The Use of Medical Experts by Administrative Law Judges in Social Security disability claims

There are a number of different scenarios in which one will find Administrative Law Judges (ALJ’s) in Social Security disability claims consult with medical experts.  Understanding why such experts may be consulted and how their opinions may impact your case is important and can help relieve some of the stress involved with attending a hearing before an ALJ. 

Many clients we represent in their Social Security disability claims will call wondering why it is that they are seeing a medical expect has been called to testify in their upcoming disability hearing.  Depending on the ALJ who is handling the claim, some are more apt to request the assistance from a medical expert than others.  There can be a number of reasons why a medical expert is called to testify.   It may be that there is insufficient evidence in the medical evidence of record (that is, in your Social Security file) that will allow the judge to determine how severe your condition is and how it impacts your ability to function.  It may be that the judge looking at the claim is of the mindset that your case may meet one of Social Security’s medical listings of impairment, but no doctor has been asked to address the issue previously and it may be too technical an analysis for the judge to make without some expert assistance from a physician who specializes in the particular area of medicine at issue.  Assuming one “meets” the criteria for a medical listing of impairment, then entitlement to disability benefits (from a medical standpoint) is likewise automatic.   It is not unusual for the ALJ to ask questions of the medical expert that addresses the extent to which a claimant would be expected to be limited in terms of their ability to sustain activities that are deemed vital for those in a work environment (that is to say, their ability to sit or stand for a length of time, walk, lift, carry, bend and twist at the waist and show up a job on a regular basis.

What is important to realize is that the ALJ may consider you disabled under Social Security’s rules if in fact your medical condition is of such a nature that it either meets or “equals in severity” one of Social Security’s listed impairments, and that such a conclusion cannot be made by an ALJ without the testimony of an expert at hearing.  Social Security’s regulations allow the ALJ to call such medical experts as they feel appropriate.   While the ALJ ordinarily will ask the expert a series of questions that they feel are appropriate to deciding the issues in your case, your Social Security disability lawyer is also given the opportunity to ask questions of the medical expert.  In some circumstances, the ALJ will only ask the expert if they believe the claimant meets a medical listing of impairment and it would be up to your attorney to ask the additional questions necessary to determine whether they may “equal in severity” a listed impairment: in some circumstances, it may be something that the ALJ didn’t consider or that the medical expert has not been asked.   Your lawyer will also have the opportunity to ask the medical expert questions concerning your ability to function and maintain attendance at a work site.  In fact, in one recent case that has been sent back on 2 occasions for rehearing (once by the Appeals Council and once by Federal District Court), the ALJ’s decision was vacated and the case was remanded for further hearing for failing to acknowledge the testimony of his own medical expert, called to testify in person at hearing, that the claimant would have difficulty maintaining regular attendance as a result of her mental health problems.  Without the assistance of an experienced Social Security disability attorney, such questions may never have been asked.

While the ALJ may call the expert to testify in person, many times the medical experts are allowed to call in to the hearing and testify by phone.   Some ALJ’s do prefer to consult with medical experts by sending them a series of questions to be answered in written form versus by way of testimony: these questions are referred to as interrogatories.  Your Social Security disability lawyer is  likewise provided an opportunity under Social Security’s rules to object to such questions, request that additional questions be asked, and in some circumstances may request that the medical expert appear to answer questions the lawyer has regarding their written responses.

Needless to say, it is advisable to have an experienced lawyer assisting you at hearing to ensure your rights are protected when it comes to the testimony of any experts.  At the Law Offices of Russell J. Goldsmith, we are happy to answer your questions and potentially assist you or a loved one with your upcoming hearing whether you reside in Maine, Massachusetts or New Hampshire.  Please feel free to reach out to us at 1-800-773-8622 or by contacting us on line to chat.