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What Happens When Social Security Ignores All of the Available Medical Evidence?

b2ap3_thumbnail_medical-impairment.jpgIn a typical Social Security disability case, an administrative law judge (ALJ) will hear medical opinions from a number of different experts. In addition to the disability applicant's own treating physicians, the ALJ will also review the views of non-treating “consultants” who have examined the applicant's medical records. For disability cases filed before March 2017, the ALJ is normally required to give the treating physician's views “controlling” weight in the event of a conflict. That said, it is permissible to discount those opinions in favor of the non-treating consultants.

Magistrate: ALJ Cannot Rely Solely on Her “Lay Expertise” in Assessing Applicant's Mental Impairments

What the ALJ may not do, however, is ignore all of the medical evidence and “play doctor” themselves. The ALJ is a legal officer, not a medical professional. That means their job is to apply the law fairly and impartially.

But we often see ALJs step outside this legal role to make improper medical diagnoses. A recent disability case from here in Illinois, Christopher P. v. Saul, provides a useful illustration. The plaintiff here applied for disability benefits over five years ago. As part of the application process, the plaintiff's treating psychiatrist opined that he suffered from a number of mental impairments that included “marked limitations in concentration, persistence, or pace, and three episodes of decompensation, along with other disabling symptoms.”

The ALJ rejected the psychiatrist's views but did not offer any reasons beyond a vague assertion that the plaintiff did not “consistently complain” of the symptoms described. The ALJ nevertheless proceeded to deny the plaintiff's claim for disability benefits. This prompted the plaintiff to appeal the denial to federal court.

A federal magistrate judge agreed with the plaintiff that the ALJ's analysis was improper. The magistrate noted the ALJ “did not minimally articulate the reasons she essentially gave [the treating psychiatrist's] opinion no weight at all.” Indeed, the magistrate said Social Security tacitly acknowledged this failure when it tried to come up with its own reasons why the ALJ might have discounted the doctor's opinions. But the magistrate said it was “well-settled law” that Social Security must review the reasons actually given by the ALJ.

More to the point, the magistrate said this was clearly a case where the ALJ “relied solely on her lay expertise” rather than expert evidence. The ALJ not only disregarded the views of the treating physician, but also those made by two non-examining consultants. Given these were the only medical opinions in the record, the magistrate said the ALJ improperly decided to play doctor herself. Consequently, the plaintiff was entitled to a new hearing on his disability claim.

Speak with an Illinois Disability Benefits Lawyer Today

This will not be the last time a Social Security ALJ decides to play doctor. It is a far-too-common problem we see in disability cases. And if you are about to apply for disability benefits yourself, you need to be aware of this problem and take appropriate action. Your first step should be to hire a qualified Cook County Social Security disability attorney to represent you. Contact Pearson Disability Law, LLC, today at 312-999-0999 to schedule a free consultation.




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