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IL disability attorneyWhen you make a Social Security disability claim, multiple different types of medical evidence will be considered to determine whether you qualify to receive benefits. An administrative law judge (ALJ) will consider a number of factors, including whether you have an impairment that is equal or similar to specific impairments described in Social Security regulations and whether you are able to work in your current occupation or perform other types of work. When looking at whether the medical tests you have received support your claim, an ALJ is required to rely on the opinions of medical experts rather than forming their own opinions.

Illinois Court Reverses ALJ’s Decision to Deny Benefits

In some cases, an ALJ may base the decision to deny a disability claim on an improper interpretation of medical tests. This was demonstrated in a recent Illinois case, Paul R. C. v Commissioner of Social Security. The plaintiff, a man in his 50s who had worked as a painter and drywaller, applied for Supplemental Security Income (SSI) based on a number of medical conditions, including arthritis in the knees, torn shoulder muscles, diabetes, carpal tunnel syndrome, and injuries to the lower back. A previous disability claim had been denied because the ALJ concluded that he was capable of a “limited range of light work.”

In the claim in question in this case, the ALJ denied benefits and ruled that the plaintiff was capable of “medium work” that did not involve climbing on ladders or scaffolds, and only occasionally included kneeling, crouching, or crawling. Even though the plaintiff was unable to do the work he had done in the past, the ALJ stated that he would be able to find a job where he could work at the “medium exertional level.”

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IL disability attorneyWhen seeking Social Security disability benefits, the opinions of your treating physicians will often provide crucial evidence in support of your case. But not all treating-physician opinions are treated equally. For instance, if your doctor simply confirms your own subjective reports regarding certain symptoms–such as chronic pain–without providing any further analysis, that may be of limited value to a Social Security administrative law judge (ALJ) reviewing your application.

Seventh Circuit Dismisses Appeal Brought by Illinois Woman with Fibromyalgia

A recent decision from the Chicago-based U.S. Seventh Circuit Court of Appeals, Apke v. Saul, helps to illustrate this point. In this case, a 37-year-old woman applied for disability benefits, citing a number of impairments, including fibromyalgia. Fibromyalgia is a pain disorder that is notoriously difficult to diagnose using objective tests. As a result, Social Security often views disability claims based on fibromyalgia with increased skepticism.

This case proved to be no different. Although the plaintiff submitted expert reports from three of her treating physicians, the ALJ overseeing the case decided after holding a hearing to solicit the views of a third-party rheumatologist. Based on the rheumatologist's findings, the ALJ ultimately denied the plaintiff's application for disability benefits.

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IL disability lawyerIn 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.

The plaintiff here applied for disability in 2013 based primarily on her fibromyalgia. Three of the plaintiff's treating physicians presented medical evidence for her disability hearing. The ALJ assigned to the case ultimately gave “little weight” to the views of two of these doctors, and only assigned “great weight” to “aspects” of the third doctor's opinions. As you might expect, the ALJ found the plaintiff did not qualify as disabled and denied her application for benefits.

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