Even if you are unable to return to your previous job due to a medical condition, Social Security will not award you disability benefits unless it is satisfied that you are incapable of performing any type of meaningful work. The opinions of your treating physician are often critical towards proving this is the case. Of course, some Social Security administrative law judges may try to “play doctor” and attempt to disregard (or misrepresent) the views of your actual physicians.

Take this recent decision from a federal magistrate judge here in Illinois, T.D.B. v. Saul. The plaintiff in this case previously worked as a registered nurse. In 2007, she suffered a serious wrist injury when she was attacked by a patient. The plaintiff's physician subsequently diagnosed her with chronic regional pain syndrome (CRPS). By 2010, the physician concluded the plaintiff had “reached maximum medical improvement,” which is a legal term used in connection with workers' compensation proceedings. At the time, this meant the plaintiff would be limited to “full-time sedentary work.”

In 2012, however, the treating physician revised this diagnosis. In a separate letter to the workers' compensation insurance adjuster assigned to the plaintiff's claim, the doctor said the plaintiff was “essentially unemployable,” i.e., she was no longer medically capable of returning to work in any capacity on a full-time basis.

It is not uncommon for Social Security officials to initially deny your claim for disability benefits. Fortunately, you have certain appeal rights. In fact, there are four levels to the disability appeals process. First, you can ask for reconsideration. Second, you may request a hearing before an administrative law judge (ALJ). Third, you can seek review of the ALJ's decision with Social Security's Appeals Council. Finally, you can seek judicial review of a “final” decision to deny benefits in federal court.

Illinois Magistrate Dismisses Social Security Appeal Filed One Day Late

At each stage of the appeals process, there are strict deadlines that you are expected to understand and comply with. If you file an appeal even one day late, a court may refuse to hear your case, regardless of the underlying merits. So it is critical that you act promptly to address a negative decision from Social Security.

For example, in a February 2020 case, McGhee v. Commissioner of Social Security, an Illinois federal magistrate judge granted the government's motion to dismiss an appeal brought by an unsuccessful disability applicant. The applicant previously went through the first three stages of the appeals process described above. In November 2017, an ALJ rejected the applicant's claim. The applicant then sought review from the Appeals Council.

Even when the medical evidence shows a person suffers from multiple–even dozens–of physical or mental impairments, that may still not convince Social Security that a person is entitled to disability benefits. One reason for this is that Social Security administrative law judges (ALJs) will frequently try to minimize or disregard a disability applicant's own description of their pain and other symptoms. Now, an ALJ is allowed to decide how much weight to give such subjective complaints. But the ALJ's findings must ultimately be rooted in the available medical evidence, not some “gut feeling.” That is to say, the ALJ must identify specific inconsistencies between the applicant's complaints and the rest of the evidentiary record.

Magistrate Rejects Social Security's Use of Disability Applicant's Pregnancy, Childcare Responsibilities as Pretext for Denying Benefits

Let's look at a recent Illinois disability case where the ALJ did not do this. In Sylvia C. v. Saul, a Social Security ALJ rejected a 41-year-old woman's application for benefits. There was no question the plaintiff had medical issues: The ALJ identified no fewer than 16 physical and mental impairments–included 9 “severe” conditions–based on the plaintiff's medical records. Nevertheless, the ALJ said the plaintiff did not meet the legal qualifications for disability.

A key reason was that the ALJ found the plaintiff's “statements concerning the intensity, persistence and limiting effects of [her] symptoms [were] not entirely consistent with the medical evidence and other evidence in the record.” On appeal, a federal magistrate judge disagreed. The magistrate said it was the ALJ's conclusions that were not adequately supported by the record. While the magistrate did not find the plaintiff was entitled to disability benefits, the court did order the ALJ to conduct a new hearing.