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.

But we often see ALJs step outside this legal role to make improper medical diagnoses. A recent disability case from here in Illinois, Christopher P. v. Saul, provides a useful illustration. The plaintiff here applied for disability benefits over five years ago. As part of the application process, the plaintiff's treating psychiatrist opined that he suffered from a number of mental impairments that included “marked limitations in concentration, persistence, or pace, and three episodes of decompensation, along with other disabling symptoms.”

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.

Let's take this recent disability case from here in Illinois, Kathy P. v. Saul. The plaintiff in this case applied for Social Security disability benefits about five years ago. Although she suffers from a number of physical and mental impairments, the critical issue here involves her mental disorders and frequent migraines. In support of her claims, the plaintiff presented expert testimony from her treating psychiatrist. Based on her extensive treatment history, the psychiatrist told Social Security that the plaintiff “was unable to meet competitive standards for several abilities such as completing a normal workday and workweek without interruptions, accepting instructions and responding appropriately to criticism from supervisors, and dealing with normal work stress.”

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.