Does Social Security Review a Disability Applicant's Entire Medical History?

 Posted on November 18, 2016 in Social Security Disability Medical Conditions

When assessing your claim for Social Security Disability insurance benefits, agency officials are required to examine your entire medical record. It is not Social Security's job to “play doctor” and interpret medical records without the benefit of expert analysis—i.e. the opinions of physicians who have either treated you personally or reviewed your file. Nevertheless, some Social Security administrative law judges (ALJs) ignore the law and simply disregard those parts of an applicant's medical file that stands in the way of denying their claim.

Social Security Ordered to Consider Disability Application a Third Time

A recent example from here in Illinois illustrates this scenario. The applicant is a woman in her mid-50s who suffers from chronic back pain, obesity, and asthma, among other ailments. She applied for Social Security disability benefits, claiming she was no longer able to work due to her impairments. As part of the disability review process, the ALJ hearing the case asked a medical expert to review the applicant's medical history.

The review took place in June 2012. Based on the applicant's file—but not a personal examination—the expert offered his opinion that despite the applicant's impairments, she could “sit, stand, and walk for up to six hours in an eight-hour work day.” Based largely on this testimony, the ALJ denied the applicant's claim for disability benefits.

However, the applicant continued to receive medical treatment well after the events contained in her June 2012 file. None of this additional medical evidence was considered by the expert or the ALJ. The applicant therefore appealed Social Security's denial of her claim, and a federal magistrate agreed that she was entitled to a new hearing.

The magistrate held the ALJ “improperly relied” on the expert's incomplete review of the applicant's medical records. As the magistrate explained, after the date of the expert's report, the applicant's additional treatment included “two multi-day inpatient hospitalizations for back pain, several months of physical therapy, diagnostic tests (such as MRIs and CT scans), treatment with a pain specialist…and several years' worth of visits with [her] other physicians.” The expert opinion considered by the ALJ took none of this into account.

What makes the ALJ's actions even more appalling is that this is the second time that the magistrate has ordered Social Security to reconsider the applicant's case. The court initially returned the case to Social Security in 2014. But the ALJ decided to rely on the exact same medical opinion he obtained before making his first decision—the one the magistrate reversed. “Instead of seeking an updated medical expert opinion,” the magistrate said, “the ALJ reached his conclusion that the new evidence did not show severe impairments apparently of his own accord.” That is not what the law requires.

Need Help From an Illinois Social Security Disability Attorney?

Unfortunately, this type of multi-appeal case is all too common when dealing with disability claims in Illinois. Hence, working with an experienced Chicago disability benefits lawyer who understands the system is essential. If you need help with your Social Security claim, please contact the offices of Pearson Disability Law, LLC, today.

Source:

https://scholar.google.com/scholar_case?case=16474599954838931549