Brown-Hunter v. Colvin, an appeal from the United States Court of Appeals for the Ninth Circuit, involved an interesting issue about what an administrative law judge (ALJ) is and is not allowed to do with respect to denying Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) benefits.
An ALJ is supposed to an independent hearing officer, but, in reality, they work for the Social Security Administration (SSA), hold hearings at an SSA hearings and adjudication office, and maintain a working office at the same site. For this reason, it should come as no surprise that ALJs will often side with SSA in denying benefits to a claimant, even if that claimant is suffering from a truly debilitating condition or set of conditions.
As our Boston SSDI attorneys can explain, there will also be a so-called vocational expert or “VE” at your disability hearing. This person is also employed by SSA and will use a book written over 30 years ago to determine if you are capable of working. This book is called the Dictionary of Occupational Titles (DOT). If the VE finds any job, you can do in your current condition, regardless of how much lower-paying it is than your current or previous job, he or she will argue you are not disabled.
In Brown-Hunter, claimant had her ALJ hearing, and the judge made a determination she was not malingering and had provided sufficient evidence to support a finding of disability, but ALJ rejected her claim anyway. Malingering is term SSA uses to mean a claimant is either completely faking their disability or has some disability but is exaggerating it for the purposes of getting benefits. It is not necessary the same as a fraud allegation, but it is a common basis SSA uses to deny benefits. It is also very hard to prove, so that works well for the agency.
On appeal, the court found that a judge does have the authority to deny a claim, even though there has been a determination claimant is not malingering, and there has been sufficient evidence presented to show he or she has an underlying impairment which might reasonably produce the pain or other symptoms. However, in order to deny a claim after making both findings, the judge must show there is sufficient and clear and convincing evidence that claimant is still exaggerating the severity of the pain and physical limitations. In other words, if the judge makes a finding claimant has a real disability and is not exaggerating, he needs to have a very convincing reason to show she should not get benefits.
In this case, the appellate court found ALJ did not present a clear and convincing reason for finding she was not in as much pain as she had claimed and vacated the ALJ’s findings. The case was remanded for further proceedings consistent with its opinion. This does not necessarily mean she is automatically entitled to benefits, but it does mean if ALJ denies benefits again, there must a clear and convincing reason for doing so.
If you are seeking Social Security Disability benefits in Boston, call for a free and confidential appointment at (617) 777-7777.
Brown-Hunter v. Colvin, No. 13-15213 (9th Cir. 2015), August 4, 2015, United States Court of Appeal for the Ninth Circuit
More Blog Entries:
SSDI Approvals Lowest in Five Years, June 20, 2014, Boston Social Security Disability Lawyers Blog