Why ALJs Tend to Find Claimants Disabled More Frequently Than Do State Agencies
Administrative law judges (ALJs) tend to find claimants disabled more frequently than do state agencies. According to a Social Security Administration study of the differences between state agency decisions and ALJ decisions, ALJs found claimants with back impairments disabled 75% of the time, while the state agency did so only 11% of the time. ALJs found claimants under age 50 with back impairments disabled 68% of the time, while the state agency found them disabled only 2% of the time. What is the reason for this difference?
This can be explained by looking at how ALJs and state agencies approach a case. The general rule is that a disability decision cannot be inconsistent with the medical evidence. State agencies tend to look no further than the medical evidence, and they tend to treat all claimants with similar medical findings the same, while ALJs tend to look at the “big picture.” With an ALJ, your Greenville disability lawyer has the opportunity to present not only your medical evidence, but also your testimony and has an opportunity to argue your case.
The state agency decision-makers have only the cold file to review and look only at the medical filings when determining a claimant’s ability to work. Your Greenville disability lawyer will not be able to present your full case to the state agency. Despite several successful lawsuits challenging state agencies’ reliance on the Listing of Impairments, state agencies still use the Listing of Impairments more often as the unstated basis for a denial determination. This is especially true for claimants under age 50.
Additionally, state agency decision-makers generally use specific formulas from state agency manuals to determine “residual functional capacity” (RFC) for certain medical impairments. These formulas essentially treat all claimants with similar medical findings the same, no matter what individual differences those claimants may have. As a result, few of the state agency formulas result in a conclusion that a claimant can do less than a wide range of sedentary work.
ALJs look at the “big picture.” They tend to evaluate the entire case when determining a possible RFC. This means that the medical findings are used more as parameters for a range of possible RFCs. ALJs also look at your testimony and your credibility when determining which RFC fits your work capacity. This is where your Greenville disability lawyer’s assistance is crucial. This is also why ALJs find claimants under age 50 disabled much more often than do the state agency decision makers.
If you have any questions about your disability case call the Dennison Law Firm for a consultation.
