Can Social Security Ignore My Doctor's Opinions for Being Too “Sympathetic”?

 Posted on July 12, 2017 in Social Security Disability

In any Social Security Disability Insurance case, the expert opinions and medical records provided by the applicant's treating physicians are critical. Obviously, no one knows an applicant's medical history better than his or her own doctors. And while Social Security is not required to find an applicant is disabled based solely on a treating physician's records and notes, the agency must give a sufficient explanation for discounting or disregarding such evidence in making a final determination.

Magistrate Criticizes Social Security for “Abstract,” Baseless Conclusions

What a Social Security administrative law judge (ALJ) cannot do, however, is ignore a treating physician's medical opinion simply because he or she disagrees with it. Yet there are many cases where an ALJ, having already made up his or her mind to deny disability benefits, goes looking for any excuse to discredit the treating physician's contrary conclusions. This goes against the letter and the spirit of Social Security regulations, and federal courts are quick to point this out when applicants appeal decisions denying benefits.

Consider a recent example from right here in Illinois. A man in his 40s was seriously injured in a car accident six years ago. He has been under the care of a number of physicians since that time for degenerative disc disease and the accompanying severe back pain. As a result of his condition, he eventually applied for Social Security Disability Insurance benefits.

At a 2014 hearing before an ALJ, the applicant's disability benefits lawyer presented medical records and treatment notes from the applicant's primary care physician. In the physician's opinion, the applicant “could stand or walk for less than one hour” at a time, would be “off task more than 30 percent due to pain,” and would need to miss at more than five days of work per month due to his impairments.

The ALJ denied the applicant's request for benefits. Among other things, the ALJ gave “little weight” to the treating physician's opinions, rationalizing “the possibility always exists that a doctor may express an opinion in an effort to assist a patient with whom he or she sympathizes for one reason or another.” The ALJ also suggested that the applicant was “quite insistent and demanding in seeking supportive notes or reports” from the physician, who in turn “might” acquiesce to such demands in order to “avoid unnecessary doctor/patient tension.”

A federal magistrate found the ALJ's reasoning “problematic on several levels.” For one thing, an “abstract” reference to the “always-present possibility of sympathy” is “not a basis for simply rejecting” a treating physician's expert medical opinion. There was, in fact, no evidence that the applicant “pressured” his doctor to give a favorable report. For this and other reasons, the magistrate said the applicant was entitled to a new Social Security hearing.

Get Help With Your Chicago Disability Benefits Case

Social Security is required to base disability decisions on actual medical evidence and not engage in vague attempts at character assassination. A qualified Chicago Social Security disability attorney can help make sure the government sticks to the facts. Call Pearson Disability Law, LLC, at 312-999-0999 if you need help today.

Source:

https://scholar.google.com/scholar_case?case=6147926595214473939