The Dangers of Letting Social Security “Fill in the Gaps” When It Comes to Medical Evidence

 Posted on April 25, 2019 in Social Security Disability Medical Conditions

In making your case for disability benefits, it is important to present Social Security with as much expert medical evidence as possible. Otherwise, an agency administrative law judge (ALJ) may attempt to “fill in the gaps” with their own, non-expert opinions. And while such conduct contradicts the law governing disability benefits, the burden is then on the applicant to show the error on appeal, which only makes the process go slower.

Magistrate to Social Security ALJ: “Not a Doctor. Shh.”

To give an example, a federal magistrate judge recently began an opinion reversing Social Security's decision to deny an application for disability benefits with a quote from the popular television program Brooklyn Nine-Nine: “Not a doctor. Shh.”

The magistrate was expressing his frustration at yet another instance of an ALJ impermissibly “playing doctor” when it comes to assessing an applicant's medical limitations in the workplace. In this particular case, the magistrate said the ALJ simply ignored the “only evidence in the record” because it contradicted the ALJ's opinions.

Here is some background. The plaintiff, in this case, applied for disability benefits in September 2015. The plaintiff's principal medical impairment involved “vein issues in her left leg,” according to the magistrate. Basically, the plaintiff suffered from chronic leg pain that required her to keep it elevated “all the time” to prevent or mitigate swelling.

A vocational expert (VE) testified at the plaintiff's hearing before the ALJ. The VE said that a person was not capable of performing even “sedentary work” if she “needed to lay on her back and elevate her leg up against a wall” during a normal working day. However, a person who only needed to elevate her leg “below desk height” could still perform such work.

The ALJ ultimately decided – without the benefit of any expert medical evidence – that the plaintiff fell into the latter category. That is, the ALJ said the plaintiff only needed to keep her leg elevated below desk height and was therefore still capable of working. On that basis, the ALJ denied the plaintiff's application for disability benefits.

But as the magistrate explained, it was “uncertain” on what basis the ALJ reached these conclusions. The only evidence came in the form of the plaintiff's medical records, which confirmed her chronic leg pain and swelling problems. Critically, the plaintiff's treating physician instructed her to “continue to elevate her legs when able” and that she was “unable to do any sort of work or employment” under this condition.

The ALJ chose to give the physician's opinions “little weight.” And while the magistrate agreed with Social Security that the plaintiff's doctor “should have been more specific about the height that Plaintiff needed to elevate her legs,” that did not give the ALJ the right to “determine the necessary height of elevation himself.” For that reason, the magistrate ordered Social Security to conduct a new hearing on the plaintiff's disability application.

Speak with a Chicago Social Security Disability Attorney Today

When you go before a Social Security ALJ, you need to present the strongest case possible. An experienced Chicago disability benefits lawyer can help. Contact Pearson Disability Law, LLC, at 312-999-0999 today to schedule a free consultation.

Source:

https://scholar.google.com/scholar_case?case=13147779751628864776