One of the many factors that the Social Security Administration (SSA) considers in reviewing a disability benefits claim is the claimant's ability to continue working. The Third Circuit's recent decision in Diaz v. Commissioner of Social Security provides a roadmap for how this question is often resolved, drawing on input from the claimant, his or her doctors and (sometimes) an independent expert. However like any roadmap, there may be different routes that the Judge can take and part of the attorney's role is to try to point out the best one to the Judge, from the claimant's point of view!
Residual Functional Capacity (RFC) is a person's ability to engage in work related activities despite mental or physical impairments. A claimant whose RFC allows them to do their prior work is considered ineligible for disability benefits. An SSDI applicant whose claim is denied can appeal the decision, usually resulting in a hearing before an Administrative Law Judge.
At hearing, the ALJ may make use of a Vocational Expert (VE), whose role is to gauge both the claimant's ability to work in jobs the claimant has performed over the last 15 years and their ability to work any other jobs that are available in the national economy based on their residual functional capacity (RFC). The RFC given to the VE is crucial in forming their response and is based on the totality of the medical and other evidence.
In Diaz, the Third Circuit upheld the SSA's denial of Plaintiff's Social Security Disability Insurance (SSDI) benefit claim, finding that although she was "extremely impaired," the applicant retained the capacity to perform light work similar to the work she had done before her impairment.
Plaintiff Marta Diaz worked as a clothing presser in a New Jersey laundry from 1997 to 2006. She applied for Social Security Disability Insurance (SSDI) benefits in March 2006, stating that she was unable to work due to depression and a variety of physical ailments. Her claim was initially denied and Diaz appealed this decision in an ALJ hearing. The Third Circuit explains the testimony from Diaz's treating physicians as follows:
Examinations by Dr. Reyes, her primary treating psychiatrist, revealed Diaz had intact cognition, no perceptual disturbances, good memory and judgment, unimpaired concentration, and average intellect. Other examiners, Drs. Arrington and Weistuch, concluded Diaz had restrictions in her ability to learn new tasks, concentrate, and make appropriate decisions, based in each case on one-time consultative examinations.
In addition, a VE testified that Diaz's prior work as a presser was considered "light work." According to the Third Circuit, "[t]he ALJ then asked the vocational expert if a hypothetical individual could work as a clothing presser given the limitations that the ALJ identified in Diaz's RFC. The vocational expert responded affirmatively." The ALJ then determined that Diaz was not eligible for SSDI benefits.
In upholding the ALJ's decision, the court found that the ALJ properly considered the RFC issue because the ALJ "compared medical examinations spanning several years and explained its decision to credit certain medical evidence" and based the hypothetical posed to the VE on Diaz's limitations as determined by the evidence.
This case makes clear the complexities in cases in which RFC is a central issue. An experienced Social Security disability attorney can provide vital assistance to a claimant in a hearing involving a VE. The attorney can gauge the VE's impartiality, expertise and professional qualifications and question the VE fully on any pertinent matter within the VE's area of expertise. The attorney may also pose additional hypothetical questions to the VE that more accurately reflect the claimant's combination of impairments; thus showing the Judge the "best route" on the disability roadmap.
Furthermore, a disability lawyer who is familiar with the unique personality of the ALJ before whom they may appear and the VE's they see repeatedly can present a case in the most effective manner. Contrast that with a "disability advocate" who may not have ever been before the Judge.
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