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3 min read

Taking the Fight to Court: Araiza's Complaint against SSDI Denial

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Reviewing a Claim for Social Security Disability Insurance (SSDI) Benefits: Demanda N. Araiza's Case

Plaintiff Demanda N. Araiza filed a claim for Social Security Disability Insurance (SSDI) benefits with the Social Security Administration on November 30, 2016. Araiza cited disability stemming from a hip injury and sleep apnea. However, Araiza's initial attempts to secure benefits were met with denials on April 25, 2017 and June 21, 2017. In order to contest these decisions, Araiza proceeded to request a hearing before an Administrative Law Judge (ALJ). The hearings were held on March 29 and July 9, 2019.

During these hearings, Araiza's case underwent a thorough evaluation revealing the presence of multiple severe impairments. However, it was determined that Araiza did not meet the specific criteria for a listed impairment that would qualify her for full SSDI benefits. While the ALJ acknowledged the challenges Araiza encountered due to her condition, it was determined that she still possessed the capacity to engage in light work, albeit with certain limitations and restrictions.

ALJ's Determination: Assessing Araiza's Ability to Engage in Employment Opportunities

The ALJ's decision regarding Araiza's disability claim relied on assessing her credibility in relation to the severity and persistence of her symptoms. While Araiza provided testimony to support her claim, the ALJ identified inconsistencies between her testimony and the medical evidence presented. Notably, the ALJ discovered that Araiza did not require an assistive device until August 21, 2018, contradicting her initial claim. As a result, on October 8, 2019, the ALJ denied Araiza's request for disability benefits.

Throughout the appeals process, several expert opinions were considered. One of these opinions came from a vocational expert (VE) who identified three light unskilled jobs that Araiza could potentially perform. Additionally, an assessment conducted by orthopedic consultative examiner Dr. Roger Wagner highlighted Araiza's positive dexterity and flexibility. Treatment notes by Dr. Lalaine Tiu, covering the period from March to July 2019, shed further light on Araiza's condition and its impact on her ability to work. 

Based on the evidence available, the ALJ concluded that Araiza had the ability to engage in employment opportunities within the national economy. This determination was supported by the vocational expert's testimony and the assessment of Araiza's residual functioning capacity. Araiza's request for the Appeals Council to review the ALJ's decision was denied.

Filing a Complaint: Taking the SSDI Denial Case to Court

Seeking a fair resolution, Araiza decided to take her case to court and filed a formal complaint on March 1, 2021. This complaint primarily focused on two key issues that arose during the fifth step of the disability assessment process, which involves the Commissioner's responsibility of identifying suitable employment options for individuals with limitations. Specifically, Araiza expressed concerns regarding the ALJ's handling of conflicts within the VE's testimony, as well as the insufficient evaluation of evidence presented by her pain management doctor.

Araiza contends that the ALJ made an error by neglecting to investigate potential conflicts between her limitations and the job descriptions provided by the VE. While the Dictionary of Occupational Titles (DOT) offers general job descriptions, the VE's testimony offers more detailed insights into the specific nature of different jobs. It is the duty of the ALJ to address any inconsistencies that may arise between the VE's testimony and the DOT.

Araiza argued that the ALJ's failure to address these conflicts constitutes a significant oversight that resulted in discrepancies between the RFC determination and the cognitive requirements of one of the suggested jobs. However, the Commissioner downplayed this alleged error, asserting that it holds no influence over the decision since there are still two other identified occupations that align with Araiza's limitations. Furthermore, the Commissioner maintains that the ALJ is only obligated to investigate further when there is an "obvious or apparent" conflict between the DOT and the applicant's residual functional capacity, noting that the ALJ is not obligated to discuss every piece of evidence. 

The Role of Medical Evidence in SSDI Denial Cases: Why It Matters

SSDI denial cases often hinge on the consistency between a claimant's allegations and the supporting medical records. The Social Security Administration (SSA) carefully evaluates this alignment when assessing disability claims. To avoid misunderstandings and doubts, it's crucial for claimants to ensure that their allegations closely match the medical evidence.

Inconsistencies can arise from various factors, such as inadvertent miscommunication of symptoms or omitting important details from the medical history. Conflicting medical opinions or insufficiently supportive records can also contribute to inconsistencies. Unfortunately, these inconsistencies often lead to benefits being denied.

It's important to remember that every SSDI case is unique, and outcomes can vary based on individual circumstances. When a denial is based on inconsistencies, seeking professional guidance from a disability attorney is highly recommended. These experts can provide valuable assistance in navigating the appeals process and presenting a strong argument to address the concerns raised in the initial denial.

A disability attorney can help establish a stronger connection between the claimant's testimony and the supporting medical records, reducing the likelihood of inconsistencies. Their expertise improves the chances of a successful SSDI claim and ensures that the claimant's case is presented effectively.