Why disability claims can be denied despite strong supporting medical evidence

Posted on March 6, 2015

A denied disability claim is always disappointing, but through various appeals, some of these decisions can be – and have been, for some Balin Law clients – overturned. In many hearings, medical evidence and vocational expert opinions play an important role.

How could the Administrative Law Judge deny me if the Vocational Expert (VE) said I cannot work?

Occasionally, Administrative Law Judge’s (ALJs) will deny claims despite testimony from a Vocational Expert (VE) that a claimant cannot work. This is usually a confusing part of the hearing, but also one of the most important.

The VE’s job is to determine whether there are any jobs in the economy that an individual with a specific set of limitations could perform. The ALJ and your attorney will ask a series of hypothetical questions to the VE to determine what sort of work is or is not out there for people with health problems similar to yours. Some of the questions will result in an answer that there are no jobs available – i.e., you are disabled and we win. Some of the questions will result in an answer that there are jobs available – i.e., you are not disabled and we lose.

The ALJ has it within his or her power to choose which of those answers he or she feels is most accurate based on the medical evidence of record and, to a lesser extent, your testimony. We’ll know what the ALJ finds when we receive the written decision in the mail. We often tell clients to view every question and answer from the VE as a separate potential outcome for your case.

Does the Administrative Law Judge (ALJ) always agree with the vocational expert (VE)?

No, the ALJ does not always agree with the vocational expert. ALJs do award claims despite unhelpful VE testimony that a claimant can work and, conversely, do deny claims despite helpful VE testimony that a claimant cannot work.

The ALJ has a duty to explain why or why not they are crediting the VE’s testimony. If the VE testimony conflicts with the Dictionary of Occupational Titles (DOT) or Selected Characteristics of Occupations (SCO), the ALJ is required to address this conflict. Having a lawyer who is fluent in the VE’s language and knowledgeable about the DOT and SCO is critical to winning your disability case because thoughtful cross-examination of the VE can help identify those conflicts and turn a loss into a win.

Here’s what you can do if your disability claim is denied

If your disability claim was denied despite strong supporting medical evidence and/or the vocational expert said you cannot work, here’s what you can do. You can make an appeal and you have 60 days from your denial to do this. You can contact an experienced Social Security attorney to help explore your options and make your case as strong as it can be. Many cases are overturned when an appeal is made, so don’t give up!