What Happens When Social Security Disregards a Physician's Opinion in a Disability Case?

 Posted on April 18, 2019 in Denied Social Security Benefits

Social Security disability decisions are supposed to be based on medical evidence, such as the findings of your treating physician. When there is a conflict in the medical evidence–i.e., different doctors reach different diagnoses–a Social Security administrative law judge (ALJ) is entitled to decide which evidence is more credible and consistent with the overall record. However, the ALJ cannot simply ignore uncontradicted medical evidence and substitute his or her own non-medical judgment.

Magistrate Rejects ALJ's Finding That Disabled Applicant Could Use Both of His Hands

When ALJs overstep their boundaries, a disability applicant may have recourse on appeal to a federal court if their claim for disability benefits was ultimately denied. Here is a recent example from here in Illinois. In this case, Andrew B. v. Berryhill, a former bus driver (the plaintiff) applied for disability benefits in 2014, citing a variety of impairments, including carpal tunnel syndrome, torn ligaments in his hands, and arthritis.

For purposes of the plaintiff's disability application, the critical time period was between November 2014 and January 2016. According to the expert opinion of the only doctor to examine the plaintiff during this period, the plaintiff “could only occasionally handle objects with both hands.” That is to say, the plaintiff could not “frequently” handle objects with his right hand due to his medical condition.

A vocational expert (VE) who testified at the plaintiff's disability hearing told the ALJ that a person capable of using both of his hands “frequently” could still find work in the national economy, but a person who could only do so “occasionally” or “less than frequently” could not.

Given this, the ALJ disregarded the medical opinion offered and determined the plaintiff could “frequently” use both of his hands during the period in question. On this basis, the ALJ denied the plaintiff's application for disability benefits.

On appeal, a federal magistrate judge held the ALJ's decision was not supported by “substantial evidence” and returned the plaintiff's application to Social Security for a new hearing. The magistrate explained that while the ALJ “was under no obligation” to accept the doctor's opinion, she was still “required to identify other medical evidence that supported her conclusion that a frequent handling limitation was more appropriate.” But the ALJ failed to identify any such evidence.

This is not to say the plaintiff legally qualifies for disability benefits. Rather, the magistrate directed Social Security to engage in “further consideration of Plaintiff's right-hand limitations during the relevant time frame.” This includes providing a clearer explanation of how the medical evidence supports the ALJ's conclusions.

Speak with a Chicago Social Security Disability Attorney Today

Social Security frequently gets it wrong the first time when it comes to considering disability applications. This is why you should not be discouraged by an initial rejection. But you should also not try to deal with Social Security on your own. A qualified Chicago disability benefits lawyer can assist you in presenting your case to the ALJ, and if necessary pursuing an appeal to the courts. Contact Pearson Disability Law, LLC, to schedule a free consultation with a member of our Social Security legal team today.

Source:

https://scholar.google.com/scholar_case?case=11037343340250405585