How Inconsistency Can Doom a Disability Claim

 Posted on October 29,2018 in Denied Social Security Benefits

Inconsistency is often a major factor in Social Security denying disability claims. If the agency feels your doctor's opinions are inconsistent with the other medical evidence available, your claim can be denied. Similarly, if an administrative law judge (ALJ) feels your own testimony with respect to your symptoms–especially with respect to subjective matters like pain–is inconsistent, that may also form the basis for denying a claim.

Appeals Court Sides With Social Security Despite Problems With ALJ's Reasoning

Consider a recent decision by the U.S. Seventh Circuit Court of Appeals here in Chicago. The plaintiff in this case unsuccessfully applied for disability benefits. He previously worked for a chemical company, and while loading chemicals onto a truck at work one day, he “felt pain in his low back.” The pain persisted, so he eventually saw a specialist, who determined the plaintiff had a large disc herniation “that was pinching a spinal nerve root.”

Although doctors initially advised a conservative course of treatment–i.e., physical therapy–the plaintiff ultimately needed back surgery. This led him to stop working in 2007. In 2008, a physical therapist suggested the plaintiff could resume performing “light” work. However, the plaintiff did not return to work and instead applied for disability benefits in 2012.

At a 2014 hearing before an ALJ, the plaintiff testified as to the effects of his own chronic pain. He also introduced medical evidence in the form of an opinion from a neurosurgeon. This doctor examined the plaintiff in 2011, recommended he undergo a second surgery, and said he needed to be “off work.”

The ALJ rejected the plaintiff's disability application. Among other findings, the ALJ gave the neurosurgeon's opinions “little weight” because they were “generally inconsistent” with the views of other doctors who reviewed the plaintiff's condition. The ALJ also determined the plaintiff's statements regarding his own pain were “exaggerated” and therefore “not fully credible.”

The Seventh Circuit upheld the ALJ's decision, although not without some critiques. The appeals court noted the ALJ “inappropriately commented” that the neurosurgeon's expert medical opinions “seem to contain a level of sympathy” for the plaintiff.“ Any such observation had to be based on actual statements made by the doctor in his treatment notes. Instead, the ALJ "broadly speculated” as to the doctor's sympathies, a practice the Seventh Circuit discouraged. The ALJ also improperly discounted the doctor's views because he was referred to the plaintiff by his internist and therefore, in the ALJ's words, was “essentially one of the claimant's choosing.” The court said there was absolutely no reason to question a doctor's credibility simply because he was a referral.

That said, the Seventh Circuit noted these “deficiencies in the ALJ's reasoning do not undermine the ALJ's broader conclusion that [the neurosurgeon's] opinions were inconsistent with the opinions from other doctors” or that the plaintiff himself was “inconsistent” in his own statements regarding the extent of his pain. Accordingly, the appeals court affirmed Social Security's decision to deny the plaintiff disability benefits.

Speak With an Illinois Social Security Disability Lawyer Today

As this case demonstrates, it is essential to present Social Security with a credible, consistent case documenting your disability. In order to ensure that you present the best argument to show your need for disability, it is important to work with an experienced Chicago disability benefits lawyer. Contact Pearson Disability Law, LLC, today at 312-999-0999 to schedule a free consultation.

Sources:

https://scholar.google.com/scholar_case?case=462726538231756895