Medical Experts at Social Security disability hearings
Sometimes when a Social Security disability case goes to hearing, the Administrative Law Judge has a brand new doctor testify (usually by telephone). This is not one of your doctors, or (usually) even one of the doctors Social Security has sent you to. These are Medical Experts (MEs) that the Judge calls for several reasons:
Establish a medically determinable impairment. In any Social Security disability case, you have to prove the existence of not only symptoms, but also an underlying cause — a diagnosis. When the records are not clear, or when different doctors have provided different diagnoses (especially over time), a Medical Expert can help clarify what the underlying conditions have been and are today.
Determine if the impairments meet or equal a listing level impairment (step 3 in the Sequential Evaluation Process). If a Medical Expert states your impairments either meet the requirements of listing level impairment, or have the same limitations as a listing level impairment, the case may be approved very quickly.
Provide limitations from the impairment(s). In many cases, treating doctors do not want to make any kind of opinion about work-place limitations. They refuse to complete forms which often results in a gap in your evidence. Even though Social Security often has one of their own doctors review a case and determine limitations during the initial case review (before the first decision), the Medical Expert can provide a new opinion. This can be a better opinion since it is based on evidence that has been developed over the course of the case.
Establish an onset date. If the Medical Expert is supportive of the disability, they may also be asked to estimate how far back the limitations existed. This is important to establishing the correct onset date in a case.
Provide a prognosis. In order for a condition to be disabling it has to either be expected to result in death or be disabling for 12 months or longer. If a condition has not clearly been disabling for 12 months, a Medical Expert may be asked whether it is likely to continue until the durational requirement is met.
While a Medical Expert may touch on any or all of these, the make or break issues are whether the impairments meet a listing, or if not, what limitations are expected to result from the impairments.
Is having a Medical Expert good or bad?
The toughest question at the Social Security hearing
You made to the hearing. The Judge has gone over your impairments, your limitations, your daily activaties. Just when you think you are done, the Judge turns to you and asks:
So, what do you see for yourself in the future?
You freeze. You ask yourself silently, “what is the Judge looking for here? This isn’t a job interview!” You need to know what this question is about.
