There is a common misunderstanding with respect to disability insurance. When considering your application for disability benefits, Social Security does not just evaluate whether or not you are medically able to perform your past work. It must decide whether you are capable of performing any type of sustained work. This distinction is often used as reasoning to deny benefits to an applicant.

Judge Orders Social Security to Reconsider Disabled Truck Driver's Claim

An applicant's failure to completely understand the law, however, does not in and of itself justify denying disability benefits. This point was hit home by a recent decision from a federal judge here in Illinois. In this case, King v. Berryhill, the plaintiff previously worked as a truck driver. He stopped working in 2008 due to chronic back pain, for which he did not seek treatment until six years later. In 2014, the plaintiff's treating physician diagnosed him with “severe lumbar degeneration” and several related conditions. 

At a 2016 hearing before a Social Security administrative law judge (ALJ), the plaintiff testified that he continued to suffer from chronic pain, and that therapy and ibuprofen provided only a modest amount of temporary relief. The ALJ nevertheless ruled that the plaintiff did not qualify as legally disabled.

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.

One of the basic responsibilities of Social Security when assessing a claim for disability benefits is to consider the effects of an applicant's medical impairments on their ability to work. Even if Social Security ultimately determines the effects do not rise to the level of a legally qualifying disability, the agency must still perform a proper assessment. In other words, Social Security cannot simply ignore a documented medical impairment altogether.

SSA Failed to Consider Effects of Disability Applicant's Edema

Consider this recent decision by a federal judge here in Illinois. The Social Security Administration denied a plaintiff's application for disability benefits. Before an administrative law judge (ALJ), the plaintiff presented medical evidence documenting the following impairments: HIV, obesity, edema, and lymphedema. The latter two refer to excess swelling in the plaintiff's left leg.

In fact, the plaintiff presented an extensive treatment history related to her edema. Basically, the condition requires her to “elevate her left leg throughout the day,” according to court records. Yet during the plaintiff's Social Security hearing, the ALJ never bothered to consider the impact of edema on the plaintiff's ability to work.