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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.


b2ap3_thumbnail_social-security-Chicago_20170402-191104_1.jpgWhen you file a claim for Social Security Disability Insurance benefits, an administrative law judge (ALJ) must review your case and determine, among other things, your “residual functional capacity” or RFC. The RFC is basically an assessment of your current work-related capabilities, taking into account your medical impairments. Additionally, an RFC classifies your ability to perform “sedentary,” “light,” or “medium” work, as well as whether you can perform the same type of job as performed before the onset of your disability.

Social Security Not Allowed to Ignore All Evidence, Make Up Their Own

A Social Security ALJ is not supposed to make up an RFC out of thin air. The ALJ must review expert medical opinions offered by your treating physician and any state agency doctors who review your medical records. The ALJ does not have to accept any medical opinion that is not supported by evidence; however, there does have to be some evidence in support of an RFC determination.


b2ap3_thumbnail_heart-condition-Chicago.jpgThere are a number of heart-related medical conditions that may qualify you for Social Security Disability Insurance benefits. Congestive heart failure, heart muscle disease (cardiomyopathy), and chronic obstructive pulmonary disease (COPD) can all limit a person's ability to maintain full-time employment. Other medical impairments, such as obesity and hypertension, may further aggravate existing heart conditions even if they do not independently qualify as disabilities.

Federal Court Cites Multiple Errors in Social Security Denial

As with any disability, it is essential to provide Social Security with reliable medical evidence documenting your conditions and any treatments you received. Even with such evidence, many Social Security officials will look for any reason to discredit your case and deny benefits. This can lead to an extended appeals process just to get Social Security to treat you fairly.


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