One of the key things Social Security looks for when assessing an application for disability benefits is whether or not the applicant can “make an adjustment to other work.” Many people assume they are disabled simply because they cannot go back to their old job. But the legal threshold is whether or not someone with the applicant's impairments and skill level can find any meaningful work in the economy.

To make such assessments, Social Security typically relies on the testimony of vocational experts (VEs), who are asked to estimate the type and number of jobs available to a person who hypothetically matches the disability applicant's profile. Unfortunately, it is not always clear exactly how VEs make their estimates or reach their conclusions with respect to a given disability applicant. To further complicate matters, he VEs often depend upon outdated government classification manuals when examining the types of work available.

Magistrate Orders New Hearing After Vocational Expert Refuses to Provide Data Sources

In some cases, a VEs failure to properly explain his or her methodology can justify granting an unsuccessful applicant a new disability hearing. That is exactly what happened in a recent Illinois case, Tolbert v. Berryhill. The plaintiff suffers from a number of physical impairments–including “arthritis, hypertension, right carpal tunnel, and asthma,” according to court records–that she said made it impossible for her to work.

One of the cardinal rules of Social Security disability cases is that agency officials are not allowed to “play doctor.” In other words, when a Social Security administrative law judge (ALJ) holds a hearing to decide whether or not an applicant is legally disabled, the ALJ must rely on medical testimony presented by qualified experts. The ALJ is not supposed to rely solely on their own interpretation of medical evidence, since, after all, they are not doctors themselves.

Federal Court Orders New Disability Hearing After ALJ Ignores Medical Evidence

Here is a recent disability case in which Social Security forgot this basic rule. This is taken from a decision by the U.S. Seventh Circuit Court of Appeals, which has jurisdiction over Illinois, although this particular case originated in Indiana. The plaintiff was a 49-year-old woman who formerly worked as a hairstylist. She stopped working in 2009 due to a variety of ailments, notably degenerative disc disease, fibromyalgia, and depression.

The degenerative disc disease–the plaintiff's chronic back pain–was the main focus of a hearing before a Social Security ALJ. At the hearing, the plaintiff's treating physician testified that her degenerative disc disease had progressed to the point where she qualifies as disabled under Social Security regulations. Although the doctor based his findings on examinations conducted during 2014, he nevertheless concluded that the plaintiff had been disabled since at least June 2011.

In Social Security disability cases, agency officials will look at two types of medical evidence: The information provided by an applicant’s own treating physicians, and testimony from outside reviewers and consultative examiners, who typically look at an applicant’s medical records but do not necessarily examine them in person. When one’s own doctor's medical opinions are supported by appropriate treatment records, Social Security is expected to afford such views substantial weight, even if they conflict with the opinions of the outside consultants.

Magistrate Orders New Hearing After Social Security Ignores Evidence from Applicant's Psychiatrist

In far too many disability cases, Social Security does not provide the proper weight to the opinions of an applicant’s own physician. A Social Security administrative law judge (ALJ) will often credit the views of the outside experts–who often believe the applicant is not disabled–and ignore the contrary opinions of the treating physician. While this is not necessarily against regulations, the ALJ cannot simply ignore evidence.

Consider a recent decision by a federal magistrate judge here in Illinois, Sartin v. Berryhill. The plaintiff in this case is a woman who first applied for disability benefits nearly five years ago. At a hearing, the ALJ accepted evidence that the plaintiff suffered from a number of severe impairments, including depression, bipolar disorder, generalized anxiety disorder, and post-traumatic stress disorder. Nevertheless, the ALJ found these impairments “do not meet or medically equal” a legally recognized disability.