Social Security Disability Claims and Second Opinions

 Posted on February 21, 2020 in Social Security Disability Medical Conditions

When you apply for disability benefits, Social Security will consider the medical opinions of your treating physician as well as non-examining consultants. These consultants basically review your medical records and offer a separate opinion as to your physical or mental impairments. In some cases, a Social Security administrative law judge (ALJ) may decide the non-examining doctors provide a more complete or accurate view of your condition than your own physician.

Magistrate Orders New Hearing on Deceased Man's Disability Claim

But what if a non-examining doctor reviews the exact same information as your treating physician and simply offers a different opinion? For instance, could a consultant look at the tests performed by your doctor and tell the ALJ they mean something different then what your doctor concluded?

A recent decision from an Illinois federal magistrate judge, Mary T. ex. rel. Falauren T. v. Saul, presented just such a scenario. This case sadly involves a now-deceased applicant for disability benefits. The applicant's mother actually continued the case following her son's death.

Social Security acknowledged the decedent suffered from a “seizure disorder and cognitive disorder.” At a hearing, an ALJ received testimony from a psychologist who examined the decedent and found he “appeared to have difficulties with his cognitive processing … moderate difficulty with effectively maintaining attention and sustained concentration, [and] moderate difficulty recalling but not understanding simple and detailed directives.”

The ALJ gave “partial weight” to these conclusions but opted to give greater, controlling weight to the views of a non-examining consultant instead. The consultant told the ALJ that the decedent only had a “mild restriction in adaptation.” Based on this, the ALJ said the decedent was still capable of working during the time he claimed to be disabled.

But as the magistrate explained, the “only evidence” reviewed by the non-examining consultant was the psychological evaluation prepared by the examining physician. This was not a case where the non-examining doctor had access to a broader medical record. The consultant simply disagreed with the examining physician's interpretation of the test results. This was not sufficient grounds, according to the magistrate, for the ALJ to give greater weight to the non-examining physician's conclusions.

Nor was this a harmless error. The magistrate noted that a vocational expert who testified before the ALJ relied on the non-examining consultant's opinions when determining the type of jobs the decedent could have performed. The ALJ, therefore, returned the case to Social Security for a new hearing.

Speak with a Chicago Disability Benefits Lawyer Today

Social Security has an obligation to review the medical evidence in disability cases fairly and impartially. It is improper for an ALJ to favor a non-examining physician's views simply because they support a finding the applicant is not disabled. If you are applying for disability benefits and need representation from an experienced Chicago Social Security attorney who will fight to make sure the government follows its own rules, contact Pearson Disability Law, LLC, today at 312-999-0999 to schedule a free consultation.

Source:

https://scholar.google.com/scholar_case?case=10103123660792988909