Does Social Security Have to Look at All of My Test Results Before Ruling on My Disability Application?

 Posted on July 17, 2020 in Social Security Disability Medical Conditions

There is often a significant delay in hearing Social Security disability cases. One result of this delay is that new information regarding an applicant's medical condition may come to light after a doctor has already reviewed the record. When this happens, a Social Security administrative law judge (ALJ) should take the time to obtain a proper expert assessment of this new information before making a decision.

Illinois Magistrate Orders New Hearing to Consider Applicant's MRIs and X-rays

Unfortunately, that is not always how things work in practice. Consider this recent decision from a federal magistrate judge here in Illinois, Renee L. M. v. Commissioner of Social Security. The plaintiff, in this case, is a woman in her 50s who applies for disability insurance benefits four years ago. Although an ALJ determined the plaintiff did suffer from a number of severe impairments, including “fibromyalgia, back arthritis, anxiety disorder, and personality disorder,” she nevertheless had the “residual functional capacity” to perform “light work” with limitations. On that basis, the ALJ denied the claim for disability benefits.

Before the magistrate, the plaintiff argued the ALJ relied on the “outdated opinion” of a state agency medical consultant. These consultants do not personally treat the disability applicant; rather they review their medical records and offer opinions to the ALJ. The ALJ is never supposed to “play doctor” themselves, but instead assess the credibility of the consultants as well as any treating physicians.

Here, the plaintiff noted that the ALJ gave “great weight” to the consultant's opinion that she could still perform light work. But the consultant failed to account for a series of X-rays and MRIs that were performed after the date of the consultant's review. The plaintiff insisted these new tests negated the consultant's “light work” finding and should have been considered by the ALJ.

The magistrate judge agreed and ordered a new hearing. The ALJ acted improperly by making his own assessment of the new diagnostic tests–asserting they actually supported the light-work restriction–without the assistance of any medical experts. And to put it bluntly, the ALJ was “not qualified” to make read and interpret radiology results on his own.

The magistrate did caution that a new hearing is not necessary “in every case where diagnostic imaging studies are done after the state agency consultant's review.” But in this case, the new diagnostics could prove critical to the plaintiff's application. Given her age, if the ALJ were to determine the plaintiff could only perform “sedentary” work as opposes to light work, she would automatically qualify for disability benefits.

Speak with a County County Social Security Disability Attorney Today

In any disability case, it is critical that Social Security properly assess all of the available medical evidence before making a decision. A qualified Chicago disability benefits lawyer can help ensure your case receives the proper consideration. Contact Pearson Disability Law, LLC, at 312-999-0999 today to schedule a free consultation.

Source:

https://scholar.google.com/scholar_case?case=4640183061020636125