HOW JUDGES DECIDE SOCIAL SECURITY DISABILITY CASES

You get to a hearing with a judge only after your disability case has been denied twice:  once at application and again at "Reconsideration."

Judges have authority to ignore other decisions and give you a new and better decision or approval.

But how do judges decide Social Security disability cases?  Believe it or not there are established, set rules for doing so.  

First the judge must decide whether you have worked since you claim to have become disabled.  If you have, (s)he must decide if you worked enough to have "substantial gainful activity," according to certain wage limits set by the regulations.

Second, the judge must decide whether you have a "severe and medically determinable impairment" that significantly interferes with your ability to perform work activities on a full-time basis.  Then, it will be decided whether you meet or equal one of the agency's published Listings.  (Most claimants will not).

If you do not meet a Listing, the Judge must determine your “residual functional capacity.”  This is the most you can physically and mentally do at work over the long haul.  The Judge will look at all the evidence in your file.

This is a two-step process.  First, the Judge determines if what you are saying about your limitations makes sense when looking at the medical records.  Could these conditions cause the symptoms you are testifying about?  Typically, the answer is “yes.”  (If not, you got problems).

It’s that second question where claims get denied.  That Judge must look at the “intensity, persistence, and limiting effects” of our client’s symptoms to determine our client’s actual work limitations.  The first place a Judge goes to wrestle with this is “objective findings” in the medical records. These are findings in the medical record that can be observed without talking to a patient, like an x ray, MRI, or a clinical test result in a doctor’s office.  If the record does not include objective findings, the Judge looks at the other evidence in the claims file to determine how much symptoms limit work ability.  This is where some Judges will go fishing for inconsistencies to justify a claim denial.

This is why the claimant's court testimony must be consistent, truthful and in accord with the statements in the doctors' files.

The residual functional capacity (RFC) will determine what level of exertion the claimant could perform or what type of work he/she could do.  The 5 exertion levels are:

Sedentary work (the easiest level)

Light work

Medium work

Heavy Work, or

Very Heavy Work

Most cases will be decided on whether the claimant can consistently perform either sedentary or light work.  I rarely see a judge consider medium level work because the assumption is that if an individual can't perform either light or sedentary work then he/she is disabled.

Arriving at an individual's residual functional capacity (RFC) is somewhat subjective.  It really helps if one of the claimant's treating doctors provides an opinion about the claimant's restrictions or limitations.  This can be very useful in getting the RFC knocked down to sedentary work, or better, below sedentary work.  The less the claimant can do, the more likely he will be found disabled.

This all requires more skill and planning than meets the eye.  A good Social Security disability lawyer can be essential in setting the legal stage for a favorable disability decision.  The odds of a claimant doing so "by accident" or by luck are almost non-existent.

____________

Call The Forsythe Firm in Huntsville for a free consultation about Social Security disability.  We know the law and the rules.  We have represented thousands of claimants at hearings.  Our consultation is FREE and we never ask for a fee unless you are approved with past due benefits.  (256) 799-0297.  

Pay us for Success, nothing less.  (256) 799-0297.