How a “Checklist” Approach Can Affect How Social Security Views Your Doctor's Opinions Regarding Your Disability

 Posted on July 31, 2020 in Social Security Disability Medical Conditions

When seeking Social Security disability benefits, the opinions of your treating physicians will often provide crucial evidence in support of your case. But not all treating-physician opinions are treated equally. For instance, if your doctor simply confirms your own subjective reports regarding certain symptoms–such as chronic pain–without providing any further analysis, that may be of limited value to a Social Security administrative law judge (ALJ) reviewing your application.

Seventh Circuit Dismisses Appeal Brought by Illinois Woman with Fibromyalgia

A recent decision from the Chicago-based U.S. Seventh Circuit Court of Appeals, Apke v. Saul, helps to illustrate this point. In this case, a 37-year-old woman applied for disability benefits, citing a number of impairments, including fibromyalgia. Fibromyalgia is a pain disorder that is notoriously difficult to diagnose using objective tests. As a result, Social Security often views disability claims based on fibromyalgia with increased skepticism.

This case proved to be no different. Although the plaintiff submitted expert reports from three of her treating physicians, the ALJ overseeing the case decided after holding a hearing to solicit the views of a third-party rheumatologist. Based on the rheumatologist's findings, the ALJ ultimately denied the plaintiff's application for disability benefits.

The plaintiff appealed the ALJ's decision all the way up to the Seventh Circuit. Unfortunately, the appeals court upheld the ALJ's findings and decision. The Court noted that the three expert reports prepared by the plaintiff's doctors were basically “checklists” that confirmed the plaintiff's subjective complaints of pain related to her fibromyalgia. As the Court saw it, the treating physicians did little more than “rubber stamp” the plaintiff's complaints without making any effort to assess the physical limitations on her ability to work.

In contrast, the Court observed, the third-party rheumatologist retained by the ALJ did make specific findings regarding the plaintiff's ability to “perform light work consistent with [her] limitations.” The ALJ was entitled to give this opinion more weight than the “checklist” reports prepared by the treating physicians. To put it another way, the Court said this was not a case where the ALJ improperly “played doctor,” but instead decided to favor the approach taken by one medical expert over another.

And while the appeals court acknowledged that there is often “no objective medical evidence indicating the presence or severity of fibromyalgia,” the ALJ was within their discretion to find that the plaintiff's “symptoms and limitations were not as severe as she claimed.” In making this finding, the ALJ properly considered not only the plaintiff's own testimony regarding her daily activities, but also the fact she “received only minor doses of prescription medications and injections” for her pain.

Speak with an Illinois Disability Benefits Lawyer Today

Living with fibromyalgia is enough of a burden without having to demonstrate its effects before a government official. But the reality is that Social Security's regulations require a certain degree of medical evidence, even when the underlying illness or condition cannot be tested for using conventional means. If you have further questions on this subject and need advice from a qualified Chicago Social Security disability attorney, contact Pearson Disability Law, LLC, today at 312-999-0999 to schedule a free consultation.

Source:

https://scholar.google.com/scholar_case?case=10198161870987745859