There are multiple levels to the process of reviewing an application for Social Security disability benefits. An administrative law judge (ALJ) employed by the Social Security Administration (SSA) normally conducts a hearing and issues a decision to grant or deny benefits. If the ALJ denies benefits, the applicant can then file an internal appeal with SSA, and if that fails, file a lawsuit against the agency in federal court.

But even if a federal judge agrees with the applicant that the ALJ's decision was incorrect, the court will typically not award disability benefits directly. Instead, the court will remand–return–the case to Social Security for a new ALJ hearing, effectively restarting the entire process. However, in rare cases, a court may decide this is unnecessary and simply order Social Security to start paying disability benefits.

Seventh Circuit: Applicant's Age, Limited Education, and Prior Work Experience Justify Award of Benefits Without a Third Hearing

We recently saw an example of this from the U.S. Seventh Circuit Court of Appeals here in Chicago. The plaintiff in this case, Marin v. Saul, has been unable to work for over a decade due to her physical and mental impairments. In 2012, an ALJ held a hearing and determined that despite the plaintiff's impairments, she could still “work in a sedentary job requiring little social interaction,” and denied her application for benefits. The plaintiff then went through the appeals process, and a federal district court ended up remanding the case back to Social Security for a new hearing.

It may surprise you to learn that roughly one in five American adults struggle with basic literacy. This is according to figures published by the U.S. Department of Education's National Center for Education Statistics. Specifically, this group representing approximately 20 percent of adults “have difficulty” with completing tasks that involve “comparing and contrasting information, paraphrasing, or making low-level inferences.” Now you may be wondering if illiteracy qualifies a person for Social Security disability benefits. The short answer is no; the mere fact a person has little or no literacy skills is not considered a disability as such. But for applicants between the ages of 45 and 54, Social Security will consider illiteracy as a factor in favor of awarding disability benefits.

Magistrate: Social Security “Failed to Properly Evaluate” Disability Applicant's Illiteracy

Of course, that assumes the applicant can demonstrate they are, in fact, illiterate. Social Security officials often have difficulty taking illiteracy claims at face value. And in some cases, this difficulty crosses the line into simply ignoring the available evidence.

A recent decision from an Illinois federal magistrate judge, Kenneth S. v. Saul, provides a useful illustration of what we are talking about. The plaintiff in this case filed for disability benefits at the age of 47, alleging a number of physical impairments related to his back, neck, shoulder, and hip. The plaintiff informed Social Security he was illiterate, but managed to work as a production laborer at a syrup factory for over 20 years thanks to a “benevolent employer.”

Social Security often denies applications for disability benefits based on the testimony of “agency consulting physicians.” These are doctors who review an applicant's medical records without personally examining or treating the applicant. In some cases, a Social Security administrative law judge (ALJ) will give greater weight to the opinions of the agency consultants over the treating physicians. This is permitted under Social Security regulations, provided the consultant's opinions are consistent with the available medical evidence.

Appeals Court Questions Social Security's Conclusions Regarding Disability Applicant's Ability to “Reach Overhead”

Here is an example of a case where an ALJ improperly credited an agency consultant. In Gibbons v. Saul, the plaintiff applied for disability benefits approximately seven years ago. The plaintiff suffered from severe chronic pain in his neck, shoulders, and arms. Several doctors provided medical evidence with respect to the plaintiff's condition.

A critical issue was whether or not the plaintiff was capable of reaching overhead. According to Social Security regulations, a person is capable of performing “sedentary work,” and therefore does not qualify for disability benefits, if they can lift up to 10 pounds.