Decisions regarding Social Security disability applications are supposed to be based on medical evidence. That is, your treating doctor's medical conclusions are normally expected to be given great weight by a Social Security administrative law judge (ALJ). But in far too many cases, we find the ALJ taking it upon themselves to “play doctor” and ignore or discount the treating physician's views.

Magistrate: Social Security “Mischaracterized” Surgeon's Findings in Denying Disability Application

In some cases, an ALJ may outright misrepresent what the treating physician found. This is not okay. To the contrary, it violates Social Security regulations and entitles an unsuccessful applicant to a new hearing on their claim.

This is precisely what happened to one Illinois disability benefits applicant in a recent case, Lisa AB v. Commissioner of Social Security. The plaintiff in this case has not worked since 2012 because of her inability to use her hands. The plaintiff had a history of severe carpal tunnel syndrome that required surgery.

Social Security administrative law judges (ALJs) are expected to rely on medical evidence when assessing an application for disability benefits. The most critical form of medical evidence comes from the applicant's own treating physicians. But the ALJ may also consider other forms of evidence, including something known as a GAF score.

GAF stands for the “Global Assessment of Function.” It is a rating system used to assess a disability applicant's mental function on a 1 to 100 scale. A higher score typically indicates a higher degree of mental functioning.

Now, a GAF score is simply a doctor's opinion regarding the overall impact of an applicant's mental disorders at a given time. It is not an objective diagnostic test. And an ALJ is not allowed to grant or deny disability benefits based solely–or even primarily–on a GAF score. Rather, it is simply one piece of information the ALJ may consider as part of an applicant's overall case.

There are situations where Social Security may award disability benefits but fix a different onset date than alleged by the applicant. The alleged onset date is basically the day you became unable to work due to your physical or mental impairments. This date is important because, under Social Security regulations, a successful applicant can claim up to 12 months of retroactive benefits from the date of their application.

In other words, let's say Mary filed for disability benefits in January 2018 with an alleged onset date of June 2017. If Social Security subsequently grants the application and agrees with the onset date, Mary would be entitled to retroactive benefits starting in November 2017, or five months after the alleged onset date. (Social Security imposes a five-month waiting period for all disability benefits.)

Magistrate Finds Social Security's Reasons Unclear for Disagreeing with Plaintiff's Alleged Onset Date

If Social Security grants your application but disagrees with your alleged onset date, you can appeal the latter decision. Social Security must then show why it determined the applicant did not become legally disabled until a different date than alleged.