ALJ Didn’t Properly Explain Claim Denial, 4th Circuit Says

A woman asking for disability based on a range of issues will get a chance to once again prove her case. A federal appellate court recently ruled that the judge who presided over her hearing failed to give proper weight to the opinion of her treating physicians and failed to adequately explain his decision to deny her benefits.

The applications for disability insurance benefits and supplemental security income for Stacey Lewis were filed with SSA in October 2010. A disability representative or a Baltimore social security disability lawyer can make sure that the applications are properly filled out. Lewis said she suffered from obesity, degenerative disc disease, degenerative joint disease, thoracic outlet syndrome, diabetes mellitus, lupus, depression and anxiety. She said the ailments started in March 2009.

Lewis was denied at initial application and at request for reconsideration. Claimants are often denied twice before they are approved for benefits. A Baltimore social security disability lawyer or a disability representative can help you with the process of applying for Maryland social security disability. Although Lewis’ request for a hearing was granted, the hearing judge still denied her applications. The ALJ said Lewis could perform light work with some exceptions and said that Lewis’ statements concerning the intensity and limiting effect of her symptoms were “not entirely credible” because the “objective findings of the claimant’s treating and examining sources do not supportĀ the severity of assessed restrictions that Ms. Lewis alleged.” The ALJ found that jobs existed in the national economy for a person with Lewis’ age, education, work experience and remaining functional capacity — basically, the judge ruled that, taking into account her ailments, their severity and her pain, there was still work that Lewis could do.

Lewis then asked a federal trial court to take a look at her case. The magistrate judge issued a letter opinion in which he said that if the ALJ “had credited her testimony, he likely would have concluded that she is unable to work.” In spite of this, the magistrate judge affirmed SSA’s decision denying benefits.

However, the 4th Circuit Court of Appeals saw things differently. Lewis argued that the ALJ failed to satisfactorily explain his decision not to credit her complaints of chronic pain. Lewis also argued that the judge failed to properly credit the testimony of her treating physicians. Although this was recently changed, the ALJ is required to give “controlling weight” to opinions offered by a claimant’s treating physician as long as the opinion is “well supported by medically acceptable clinical and laboratory diagnostic techniques and is not inconsistent with the other substantial evidence in the claimant’s record.” Lewis’ treating rheumatologist said Lewis’ pain constantly interfered with attention and concentration, that she could not lift more than five pounds and was incapable of even low stress jobs. Lewis’ primary treating physician, who had treated Lewis for four years, said she could not sit for more than two hours, or stand or walk for more than three hours and had significant limitations with reaching, lifting and keeping her neck in a constant position.

The ALJ gave “short shrift” to one opinion and discounted the other, the appeals court said. The ALJ failed to explain why he did not give the opinions of Lewis’ treating physicians controlling weight under 20 C.F.R. 404.1527(c)(2) and 416.927(c)(2). “In contrast to Lewis’ well-documented medical history, the ALJ’s rejection of Lewis’ treating physician sources is perfunctory,” the 4th Circuit wrote. The ALJ did not point to anything in the record to indicate that a non-treating source disputed that the medical opinions of Lewis’ doctors were not well-supported by medically acceptable clinical and laboratory diagnostic techniques, the court said. In fact, the court said, the ALJ’s analysis only consisted of four lines.

In addition, the outside physicians used by SSA to evaluate Lewis’ case bolstered the opinions of her doctors, yet the ALJ ignored their conclusions, the court said.

As a result, the case was sent all the way back to SSA for further proceedings.

A Baltimore social security disability lawyer or a disability representative can provide you with guidance so that your Maryland social security disability case is won at the earliest possible point. Filling out the application and making sure that medical records are complete is a difficult and complex process, a Baltimore social security lawyer or a disability representative can help. Delmarva Disability Advocates has experience in obtaining social security disability. Call us at 844.327.5567 for a free consultation.

Appeals, Hearing, Initial Application, Request for Reconsideration