When a person applies for Social Security disability benefits, there are many different factors that are considered to determine whether the person is considered to be disabled. A person must suffer from a physical or mental impairment that is “medically determinable,” and this condition must have lasted or be expected to last at least 12 months. An impairment must also affect a person’s ability to find gainful employment.

If a Social Security disability claim is denied, an applicant may appeal this decision, and an administrative hearing before an Administrative Law Judge (ALJ) may be held to review the case and determine whether the person is disabled. An ALJ will follow a multi-step process to evaluate the person’s claim, and one important step in this process is determining whether the claimant’s condition meets or equals any of the items included in the Listing of Impairments in the Social Security Code of Regulations.

Magistrate Reverses ALJ’s Decision Based on Improper Analysis of Listing of Impairments

One recent case in Illinois demonstrates the role that the Listing of Impairments may play in an administrative hearing. In Angela L. H. v. Commissioner of Social Security, a woman’s disability claim had been denied, and after appealing this decision, the ALJ who reviewed the case determined that she was not disabled, since her impairments permitted her to find work other than what she had previously performed.

There are a variety of conditions that can cause a person to become disabled, and some of them may be less obvious than others. While injuries or physical impairments can affect the type of work a person can perform, mental health concerns can also lead to disability. Unfortunately, those who suffer from mental illness may be denied Social Security Disability benefits, and they should understand their options for appealing these decisions.

Magistrate Overrules ALJ’s Decision Due to Incorrect Consideration of Mental Limitations

One recent Illinois case illustrates some of the reasons a person with a mental illness may be improperly denied disability benefits. In the case of Panayiota P. K. v. Commissioner of Social Security, the plaintiff was a 49-year-old woman who suffered from multiple mental impairments, including bipolar disorder, generalized anxiety disorder, and post-traumatic stress disorder (PTSD). She reported difficulty with concentration, understanding and following instructions, and getting along with authority figures. She also experienced anxiety attacks multiple times per week, anger issues, and a voice in her head that told her to strike people who upset her.

At the plaintiff’s evidentiary hearing, the Administrative Law Judge (ALJ) determined that the plaintiff had the residual functional capacity (RFC) to perform work involving simple, routine tasks. A vocational expert (VE) testified that the plaintiff could work in light jobs such as a cleaner or production worker, but they noted that being off-task for at least 10% of the time would result in termination, and the plaintiff would likely also be terminated if she had any verbal or physical confrontations while at work. The ALJ denied disability benefits and stated that the plaintiff should be able to find work within her limitations.

When a person makes a Social Security disability claim, the decision about whether to award benefits will usually depend on the medical examinations they receive, as well as evaluations that are meant to determine whether they have the ability to work. In these cases, the opinions of a person’s regular doctor, who is known as a “treating source physician,” are given a great deal of weight. This is because a treating physician will have established a relationship with the patient that gives them a better understanding of their physical condition and their capabilities to perform work. However, in some cases, disability claims are improperly denied because Social Security does not properly consider the opinions of a treating source physician.

Appeals Court Vacates Denial of Benefits Based on Failure to Give Weight to Treating Physician’s Opinion

One recent case in Illinois demonstrates how Social Security may deny benefits without properly considering the opinions of a treating source physician. In Hargett v. Commissioner of Social Security, the United States Court of Appeals considered a situation in which an applicant had been denied benefits by an administrative law judge (ALJ), and this decision was upheld by a federal magistrate judge.

The plaintiff applied for disability benefits based on a number of impairments, including type 2 diabetes, chronic obstructive pulmonary disease, curvature of the spine, and high blood pressure. He had been receiving treatment from his primary care physician, who referred him to a physical therapist for a functional capacity evaluation (FCE). This evaluation found that while he had the lifting capacity to perform “medium-strength” work, he was unable to stand for more than five minutes, could not walk for more than a tenth of a mile, could not balance well while walking or standing, and could not crouch or stoop. The primary care physician signed off on the results of this evaluation.