Will Stopping Medical Treatment Hurt My Disability Case?

 Posted on November 30, 2018 in Denied Social Security Benefits

Social Security disability applicants who suffer from chronic pain often face a difficult choice. If they stop treatment that is no longer effective, Social Security may cite that as proof the pain is not that bad. But if the treatment continues, the agency may say that shows the applicant can effectively “manage” their pain. Either way, Social Security may decide that the applicant is not disabled.

Fortunately, the federal courts often see through this “heads I win, tails you lose” logic. The reality is that a disability applicant may need to stop treatment for a number of valid reasons. This does not, in and of itself, mean they are able to work full-time in spite of their chronic pain and other ailments.

Social Security Criticized for Inaccurate Description of Disability Applicant's Pain, Treatment Options

Here is a recent example from here in Illinois: the plaintiff in this case–a woman now in her mid-60s–lost her job in 2009 because she required “too much time off” to deal with her existing medical problems. Later that same year, she was diagnosed with lupus, which only further aggravated her existing back pain problems.

Starting in 2011, the plaintiff started seeing a pain specialist. She underwent an extensive treatment regimen, which included multiple operations. The plaintiff was forced to stop these treatments in 2014, however, due to changes in her health insurance.

By the time the plaintiff appeared before a Social Security administrative law judge (ALJ) regarding her claim for disability benefits, she said “her pain was the same or worse as it was when she began treatment.” A medical expert told the ALJ that despite the plaintiff's chronic pain and health issues, she was not legally disabled, because the prior treatments “helped.” When pressed further on this point, the expert said the treatment must have been effective, because her doctors did not recommend spinal surgery.

This explanation was good enough for the ALJ, but not the federal magistrate who reviewed Social Security's decision to deny the plaintiff disability benefits. For one thing, the magistrate noted that the fact the plaintiff never received spinal surgery was largely pointless, as neither the ALJ nor the medical expert “identified a particular surgery that had a reasonable chance of working.” In addition, the ALJ simply ignored the plaintiff's explanation for why she stopped treatment, which was because of “the problem with her insurance,” not because she was cured of her back pain.

The magistrate also questioned the ALJ's characterization of the plaintiff's “daily activities,” which supposedly contradicted her claims of “constant pain.” In fact, the magistrate said the plaintiff testified that her pain was “episodic” and severe but not “constant.” This is important, the magistrate said, because by setting up a “24-7 pain strawman,” the ALJ was able to dismiss the plaintiff's credibility based on “almost any activity or physical exertion, no matter how infrequent, minor, or innocuous.” Since this was not consistent with the evidence presented, the plaintiff was entitled to a new Social Security hearing.

Speak With a Chicago Social Security Disability Lawyer Today

It is important for Social Security officials to accurately assess the evidence presented at a disability hearing. Having an experienced Illinois disability benefits lawyer by your side can help ensure Social Security treats you fairly. Contact Pearson Disability Law, LLC, at 312-999-0999 today to schedule a free consultation so we can sit down and discuss your Social Security case.

Sources:

https://scholar.google.com/scholar_case?case=14912944690872900664