This article summarizes an actual claim for Social Security disability benefits that was denied by an administrative law judge (ALJ) and appealed to federal court. I'll explain the history of the case and why the federal court disagreed with the ALJ's denial of benefits.
The claimant, Debora Ghiselli, applied for Social Security disability insurance (SSDI) in 2010 based on a combination of impairments, including degenerative disk disease, obesity, and asthma. She alleged that a 2007 workplace accident in which she was struck in the back by a shopping cart had left her unable to perform a full-time job.
After an appeal hearing before an ALJ, the claimant's claim was denied. The ALJ found that although Ms. Ghiselli was not able to return to her previous job as a retail customer service manager, there were other jobs that she could perform. The ALJ found her not disabled, and the Appeals Council (the next level of appeal) agreed.
On appeal to the Seventh Circuit Court of Appeals, the claimant's arguments were twofold:
In its opinion, the Seventh Circuit essentially rejected the claimant's first argument that the ALJ had improperly disregarded the opinions of the claimant's treating physician, Dr. Delo. The court found that Dr. Delo's opinion that the claimant could work only four-hour shifts was not supported by any objective medical evidence. Rather, this restriction seemed to be based entirely on the claimant's subjective complaints. As a result, the ALJ was not required to give controlling weight to Dr. Delo's opinion.
As to the second argument, the Seventh Circuit found that the ALJ's credibility analysis was indeed flawed. The ALJ had found the claimant less than fully credible based on a number of purportedly inconsistent statements, including that the claimant expressed a desire to work even while applying for disability benefits. The court questioned whether this was truly inconsistent:
While a claimant's statements in applying for work following a disability claim might be relevant to her credibility when the statements undermine the basis for her claim, such is not the case here. Persisting in looking for employment even while claiming to suffer from a painful disability might simply indicate a strong work ethic or overly optimistic outlook rather than an exaggerated condition… This is not a situation where the claimant told prospective employers that her pain issues were in the past or otherwise denied suffering from the symptoms that formed the basis for her disability claim.
The claimant had also testified that she was able to perform activities of daily living including light housework, reading, taking care of pets, driving, and grocery shopping. The ALJ found that this testimony was "strong evidence" that the claimant was not in fact disabled, contrary to her claims. As in several other recent Seventh Circuit cases, the court found that the ALJ failed to acknowledge the "critical differences" between most daily activities and full-time work. In particular, individuals generally have greater flexibility in carrying out daily activities; daily activities do not need to meet a particular standard of quality (as they would in a job setting), and help from others is much more likely to be available with daily activities than in the workplace.
The court found that the ALJ's mistake in finding that the claimant lacked credibility was not "harmless error," but that it informed much of the ALJ's decision. Accordingly, the Seventh Circuit sent the case back to Social Security for further proceedings.
Administrative law judges are generally given wide latitude to determine a disability claimant's credibility. The theory is that the ALJ who speaks with the claimant face-to-face is in a much better position than a federal appeals court to evaluate the claimant's truthfulness.
While significant discretion for the ALJ is the general rule, the Seventh Circuit points out that federal appeals courts have a greater ability to review ALJ's credibility assessments when they are based upon objective factors rather than subjective considerations such as the claimant's demeanor.
In other words, the ALJ does not have absolute discretion; he or she must state a logical reason for discounting the claimant's credibility, particularly when that reason has nothing to do with the claimant's behavior before the ALJ.
It's also worth noting that, contrary to the statements of many ALJs throughout the country, applying for disability and expressing a desire to work are not necessarily inconsistent, according to the Seventh Circuit. Moreover, the ability to read a book, care for a pet, or shop for groceries is not "strong evidence" that a person can perform a full-time, 40-hour-a-week job.
If your claim has been denied because the ALJ found that you lacked credibility, it may be worth appealing your case to federal court, especially if you live within the Seventh Circuit's jurisdiction of Illinois, Indiana, and Wisconsin.
Read the full text of this case, Ghiselli v. Colvin, 837 F.3d 771 (7th Cir. 2016).