Judge Rebukes Social Security Official for Relying on Non-Medical Expert's Opinion

 Posted on September 08, 2015 in Social Security Disability

In assessing a claim for Social Security Disability Insurance benefits, an administrative law judge (ALJ) must examine an applicant's “residual functional capacity” (RFC). This is a measure of the applicant's ability to work, taking into account any mental or physical disabilities. Since the judge is not a doctor, he or she must review the opinions of physicians who have treated the claimant. The ALJ must ultimately weigh the credibility of these medical experts in making a final decision to grant or deny disability benefits.

Never Seek Medical Advice from Bureaucrats

But there are cases where judges fail to justify their decisions properly or rely on improper evidence. For example, a Chicago magistrate judge recently determined an administrative law judge improperly denied a disability applicant's claim without providing “substantial evidence.” Specifically, the magistrate said the ALJ failed to assess the claimant's RFC properly.

The applicant, in this case, worked as a truck driver. In 2005, he injured his back while working and subsequently required two surgeries. The claimant was never able to resume his job as a truck driver. Following the second surgery, he worked a number of odd jobs, including courier and pizza delivery driver, but the claimant said chronic back pain prevents him from working full-time.

The claimant filed his most recent application for Social Security disability benefits in July 2010. As part of the application review process, a Social Security official known as a “Single Decisionmaker” completed an RFC assessment. The Single Decisionmaker is not a physician or medical professional. According to the Social Security Administration, the Single Decisionmaker's role is to determine a whether a claimant is eligible for disability benefits “after any appropriate consultation with a medical or psychological consultant.”

In this case, the Single Decisionmaker's RFC stated despite the claimant's disabilities, he nevertheless “maintained the ability to perform light work, such as mail clerk, picking table worker, and base filler.” The ALJ, who later reviewed the case, relied on this opinion in denying the claimant's application.

On appeal, U.S. Magistrate Judge Michael T. Mason said that was inappropriate. Mason said he was “confounded” by the ALJ's inaccurate description of the Single Decisionmaker as a “State agency reviewing physician,” when, in fact, she was a layperson. Indeed, Judge Mason noted the Social Security Administration has said a Single Decisionmaker “cannot even offer non-medical opinions” regarding an applicant's claim. An RFC determination must always be supported by evidence offered by a qualified physician who has actually examined the claimant.

Here, the ALJ did review evidence from a medical doctor who previously treated the claimant. Unfortunately, the doctor did not assess the claimant's RFC after the date for which he claimed permanent disability. Judge Mason further noted the ALJ's treatment of the doctor's testimony was contradictory, simultaneously affording it “significant weight” while “questioning its veracity.” This “raises a red flag,” Judge Mason said, and warranted returning the case to the Social Security Administration for a new hearing.

Need Help With a Disability Claim?

Cases like this illustrate the lengthy nature of the Social Security disability review process. That is why it is important not to attempt to apply for benefits yourself but instead work with an experienced Chicago Social Security Disability benefits attorney. Pearson Disability Law, LLC, can help you at all stages of a disability case, from initial application to appeal. Contact us today if you have any questions.

Source:

https://scholar.google.com/scholar_case?case=1466599845550233658