Medical evidence

Judge Zobel summarized the case as follows: "The record paints a picture of a woman (1) who was gainfully employed for 19 years; (2) who had a serious workplace accident requiring three days of hospital care, (3) that resulted in (I) years of treatments and therapies and prescription drugs (all of…

Client with bipolar and other MIs.   DRB reviewed and upheld ALJ (Merrill).   Ct. relates adequate assessment of the evidence to the condition - bipolar - The particular features of the disease should guide the evaluation of the evidence.   ALJ has not adequately…

HIPAA (Health Insurance Portability and Accountability Act) is a federal law that  protects the privacy of your medical records and information.  HIPAA limits who your health care providers can share your medical information with, unless you give your permission in writing by…

Ability to Stoop. Medical records showing treatment limited to 10 months is evidence that impairment did not last the required 12 months. RFC limited claimant to four hours of sitting, less than the six hours usually required for sedentary work. This limitation erodes the occupational base more than…

At Step 4, the ALJ is entitled to credit the claimant's own description of her past work and her functional limitations, but the ALJ has some burden independently to develop the record. Citing Santiago, 944 F.2d 1 (1st Cir. 1991). Remand. Illegibility of non-trivial parts of medical record,…

Claimant's failure to seek treatment is not evidence of medical improvement where claimant didn't seek treatment for 2.5 years prior to initial disability finding. Whether claimant continues to meet a listing is not dispositive in determining medical improvement. ALJ erred in finding medical…

Even though Chronic Fatigue Syndrome POMS were promulgated after adverse ALJ decision, previous version of same section of POMS re: evaluation of Epstein Barr Virus set forth the same principles. Since historically, EBV and CFS have been used interchangeably (even though the medical evidence is…

Report of non-examining, non-testifying physician may, under some circumstances, act as substantial evidence to support a finding that a claimant is not disabled.

Conflicts in evidence are for the Commissioner to resolve. Inference could be drawn that claimant would have secured more treatment if her pain had been as intense as alleged. Court will review ALJ decisions to determine if they are supported by substantial evidence. Court must uphold the…

ALJ may make common sense judgments about functional capacity based on medical findings as long as he does not overstep the bounds of a lay person's competence and render a medical judgment. Evidence regarding claimant's daily activities and demeanor at the hearing, plus doctor's…

ALJ must determine what evidence he credits in order to pose a hypothetical which will be relevant and helpful. The issue of whether or not the testimony of a medical advisor who reviews the record and testifies at the hearing can alone constitute substantial evidence varies with the circumstances,…

The testimony of a non-examining medical advisor--to be distinguished from the non-testimonial written reports in the instant case--can alone constitute substantial evidence, depending on the circumstances. Substantial evidence does not exist to support a finding that exertional impairments are not…

An ALJ's credibility determinations are owed "considerable deference." Claimant did not seek medical treatment during the time in question therefore there was no credible medical evidence supporting claim of pain during that time period. Appeals Council in this own motion review, did…

Dysthymic disorder is severe impairment. To determine the severity of a mental impairment, an ALJ must rate the degree of functional loss in four areas that the SSA has identified as essential to work: 1) activities of daily living; 2) social functioning; 3) concentration, persistence, or pace; and…

Fibrositis. Although Appeals Council was uncertain that fibrositis is a recognized disease, it emphasized that the nomenclature used to diagnose a condition is immaterial to a finding of disability. Medical expert's sworn statement that "if claimant has fibrositis" she is disabled, not…

Consulting examiner's opinions carry no less weight than those of the treating physician. Post - McDonald decision. Discussion of SSR 85-28.

Error for ALJ to discount medical report because it was obtained after claim filed and on advice of counsel. It's common practice in Social Security cases to obtain further medical reports in support of claim. ALJ's decision to discredit medical reports must be based on something more substantive…

ALJ allowed to rely on medical advisor's opinion in the face of contradictory findings. Claimant's burden at Step 4 includes proving the particular demands of past work that she cannot perform. Secretary allowed to rely on medical advisor's opinion that the treadmill exercise test was…

Leading case setting out analysis to be used in analyzing pain. There must be a clinically determinable medical impairment that can reasonably be expected to produce the pain alleged. Other evidence including statements of the claimant or his doctor, consistent with the medical findings, shall be…

Cardiac and mental impairments. Although the Secretary is not bound by a psychiatrist's "sweeping conclusion" as to disability, when uncontroverted evidence exists as to mental impairment, the Secretary should assess the impact of the alleged mental impairment on the claimant's…

Treating physician's opinion not binding on Secretary. Step 2 termination.

Approves administrative notice of occupational reference materials for information regarding various types of work. Court notes that the 4th circuit has held that the Secretary may rely on general categories in the Supplement to the DOT as presumptively applicable to the claimant's past work.…

"Good cause" for remand due to Secretary's failure to develop record. ALJ is not at liberty to substitute his own impression of an individual's health for uncontroverted medical opinion. Given unchallenged diagnosis of chronic schizophrenia, coupled with uncontradicted testimony…

Generally, a remand order is an interlocutory order that does not divest a court of jurisdiction over a case. Absent a clear statement to the contrary, legislation should not ordinarily be interpreted to oust a federal court's equitable power, or its jurisdiction over a pending case. Social…

Possibility of mental impairment causing failure to take medication where medical report states that non-compliance "may be inherent to suspicious paranoia." "It could be unfair for the Secretary to refuse to give disability benefits under § 404.1530 if the claimant's mental…

No substantial evidence that hypertension not controlled because of claimant's failure to follow prescribed treatment. Any departure from a grid rule must, at a minimun, be explained. ALJ made factual errors in application of grid. Remanded.

Although views of medical advisor are not always by themselves substantial evidence when medical advisor does not examine claimant, this rule is of limited value in a case involving a condition alleged to have existed many years before, and where claimant's proof of disability is slight.…

Neither absence of treatment records from relevant time period and retrospective nature of treating doctor's opinion justify ALJ's finding that treating source's report was too speculative a basis for establishing a severe impairment. (remanding for ALJ to obtain retrospective opinions…

A treating physician's opinion may be rejected by the Secretary, who may accord greater weight to his own experts. Treating physician's diagnosis is not necessarily entitled to more weight than CEs.

Court consider the medical opinion given by one or more physicians designated by the Secretary in deciding medical equivalence. Disability finding for widow's benefits requires meeting or medical equivalence to a listed impairment. It is for the Secretary, not the court, to resolve conflicts in…

Court must uphold the Secretary's findings if a reasonable mind, reviewing the evidence in the record as a whole, could accept it as adequate to support his conclusion.

A doctor's conclusory reflections as to claimant's employability, unaccompanied by any formal opinion and diagnoses, do not constitute substantial evidence. Due to non-adversarial nature of proceedings, SSA's responsibility to develop the evidence increases where claimant is…

Disparity between claimant's symptoms and medication prescribed did not compel conclusion that doctor was inaccurate in describing severity of claimant's mental impairments, even though that inference could be drawn. Doctor was a general practitioner, not a psychiatrist. Court comments that…

Unemployment Benefits.Although Court has reservations about the significance of evidence that claimant collected unemployment benefits, Court is reluctant to say that a claimant's decision to hold himself out as able to work for the purpose of receiving unemployment benefits may never be…

Where claimant does not follow the prescribed medical advice which would remedy or reduce his impairments, such conduct is "arguably inconsistent with his complaints of pain."

Discussion of observable signs of pain. ALJ under no duty to go to "inordinate lengths to develop a claimant's case." Holding that Secretary is not at the mercy of every claimant's subjective assertions of pain applies equally well to subjective claims of dizziness. Claimant must…

The claimant has the burden of showing an impairment that is medically determinable. In some rare instances (this case is not such an instance), a claimant can satisfy that burden without medical evidence.

Certainly board certification has never been held a prerequisite to qualification as an expert medical witness. The medical opinion of specialists may be entitled to greater weight than that of general practitioners.

A written report submitted by a non- testifying, non-examining physician who merely reviewed the written medical evidence could not alone constitute substantial evidence to support the Secretary's conclusion. The report "lacks the assurance of reliability that comes on the one hand from first-hand…

Fact that claimant failed to seek medical treatment was arguably inconsistent with his complaint of pain and lent credence to suspicions that he may have been exaggerating. Only when claimant meets his burden to establish that he's unable to return to his former work is there a need for SSA to…