Public Health — disability benefits

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United States Court of Appeals For the Seventh Circuit

Civil

Public Health — disability benefits

Where a disability claimant is only able to work three hours per day at most, it was error to deny her disability benefits.

“The second medical report that Dr. Rafiq submitted was a form that the Illinois disability determinations agency had asked him to fill out, and one of the questions was how long Bjornson could sit, stand, and walk and what she did when she couldn’t do any of those things. When he stated on the form that she could sit, stand, and walk for a total of only three hours in an eight-hour workday, he was not invading any prerogative reserved to the Social Security Administration. But his statement inescapably implied that she can’t work full time, for what employer would hire for a fulltime job someone who has to lie down for five hours during the workday?”

“The administrative law judge not only forgot his dismissive view of physicians’ testimony relating to issues “reserved to the Commissioner” when he came to Dr. Ezike, but compounded the inconsistency by adding that he was ‘assign[ing] substantial weight to Dr. Ezike’s opinions, as he is familiar with the Social Security disability program, reviewed all available medical evidence, listened to Bjornson’s testimony [at the second administrative hearing] regarding her symptoms and functional limitations, and issued opinions consistent with the rest of the medical evidence record.’ Apart from the fact that Dr. Ezike’s testimony was not ‘consistent with the rest of the record,’ his familiarity with the social security disability program could be relevant only if it permitted him to offer an opinion concerning Bjornson’s eligibility—which the administrative law judge had just said was the prerogative of the Social Security Administration. The regulation does state that ‘the amount of understanding of our disability programs and their evidentiary requirements that an acceptable medical source has . . . [is among the] relevant factors that we will consider in deciding the weight to give to a medical opinion.’ § 404.1527(d)(6). But the administrative law judge seems to have forgotten that when he dismissed Dr. Rafiq’s evidence. And remember that it was a sister government agency (in effect) of the Social Security Administration that had hired Dr. Rafiq to examine Bjornson, which implies that Rafiq was believed to know as much as he needs to know about the social security disability program in order to be able to give an informed professional opinion about the physical condition of an applicant for disability benefits.”

Reversed and Remanded.

11-2422 Bjornson v. Astrue

Appeal from the United States District Court for the Northern District of Illinois, Bucklo, J., Posner, J.