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Recent Blog Posts
When Can Social Security Reject the Views of My Treating Physicians in a Disability Case?
In Social Security disability cases filed before March 27, 2017, agency officials are normally required to give “controlling weight” to the medical opinions of your treating physicians when assessing your claim for benefits. A Social Security administrative law judge (ALJ) may only depart from this controlling-weight rule by giving specific reasons, based on the available medical evidence, why the treating physician's views are contradicted by other evidence or are someone internally inconsistent.
Judge Rules ALJ Failed to Properly Follow Pre-2017 Regulations
Even though the pre-2017 rule is well understood, it is not always correctly applied. Take this recent decision from an Illinois federal judge, Rosalinda G. v. Saul. In this case, the judge ordered Social Security to conduct a new disability hearing after finding the ALJ failed to properly follow the treating-source rule.
Does Social Security Have to Look at All of My Test Results Before Ruling on My Disability Application?
There is often a significant delay in hearing Social Security disability cases. One result of this delay is that new information regarding an applicant's medical condition may come to light after a doctor has already reviewed the record. When this happens, a Social Security administrative law judge (ALJ) should take the time to obtain a proper expert assessment of this new information before making a decision.
Illinois Magistrate Orders New Hearing to Consider Applicant's MRIs and X-rays
Unfortunately, that is not always how things work in practice. Consider this recent decision from a federal magistrate judge here in Illinois, Renee L. M. v. Commissioner of Social Security. The plaintiff, in this case, is a woman in her 50s who applies for disability insurance benefits four years ago. Although an ALJ determined the plaintiff did suffer from a number of severe impairments, including “fibromyalgia, back arthritis, anxiety disorder, and personality disorder,” she nevertheless had the “residual functional capacity” to perform “light work” with limitations. On that basis, the ALJ denied the claim for disability benefits.
What Happens When Social Security Ignores All of the Available Medical Evidence?
In 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.
Can Social Security Disregard a Treating Psychiatrist's Views in Favor of a Non-Treating Psychologist?
When 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.
Will Social Security Put My Credibility “On Trial” If I Apply for Disability?
A Social Security disability hearing is not a criminal trial. The role of the Social Security administrative law judge (ALJ) is not to assess your honesty, character, or credibility as a person. The ALJ's responsibility is to assess the medical evidence presented and make a fact-based determination as to whether or not you meet the listed requirements for disability benefits.
Federal Court Criticizes Social Security ALJ for Relying “Too Heavily” on Judgments About Applicant's Character
Although Social Security's own regulations instruct ALJs to avoid making statements regarding a disability applicant's “overall character or truthfulness,” this principle is not always followed in practice. When that happens, a federal court may decide an unsuccessful applicant is entitled to a new hearing.
To give a recent example, in a June 2020 decision, Dawn K. v. Saul, an Illinois federal magistrate judge found an ALJ relied “too heavily on character-doubting inconsistencies” in denying the plaintiff's application for disability benefits. The plaintiff is a woman in her mid-40s who applied for disability more than four years ago based on a number of impairments, notably problems with her right arm.
How Many Times Is Social Security Allowed to Ignore Medical Evidence?
When a federal court determines Social Security has failed to properly weigh medical evidence in a disability case, the normal course of action is to remand–return–the case to the agency for a new hearing. But what happens when Social Security ignores the court's instructions? Indeed, what happens when the same disability case is brought to court multiple times?
Magistrate: ALJ Ignored Disability Applicant's Pain During Hearing
This scenario recently played out before an Illinois federal magistrate judge. This particular case, Kimberly M. v. Saul, involves a woman who has not worked in nearly 15 years. The plaintiff is in her mid-50s and stopped working in 2005 due to ongoing complications from a back injury. Despite surgery in 2016, the plaintiff continues to experience “significant pain in her spine, right hip, buttock and leg,” according to the magistrate's opinion.
Assessing the Impact of Your Mental Disability on Workplace Productivity
Mental impairments, such as bipolar disorder, often make it impossible for a person to focus on their work. When applying for disability benefits, Social Security officials often discuss an applicant's “concentration, persistence, and pace” to describe this focus, or lack thereof. Essentially, if the symptoms of your mental disorder–or even the treatment for your disorder–reduce your overall productivity in the workplace, that is a crucial piece of evidence in support of your claim for disability benefits.
Illinois Woman Granted New Hearing After Social Security Failed to Properly Assess Limits on Her Concentration, Persistence, and Pace
If a Social Security administrative law judge (ALJ) fails to properly account for limitations in your concentration, persistence, and pace, you may be entitled to a new hearing. This is precisely what happened in a recent Illinois disability case, Thea P. v. Saul. The plaintiff in this case filed for disability more than 5 years ago, citing a number of mental impairments, including bipolar disorder and depression.
Does Having the Occasional “Good Day” Prove That My Mental Disorder Is Not a Disability?
Psychiatric disorders often manifest themselves through inconsistent symptoms. That is to say, a person can feel “fine” one day yet be totally incapable of leaving the house the next. Such inconsistency often leads Social Security disability officials to incorrectly conclude an applicant's medical disorder is not “severe” enough to justify an award of benefits.
Court Orders New Hearing After Social Security Official Disregards Testimony from Multiple Psychiatrists
Take this recent Illinois disability case, Nicole D. v. Saul. The plaintiff in this case applied for disability benefits more than five years ago. She suffers from a number of psychiatric disorders, including major depression, anxiety, and post-traumatic stress disorder.
At a disability hearing, the plaintiff presented expert opinions from three of her treating physicians. The first doctor, a psychiatrist, explained the plaintiff's mental disorders were “severe enough to meet or equal” Social Security's disability requirements. The psychiatrist based her findings on her extensive treatment of the plaintiff, which encompassed approximately 40 consultations between 2014 and 2016.
Are Subjective Complaints Regarding My Symptoms Enough to Receive Disability Benefits?
In a Social Security disability case, your own testimony regarding your symptoms will not be enough to secure an award of benefits. Your “subjective complaints,” as they are called in these cases, must be supported by medical evidence, such as a diagnosis from your treating physician. Absent such evidence, Social Security will deny your application.
Court Finds No Medical Evidence Disability Applicant Is Allergic to Electricity
A recent decision from the U.S. Seventh Circuit Court of Appeals here in Chicago, Atkins v. Saul, helps to illustrate the critical role that medical evidence plays in disability cases. The plaintiff in this case is an Indiana man who claimed he was disabled based on his “hypersensitivity to chemicals and electromagnetic fields.”
The plaintiff's family doctor conducted an examination. The doctor determined that while the plaintiff had a “very odd, flat affect”–i.e., diminished emotional expression–his results were otherwise normal. Later, this same doctor diagnosed the plaintiff with “acne and allergic rhinitis,” for which he prescribed medication. But the doctor explained that, contrary to the beliefs of the plaintiff and his family, he was not allergic to electricity and “all” chemicals.
Determining “Residual Functional Capacity”
In determining eligibility for disability insurance benefits, Social Security must first determine your “residual functional capacity” or RFC. This is an assessment of your ability to work, taking into account any documented physical or mental impairments that you have. By law, Social Security must take all of your limitations into account when formulating an RFC.
Magistrate: Social Security Acknowledged Disability Applicant's Severe Headaches, Yet Did Not Account for Them in RFC
That does not, however, mean that Social Security officials always follow the law. A recent decision from a federal magistrate judge here in Illinois, Charlene J. v. Saul, provides a case in point. This case actually involves a plaintiff who filed for Supplemental Security Income (SSI) benefits. SSI is a type of benefit available to low-income individuals who do not enough of a work history to qualify for disability insurance (SSDI). That said, Social Security uses the same RFC standards when assessing SSI and SSDI claims, so the issues discussed here also apply to disability cases.
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