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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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IL disability lawyerAs advanced as medical technology is, it is not perfect. There are many people who suffer physical or mental ailments with no clear cause. Even trained doctors may look at the same patient presenting the same symptoms and reach different conclusions. But how does Social Security deal with such lack of consensus when assessing disability benefit applications.

Magistrate Orders New Disability Hearing After ALJ Failed to Consult Any Medical Experts

As is often the case with Social Security, their first instinct is often to declare the applicant is not disabled. In some situations, a Social Security administrative law judge (ALJ) may simply make guesses about the applicant's actual medical condition. Such an approach is not only unscientific, but it also goes against how the law is supposed to work in this area.

A recent decision from a federal magistrate judge here in Illinois offers a helpful illustration. In this case, a 43-year-old woman applied for disability benefits four years ago. In her application, the plaintiff described a variety of impairments that have rendered her unable to return to full-time work.

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IL disability lawyerMany Social Security disability applicants often get tripped up by the process. They may assume they qualify as “disabled” based on a prior doctor's diagnosis or state-agency decision. But Social Security has its own standards for assessing disability. And if you proceed without fully developing the record in support of your claim, you are likely to be denied benefits, even if your case has merit.

Appeals Court Upholds Social Security Decision Despite ALJ's Failure to Fully Develop the Record

A recent decision from the U.S. Seventh Circuit Court of Appeals, Elder v. Berryhill, helps illustrate the hurdles that disability applicants face. The plaintiff in this case applied for disability benefits in 2012, alleging he had been unable to work since 2010 due to a number of physical impairment.

The plaintiff presented his own case to an administrative law judge (ALJ) without the assistance of a qualified disability attorney. At the hearing, the plaintiff said the Illinois Department of Human Services “deemed him disabled and provided him with a home-care assistant.” The plaintiff further testified he suffered from “excessive pain” and required constant medication.

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