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Will Social Security Believe Regulatory “Experts” Over Your Own Doctor?

Posted on in Denied Social Security Benefits

disability cases, Chicago SSID lawyer, disability claim, Chicago Social Security lawyer, disability applicantMost disability cases involve a person who requires ongoing medical care from one or more highly trained specialists. When it comes to actually assessing your claim for benefits, however, Social Security officials often prefer to rely on the opinions of general practitioners whose only “specialty” is their understanding of disability regulations. In most cases, these “consulting” doctors do not even bother to review all of the disability applicant's medical records. Instead, their primary job is supplying an administrative law judge (ALJ) with the answers they want to hear—namely, that the applicant’s impairments are not that serious and do not constitute a legal disability.

Court Orders New Hearing After Social Security Ignores Credible Medical Testimony

Fortunately, federal judges in Illinois understand the law better than Social Security. Consider this recent decision from a magistrate judge, who ordered Social Security to conduct a new disability hearing for a 63-year-old former crane operator, who has been unable to work since 2013 due to severe back problems. At a hearing before a Social Security ALJ, the applicant presented an extensive medical history, including the expert opinions of his treating physician and an orthopedic surgeon, both of whom found he was medically incapable of working.

The ALJ chose to disregard the two experts in favor of a third opinion offered by a “consultative examiner,” whose interaction with the applicant was limited to a single 26-minute exam. Not surprisingly, the consultant told the ALJ the applicant was perfectly capable of working. But as the magistrate put it, the examiner was “a family physician with no special training or area of expertise.” The examiner did not even have the opportunity to review the applicant's medical records.

Despite this, the ALJ considered the examiner's opinion more reliable that the applicant's two expert treating physicians because she was more “familiar with the rules and regulations of disability determinations.” As the magistrate explained, this was not a good reason: “[A]n ALJ cannot reject a treating physician's opinion simply because a non-treating doctor is more familiar with the disability standards.” More to the point, the ALJ still has to give “good reasons” for discounting a treating physician's opinion. The ALJ did not do so here. Furthermore, the ALJ was wrong to assign “great weight” to the examiner's opinions given they “were based on an incomplete review of the medical record.”

The magistrate identified a number of other problems with the ALJ's decision. One item of note was the ALJ discounted the credibility of the applicant in describing his pain any other symptoms. The magistrate did not directly reverse the ALJ's credibility findings—since he returned the case for a new hearing for the reasons discussed above—but he did note that the applicant had an uninterrupted 37-year work history prior to claiming disability, and this should be strongly weighed in his favor during the rehearing.

A Chicago Social Security Disability Lawyer Can Help

Social Security is supposed to rely on medical evidence and not conjecture when it comes to assessing your disability claim. The best way to make sure they do just that is to work with an experienced Chicago Social Security lawyer who knows the law in this area. Contact Pearson Disability Law, LLC if you are filing a disability claim and need help today.



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