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IL disability lawyerWhen a Social Security administrative law judge (ALJ) denies your application for disability benefits, they must give credible reasons for that denial. It is not enough for the ALJ to simply state you failed to provide enough evidence. The ALJ is required to provide sufficient reasons so that a reviewing court can later decide if those reasons were valid. An ALJ who fails to give such reasons, but instead offers nothing more than a lazy or “perfunctory” analysis of the applicant's case, is subject to summary reversal by a federal court.

Magistrate Chides ALJ for “Perfunctory” Analysis of Disability Claim

Here is an example of what we mean. This is taken from a recent decision by a federal magistrate judge here in Illinois, Jonie G. v. Saul. In this case, a plaintiff applied for disability benefits and appeared at a hearing before an ALJ in 2016. The ALJ ended up denying the plaintiff's application, which Social Security later upheld in its internal appeals process.

The main issue in the plaintiff's case was the impact of her type-2 diabetes on her ability to walk and sit. Before the ALJ, the plaintiff produced medical evidence from her treating podiatrist, who opined that the plaintiff “could not walk a single block without pain, required a cane, could not lift ten pounds, could not stand for more than thirty minutes, must keep her feet elevated for 90% of a workday, could not sit for more than four hours, [and] would be absent from work more than 25% of the time.” In short, the plaintiff was not capable of holding down a full-time job under these restrictions.

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IL disability lawyerSocial Security disability cases are supposed to center on medical evidence, in particular, the diagnosis and expert views of the applicant's treating physicians. Social Security administrative law judges (ALJs) are normally expected to give “controlling weight” to a treating physician's views. If the ALJ discounts or rejects this testimony, there are a number of regulatory factors that must be considered and explained.

Magistrate: ALJ Failed to Follow Agency Regulations Before Discounting Doctor's Evidence

But as we have often found in practice, ALJs often disregard treating-physician evidence without giving a valid explanation, or even any explanation at all that conforms to the agency's own regulatory factors. A recent decision from a federal magistrate judge here in Illinois, Deborah AM v. Saul, offers a textbook example of this problem.

In this case, the plaintiff applied for disability benefits nearly five years ago. Following a hearing on the plaintiff's application, a Social Security ALJ held she did not legally qualify for disability benefits. The ALJ reached this conclusion after deciding not to give controlling weight to the evidence offered by the plaintiff's treating physician.

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IL disability lawyerIt is a well-established rule in Social Security disability cases that the agency's administrative law judges (ALJs) are not allowed to “play doctor.” That is to say, the ALJ is a layperson, not a doctor or a medical expert. Therefore, when assessing an applicant's disability claim, the ALJ must rely on testimony or evidence offered by such experts rather than trying to diagnosis the claimant themselves.

Court Cites ALJ's Failure to Call Medical Expert in Ordering New Disability Hearing

Unfortunately, this rule is not always so easy to implement in practice. As an Illinois federal magistrate judge observed in a recent disability case, Michelle M. v. Saul, it is often difficult to distinguish “playing doctor” from “merely noting or summarizing the evidence.” Indeed, the magistrate observed that “there do not appear to be many clear rules to determine when the doctor-playing line is crossed.”

This particular case illustrated the problem. The plaintiff here applied for disability benefits alleging a number of physical impairments, including chronic pain in her back, hands, and feet. But as the magistrate explained, the plaintiff's treating physicians have been able to make a “single consistent diagnosis” to explain the cause of her problems. Additionally, the plaintiff received significant treatment after her disability hearing before the ALJ, and as a result, there were “200 pages of treatment records” submitted after the hearing.

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