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b2ap3_thumbnail_medical-impairment.jpgIn a typical Social Security disability case, an administrative law judge (ALJ) will hear medical opinions from a number of different experts. In addition to the disability applicant's own treating physicians, the ALJ will also review the views of non-treating “consultants” who have examined the applicant's medical records. For disability cases filed before March 2017, the ALJ is normally required to give the treating physician's views “controlling” weight in the event of a conflict. That said, it is permissible to discount those opinions in favor of the non-treating consultants.

Magistrate: ALJ Cannot Rely Solely on Her “Lay Expertise” in Assessing Applicant's Mental Impairments

What the ALJ may not do, however, is ignore all of the medical evidence and “play doctor” themselves. The ALJ is a legal officer, not a medical professional. That means their job is to apply the law fairly and impartially.

But we often see ALJs step outside this legal role to make improper medical diagnoses. A recent disability case from here in Illinois, Christopher P. v. Saul, provides a useful illustration. The plaintiff here applied for disability benefits over five years ago. As part of the application process, the plaintiff's treating psychiatrist opined that he suffered from a number of mental impairments that included “marked limitations in concentration, persistence, or pace, and three episodes of decompensation, along with other disabling symptoms.”

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IL disability lawyerMental impairments, such as bipolar disorder, often make it impossible for a person to focus on their work. When applying for disability benefits, Social Security officials often discuss an applicant's “concentration, persistence, and pace” to describe this focus, or lack thereof. Essentially, if the symptoms of your mental disorder–or even the treatment for your disorder–reduce your overall productivity in the workplace, that is a crucial piece of evidence in support of your claim for disability benefits.

Illinois Woman Granted New Hearing After Social Security Failed to Properly Assess Limits on Her Concentration, Persistence, and Pace

If a Social Security administrative law judge (ALJ) fails to properly account for limitations in your concentration, persistence, and pace, you may be entitled to a new hearing. This is precisely what happened in a recent Illinois disability case, Thea P. v. Saul. The plaintiff in this case filed for disability more than 5 years ago, citing a number of mental impairments, including bipolar disorder and depression.

In denying the plaintiff's application, the ALJ nevertheless found that she had “moderate difficulties of concentration, persistence, or pace.” During the hearing, the ALJ questioned a vocational expert (VE). Such experts commonly testify in disability hearings; their role is to explain the types and number of jobs a person could hold, taking into account certain limitations. Here, the ALJ asked the VE to consider the hypothetical employment opportunities for an individual who was limited to “performing more than simple routine tasks” without having to meet any “strict quotas” for production.

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IL disability attorneyIt is not uncommon for Social Security officials to initially deny your claim for disability benefits. Fortunately, you have certain appeal rights. In fact, there are four levels to the disability appeals process. First, you can ask for reconsideration. Second, you may request a hearing before an administrative law judge (ALJ). Third, you can seek review of the ALJ's decision with Social Security's Appeals Council. Finally, you can seek judicial review of a “final” decision to deny benefits in federal court.

Illinois Magistrate Dismisses Social Security Appeal Filed One Day Late

At each stage of the appeals process, there are strict deadlines that you are expected to understand and comply with. If you file an appeal even one day late, a court may refuse to hear your case, regardless of the underlying merits. So it is critical that you act promptly to address a negative decision from Social Security.

For example, in a February 2020 case, McGhee v. Commissioner of Social Security, an Illinois federal magistrate judge granted the government's motion to dismiss an appeal brought by an unsuccessful disability applicant. The applicant previously went through the first three stages of the appeals process described above. In November 2017, an ALJ rejected the applicant's claim. The applicant then sought review from the Appeals Council.

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