Skip to main content

SUBSTANTIAL EVIDENCE OF DISABILITY

 

Social Security cases fall within the realm of administrative law. Administrative Law Judges (ALJs) are allowed great discretion in their decisions by something called a “zone of choice.”  The judge may reach any conclusion as long as it is based on “significant evidence.”  Yet there are other rules which prohibit decisions with an inadequate basis in the record, or ignoring evidence. 

In Buxton v. Halter, a federal court reversed the ALJ’s decision but stated “Substantial evidence is “ ‘more than a mere scintilla. It means such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.’ ”Thus, the findings of the Social Security commissioner are not reversible by the courts if the judge based the decision on substantial evidence.. However, there are limits.  An administrative law judge may not ignore plain evidence but must give it fair consideration.  In Buxton v. Halter, the federal court reversed a judge’s denial because the judge made a decision without an adequate basis in the medical record and assuming medical facts that only a medical expert could propose.  At the same time, the courts have made it clear that “The findings of [an ALJ] as to any fact, if supported by substantial evidence, shall be conclusive…. In other words, on review of the Commissioner’s decision that a claimant is not totally disabled within the meaning of the Social Security Act, the only issue reviewable by [the] court is whether the decision was based on substantial evidence. It matters not whether the court agrees with the judge’s decision or not.

It also doesn’t matter if there is evidence in the record that supports a different conclusion.  If there is some evidence that points to disability and other evidence that points to not being disabled, the administrative law judge can arrive at either conclusion, as long as there is “substantial evidence” to support the decision.

This totally negates the myth that all the claimant has to do is tell the judge a good story, or explain why he needs disability benefits.  The approval or denial of the claim will certainly rest on whether the claimant has presented “substantial” and objective evidence that he/she meets the rules of the Social Security Administration for disability. In the end, this falls upon the medical records and a reasonable interpretation of their contents.

I am afraid that many claimants fail to understand their burden of proof when going before an administrative law judge for a hearing.

As your advocates, our job in representing you is twofold:  to find substantial evidence which supports a finding of disability, and to present such evidence in a way that the judge is comfortable in making an award of disability benefits. 

 - - - - -  - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

Charles W. Forsythe, MS, is a co-founder of The Forsythe Firm in Huntsville, AL.  Social Security disability counselors and representatives. 

Labels:

Comments

Post a Comment

Popular posts from this blog

MEETING SOCIAL SECURITY'S DURATION REQUIREMENT FOR DISABILITY

SSDI, or Social Security Disability Insurance, requires a severe impairment which has lasted for at least 12 straight months, is expected to last at least 12 straight months OR is expected to end in death. This 12 consecutive months requirement is called the "Duration Requirement."  Disabilities with a duration of less than 1 year are not covered under the Social Security Act. You do not have to wait 12 months to file a claim. There is no requirement to wait 12 months to file.  But if your disability has not already last for at least 12 months, the nature of the impairment must be such that is can reasonably be expected to last 12 months or longer OR to end in death.  Short term impairments are not covered. What you will need to document for your medical and/or mental impairment(s):   A claimant will require objective medical proof.  This comes in the form of official medical records from doctors, clinics, hospitals, counselors, therapists and other professiona...
Post a Comment
Read more

SOCIAL SECURITY BENEFITS FOR DOWNS SYNDROME

Downs Syndrome may qualify for automatic SSI disability in children. A child with Translocation Syndrome or Trisomy 21 will usually be classified as disabled from birth. This type of syndrome affects about 98 percent of the Downs Syndrome population. Social Security will want a diagnosis from a medically acceptable source and they will want certain tests.Once the documentation is presented, an SSI award may be automatic.  Those with Mosaic Down syndrome may qualify, but your child would need more than a diagnosis to be approved. Because [according to SSA] people with Mosaic Down syndrome may not have as many intellectual or physical disabilities as those with other forms of Down syndrome, you’ll need to meet another listing in the Blue Book to qualify. Social Security will consider the complications or manifestations of Downs Syndrome in making a decision. If the claimant is a child (under 18), k eep in mind that SSI is a needs-based program for families with limited resources...
Post a Comment
Read more

A DISABILITY DENIAL IS NOT THE END OF YOUR CASE

By Charles W. Forsythe The Forsythe Firm Social Security denies a lot of applications.  It's expected.  But it's not the end. The good news is:  You can probably win your case on appeal and get paid benefits.  It just takes a bit longer. About 8 out of 10 new disability claims will be routinely denied.  So, it's rather unusual to be approved just by filing an application. An appeal sounds like a last resort or tricky legal maneuver.  It's really quite common--almost  normal--in a Social Security disability case. 8 out 10 claims will be appealed at least once, often twice, before they are paid. The process that pays Social Security disability is not the application, it's the appeal process. Many claimants who don't understand the importance of appeals give up after the first denial.  A serious mistake.  You odds get better in appeals. TIME LIMIT ON APPEALS.  All unfavorable Social Security decisions must be appealed within 60 days.  ...
Post a Comment
Read more