What Is Extra-Record Evidence in a Social Security Disability Appeal?

 Posted on December 26, 2020 in Social Security Disability

When applying for Social Security disability benefits, a person will need to provide evidence to show that they have severe physical or mental impairments that affect their ability to find gainful employment. If disability benefits are denied, a person can appeal this decision, and their case will be heard by an Administrative Law Judge (ALJ). In these types of hearings, the ALJ must base their decision on evidence provided by both sides, as well as the opinions of medical and vocational experts. Any additional evidence considered by the ALJ is known as “extra-record evidence,” and certain rules apply regarding when this type of evidence can be used.

Magistrate Reverses ALJ’s Decision Based on Reliance on Extra-Record Evidence

A recent case in Illinois, Elizabeth D. v. Commissioner of Social Security, illustrates when extra-record evidence can and cannot be used by an ALJ. In this case, a woman had been found disabled in 2003 after receiving kidney and pancreas transplants. In 2011, Social Security determined that she was no longer disabled, and she appealed this decision, stating that in addition to her prior medical issues, she also suffered from extreme fatigue, depression, anxiety, migraines, and personality disorder.

When reviewing the evidence, the ALJ chose to give limited weight to the opinions of a doctor who had been treating the plaintiff since 2003, since this doctor’s opinions relied heavily on the plaintiff’s subjective complaints. Instead, the ALJ gave great weight to the opinion of a doctor who saw the plaintiff twice in preparation for hysterectomy surgery. This doctor stated that the plaintiff had an exercise capacity of 10 METs.

To support this doctor’s opinion, the ALJ cited a scholarly article titled “Metabolic Equivalents (METs) in Exercise Testing, Exercise Prescription and Evaluation of Function Capacity.” The plaintiff argued that by doing so, the ALJ relied on extra-record evidence to support his conclusion. The Commissioner of Social Security argued that the ALJ did not use the article to resolve the issue, but instead simply used it to research and clarify the definition of a medical term (METs).

Upon review, the magistrate found that the ALJ incorrectly used the article as extra-record evidence. While the doctor’s opinion considered the plaintiff’s capacity to endure physical stress during and after surgery, the ALJ used the information in the article to extrapolate on these findings and determine that the plaintiff could perform household chores at a heavy level, and thus was not disabled. In addition, the ALJ did not provide the plaintiff with the opportunity to review this extra-record evidence, comment on it, or provide other similar evidence that would support her claims. Because the ALJ made this legal error, the magistrate reversed his decision and remanded the case for reconsideration.

Contact Our Cook County Social Security Disability Appeal Lawyer

If your disability claim has been denied, Pearson Disability Law, LLC can help you determine whether you can appeal this decision. We will provide you with representation during your case, help you provide evidence of your disability, and counter any arguments used to improperly deny benefits. Schedule your free consultation by contacting our Chicago Social Security disability attorney at 312-999-0999.

Source:

https://scholar.google.com/scholar_case?case=1648645790423467572