Chicago Workers’ Compensation Lawyers & Illinois Injury Lawyers

Can an Administrative Law Judge in Illinois Disregard All of Your Doctors’ Medical Opinions in Your Social Security Disability Case?

| May 29, 2024 | Social Security |

In a case where there is no jury, the judge is the one who decides the outcome. As a layperson, you probably think that a judge in this kind of situation can pretty much do whatever he/she wants. That is not exactly correct. There are certain limitations established by statutes and by previous case decisions, which constrain what a judge can do. That is true in Social Security Disability benefits cases, as well. Having legal representation from a skilled Chicago Social Security Disability attorney can be essential to the success of your case, especially when it comes to identifying what a judge cannot do… and how to respond when they do cross that line.

There are many ways that a judge can step outside the bounds of what’s allowed. The recent disability benefits case of B.J. is a clear example of one. B.J. was a 60-year-old woman who experienced right knee pain and right shoulder pain, the latter of which stemmed from a torn rotator cuff. On the basis of those problems, she applied for Social Security Disability benefits.

At B.J.’s hearing, the judge received evidence from three doctors. The woman’s treating physician said she could not lift more than 10 pounds. A state-agency physician, Dr. F.M., testified that B.J. could, at most, occasionally lift 20 pounds and frequently lift or carry up to 10 pounds. A second state-agency physician, Dr. B.W., later assessed B.J. and reached the same conclusion as Dr. F.M.

At the end of the hearing, the administrative law judge (ALJ) ruled against awarding B.J. disability benefits. The ALJ decided that B.J. could perform “medium work.” In disability law, the federal regulations define “medium work” as “lifting no more than 50 pounds” occasionally and “up to 25 pounds” frequently.

As you can see, that was much different from what B.J.’s doctor recommended, and it was much different than what the state doctors advised, as well.

Ignoring all the doctors requires a ‘good explanation’ and ‘substantial evidence’

Essentially, what happened was that the judge discounted all three of the doctors’ opinions. The law doesn’t say that an ALJ can never do that, but there are some fairly substantial obligations on ALJs who do take that step. The appeals court, in reversing the ALJ’s ruling denying benefits to B.J., specifically wrote that “rejecting the opinion of an agency’s doctor that supports a disability finding is ‘unusual’” and needs to be backed up by “a good explanation.”

If the ALJ does not provide that good explanation, then that may enhance an applicant’s chances of obtaining a reversal of the denial. The law says that whenever the medical opinions provided by the doctors are all in agreement, an ALJ may not substitute his/her own medical judgment for the medical opinions of the doctors unless the ALJ has substantial evidence to support that denial. In B.J.’s case, the doctors from both sides all agreed that B.J. had limitations that ruled out performing “medium” work as defined by the federal regulations. Nevertheless, the ALJ rejected that medical testimony, despite lacking substantial evidence for doing so. That was improper and required B.J. to get a new opportunity to make her case for an award of benefits.

When you’ve been hurt and need to seek Social Security Disability benefits, rely on the experienced Social Security Disability attorneys at Katz, Friedman, Eisenstein, Johnson, Bareck & Bertuca to provide you with the knowledgeable and diligent representation your case deserves. Our team has many decades of experience fighting for the rights of injured workers and knows how to deliver results. To set up a free case evaluation, contact us at 312-724-5846 or through our website.