United States Court for the seventh circuit issued a remand in a case of a 40 year old applicant who applied for SSDI claiming disability on the basis of severe abdominal pain caused by cirrhosis of the liver, severe thrombocytopenia, hepatitis C, and umbilical hernia.
Stating that the claimant was “one of the most seriously disabled applicant for social security disability benefits whom we’ve encountered in many years of adjudicating appeals from benefit denials,” Judge Posner reversed the ALJ’s findings as to the claimant’s credibility, the severity of his impairments, and his ability to perform sedentary job. The court observed that even though the claimant was able to work on a part time basis after the onset of his disability, his continuous employment was only possible because of a special long term relationship with his employer who was willing to tolerate frequent absences (the VE at the hearing testified that a worker who misses work more than one day a month beyond sick leave, vacation days, and other authorized leave would have difficulty sustaining employment).
The court also criticized the ALJ’s unwillingness to consider a statement from the claimant’s treating physician that he will “be unable to return to any form of employment.” The ALJ’s rejection of this statement because it was a “conclusion reserved to the commissioner” is wrong. A conclusion of whether the applicant is sufficiently disabled to qualify for social security disability benefits is a question of law that can’t be answered by a physician. But the answer to the question depends on the applicant’s physical and mental ability to work full time, and that is something “to which medical testimony is relevant and if presented can’t be ignored.” Additionally, the ALJ’s adverse inference from the fact that the claimant did not seek treatment almost a year after the onset of his painful symptoms was erroneous because the ALJ failed to inquire why the claimant failed to seek treatment (he had no health insurance).