Can Social Security Deny My Disability Claim Based on My “Conservative” Treatment?

 Posted on June 27, 2018 in Denied Social Security Benefits

Social Security often adopts a “blame the victim” approach when it comes to reviewing applications for disability benefits. A common tactic is to cite an applicant's “conservative treatment” history. In other words, a Social Security administrative law judge (ALJ) will point to an applicant's decision not to seek a particularly aggressive form of medical care as “proof” that his or her impairment is not really that serious, and therefore not a disability.

Social Security Must “Explore the Claimant's Reasons for the Lack of Medical Care

The flaw in this line of reasoning is that there are plenty of legitimate reasons why a person with a serious mental or physical disability may not seek treatment as often, or as aggressively, as the ALJ might prefer. In many cases it simply comes down to a lack of money. Disability applicants are, by definition, people who are not presently working. Without any income or employer-sponsored health insurance, they are simply unable to afford treatment.

In other cases, even if the applicant can afford certain treatments, there may be medical reasons for pursuing a more conservative course of action. Perhaps a given treatment produces harmful or side effects. Or perhaps the treatment simply is not effective in the applicant's specific use case.

The U.S. Seventh Circuit Court of Appeals, which oversees all disability cases in Illinois, has made it clear on multiple occasions that an ALJ "must first explore the claimant's reasons for the lack of medical care before drawing a negative inference” regarding such treatment decisions.

Despite this mandate, however, Social Security continues to blindly dismiss disability benefit claims based on a cursory glance at the applicant's treatment history. Indeed, there was just such a case recently decided by a federal magistrate here in Illinois. While the magistrate did not say the applicant in this case was entitled to disability benefits, he did say a new hearing was justified due to the ALJ's failure to follow the Seventh Circuit's interpretation of the law.

The plaintiff filed for disability benefits over four years ago. His main physical impairments include lower shoulder pain and chronic back pain. The ALJ determined that while these impairments existed and were “severe,” they did not justify a disability award, in part because the plaintiff's medical records “reflect[] a history of sporadic, routine, and conservative treatment.”

But as the magistrate explained, this justification did not meet the Seventh Circuit's requirements. At a minimum, the ALJ needed to ask the plaintiff “why he had not sought more aggressive or frequent treatment.” Instead, she simply drew “an adverse inference” against the plaintiff without attempting any further inquiry. This justified granting the plaintiff a new disability hearing.

Speak With a Chicago Social Security Attorney Today

Social Security will carefully scrutinize your medical history, searching for any evidence that might undermine your disability claim. This is why you need to work with an aggressive Cook County disability benefits lawyer who will make sure the agency does not step outside the bounds of the law. Contact Pearson Disability Law, LLC to schedule a consultation with a member of our team today to discuss your Social Security application.

Sources:

https://scholar.google.com/scholar_case?case=6966128777559762733

https://scholar.google.com/scholar_case?case=18094071222539597192