How Your Doctor's Opinion Can Help You in a Social Security Disability Benefits Claim - Oblinger v. Commissioner Social Security

June 03,2014
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In Oblinger v. Commissioner Social Security, the District Court for the Southern District of Ohio once again explains the importance of treating physician opinions in a Social Security Disability case.

The Social Security Administration (SSA) denied Plaintiff Dean Oblinger’s Disability benefits claim, in which he asserted that he was unable to work due to back pain resulting from a broken back and spinal fusion procedure. A 46-year-old who had previously worked in sanitation, as a retail stock supervisor and as a “security gate guard,” Plaintiff later appeared at an administrative hearing before an SSA Administrative Law Judge (ALJ). Although Plaintiff testified at the hearing that he experiences severe pain radiating through his legs on a daily basis and can stand or sit for only limited amounts of time before his legs go numb, the ALJ found that Plaintiff was not disabled for benefits purposes.
Specifically, the ALJ determined that Plaintiff retained the residual functional capacity (RFC) to perform a limited range of light work, with the ability to sit, stand or walk for up to six hours a day so long as he could change positions at will. With this RFC, the ALJ ruled that Plaintiff could return to previous work as a gate guard. The RFC determination was based on the expert opinion of Dr. Gaitens and the results of a functional capacity assessment performed by Dr. Cho, a state agency reviewer, while the decision regarding the type of jobs Plaintiff could perform was based on the testimony of a vocational expert.
On appeal, the District Court found that the ALJ failed to give appropriate weight to the opinion of Dr. Fitz, who treated Plaintiff from 2004 to 2009 and stated that he was disabled. As the Court explained, “[i]f not contradicted by any substantial evidence, a treating physician’s medical opinions and diagnoses are afforded complete deference.” In the event that an ALJ decides to afford less weight to a treating physician’s opinion, the judge must explain the specific amount of weight given to the opinion and the reasons for it.
Here, the Court found that the reasons provided by the ALJ for giving Dr. Fitz’s opinion “little weight” were not sufficient. Despite finding that Dr. Fitz’s opinion was inconsistent with his clinical findings and not supported by diagnostic tests, the ALJ did not identify the inconsistent findings nor explain the tests, according to the Court.

The Court also found that the ALJ’s finding that Fitz “did not reference specific medical findings within the record and/or explain how those medical findings supported the opinion expressed,” was also not sufficient to discount the opinion. In fact, Fitz provided “a very detailed letter” explaining Plaintiff’s conditions – diagnosed by objective testing – and their effect on his ability to sit, stand and walk. Noting further that “some limitations caused by pain are subjective in nature and will never have a direct correlation with objective measurements,” the Court explained that this is exactly why the law affords greater weight to the opinion of a treating physician, who has been able to examine a claimant over time, than to others who have more limited familiarity with the claimant.
As a result, the Court reversed the decision and remanded the case back to the ALJ for further proceedings.
The information that a treating physician provides has a huge impact on a Social Security disability claim. For a successful claim, the applicant’s treating doctor should provide the claimant with a letter detailing how the claimant’s medical conditions limit his or her ability to return to work and to do everyday activities. Many doctors are reluctant to involve themselves with the paperwork necessary for a successful claim, but an experienced disability attorney can assist in making sure that the claimant’s medical records are clear and complete.