Can Social Security Reject a Disability Claim Based on an Interpretation of Medical Tests?

 Posted on August 10,2020 in Social Security Disability Medical Conditions

When you make a Social Security disability claim, multiple different types of medical evidence will be considered to determine whether you qualify to receive benefits. An administrative law judge (ALJ) will consider a number of factors, including whether you have an impairment that is equal or similar to specific impairments described in Social Security regulations and whether you are able to work in your current occupation or perform other types of work. When looking at whether the medical tests you have received support your claim, an ALJ is required to rely on the opinions of medical experts rather than forming their own opinions.

Illinois Court Reverses ALJ’s Decision to Deny Benefits

In some cases, an ALJ may base the decision to deny a disability claim on an improper interpretation of medical tests. This was demonstrated in a recent Illinois case, Paul R. C. v Commissioner of Social Security. The plaintiff, a man in his 50s who had worked as a painter and drywaller, applied for Supplemental Security Income (SSI) based on a number of medical conditions, including arthritis in the knees, torn shoulder muscles, diabetes, carpal tunnel syndrome, and injuries to the lower back. A previous disability claim had been denied because the ALJ concluded that he was capable of a “limited range of light work.”

In the claim in question in this case, the ALJ denied benefits and ruled that the plaintiff was capable of “medium work” that did not involve climbing on ladders or scaffolds, and only occasionally included kneeling, crouching, or crawling. Even though the plaintiff was unable to do the work he had done in the past, the ALJ stated that he would be able to find a job where he could work at the “medium exertional level.”

When appealing this decision, the plaintiff claimed that the ALJ’s assessment was not supported by the evidence because in his previous claim, a doctor had stated that he was capable of light work, and additional medical evidence showed that he was limited to light work rather than medium work. At the plaintiff’s age, he would be considered disabled if he was only capable of light work. While the court found that the doctor’s opinion in the previous claim was no longer relevant to the subsequent claim, it did agree that the ALJ’s interpretation of an MRI was incorrect.

Specifically, the ALJ did not base their decision on an expert’s interpretation of the results of a lumbar MRI the plaintiff received. The radiology report showed “moderate” findings, and because of this, the ALJ concluded that the plaintiff was capable of medium work. However, the court ruled that the ALJ was not qualified to make this determination, and there was no logical link between the evidence and the conclusions made by the ALJ. Because of this, the court reversed the denial and remanded the case to the Social Security Commissioner for a rehearing in which the evidence would be reconsidered.

Contact Our Chicago Social Security Disability Lawyer

Social Security disability claims are often denied because an ALJ does not properly consider the evidence or rely on the opinions of medical experts. If you need to appeal the denial of a disability claim, you should work with a Chicago, IL Social Security disability appeal attorney at Pearson Disability Law, LLC. Call our office today at 312-999-0999 to set up a free consultation.

Source:

https://scholar.google.com/scholar_case?case=11961075594807477415