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IL disability attorneyWhen you make a Social Security disability claim, multiple different types of medical evidence will be considered to determine whether you qualify to receive benefits. An administrative law judge (ALJ) will consider a number of factors, including whether you have an impairment that is equal or similar to specific impairments described in Social Security regulations and whether you are able to work in your current occupation or perform other types of work. When looking at whether the medical tests you have received support your claim, an ALJ is required to rely on the opinions of medical experts rather than forming their own opinions.

Illinois Court Reverses ALJ’s Decision to Deny Benefits

In some cases, an ALJ may base the decision to deny a disability claim on an improper interpretation of medical tests. This was demonstrated in a recent Illinois case, Paul R. C. v Commissioner of Social Security. The plaintiff, a man in his 50s who had worked as a painter and drywaller, applied for Supplemental Security Income (SSI) based on a number of medical conditions, including arthritis in the knees, torn shoulder muscles, diabetes, carpal tunnel syndrome, and injuries to the lower back. A previous disability claim had been denied because the ALJ concluded that he was capable of a “limited range of light work.”

In the claim in question in this case, the ALJ denied benefits and ruled that the plaintiff was capable of “medium work” that did not involve climbing on ladders or scaffolds, and only occasionally included kneeling, crouching, or crawling. Even though the plaintiff was unable to do the work he had done in the past, the ALJ stated that he would be able to find a job where he could work at the “medium exertional level.”

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IL disability attorneyWhen reviewing Social Security disability applications, an administrative law judge (ALJ) needs to weigh the evidence offered by various medical experts. As a general rule, the ALJ should give more weight to the testimony offered by a doctor with respect to their own specialty as opposed to someone who is not. For example, if a disability applicant is unable to walk, you would credit the testimony of an orthopedic surgeon over, say, a dermatologist.

This might sound like just basic common sense. Yet there are many cases where ALJs will disregard the specialist's view in favor of a non-specialist's view–especially when the latter is willing to say the applicant's condition does not really qualify them for disability benefits. Such decision-making not only defies common sense, but it is also often in direct contravention of Social Security regulations.

Let's take this recent disability case from here in Illinois, Kathy P. v. Saul. The plaintiff in this case applied for Social Security disability benefits about five years ago. Although she suffers from a number of physical and mental impairments, the critical issue here involves her mental disorders and frequent migraines. In support of her claims, the plaintiff presented expert testimony from her treating psychiatrist. Based on her extensive treatment history, the psychiatrist told Social Security that the plaintiff “was unable to meet competitive standards for several abilities such as completing a normal workday and workweek without interruptions, accepting instructions and responding appropriately to criticism from supervisors, and dealing with normal work stress.”

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IL disability lawyerIn reviewing your application for disability benefits, Social Security will not just look at your medical record. It will also review many other aspects of your personal life, such as your ability to perform household tasks or even the vacations you have taken. In some cases, a Social Security administrative law judge (ALJ) may even cite the fact you went on vacation as proof your testimony regarding your disability is not “credible.”

Magistrate: Vacations Do Not Disprove Disability Applicant's Testimony Regarding Her Panic Attacks

Federal courts, however, have cautioned Social Security not to simply assume an applicant is not credible simply because they were able to go on vacation. A recent decision from an Illinois federal magistrate judge, Lorena T. v. Saul, provides a case in point. The plaintiff here applied for disability benefits based on a number of mental impairments, including her frequent panic attacks. The ALJ ruled the plaintiff did not legally qualify for disability benefits, but the magistrate reversed that decision and ordered a new hearing.

As the magistrate noted, the ALJ expressed “skepticism towards [the plaintiff's] panic attack allegations throughout his opinion.” Among other reasons for this skepticism, the ALJ cited the fact the plaintiff went on two vacations, one to Florida and the other to New York and New Jersey. Both times the plaintiff said she suffered panic attacks, but the ALJ insisted this undercut her credibility. In particular, the ALJ did not understand why the plaintiff took her second vacation after allegedly suffering a panic attack during the Florida vacation.

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