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Will Social Security Use My Ignorance of the Law Against Me?
There is a common misunderstanding with respect to disability insurance. When considering your application for disability benefits, Social Security does not just evaluate whether or not you are medically able to perform your past work. It must decide whether you are capable of performing any type of sustained work. This distinction is often used as reasoning to deny benefits to an applicant.
Judge Orders Social Security to Reconsider Disabled Truck Driver's Claim
An applicant's failure to completely understand the law, however, does not in and of itself justify denying disability benefits. This point was hit home by a recent decision from a federal judge here in Illinois. In this case, King v. Berryhill, the plaintiff previously worked as a truck driver. He stopped working in 2008 due to chronic back pain, for which he did not seek treatment until six years later. In 2014, the plaintiff's treating physician diagnosed him with “severe lumbar degeneration” and several related conditions.
Will Stopping Medical Treatment Hurt My Disability Case?
Social Security disability applicants who suffer from chronic pain often face a difficult choice. If they stop treatment that is no longer effective, Social Security may cite that as proof the pain is not that bad. But if the treatment continues, the agency may say that shows the applicant can effectively “manage” their pain. Either way, Social Security may decide that the applicant is not disabled.
Fortunately, the federal courts often see through this “heads I win, tails you lose” logic. The reality is that a disability applicant may need to stop treatment for a number of valid reasons. This does not, in and of itself, mean they are able to work full-time in spite of their chronic pain and other ailments.
Social Security Criticized for Inaccurate Description of Disability Applicant's Pain, Treatment Options
Accounting for Medical Impairments When Assessing a Disability Claim
One of the basic responsibilities of Social Security when assessing a claim for disability benefits is to consider the effects of an applicant's medical impairments on their ability to work. Even if Social Security ultimately determines the effects do not rise to the level of a legally qualifying disability, the agency must still perform a proper assessment. In other words, Social Security cannot simply ignore a documented medical impairment altogether.
SSA Failed to Consider Effects of Disability Applicant's Edema
Consider this recent decision by a federal judge here in Illinois. The Social Security Administration denied a plaintiff's application for disability benefits. Before an administrative law judge (ALJ), the plaintiff presented medical evidence documenting the following impairments: HIV, obesity, edema, and lymphedema. The latter two refer to excess swelling in the plaintiff's left leg.
Social Security Cannot Ignore “Subjective Complaints” About Back Pain
Social Security officials often try to discredit or discount the expert opinions of a disability applicant's treating physicians. In many cases, a Social Security administrative law judge (ALJ)–who is not a doctor–will attempt to substitute their own judgment for that of the medical professionals. Such actions are inconsistent with Social Security's own regulations and can lead to significant problems for the agency if a rejected applicant seeks judicial review in the courts.
Federal Appeals Court Orders SSA to Reconsider Disability Applicant's Case
For example, the U.S. Seventh Circuit Court of Appeals here in Chicago recently ordered Social Security to conduct a new hearing in the case of a disability applicant who was previously denied benefits. The main problem identified by the appeals court was the ALJ's failure to properly explain her reasons for largely ignoring the medical testimony of the plaintiff's treating physicians. Although the Court did not rule that the plaintiff was legally disabled, it did hold that Social Security owed him a better explanation for denying his application.
The Role of Consultative Physicians in Disability Cases
When applying for Social Security disability benefits, the medical records provided by your own treating physicians are rarely taken at face value. Social Security will also seek one or more consultative medical examinations. These are exams conducted by doctors hired by the government to supplement the existing medical records in your case. In many cases, consultative physicians only do a quick exam, yet their views are often afforded great weight by Social Security administrative law judges (ALJs) when deciding whether to grant or deny a disability application.
Appeals Court Rejects Disability Applicant's Interpretation of Doctors' Opinions
When dealing with consultative physicians, it is important to be honest. Do not exaggerate or downplay any symptoms you are experiencing. Similarly, you need to be accurate when citing or discussing any findings presented by the consultative physicians.
How Inconsistency Can Doom a Disability Claim
Inconsistency is often a major factor in Social Security denying disability claims. If the agency feels your doctor's opinions are inconsistent with the other medical evidence available, your claim can be denied. Similarly, if an administrative law judge (ALJ) feels your own testimony with respect to your symptoms–especially with respect to subjective matters like pain–is inconsistent, that may also form the basis for denying a claim.
Appeals Court Sides With Social Security Despite Problems With ALJ's Reasoning
Consider a recent decision by the U.S. Seventh Circuit Court of Appeals here in Chicago. The plaintiff in this case unsuccessfully applied for disability benefits. He previously worked for a chemical company, and while loading chemicals onto a truck at work one day, he “felt pain in his low back.” The pain persisted, so he eventually saw a specialist, who determined the plaintiff had a large disc herniation “that was pinching a spinal nerve root.”
How Your Debts May Affect Your Social Security Disability Award
Many Illinois residents are understandably reluctant to hire an attorney to represent them when applying for Social Security disability benefits, because they simply cannot afford to pay a lawyer–especially when they are already unable to work and have limited financial resources. This is why a qualified disability lawyer works on a contingency basis. In other words, the lawyer only accepts payment if they obtain a disability award for the client.
Federal law also requires Social Security to pay applicants’ attorney’s fees in certain cases. Specifically, the Equal Access to Justice Act (EAJA) provides that when an applicant prevails in litigation against the Social Security Administration–and the government's position was not “substantially justified”–then a judge may order an award of attorney's fees to the successful applicant. However, an EAJA award is payable directly to the disability applicant rather than his or her attorney.
How Does Using a Cane Affect My Disability Claim?
One sign that you may qualify for Social Security disability benefits is the need to use a cane in order to walk or stand for prolonged periods of time. While the use of a cane does not automatically mean you are legally disabled, it does provide strong evidence that you are unable to perform the type of activities typically associated with full-time work. At the same time, Social Security officials may attempt to minimize or discount the importance of your need to use a cane as a pretext for rejecting your disability application.
Social Security Ordered to Reconsider Stroke Victim's Case
Consider a recent disability case from here in Illinois. The plaintiff in this case was a man in his early 50s. Five years ago, he suffered a heart attack followed by a stroke. As a result, he continues to experience weakness on the left side of his body, which requires him to use a cane for walking.
The Importance of Challenging Social Security Vocational Experts
One of the messiest aspects of the Social Security disability benefits process is dealing with the vocational experts (VEs) retained by the government to decide whether or not an applicant is still capable of working in spite of their physical or mental impairments. Despite the fact that they are referred to as “experts,” in many cases, these individuals are simply pulling numbers out of thin air. Ideally, a VE is supposed to provide reliable estimates of the types of work–and number of jobs available–that a hypothetical applicant could perform. However, in practice, a VE is often forced to rely on outdated methodology that provides little in the way of useful evidence.
Magistrate: Social Security Failed to Press VE on Source of Job Estimates
Unfortunately, the flawed methodology used by VEs does not stop Social Security from relying on such evidence. Consider a recent decision from a federal magistrate judge here in Illinois. In this case, the plaintiff applied for disability benefits eight years ago. At a 2016 hearing, a VE testified regarding the plaintiff's past work and hypothetical job prospects given his disability. The VE explained that the plaintiff previously worked as a “combination photographer and retail store manager.”
Will Alcohol Addiction Prevent Me From Receiving Disability Benefits?
Many Illinois residents suffer from alcohol or drug addiction. Such conditions can substantially impair a person's ability to maintain gainful employment. Unfortunately, Social Security tends to treat addiction as a moral failing rather than a medical condition. According to federal regulations, drug and alcohol addiction are not impairments that qualify an individual for disability benefits. In fact, Social Security may reject an applicant with other impairments if it determines that drug addiction or alcoholism is a “contributing material factor” towards their disability.
Court Holds Applicant Not Legally Disabled, Regardless of Alcoholism
In plain English, if Social Security thinks you would be fine to work if you stopped drinking, it will find that you are not legally disabled. The burden of proof is on you, as the applicant, to prove that alcoholism is not material to your disability. This is in addition to the burden all applicants must meet to prove they have a disability in the first place.