Social Security Judge Erred, Failed To Credit Claimant’s Pain Allegations, Reversed, Collect Benefits

Social Security Judge Erred on Credibility. Decision Reversed.

 

Disability ClaimOct. 3, 2016 – The U.S. Court of Appeals for the Seventh Circuit granted a Wisconsin woman’s claim for disability insurance benefits, concluding that an Administrative Law Judge (ALJ) erred when making a credibility determination.

Claimant, Debora Ghiselli, applied for disability benefits under the Social Security Act. She claimed that certain health problems, including degenerative disc disease, asthma, and obesity, prevented her from working.

An Administrative Law Judge (ALJ) denied the claim.

A Judge for the U.S. District Court for the Eastern District of Wisconsin upheld the ALJ’s decision.

But Ghiselli appealed, arguing that the ALJ committed errors.

The ALJ had followed the Five-step Sequential Evaluation Process for evaluating the claim, under 20 C.F.R. section 404.1520(a)(4).

(See https://www.amazon.com/socialNsecurity-Confessions-Social-Security-Judge/dp/1449569757/ref=asap_bc?ie=UTF8)

The Fourth Step required the ALJ to consider Ghiselli’s “residual functional capacity” (RFC) and “past relevant work”(PRW).

To do this, the ALJ considered reports from several physicians. One was the doctor who treated Ghiselli after a workplace injury to her back. The Treating Doctor had recommended that Ghiselli limit daily work to four hours as a customer service manager.

Two other Consultative Doctors, state agency medical consultants, said Ghiselli had “severe pain and limited mobility” but the medical evidence did not support such extreme restrictions. Two other physicians performed imaging examinations and found only mild impairment.

The ALJ determined that a four-hour workday restriction may have made sense after an initial injury, but there was no medical basis to support the restriction years later. The judge assigned “significant weight” to the non-treating physicians’ reports.

In determining Ghiselli’s “residual functional capacity (RFC),” the ALJ noted Ghiselli’s own testimony. Ghiselli said she could still do light housework, drive her car, go grocery shopping, care for her pets, and perform other activities of daily living (ADL).

The ALJ also found that Ghiselli gave inconsistent statements that damaged her credibility. For instance, in one report, Ghiselli claimed her doctor restricted her from working at all until she was cleared to lift more than 15 pounds. But the doctor had said she could work four hours per day, as long as she lifted no more than 25 pounds.

The ALJ ultimately concluded that Ghiselli could perform a range of light work and was not functionally disabled for purposes of disability insurance. The district court affirmed.

But in Ghiselli v. Colvin, No. 14-2380 (Sept. 16, 2016), a three-judge panel for the Seventh Circuit Court of Appeals vacated the ALJ’s decision and remanded the case to the Social Security Administration (SSA).

The panel ruled that the ALJ made an improper credibility determination based on Ghiselli’s subjective accounts of the pain she was experiencing.

“His credibility determination was based in part on his conclusion that Ghiselli could successfully perform numerous life activities,” wrote Judge Diane Wood.

“But without acknowledging the differences between the demands of such activities and those of a full-time job, the ALJ was not entitled to use Ghiselli’s successful performance of life activities as a basis to determine that her claims of a disabling condition were not credible.”

The panel said the error was not harmless “as it informed several aspects of the ALJ’s findings with respect to Ghiselli’s residual functional capacity (RFC) and consequently her ability to perform past relevant work (PRW) or to adjust to other work.”

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