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IL disability lawyerWhen you apply for disability benefits, Social Security will consider the medical opinions of your treating physician as well as non-examining consultants. These consultants basically review your medical records and offer a separate opinion as to your physical or mental impairments. In some cases, a Social Security administrative law judge (ALJ) may decide the non-examining doctors provide a more complete or accurate view of your condition than your own physician.

Magistrate Orders New Hearing on Deceased Man's Disability Claim

But what if a non-examining doctor reviews the exact same information as your treating physician and simply offers a different opinion? For instance, could a consultant look at the tests performed by your doctor and tell the ALJ they mean something different then what your doctor concluded?

A recent decision from an Illinois federal magistrate judge, Mary T. ex. rel. Falauren T. v. Saul, presented just such a scenario. This case sadly involves a now-deceased applicant for disability benefits. The applicant's mother actually continued the case following her son's death.

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IL disability lawyerIn looking at an application for disability benefits, Social Security officials must determine how your physical and mental impairments affect your ability to work in a practical sense. That is to say, if your doctors tell Social Security you can only work under certain medical restrictions, an administrative law judge (ALJ) must factor those limitations into a final evaluation of your “residual functional capacity” to work.

ALJ Failed to Consider Impact of Plaintiff's Need to Elevate His Leg Throughout the Day

Let's consider a recent disability case from here in Illinois where the ALJ failed to do this, at least in the view of a federal magistrate judge who ordered Social Security to reconsider its decision. The plaintiff in this case first applied for disability benefits more than five years ago. Although Social Security did find the plaintiff was disabled, it fixed the “onset date” of the disability in May 2014. The plaintiff alleged a much earlier onset date in September 2011.

Before the magistrate, the plaintiff argued the Social Security assigned to his case improperly evaluated several key pieces of evidence. Notably, the ALJ did not evaluate or weigh an opinion from the plaintiff's treating physician, who found that due to the plaintiff's impairments, he needed to “elevate his legs to heart level or above for 30 minutes, four times a day.”

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Illinois Social Security disability application lawyerOne of the cardinal rules of Social Security disability cases is that agency officials are not allowed to “play doctor.” In other words, when a Social Security administrative law judge (ALJ) holds a hearing to decide whether or not an applicant is legally disabled, the ALJ must rely on medical testimony presented by qualified experts. The ALJ is not supposed to rely solely on their own interpretation of medical evidence, since, after all, they are not doctors themselves.

Federal Court Orders New Disability Hearing After ALJ Ignores Medical Evidence

Here is a recent disability case in which Social Security forgot this basic rule. This is taken from a decision by the U.S. Seventh Circuit Court of Appeals, which has jurisdiction over Illinois, although this particular case originated in Indiana. The plaintiff was a 49-year-old woman who formerly worked as a hairstylist. She stopped working in 2009 due to a variety of ailments, notably degenerative disc disease, fibromyalgia, and depression.

The degenerative disc disease–the plaintiff's chronic back pain–was the main focus of a hearing before a Social Security ALJ. At the hearing, the plaintiff's treating physician testified that her degenerative disc disease had progressed to the point where she qualifies as disabled under Social Security regulations. Although the doctor based his findings on examinations conducted during 2014, he nevertheless concluded that the plaintiff had been disabled since at least June 2011.

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