Can the ALJ Disregard Medical Evidence?

Parmele Law FirmSocial Security, Uncategorized

Administrative Law Judges (“ALJs”) are responsible for taking testimony and evidence at Social Security disability hearings when an applicant is denied Social Security Disability Insurance benefits (“SSDI” or “disability benefits”).

There are any number of reasons why a disability application could be denied, but going to hearing is the applicant’s chance to have the judge take a “fresh look” at the evidence and to hopefully, decide in the applicant’s favor.

Judges, whether they are state, federal or administrative, are supposed to be fair and impartial. We expect them to consider all the evidence and to weigh it carefully, and most of the time, that is exactly what they do.

But sometimes, judges can be biased—either in favor or against a party.

In disability cases, it just so happens that most ALJs hear hundreds of cases—many of them involving applicants complaining of having a “bad back” or “chronic pain.” As we have discussed elsewhere in our blog, some people, ALJs included, are biased against disability applicants.

Disability decisions made by Social Security ALJs are supposed to be based on the medical evidence. Yet some officials disregard the medical evidence in favor of their own preconceived biases.

One recent case decided by the U.S. Seventh Circuit Court of Appeals in Chicago discussed this situation.

In the case of Plessinger v. Berryhill, decided on August 20, 2018, the Court of Appeal expressed its exasperation with such practices by the SSA. In that case, the ALJ largely disregarded the testimony of the applicant and his treating physicians regarding the applicant’s pain from congenital spinal stenosis and other serious medical impairments. Instead, the judge deferred to the testimony of a non-treating consulting physician who specialized in lung disease—not back problems or chronic pain when it came to whether or not the applicant’s claims were “credible.” Ironically, that same doctor in his report deferred the credibility issue to the ALJ. Nevertheless, the ALJ said the consultant’s views were entitled to great weight because he conducted a “careful analysis” of the applicant’s condition, although the ALJ offered no specific examples.

Because the doctor (Dr. Pella) had not examined the applicant, his report specifically indicated that he did not include in his findings the applicant’s own assessment of his condition and was not rendering an opinion on the applicant’s credibility. The ALJ simply ignored this. In his decision, the ALJ deferred the issue of credibility to Dr. Pella, while Dr. Pella had deferred that decision to the ALJ.

The Court of Appeal ruled that as a matter of law, “The ALJ cannot delegate to any doctor, and certainly not to a non-examining doctor, the task of evaluating the claimant’s credibility.” This was not a minor point, the Court said. If the applicant’s “own account of his pain and resulting limitations” were accurate, it should show that he is “totally disabled and eligible for benefits.”

This case is important because it makes it clear that an ALJ cannot defer credibility decisions to physicians. It also points out some of the disability bias that many applicants face in pursuing disability benefits.

Consult With Disability Counsel.

Winning social security disability benefits is never easy. If you have been denied benefits, call us. We are experienced disability attorneys. We FIGHT to get our clients the benefits they deserve. We have offices throughout Missouri, and Kansas, and in Belleville/Swanson, Illinois. We have offices in several cites in Oklahoma, too. We offer free consultations and we do not get paid unless you win your case. Send us an e-mail or call 855-727-8625.