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Illinois Social Security disability application lawyerOne of the cardinal rules of Social Security disability cases is that agency officials are not allowed to “play doctor.” In other words, when a Social Security administrative law judge (ALJ) holds a hearing to decide whether or not an applicant is legally disabled, the ALJ must rely on medical testimony presented by qualified experts. The ALJ is not supposed to rely solely on their own interpretation of medical evidence, since, after all, they are not doctors themselves.

Federal Court Orders New Disability Hearing After ALJ Ignores Medical Evidence

Here is a recent disability case in which Social Security forgot this basic rule. This is taken from a decision by the U.S. Seventh Circuit Court of Appeals, which has jurisdiction over Illinois, although this particular case originated in Indiana. The plaintiff was a 49-year-old woman who formerly worked as a hairstylist. She stopped working in 2009 due to a variety of ailments, notably degenerative disc disease, fibromyalgia, and depression.

The degenerative disc disease–the plaintiff's chronic back pain–was the main focus of a hearing before a Social Security ALJ. At the hearing, the plaintiff's treating physician testified that her degenerative disc disease had progressed to the point where she qualifies as disabled under Social Security regulations. Although the doctor based his findings on examinations conducted during 2014, he nevertheless concluded that the plaintiff had been disabled since at least June 2011.

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Illinois disability hearing attorney physician opinionIn Social Security disability cases, agency officials will look at two types of medical evidence: The information provided by an applicant’s own treating physicians, and testimony from outside reviewers and consultative examiners, who typically look at an applicant’s medical records but do not necessarily examine them in person. When one’s own doctor's medical opinions are supported by appropriate treatment records, Social Security is expected to afford such views substantial weight, even if they conflict with the opinions of the outside consultants.

Magistrate Orders New Hearing After Social Security Ignores Evidence from Applicant's Psychiatrist

In far too many disability cases, Social Security does not provide the proper weight to the opinions of an applicant’s own physician. A Social Security administrative law judge (ALJ) will often credit the views of the outside experts–who often believe the applicant is not disabled–and ignore the contrary opinions of the treating physician. While this is not necessarily against regulations, the ALJ cannot simply ignore evidence.

Consider a recent decision by a federal magistrate judge here in Illinois, Sartin v. Berryhill. The plaintiff in this case is a woman who first applied for disability benefits nearly five years ago. At a hearing, the ALJ accepted evidence that the plaintiff suffered from a number of severe impairments, including depression, bipolar disorder, generalized anxiety disorder, and post-traumatic stress disorder. Nevertheless, the ALJ found these impairments “do not meet or medically equal” a legally recognized disability.

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Illinois Social Security disability application attorney absenteeismNot everyone who applies for Social Security disability benefits is incapable of performing some degree of work. However, one of the questions a Social Security official needs to consider is: How often will a person be absent from work or “off-task” due to their physical or mental impairments? After all, a person who needs to take 10 days a month off to deal with their disability is not exactly employable in any traditional sense of the word. For this reason, Social Security needs to not only make inquiries about the effects of a disability applicant's potential absenteeism, but the agency must also incorporate a proper assessment of such limitations in reaching a final decision.

Social Security Fails to Properly Address Limits on Disability Applicant's Ability to Remain On-Task

In one recent case, Social Security fell short of the mark when assessing absenteeism. In Hawist v. Berryhill, the plaintiff applied for disability benefits due to a number of impairments, including “osteoarthritis, back, knee, and shoulder pain, learning difficulty, depression, anxiety, and substance abuse,” according to court records. At a hearing, a Social Security administrative law judge (ALJ) posed several hypothetical questions to a vocational expert (VE). Such questions are commonly used to assess the types of jobs a person with the applicant's symptoms can hold when accounting for certain impairments.

The ALJ asked the VE to assume a person with the plaintiff's physical and medical impairments “would be reasonably likely to be off task for more than 20 percent of the workday due to pain, fatigue, and mental health symptoms.” This assumption was consistent with the medical evidence presented by the plaintiff's doctors. Based on the ALJ's hypothetical, the VE testified that a person would be unable to maintain any form of “competitive employment.” The VE added that a typical worker “should be on task 85 to 90 percent of the day.”

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