State Agency Doctors

During the first two levels of review for a Social Security Disability (“SSD”) application, the State agency basically has its doctors deciding the claim.  The State agency doctors frequently lack the credentials or qualifications to evaluate a claimant’s impairments.  Therefore, Social Security attempts to insulate the opinions of State agency doctors by refusing to disclose their full names.

Although federal courts rarely accept the opinions of the State agency medical consultants, administrative law judges (“ALJs”) frequently rely on those opinions to deny SSD benefits.  Fortunately, ALJ Crawley is not one of them.

We represent a 54 year old financial analyst from North Babylon with severe back and knee impairments.  His SSD application was at the first two levels of review based upon the opinions of the State agency doctors, who asserted the claimant could perform light work.  ALJ Crawley rejected those opinions in favor of the claimant’s physiatrist for two reasons.  First, the opinions of State agency doctors were unpersuasive because they were based on a review of the record, and not a direct examination of the claimant.  Second, those opinions were obtained before significant evidence was available for review, which rendered them less relevant in assessing the claimant’s functioning.

If you are considering applying for disability benefits, it is in your best interest to retain an attorney who specializes in disability.  You can call our office for a free phone consultation.  Our offices are conveniently located on Long Island in both Nassau and Suffolk counties.

 

Lung Cancer Approval

We represent a service manager from Shirley, who unfortunately has Stage 4 lung cancer.  By promptly alerting the right representatives at Social Security, and submitting the medical information to qualify for expedited processing, we succeeded in getting benefits approved in 2.5 months.

Delays in processing Social Security applications are well documented.  Knowing how, and being willing, to navigate the Social Security application process from inception is important to ensuring that late stage cancer claims get expedited.

DDS Inconsistency

 

The State agency makes the initial decision on Social Security Disability (“SSD”) applications.  When we advised the State agency that our 24 year old claimant from Uniondale with back problems would not attend a consultative examination (“CE”) due to the COVID-19 pandemic, the State agency agreed that the treating spine specialist could do the CE.  The specialist provided the very information that the State agency requested, yet it denied the claimant’s SSD application anyway.

The administrative law judge (“ALJ”) found the evidence regarding the claimant’s spine impairments compelling, and promptly approved SSD benefits.  The State agency received the exact information that it had requested, and it all supported the claimant’s SSD application. One can only surmise that the State agency gave no regard to the medical evidence because it had predetermined to reject the claim of a 24 year old.

If you are thinking about applying for SSD benefits, it's in your best interest to retain an attorney who specializes in disability.  For more information, please call my office for a free phone consultation.  We have offices conveniently located on Long Island in Nassau and Suffolk counties.

ALJ Schriver Reversed

We received a federal court decision today that reversed the denial of Social Security disability (“SSD”) benefits by administrative law judge (“ALJ”) Robert Schriver.

We represent a 50 year old title reader from Bellerose Manor with fibromyalgia.  The ALJ rejected the opinion of the treating rheumatologist that the claimant lacked a sedentary residual functional capacity (“RFC”) because of the fibromyalgia.  We argued that the ALJ impermissibly relied upon his own lay judgment in lieu of medical opinions when concluding the claimant had the RFC for full time work.  The federal district court agreed.

The judge ruled that because the ALJ is a layperson, not a doctor, he is not permitted to interpret raw medical information into an RFC without the assistance of a medical professional’s insight.  The court added that, “Because an RFC determination is a medical determination, an ALJ who makes an RFC determination in the absence of supporting expert medical opinion has improperly substituted his own opinion for that of a physician, and has committed legal error.”

The most noteworthy part of the decision was that the judge highlighted the importance of the treating physician's opinion even after the repeal of the treating physician rule.

It's important to note, that when you hire an attorney to represent you with a Social Security Disability claim,  you should confirm that he/she has the credentials to take your case to Federal Court, if the need should arise.  Please contact our office for a free phone consultation if you are considering filing for disability.  Our offices are conveniently located on Long Island in both Nassau and Suffolk counties.