Because you are disabled.

File for disability benefits.

Appeal your case.

How you presented your initial application was the best you could do at that time given what you knew and were told.

But, if you were not successful, appeal (1) because you are disabled and (2) because you can improve on your presentation.

Saturday, April 5, 2014

Valvular Heart Disease, Aortic Aneurysm, Postoperative Sternal Complications, Major Depressive Disorder, Obesity and Diabetes Mellitus.

In discussing the Administrative Law Judge’s credibility findings, the magistrate judge cited case law that, “an ALJ’s credibility determinations regarding subjective complaints must be reasonable and supported by substantial evidence” (citation omitted).

“In evaluating plaintiff’s mental condition, the ALJ found that plaintiff was not entirely credible, in part because he had not received any psychiatric treatment nor been prescribed any psychotropic medication to treat depression since April 2010 . . . . The ALJ determined that plaintiff’s lack of treatment suggested that his symptoms were less severe than alleged . . . .”

The court, however, pointed out that Social Security Ruling 96-7p requires an ALJ making a credibility inference from a claimant’s failure to obtain medical treatment to first consider the claimant’s explanation for his failure to pursue treatment.  The ruling gives an example of an individual who “may be unable to afford treatment and may not have access to free or low-cost medical services . . . .”

The claimant testified at the hearing that he had previously seen a therapist and psychiatrist, until he “ran out of insurance” and then he relied on his primary care physician to prescribe the same medication.

The court stated that the ALJ’s decision did not address either the explanation for the lack of continuing psychiatric treatment or the claimant’s subsequent treatment with his primary care physician after that date. “Furthermore, contrary to the ALJ’s decision, the record supports plaintiff’s testimony that [the primary care physician] treated his mental impairments after he stopped treatment at Pine Rest. . . . 

Based on this record, the ALJ’s credibility determination was not supported by substantial evidence to the extent that the ALJ relied on plaintiff’s lack of treatment . . . .”

The magistrate judge recommended that the decision be reversed and remanded.


Officially, Social Security disability applications are considered in a nonadversarial manner but too often Social Security rules and rulings are not followed.

The use of credibility by ALJs (as a denial device) is anticipated by representatives as they prepare for hearings and must also be anticipated by claimants as they prepare Social Security forms.  See HOW TO GET SOCIAL SECURITY DISABILITY AND SSI DISABILITY.

Martin v. Commissioner of Social Security, Case No. 1:12-cv-1030 (D. W.D. Mich., S. Div., Feb. 3, 2014).

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