Competing Medical Opinions in New Jersey Social Security Disability Cases - Keith v. Commissioner of Social Security

April 22,2014
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Social Security Disability cases often come down to a battle of medical experts, with a decisionmaker left to choose between competing opinions on how certain impairments impact the claimant’s ability to work. In Keith v. Commissioner of Social Security, the U.S. District Court for the District of New Jersey explains that a Social Security Administration judge considering such opinions must provide a clear explanation of just how much weight the judge gives them and why he or she sides with one over another.
Ms. Keith filed a claim for Social Security Disability Insurance benefits in 2008, alleging that she was no longer able to work due to hypertension, hypothyroidism and a back condition, as well as frequent headaches. The Social Security Administration denied the claim initially and again on reconsideration. Following a July 2010 hearing before an SSA Administrative Law Judge, the judge found that Keith’s hypertension, hypothyroidism and back condition were severe impairments. The judge further concluded, however, that she could continue to perform light work in certain jobs available in the national economy. As a result, the ALJ said Keith wasn’t disabled for benefits purposes.
Vacating the decision on appeal, the District Court said the ALJ may have failed to properly weigh the opinion given by Dr. Li, a state agency medical consultant. Li found that Keith’s hypothyroidism was “controlled” and that she could perform less than a full range of light work based on her impairments. The Court said this opinion was contradicted by other evidence in the record. “Where the opinion of a treating physician conflicts with that of a non-treating, non-examining physician, an ALJ may choose whom to credit but cannot reject evidence for no reason or for the wrong reason,” the Court explained, citing the 2000 decision by the U.S. Court of Appeals for the Third Circuit in Morales v. Apfel.
In this case, the Court said Dr. Li’s opinion was contradicted by the opinion of Dr. Silva, one of Keith’s treating physicians. “While Dr. Li stated that Plaintiff’s hypothyroidism was under control, Dr. Silva increased Plaintiff’s thyroid medication due to Plaintiff’s ‘very high thyroid stimulating hormones,'” the Court explained. Silva also determined that Keith was unable to work for up to six months. Despite the varying opinions, the Court said the ALJ didn’t specifically state where he came down on these issues and how much weight he gave to each opinion. Instead, the ALJ simply said that he gave “some weight” to Li’s opinion in determining that Keith remained capable of working.
The Court said it needed to know the exact weight given to LI’s opinion, and the ALJ’s reasons behind this decision, in order to make the ultimate determination of whether the ALJ’s decision was supported by substantial evidence. “Under the substantial evidence test, an ALJ must sufficiently explain the weight he has given to probative evidence,” the Court said. As a result, the Court vacated the ALJ’s decision and remanded the case for further proceedings.
If you or a loved one is considering filing a claim for SSD benefits, contact the New Jersey Social Security Disability lawyers at Hermann Law Group, PLLC. We are dedicated to providing high quality, personalized legal services and we maintain a very high success rate in Social Security Disability cases. Please call or contact us to set up an appointment.
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