Appealing an SSDI Decision to Disregard a Physician's Expert Opinion

 Posted on December 23, 2019 in Denied Social Security Benefits

Social Security disability cases are supposed to center on medical evidence, in particular, the diagnosis and expert views of the applicant's treating physicians. Social Security administrative law judges (ALJs) are normally expected to give “controlling weight” to a treating physician's views. If the ALJ discounts or rejects this testimony, there are a number of regulatory factors that must be considered and explained.

Magistrate: ALJ Failed to Follow Agency Regulations Before Discounting Doctor's Evidence

But as we have often found in practice, ALJs often disregard treating-physician evidence without giving a valid explanation, or even any explanation at all that conforms to the agency's own regulatory factors. A recent decision from a federal magistrate judge here in Illinois, Deborah AM v. Saul, offers a textbook example of this problem.

In this case, the plaintiff applied for disability benefits nearly five years ago. Following a hearing on the plaintiff's application, a Social Security ALJ held she did not legally qualify for disability benefits. The ALJ reached this conclusion after deciding not to give controlling weight to the evidence offered by the plaintiff's treating physician.

To go into more detail, the plaintiff's disability application centered on her degenerative joint disease in her ankles. The plaintiff's treating orthopedist determined that due to her condition the plaintiff could only “sit for 30 minutes and stand for 10 minutes at a time,” required a “10-to-15-minute break from work every hour,” and “would likely miss more than 4 days each month.” In other words, the plaintiff was medically unable to work a normal full-time job.

The ALJ gave “little weight” to the orthopedist's views because they were “not consistent with the objective medical evidence” in the record. But as the magistrate noted, the ALJ did not cite any specific evidence that refuted the orthopedist's findings. Instead, the ALJ made a “blanket citation to virtually the entire record,” which was not permissible under Social Security regulations.

More to the point, the ALJ said the medical evidence showed the plaintiff “had nerve regeneration” in her right leg, which suggested the plaintiff had recovered her normal strength and reflexes. Not so, the magistrate said. Although there was an exam note in the plaintiff's medical records from October 2015 that said there was “evidence of nerve regeneration,” that same note said the process “was far from complete and its ultimate impact on [the plaintiff's] condition was unknown, neither of which is a basis for rejecting [the treating orthopedist's] opinion.”

Ultimately, the magistrate said the ALJ engaged in impermissible “cherry-picking” and failed to consider all of the necessary regulatory factors before discounting the orthopedist's testimony. The court, therefore, ordered Social Security to conduct a new disability hearing on the plaintiff's application.

Speak with a Illinois Social Security Attorney Today

Getting Social Security to accept your own doctor's opinions regarding your medical condition is often more of an uphill battle than you might expect. This is why it is critical to work with an experienced Chicago disability benefits lawyer who understands the process and will fight for your best interests. Contact Pearson Disability Law, LLC at 312-999-0999 today to schedule an initial consultation with a member of our team.

Source:

https://scholar.google.com/scholar_case?case=525198233995133991