SSDI claims are sometimes denied because the Administrative Law Judge (ALJ) finds that the claimant lacks credibility. The rules governing review of SSDI cases were revised in 2016 and have eliminated claimant credibility as a determining factor in the claims approval process. On appeal, some denials that are based on credibility can be reversed by the courts. When an SSDI claim is rejected because of credibility issues, a Social Security disability attorney can help determine whether there is a basis to appeal the claim.
A Fair Medical Evaluation
In determining the validity of an SSDI claim, ALJs are required to conduct a fair medical evaluation and consider all of the evidence available. The goal of this assessment is to determine the severity of the disability. The ALJ must review the medical evidence to determine whether the individual has an impairment that would produce the symptoms described by the claimant. He or she then must assess the symptoms to determine if they prevent the individual from working or performing daily activities independently.
The ALJ reviewing the case can use the opinion of treating physicians, government agencies, consulting physicians, and other medical practitioners to determine the validity of the impairment. To establish whether the medical condition will prevent the claimant from working or functioning independently, the ALJ may consider:
- Claimant’s daily activities
- Intensity and duration of pain and symptoms
- Activities that cause or aggravate the symptoms
- Medication dosage and side effects
- Other treatment measures used to alleviate symptoms and pain
A Social Security disability attorney will want to know if the case review followed this process and focused on the medical evidence for the disability claim.
Credibility Not a Valid Reason for Claim Denial
Some ALJs have gone beyond the fair medical evaluation by evaluating a claimant’s credibility to determine disability. For example, a claimant’s desire to continue seeking employment was determined in one case to be an indication that they were not truly disabled.
An appeals court determined that seeking employment while claiming a disability does not necessarily diminish the claimant’s credibility. The court pointed out that the individual may simply have a strong work ethic. It also determined that the issue of credibility had an unfair influence on the decision to deny the claim.
If an individual’s SSDI claim is denied because of lack of credibility, a Social Security disability attorney may be able to appeal the denial and help secure SSDI benefits.