Security disability applications are supposed to be based on medical evidence. That is, your treating doctor's medical conclusions are normally expected to be given great weight by a Social Security administrative law judge (ALJ). But in far too many cases, we find the ALJ taking it upon themselves to “play doctor” and ignore or discount the treating physician's views.

Magistrate: Social Security “Mischaracterized” Surgeon's Findings in Denying Disability Application

In some cases, an ALJ may outright misrepresent what the treating physician found. This is not okay. To the contrary, it violates Social Security regulations and entitles an unsuccessful applicant to a new hearing on their claim.

This is precisely what happened to one Illinois disability benefits applicant in a recent case, Lisa AB v. Commissioner of Social Security. The plaintiff in this case has not worked since 2012 because of her inability to use her hands. The plaintiff had a history of severe carpal tunnel syndrome that required surgery.

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IL disability attorneyWe have seen a number of Social Security disability cases here in Illinois recently where the government has failed to properly account for an applicant's limitations in concentration, persistence, or pace (CPP). As defined by Social Security's own regulations, CPP refers to a person's “ability to sustain focused attention sufficiently long to permit the timely completion of tasks commonly found in work settings.” If an applicant's mental health impairments limit their CPP to the point where they cannot reasonably function in any work setting, they are generally entitled to receive disability benefits.

Appeals Court: ALJ Improperly Ignored Answer to Hypothetical Question

In the most recent decision from the Chicago-based U.S. Seventh Circuit Court of Appeals to address CPP limitations, Crump v. Saul, Social Security was once again faulted for its inadequate approach to this subject.

As described by the Court, the plaintiff in this case “has a long history of mental health impairments,” notably bipolar disorder. During a hearing before a Social Security administrative law judge (ALJ), the plaintiff “testified that she has 'too many thoughts at one time' and 'can't focus' on what she is supposed to be doing.” Despite acknowledging the plaintiff had “moderate” CPP limitations, however, the ALJ determined she did not meet the legal standard for disabled.

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b2ap3_thumbnail_diagnosis.jpgIn Social Security disability cases, agency officials are not allowed to “play doctor.” Instead, administrative law judges (ALJs) are expected to look at the medical evidence presented to them. And if two doctors offer different medical assessments of a disability applicant, it is the ALJ's job to resolve that conflict.

ALJ Unable to Resolve Cause of Disability Applicant's “Exploding Head Syndrome”

Here is a recent Illinois disability case, John L. v. Berryhill, where the ALJ did not do that. In this case, the plaintiff applied for Social Security disability benefits seven years ago. At a 2015 hearing, an ALJ considered medical evidence related to the plaintiff's sleep parasomnia, i.e., his sleep disorder.

A sleep specialist diagnosed the plaintiff with “possible exploding head syndrome.” This refers to a rare type of parasomnia “in which affected individuals awaken from sleep with the sensation of a loud bang,” according to a 2013 report from the National Institutes of Health. The plaintiff told the specialist that he “heard sounds when he was sleepy 4 to 5 times a day or when he shifted his attention.”

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