New York Court Rejects Social Security Judge's Decision in Disability Case, Citing Treating Physician Rule - Olenick v. Astrue

June 09,2009
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If the Social Security Administration (SSA) were to compile a list of the most important rules for its Administrative Law Judges (ALJs) to follow in considering a disability claim, somewhere near the top would be the treating physician rule, which provides that an opinion by a claimant’s treating physician is given controlling weight if it is well-supported by medically acceptable clinical and laboratory diagnostic techniques and is not inconsistent with the other substantial evidence in a claimant’s record. In Olenick v. Astrue, the District Court for the Eastern District of New York explains that an extension of the rule requires an ALJ who rejects a treating physician’s opinion to properly explain the reasoning for this decision.
Plaintiff Karen Olenick filed a claim for Social Security disability benefits, asserting that she’s unable to work due to back pain resulting from a 2002 injury sustained while working as a “packager/picker” for a vitamin manufacturer. The SSA denied the claim. Following an administrative hearing, an SSA ALJ found that Plaintiff was not disabled for benefits purposes because, although she could not return to her previous career, she retained the ability to perform a full range of sedentary work.
On appeal, Plaintiff argued that the ALJ improperly discounted the opinion of her treating physician, Dr. Nolan Tzou. An anesthesiologist specializing in pain management, Dr. Tzou began treating Plaintiff one year after she sustained the injury. He diagnosed her with cervicalgia, displacement of a cervical disc, and an intervertebral disc disorder and prescribed pain medication. Although Plaintiff began working as a Target sales clerk in 2003, the following year Dr. Tzou found that she was “totally disabled” as a result of ongoing back pain.
In reversing this decision, the court determined that the ALJ failed to give sufficient reasoning for rejecting Dr. Tzou’s opinion. “Where an ALJ declines to accord controlling weight to the medical opinion of a treating physician, he must give good reasons for refusing to do so,” the court noted, citing its 2011 opinion in Taub v. Astrue. the court held that where an ALJ rejects or fails to give controlling weight to the opinion, the case must be remanded, even where the ALJ’s ultimate decision is supported by substantial evidence. This requirement, according to the court, is at least partially designed “to let claimants understand the disposition of their cases, since a claimant might be especially bewildered when told by an administrative bureaucracy that she is not disabled, unless some reason for the agency’s decision is supplied.”
In this case, the court found that the ALJ failed to give “good reasons” for rejecting Dr. Tzou’s opinion. In fact, according to the court, it appears that the ALJ gave no reasons at all for this decision, adding “assuming it was not entirely overlooked.” Thus, the court remanded the case back to the ALJ for further proceedings with instructions that the judge consider Dr. Tzou’s opinion.

As experienced New York Social Security disability lawyers, we often see cases in which an ALJ rejects a treating physician’s opinion for seemingly no good reason. If also denied by the Appeals Council, a claimant’s only recourse is to file suit in Federal Court. Claimants represented by an experienced disability lawyer can be assured that their cases will be handled properly from application through any necessary appeal, including to Federal Court. Non-attorney representatives, on the other hand, are not permitted to appear in federal court and thus, when necessary, a denied claimant must go through the difficult process of finding representation willing to argue the case on his or her behalf at the Federal Court level.