When an Administrative Law Judge (ALJ) denies the disability claim at the hearing level, as the Social Security Disability representative, you must decide if the case is suitable for appeal. Let’s examine several common errors that are made at each step of the 5-Step Sequential Evaluation that may help your appeal.
Appealable Errors of SSD Law
Step 1
The ALJ considered monies posted after the AOD that should have been eliminated as SGA, such as short and long-term disability benefit payments, and issued a partially favorable or unfavorable decision
The ALJ denied or issued a partially favorable decision based solely on receiving unemployment benefit payments
Step 2
The ALJ did not realize SGA was part of an unsuccessful work attempt and denied the claim at Step 2 for not meeting the durational requirement
Obesity was not considered in conjunction with a respiratory, cardiovascular, or musculoskeletal impairment
The ALJ’s finding of a nonsevere impairment is not supported by substantial evidence
Step 3
The ALJ failed to realize the Listing used for the Step 3 argument is allowed under SSA policy
For example, Listing 11.02 involves epilepsy and is also used for a non-listed impairment of migraine
The ALJ missed positive straight leg raise tests for a severe back impairment
The ALJ gave less weight to a treating source opinion that opined an individual meets a listing and is supported by the medical evidence of record; however, the ALJ gave a nonexamining source opinion more weight that is not consistent with the evidence
Step 3.5/RFC
RFC does not reflect the severe mental impairment
The ALJ’s decision does not reflect that a third-party statement on functional limitations (found usually in the file’s E section)
Established RFC in the decision is more restrictive than the one posed to the VE
Step 4
Work that was not performed at the SGA level, or not performed long enough to be learned at the skill level, or not performed within the last 15 years was counted as PRW and denied on that basis
The ALJ did not clarify inconsistencies in the VE testimony for an advanced age individual
Step 5
The ALJ did not apply the borderline age policy when applicable; the decision would have been favorable otherwise
The ALJ applied incorrect Medical-Vocational Rules for two different age categories; the decision would have been favorable otherwise
RFC includes numerous nonexertional limitations without VE testimony or interrogatory
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