Elder Law

Top 10 Winning Arguments When Appealing From An ALJ?s Denial Of A Social Security Or SSI Disability Claim

By dvanar

Here are 10 arguments that can be used effectively when appealing the denial of a Social Security or Supplemental Security Income disability claim by an Administrative Law Judge (ALJ):

1. Failure to properly evaluate mental impairment(s). The ALJ may have erred in failing to evaluate the claimant?s mental impairment and resulting functional limitations as required by 20 C.F.R §404.1520a.
2. Failure to address opinions of State agency non-examining medical consultants. The ALJ failed to comply with 20 C.F.R. §404.1527(f)(2) in ignoring the opinion of the State agency non-examining physician and in failing to provide any reasons for his obvious rejection of this evidence.
3. Failure to address treating physician evidence. While the ALJ referenced the opinion of the treating physician, he/she failed to comply with 20 C.F.R. §404.1527 in not providing any reasons for his/her rejection of the treating physician?s opinion.
4. Failure to address other medical opinions of record. The ALJ committed reversible error in failing to provide any reasons for his/her rejection of the of the opinion of Dr. XXX whose opinion conflicts with the ALJ?s residual functional capacity (RFC) finding.
5. Failure to make a proper credibility finding. The ALJ committed reversible error in failing to comply with SSR-96-7p and 20 C.F.R. §404.1529 in failing to evaluate the claimant?s subjective complaints.
6. Failure to properly assess the claimant?s RFC. The ALJ committed reversible error in failing to comply with SSR-96-8p in assessing the claimant?s RFC.
7. Failing to properly consider the mental and physical demands of the claimant?s past work. The ALJ committed reversible error in failing to comply with SSR 82-62 in not discussing the specific mental and physical demands of the claimant?s past relevant work prior to summarily determining that he/she can return to that work.
8. Failure to obtain vocational expert testimony. The ALJ committed reversible error in mechanically relying on the Medical-Vocational Guidelines and in failing to obtain vocational expert testimony.
9. Failing to comply with the HALLEX procedures in soliciting post-hearing evidence. The ALJ failed to comply with the procedures set forth in HALLEX I-2-5-42 in failing to transmit the proposed interrogatories to the claimant prior to submission to the physician, or in failing to proffer the new evidence to the claimant.
10. Mischaracterization or misstatement of the record in some significant degree.

Source: Winning Appeals Council Arguments, 4th Ed., by Sarah H. Bohr. (A great resource!)

Full post as published by Law Office of Donald D. Vanarelli Blog on July 09, 2009 (boomark / email).