Social Security Judges Must Follow Treating Physician Rule

Judge Revives Claim For Disability Benefits

 

Eastern District Judge Arthur Spatt (See Profile) has ordered the Social Security Administration (SSA) to reconsider its decision to deny disability benefits to a 55-year-old union carpenter with a knee injury, finding that an administrative law judge rejected the opinions of the man’s treating physician without justification.

The plaintiff, William Box, slipped and fell on the job in January 2009. He was later diagnosed with multiple injuries in his right knee, including a torn anterior cruciate ligament and torn meniscus. He eventually underwent two surgeries. In November 2009, Box applied for disability benefits. In August 2010, an administrative law judge denied the application. An Appeals Council (A/C) denied Box’s petition for review, and in March 2012, he sued the Social Security Administration seeking to overturn the decision.

Box’s treating physician, Benizon Benatar, submitted an opinion that Box was completely disabled because he could not stand or walk for more than two hours a day.

Another doctor, Erlinda Austria, also examined Box at the request of the New York State Division of Disability Determination. Austria opined that Box was capable of light work. A person capable of light work is presumed to be able to stand and/or work for six of eight hours in a day.

District Judge Spatt found that the ALJ had improperly credited Austria’s testimony over Benatar’s without justification, going against the “treating physician rule,” which requires deference to an applicant’s treating physician.

While an ALJ can choose not to credit a treating physician, Spatt said, that choice must be justified by an analysis of the record, which the ALJ did not do.

Spatt therefore remanded the case for further proceedings consistent with the opinion.

The Claimant, William Box is represented by Sharmine Persaud.

The SSA is represented by Eastern District Assistant U.S. Attorney Vincent Lipari.

The case is Box v. Colvin, 12-cv-1317.

(Brendan Pierson, New York Law Journal,March 19, 2014  )
Read more: http://www.newyorklawjournal.com/id=1202647472089/Judge-Revives-Claim-For-Disability-Benefits#ixzz2wRwdyspq

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