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Recent Blog Posts
Determining “Residual Functional Capacity”
In determining eligibility for disability insurance benefits, Social Security must first determine your “residual functional capacity” or RFC. This is an assessment of your ability to work, taking into account any documented physical or mental impairments that you have. By law, Social Security must take all of your limitations into account when formulating an RFC.
Magistrate: Social Security Acknowledged Disability Applicant's Severe Headaches, Yet Did Not Account for Them in RFC
That does not, however, mean that Social Security officials always follow the law. A recent decision from a federal magistrate judge here in Illinois, Charlene J. v. Saul, provides a case in point. This case actually involves a plaintiff who filed for Supplemental Security Income (SSI) benefits. SSI is a type of benefit available to low-income individuals who do not enough of a work history to qualify for disability insurance (SSDI). That said, Social Security uses the same RFC standards when assessing SSI and SSDI claims, so the issues discussed here also apply to disability cases.
Third Disability Hearing Ordered for Ex-Nurse Injured in Patient Assault
Even if you are unable to return to your previous job due to a medical condition, Social Security will not award you disability benefits unless it is satisfied that you are incapable of performing any type of meaningful work. The opinions of your treating physician are often critical towards proving this is the case. Of course, some Social Security administrative law judges may try to “play doctor” and attempt to disregard (or misrepresent) the views of your actual physicians.
Take this recent decision from a federal magistrate judge here in Illinois, T.D.B. v. Saul. The plaintiff in this case previously worked as a registered nurse. In 2007, she suffered a serious wrist injury when she was attacked by a patient. The plaintiff's physician subsequently diagnosed her with chronic regional pain syndrome (CRPS). By 2010, the physician concluded the plaintiff had “reached maximum medical improvement,” which is a legal term used in connection with workers' compensation proceedings. At the time, this meant the plaintiff would be limited to “full-time sedentary work.”
How Long Do I Have to Appeal a Denial of Disability Benefits?
It is not uncommon for Social Security officials to initially deny your claim for disability benefits. Fortunately, you have certain appeal rights. In fact, there are four levels to the disability appeals process. First, you can ask for reconsideration. Second, you may request a hearing before an administrative law judge (ALJ). Third, you can seek review of the ALJ's decision with Social Security's Appeals Council. Finally, you can seek judicial review of a “final” decision to deny benefits in federal court.
Illinois Magistrate Dismisses Social Security Appeal Filed One Day Late
At each stage of the appeals process, there are strict deadlines that you are expected to understand and comply with. If you file an appeal even one day late, a court may refuse to hear your case, regardless of the underlying merits. So it is critical that you act promptly to address a negative decision from Social Security.
Does Taking Care of My Children Mean I Am Not Disabled?
Even when the medical evidence shows a person suffers from multiple–even dozens–of physical or mental impairments, that may still not convince Social Security that a person is entitled to disability benefits. One reason for this is that Social Security administrative law judges (ALJs) will frequently try to minimize or disregard a disability applicant's own description of their pain and other symptoms. Now, an ALJ is allowed to decide how much weight to give such subjective complaints. But the ALJ's findings must ultimately be rooted in the available medical evidence, not some “gut feeling.” That is to say, the ALJ must identify specific inconsistencies between the applicant's complaints and the rest of the evidentiary record.
Magistrate Rejects Social Security's Use of Disability Applicant's Pregnancy, Childcare Responsibilities as Pretext for Denying Benefits
Let's look at a recent Illinois disability case where the ALJ did not do this. In Sylvia C. v. Saul, a Social Security ALJ rejected a 41-year-old woman's application for benefits. There was no question the plaintiff had medical issues: The ALJ identified no fewer than 16 physical and mental impairments–included 9 “severe” conditions–based on the plaintiff's medical records. Nevertheless, the ALJ said the plaintiff did not meet the legal qualifications for disability.
Does Performing Farm Chores Prove That Someone Is Not Disabled?
Many people are forced to apply for disability benefits because they are unable to work due to chronic pain. Unfortunately, Social Security officials are often quick to dismiss such complaints, even when supported by medical evidence. Some administrative law judges (ALJ) seem to think that applicants are exaggerating or fabricating their complaints of pain. This often leads ALJs to selectively cherry-pick information that they think will support denying an application for benefits.
Seventh Circuit Orders New Disability Hearing After ALJ Disregards Key Medical Evidence
But at the end of the day, Social Security must follow the law. A recent decision from the U.S. Seventh Circuit Court of Appeals here in Chicago, Reinaas v. Saul, provides a cautionary example. This case involves a man (the plaintiff) in his mid-50s who lives on a small farm in Wisconsin. The plaintiff previously worked as a factory machine operator. While on the job, he seriously injures his spine and rotator cuff. Following multiple surgeries, he was able to return to work for a time but continued to experience headaches and significant pain in his neck and shoulder.
Why Your Lifting Ability Matters When Applying for Disability Benefits
In order to receive Social Security disability benefits, you must be completely unable to work. Even if you are incapable of returning to your previous job, Social Security will also look at whether you can perform different types of work, including “sedentary” work. Among other things, sedentary work includes jobs that do not require a person to lift more than 10 pounds at once during the workday.
Illinois Magistrate: Social Security Failed to Give “Controlling Weight” to Disability Applicant's Doctor
So if your treating physician determines you cannot lift more than 10 pounds, that should weigh in favor of granting your application for disability benefits. Of course, Social Security does not always make things that easy. Take this recent decision from an Illinois federal magistrate judge, Lucy S. v. Saul. In this case, a Social Security administrative law judge (ALJ) disregarded the findings of an applicant's treating physician with respect to her ability to lift. The magistrate took exception to the ALJ's decision and returned the case to Social Security for a new hearing.
How Does My “Date Last Insured” Impact My Application for Disability Benefits?
Social Security disability is a form of insurance. This means that you can only apply for benefits if you are actually covered–insured–at the time you became disabled. In most cases, your “date last insured” for disability purposes is five years after you left your last job.
Appeals Court: Social Security May Not Ignore Medical Opinions Rendered After Date Last Insured
But can Social Security consider a medical diagnosis or opinion rendered by your doctor after your date last insured (DLI) when assessing your disability claim? The U.S. Seventh Circuit Court of Appeals here in Chicago recently addressed this question in an unpublished decision, Marquardt v. Saul. The plaintiff in this case applied for disability benefits based on his lupus and related impairments.
Can Social Security Ignore the Opinions of a Podiatrist Because She Is Not a “Medical Doctor?”
As a general rule, your own doctor knows your medical condition best. In the context of a Social Security disability benefits hearing, an administrative law judge (ALJ) is therefore required to give your doctor's views “controlling weight,” so long as the doctor's opinions are supported by the available medical evidence. If the ALJ chooses to discount or disregard your doctor's diagnosis, the ALJ must provide “good reasons” for that decision, which also must be supported by evidence.
Christopher C. v. Saul
What the ALJ may not do is misrepresent the evidence in order to discredit your doctor's testimony. Unfortunately, this happens more than Social Security would like to admit. Just recently, an Illinois federal magistrate judge ordered Social Security to conduct a new disability hearing precisely because an ALJ failed to follow the rules in assessing a treating physician's views.
Will Taking a Vacation Affect My Ability to Receive Disability Benefits?
In reviewing your application for disability benefits, Social Security will not just look at your medical record. It will also review many other aspects of your personal life, such as your ability to perform household tasks or even the vacations you have taken. In some cases, a Social Security administrative law judge (ALJ) may even cite the fact you went on vacation as proof your testimony regarding your disability is not “credible.”
Magistrate: Vacations Do Not Disprove Disability Applicant's Testimony Regarding Her Panic Attacks
Federal courts, however, have cautioned Social Security not to simply assume an applicant is not credible simply because they were able to go on vacation. A recent decision from an Illinois federal magistrate judge, Lorena T. v. Saul, provides a case in point. The plaintiff here applied for disability benefits based on a number of mental impairments, including her frequent panic attacks. The ALJ ruled the plaintiff did not legally qualify for disability benefits, but the magistrate reversed that decision and ordered a new hearing.
Social Security Does Not Always Base Disability Decisions on the Actual Medical Evidence
When applying for Social Security disability benefits, it is important to remember that the officials who will rule on your claim are not themselves doctors or medical experts. Social Security regulations require officials to carefully consider the medical evidence, as well as your own testimony regarding your symptoms, in making a decision. It is improper for Social Security to “play doctor” on its own accord or rule in a way that is not supported by the actual medical evidence presented.
Illinois Magistrate Orders New Hearing for Disability Applicant, Citing Multiple Legal Errors
Let's take this recent decision from a federal magistrate judge here in Illinois, Matthew DS v. Saul. In this case, Social Security denied the disability application of a man (the plaintiff) who suffers from “inflammatory arthritis, rheumatoid arthritis, and obesity.” Following a hearing, a Social Security administrative law judge (ALJ) determined these impairments did not qualify the plaintiff for the disability benefits.
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