Disability Hearings and Outdated Medical Records

 Posted on February 20, 2018 in Social Security Disability

Fully resolving a claim for Social Security Disability Insurance benefits often takes years. Much of this delay is due to the Social Security Administration's failure to follow its own regulations when evaluating an applicant's medical records. Indeed, the delay itself often creates an additional problem: During reconsideration of an application, an administrative law judge (ALJ) may be relying on a stale, outdated analysis of the applicant's medical condition.

Court Orders New Hearing in 11-Year-Old Disability Case

The U.S. Seventh Circuit Court of Appeals here in Chicago recently addressed such a case. The plaintiff first applied for disability benefits approximately 11 years ago. An ALJ initially heard and denied the plaintiff's application in 2010. Following an initial round of appeals, a supplemental hearing was held before a different ALJ in 2014, which also resulted in a denial.

Although the circumstances leading to the plaintiff's disability application started with a physical injury—a workplace accident in 2006—the focus of the supplemental hearing was related to mental impairments that he developed during the intervening years, notably depression. During the 2014 supplemental hearing, the ALJ considered the expert opinion of a psychologist who examined the plaintiff's medical records and determined he was “not significantly limited” in his ability to perform many simple unskilled jobs despite his mental impairment.

That psychologist's opinion, however, was prepared in 2007. Between 2007 and 2014, the plaintiff received medical treatment from at least two other doctors. Yet the ALJ never sought an updated medical opinion to account for these doctors' treatment notes. Instead, the ALJ concluded this new information would not have made a difference, even though one of the doctors diagnosed the plaintiff with “major depressive disorder” and prescribed medication.

The Seventh Circuit said the ALJ erred in not seeking out an updated medical assessment. In a written opinion, the appeals court said that when it comes to disability cases like these, “An ALJ should not rely on an outdated assessment if later evidence containing new, significant medical diagnoses reasonably could have changed the reviewing physician's opinion.” Indeed, it is not the ALJ's place to simply declare new evidence would not change an assessment as “ALJs are not qualified to evaluate medical records themselves, but must rely on expert opinions.”

While the Seventh Circuit recognized ALJs are “significantly overburdened with massive caseloads and insufficient resources,” when there is a seven-year gap between an expert preparing an opinion and the applicant's disability hearing, it is improper for the Social Security Administration to rely on “stale analysis.” Accordingly, the Seventh Circuit returned this case to Social Security for a third ALJ hearing.

Speak With a Cook County Social Security Disability Lawyer Today

Unfortunately, even when appeals courts order a new hearing, that only means additional delays for applicants who desperately need the income that disability benefits provide. This emphasizes the critical importance of working with an experienced Chicago disability benefits lawyer who understands how to manage Social Security cases from start-to-finish. Contact Pearson Disability Law, LLC, at 312-999-0999 to schedule a consultation today.

Source:

http://media.ca7.uscourts.gov/cgi-bin/rssExec.pl?Submit=Display&Path=Y2018/D02-16/C:17-1954:J:PerCuriam:aut:T:fnOp:N:2108722:S:0