There is a tendency among Social Security officials to take claims involving psychological impairments less seriously than those involving physical impairments. Legally, this should not matter. If a person is unable to work due to a documented mental disorder, they are just as entitled to disability benefits as someone with a physical impairment. Unfortunately, that is not always the reality.

Illinois Magistrate Orders a New Hearing, Criticizes ALJ for “Playing Doctor”

Take this recent decision from an Illinois federal magistrate judge, Anthony S. v. Saul. In this case, a 55-year-old man (the plaintiff) applied for disability benefits, citing a number of psychological impairments, including post-traumatic stress disorder and bipolar disorder. After a hearing, a Social Security administrative law judge (ALJ) determined these impairments did not prevent the plaintiff from performing some types of “light work” and denied his disability claim.

The magistrate, who reviewed the case after the plaintiff sued the Social Security Administration, noted the ALJ failed to “explicitly” state a “single theory” to explain the decision to deny benefits. Based on the content of the ALJ's decision, however, the magistrate interpreted rationale as that the plaintiff was “malingering,” i.e., the “intentional production of false or grossly exaggerated [] psychological symptoms.”

Social Security disability cases are supposed to center on medical evidence, in particular, the diagnosis and expert views of the applicant's treating physicians. Social Security administrative law judges (ALJs) are normally expected to give “controlling weight” to a treating physician's views. If the ALJ discounts or rejects this testimony, there are a number of regulatory factors that must be considered and explained.

Magistrate: ALJ Failed to Follow Agency Regulations Before Discounting Doctor's Evidence

But as we have often found in practice, ALJs often disregard treating-physician evidence without giving a valid explanation, or even any explanation at all that conforms to the agency's own regulatory factors. A recent decision from a federal magistrate judge here in Illinois, Deborah AM v. Saul, offers a textbook example of this problem.

In this case, the plaintiff applied for disability benefits nearly five years ago. Following a hearing on the plaintiff's application, a Social Security ALJ held she did not legally qualify for disability benefits. The ALJ reached this conclusion after deciding not to give controlling weight to the evidence offered by the plaintiff's treating physician.

Social Security administrative law judges (ALJs) are expected to rely on medical evidence when assessing an application for disability benefits. The most critical form of medical evidence comes from the applicant's own treating physicians. But the ALJ may also consider other forms of evidence, including something known as a GAF score.

GAF stands for the “Global Assessment of Function.” It is a rating system used to assess a disability applicant's mental function on a 1 to 100 scale. A higher score typically indicates a higher degree of mental functioning.

Now, a GAF score is simply a doctor's opinion regarding the overall impact of an applicant's mental disorders at a given time. It is not an objective diagnostic test. And an ALJ is not allowed to grant or deny disability benefits based solely–or even primarily–on a GAF score. Rather, it is simply one piece of information the ALJ may consider as part of an applicant's overall case.