The Importance of Treating Doctor Evidence in Social Security Disability Cases - Mussaw v. Commissioner of Social Security

November 10,2009
imgpsh_fullsize (15)

Medical evidence is key in Social Security Disability cases. As the U.S. District Court for the Northern District of New York explains in Mussaw v. Commissioner of Social Security, statements from a claimant’s personal doctor are often given substantial, and even “controlling”, weight in determining whether the person is entitled to Disability benefits.

Ms. Mussaw filed a claim for Social Security Disability Insurance and Supplemental Security Income benefits in April 2008, alleging that she was no longer able to work as a result of a variety of physical and mental impairments. The Social Security Administration initially denied the claim and Mussaw later appeared at a hearing before an SSA Administrative Law Judge. Following the hearing, the ALJ determined that Mussaw was not disabled for benefits purposes because she retained the ability to perform certain jobs available in significant numbers in the national economy.

On appeal, the District Court reversed the ALJ, finding that the ALJ improperly discredited the opinion of Mussaw’s treating psychiatrist. Dr. Elizabeth Pierson provided a statement concluding that Mussaw was moderately limited in her simple decisionmaking ability as well as in her capacity for interacting appropriately with the public, supervisors, and co-workers. Pierson further determined that Mussaw suffered marked limitations in understanding and carrying out detailed instructions. The ALJ gave “little weight” to this opinion, finding no evidence – such as “evaluation or treatment notes by Dr. Parson” – to support it.

The court said it was unclear whether the ALJ simply misspelled Pierson’s name or thought that Parson was a separate doctor who performed a one-time evaluation. Either way, the ALJ’s decision to discredit Pierson’s statement was erroneous, according to the court.

“First, if the ALJ mistakenly assessed the medical source statement as the work product of a psychiatrist with no treatment history of Mussaw, he undoubtedly failed to properly apply the treating source rule,” the court said. Generally, a treating doctor’s statement is to be given “controlling weight” where it is supported by acceptable techniques. “If the ALJ simply misspelled Dr. Pierson’s name, on the other hand, his lack of awareness that the record contained evaluation and treatment notes by her nevertheless indicates that he did not properly consider the length, nature and extent of the treatment relationship, or the frequency of examination.”

The court further found that this error was not “harmless” – as argued by SSA – because it concerned a fundamental failure to apply the appropriate law to the facts of the case. As a result, the court reversed the ALJ’s decision and remanded the matter back to the judge for further proceedings.

Although legal representation doesn’t guarantee success in a Social Security disability claim, an experienced disability lawyer can provide vital assistance and expertise that may very well mean the difference between approval and denial of a claim at or before the Hearing level. If you or a loved one is considering filing a claim for SSD benefits, contact the New York Social Security Disability lawyers at Hermann Law Group, PLLC. We are dedicated to providing high quality, personalized legal services.