Social Security Judges and Their Impact on Disability Claims, Part Two

Welcome to Season 1, Episode 24 of Winning Isn't Easy: Navigating Your Social Security Disability Claim. In this episode, we'll dive into the complicated topic of "Social Security Judges and Their Impact on Disability Claims, Part Two."

If last week’s episode of Winning Isn’t Easy pulled back the curtain on the power Social Security judges have over your disability claim, this week’s part two goes even deeper. If you’ve ever felt like your symptoms were dismissed, your story ignored, or your life reduced to a few vague evaluations - this episode is for you. Host Nancy L. Cavey shares real-world wins from claimants with chronic kidney disease, heart conditions, and cognitive issues after seizures - cases where strong, consistent evidence changed the outcome. You'll learn how RFC forms, detailed doctor reports, and letters from former employers helped judges see the full picture. These aren’t just medical cases - they’re stories of perseverance, credibility, and what it takes to be believed. If you’re preparing for a hearing, gathering evidence, or just want to know how the system can work - don’t miss this one. You deserve to be seen, heard, and believed. Let’s get into it.

In this episode, we'll cover the following topics:

1 -  Social Security Judge Awards Disability Benefits for Chronic Kidney Disease Based on State Consulting Physician’s Report and Letter From Employer

2 - Social Security Judge Awards Disability Benefits for Heart Disease to Former Appliance Installer

3 - Social Security Judge Awards Benefits to Engineer Who Has Cognitive and Physical Issues After Suffering From Seizures

Whether you're a claimant, or simply seeking valuable insights into the disability claims landscape, this episode provides essential guidance to help you succeed in your journey. Don't miss it.


Listen to Our Sister Podcast:

We have a sister podcast - Winning Isn't Easy: Long-Term Disability ERISA Claims. Give it a listen: https://wiedisabilitypodcast.buzzsprout.com


Resources Mentioned In This Episode:

LINK TO YOUR RIGHTS TO SOCIAL SECURITY DISABILITY: https://mailchi.mp/caveylaw/your-rights-to-social-security-disability-benefits

FREE CONSULT LINK: https://caveylaw.com/contact-us/


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Transcript

Nancy Cavey [00:00:14]:
 Welcome back to Winning Isn't Easy, Social Security Disability Benefits, the podcast where we break down everything you need to know about navigating the Social Security system. I'm your host, Nancy Cayvey. Now, before we get started, I've got to give you a legal disclaimer. This podcast is not legal advice. The Florida Bar association says I have to say this. Now that I've said it, nothing will ever prevent me from giving you an easy to understand overview of the Social Security disability claims process, the games that are played during it, and what you need to know to get the disability benefits you deserve. So off we go. Now, in our last episode, I talked about the role of Social Security judges and how their decisions can make or break a disability claim.
 
 Nancy Cavey [00:00:59]:
 This is part two and it's for everybody who's felt invisible in the system. Maybe you've had your symptoms dismissed, maybe your file was reduced to a few checkboxes and maybe you wondered if anybody actually listened to your story or much less read your medical records. So today I want to share with you some real world victories, cases where judges dug deeper, challenged flaw state DDS reports and and ultimately ruled in favor of the claimants dealing with serious, complex conditions like chronic kidney disease, heart disease and cognitive impairments after seizures. And you're going to hear about how thoughtful evidence like detailed reports from treating doctors called residual functional forms and even letters from former employers help paint a fuller picture of the claimant's limitations and their day to day reality. Now these stories aren't just about medical records or legal standards. They're about perseverance, credibility and the power of consistency. They're about what it takes to be believed by the Social Security system and by judges. If you're preparing for a hearing or wondering how to support your own claim, searching for examples of how the system can work, this episode is for you.
 
 Nancy Cavey [00:02:12]:
 So let's get into it. I'm going to cover three things today. Number one, the story of how a Social Security judge awarded disability benefits for chronic kidney disease based on a state consulting physician's report and a letter from the employer. Number two, a Social Security judge awards disability benefits for heart disease to a former appliance installer. And thirdly, how a Social Security judge awarded benefits to an engineer who had cognitive and physical issues after suffering seizures. Now these are inspiring stories, but they're educational stories. It tells you what it takes to put together a winning claim, about strategy and tactics and how you can prepare for your claim from beginning to end and more importantly, how you can deal with a Social Security judge at a hearing. Got it.
 
 Nancy Cavey [00:03:03]:
 Let's take a break for a moment before we get into this episode.
 
 Speaker B [00:03:07]:
 Are you considering filing for Social Security disability or has your claim been denied already? Either way, you require a copy of your rights to Social Security disability benefits, which will cover everything you need to know about the Social Security disability claims process. Request your free copy of the book@kvlaw.com today.
 
 Nancy Cavey [00:03:31]:
 Welcome back to Winning Isn't Easy. Ready to get started? Let's talk about a case where the Social Security judge awarded disability benefits for chronic kidney disease based on the state consulting physician's report and a letter from the employer. Now, you may not have chronic kidney disease, and even if you don't, you can learn some lessons from this segment. Chronic kidney disease can result in impairment of kidney function and immune system problems. This in turn can cause complications such as chronic fatigue, recurrent infections, weakness and inability to concentrate for sustained period, nauseousness and vomiting. It's important that your treating physician document your symptoms. So that means you have to give a good history of your symptoms. And just as important as the history is, is the impact the symptoms rather have on your functioning and ultimately how that all goes into helping your physician support your claim by filling out a residual functional capacity form.
 
 Nancy Cavey [00:04:33]:
 Now, why is this all important? Well, it's important because the Social Security Administration at the initial application stage and the request for reconsideration stage is going to determine your level of physical functioning and consider not only the objective medical problems you have, but the subjective complaints. And if your claim gets denied at steps one, you have to file an appeal called a request for reconsideration. If your request for reconsideration gets denied, you need to file an appeal, and that is called a request for a hearing. That request for hearing gets us out of the world of DDS disability determination services that deals with step with the application and the recon, but then also gets us to the administrative law judges. So we're dealing with odor Office of Disability Adjudication and Review. Now, when a judge hears your case, they're not bound by these earlier denials. They are also going to determine your level of physical functioning. And we'll consider in determining that the nature of your symptoms and the impact those symptoms have on your functionality.
 
 Nancy Cavey [00:05:42]:
 Now, the judge wants to understand the basis of those subjective complaints, and they're going to look for something in the medical records that confirm that you have the problems that you say you have and that there's an objective basis for them. Look, anybody can say they have Chronic fatigue, weakness, or an inability to concentrate, or they're depressed. Everybody will say that. But as part of the analysis, the judge is going to start out by looking at what the state agency doctors said about your restrictions and limitations. Why is that important? Because the Social Security Administration ostensibly is supposed to get all of your medical records at the initial application stage. They have their doctors at DDS review the records to determine your restrictions limitations. Now, I will find that very often the DDS will use doctors who are incompetent and qualified. I actually tried a case this morning before I recorded this episode where the claimant had, among other things, IBS and the Social Security Administration had a pediatrician review the file and rendered opinions.
 
 Nancy Cavey [00:06:48]:
 Now, obviously, I objected to the opinion. It was admissible. But it will go to the weight of the judge's determination. And if a judge relies on a pediatrician's opinion about something like ibs, that certainly would be reversed by the appeals council. But in any event, what happens is the state agency doctors review the medical records and decide what they think your physical level of functioning or your psychiatric level of functioning might be. They're also looking at the complaints that you made to your doctors about your symptoms to determine whether or not there is consistency in regard to the intensity, duration, and nature of your symptoms. In other words, do the medical records, particularly objective testing, corroborate the level of the intensity of your symptoms of which you are complaining? Now, the DDS folks don't necessarily always review letters from former employers. More often than not, these come at the hearing level, and I'll explain why in a minute.
 
 Nancy Cavey [00:07:49]:
 But I recently tried David's case, and David had been evaluated by a state agency doctor in the form of a consultative evaluation. So the DDS doctors who originally reviewed the file didn't think there was enough evidence. And ultimately, Social Security, the local office DDS recommended that David undergo a consultive examination. The state agency doctor noted that David was physically tired after the interview and that his concentration diminished over the course of the interview. Now, that was a very helpful opinion. I can't tell you that every DDS opinion or CE opinion is helpful. More often than not, they aren't. And that's a different topic.
 
 Nancy Cavey [00:08:36]:
 But in this particular case, because the DDS denied the claim. And notwithstanding the favorable CE opinion, we ended up in front of the judge. So the judge is looking at all the medical records in the file. Starts out with the agency doctor's opinions, looks at the treating physician's records, and then heard Davis testimonies. Now, one of the Most important functions of the judge is determine if you're believable. They look at that in terms of your medical records for consistency. They also look at the forms that you've filled out in the course of your hearing, rather your claim you may have filled out a pain function report or other function reports at the request of Social Security, and that judge is looking at what you said, then looking at your medical records to see the progression of your symptoms and then determining whether or not this is all consistent or not. Now, when we tried David's case, we also submitted a letter from a former supervisor.
 
 Nancy Cavey [00:09:37]:
 Why is that? Well, the medical records were supportive, but they didn't necessarily explain the problems that David had before he stopped working, the impact of his symptoms, his hospitalizations, his attempt to return to work, the problems that he had doing his job duties. And he had worked for this supervisor for many years. The supervisor was able to comment on what David's level of functioning was before he stopped working, what problems he was having when he stopped working, and then his attempts to come back to work, which always generally, in my view, impress a judge. So this letter was very cooperative. In other words, there was consistency between what David had said in his forms, what David had said in his medical records, what the doctors had said about him in their RFC forms. And this was all corroborated by an employer. Now, the judge found that all this evidence was consistent and supportive of his complaints. You've heard me mention in the course of this segment that residual functional capacity forms.
 
 Nancy Cavey [00:10:46]:
 Now, I really think that these are key in every Social Security case. Not all doctors are willing to fill them out, but I think they're key. We Social Security lawyers have developed about 75 different forms. And we, as your attorney or your attorney, will pick out the right form that is applicable to your particular medical condition. That form will document the objective basis of the diagnosis, your restrictions and limitations, and will comment on things like your ability to engage in bilateral manual dexterity, your need for breaks, whether you would be off task, absenteeism. All of those factors can impact a decision as to whether or not you can do your past work or whether there's other work in the mythical hypothetical, not real world national economy. So the key here, credibility, consistency, were really the key to winning the benefits. And congratulations to David.
 
 Nancy Cavey [00:11:43]:
 Let's take a break. Foreign welcome back to Winning isn't Easy. Social Security judge awards disability benefits for heart disease to a former appliance installer. Now, cardiomyopathy and congestive heart failure can be disabling in and of themselves. But when you combine that with chronic kidney disease and reduced kidney functioning, it can be impossible to work. Now, medical problems can cause difficulty with sitting or standing for long periods of time, shortness of breath, with or without exertion, dizziness, or weakness. And worse yet, these symptoms can make it difficult to complete personal care or household duties. Now, as I've said many times, symptoms are really important.
 
 Nancy Cavey [00:13:03]:
 So regardless of the nature of your medical problem, so you want to be documenting to your doctor what your symptoms are by medical problem and how those symptoms impact your ability to function. But that's not enough to win a Social Security case. Objective medical testing, like echocardiograms, heart catheterizations with other diagnostic studies should be consistent with the level of pain, weakness and symptoms claim. So, for example, you have a back problem with radicular pain that radiates down your leg, that causes you difficulty sitting or standing and limits your lifting. Social Security is going to look at your medical records. They're going to look for an mri, they're going to look for a CAT scan, they're going to look for X rays, they're going to look for EMGs and nerve conduction study tests to corroborate the objective basis for the symptoms that you're complaining of. So regardless of the nature of your medical problems, an objective basis which really translates into what's called a medically determinable impairment, but also a documentation of the symptoms and functionality. When a judge reviews the case, they're going to determine the level of physical functioning and consider not only the objective medical problems, but the subjective complaints, the pain, the tingling, the numbness, or in the case of a cardiac issue, shortness of breath with or without exertion, fatigue, the need to take naps.
 
 Nancy Cavey [00:14:27]:
 Now, the judge wants to understand the basis of the subjective complaints, and they're going to look for corroboration of those subjective complaints. Because again, anybody can complain of back pain, leg pain, tingling and numbness, shortness of breath. They've heard it so many times that in some respects they become jaded. But part of the analysis is going to be them looking at your medical records. That's going to start with what the state agency doctors had to say about your restrictions and limitations. When you are applying for Social Security, the state agency disability determination services that handles the claims at the initial application and request reconsideration stage are going to have their doctors take a look at the medical records and determine what they think your restrictions and limitations might be. They may even send you out for A consultative examination. But in doing that, they're also looking at your medical records.
 
 Nancy Cavey [00:15:20]:
 They're looking at what your complaints were. So if you have swelling in your legs or you have to go to the restroom frequently, you want to make sure that those symptoms are documented in your medical records. If because of cardiac issues you've got fluid retention and you have to raise your legs to reduce the swelling, it's going to be pretty hard to do a desk job. If you've got to run to the bathroom, it's hard to meet the pace and production requirements of sedentary work. So again, this is really important that you're documenting in your medical records your symptoms and your functionality. Why? Let me tell you the story of Ken. Ken was evaluated by a state agency doctor who said that he could do light work. Now, light work is basically lifting up to 20 pounds.
 
 Nancy Cavey [00:16:04]:
 And while that would eliminate his work as an appliance installer at step four, he would still be able to do sedentary work at step five, which would result in a denial. So we're trying to match up the restrictions and limitations with the physical level of functioning for past work. So based on that, can you do or not do your past work? Oh great. At step four, you can't do your past work. Many times these cases are decided at step five, which is a test that is kind of weird. The question is, can you do other work in the mythical, hypothetical, not real world national economy that you wouldn't be interested in doing that does not pay a living wage in view of your age, your education, the skills you learned in your past work, and whatever those restrictions and limitations might be. So as a practical matter, we basically have to prove that you can't do the full range of sedentary work on a full time basis or depending on your age, that you grid out. Now, the grids are useful if you're over age 50 and it's an alternative test.
 
 Nancy Cavey [00:17:17]:
 The grids again are based on your level of physical functioning and the grid is a grid. We have grids for heavy work, medium work, light work, sedentary work. So you can actually look at the top of the grid and pick out the right one based on your level of functioning. You look down on the left hand side, there's your age, you move across the grid, there is your education. As you're moving left to right, the question is, well, do you have skills that are transferable or not? And then in that right hand column you get the answer, yes, you're disabled or no, you aren't. Disabled. That's the alternative test. Now, the older you are, the less educated you are, the better.
 
 Nancy Cavey [00:18:00]:
 As a practical matter, you want to be at the light or this, preferably the sedentary functional level. It's better to be at the sedentary level, which is basically a sitting job doing, you know, things with your hands and meeting the pace and production requirements. Now, if your skills are skills that aren't transferable and you're functioning at the sedentary or light level, that's, that's better. And transferable skills is another topic that we've discussed in other podcasts. I always want to argue that my clients over 50 grit out and they can't do the full range of sedentary work on a full time basis. So how does all that translate into Ken's case? Well, the judge reviewed the state agency's doctor's opinion, the treating physician's opinions, and heard his testimony. One of the most important functions that the judge is, is to look for this consistency. Are you believable, not believable? In a cardiac case, it's really crucial that your cardiologist complete a residual functional capacity form that documents how long you can sit and stand, how much you can lift, your need for breaks, your need to elevate your legs, whether you can work full time or part time, how many times you would be absent every month, and how much you would be off task.
 
 Nancy Cavey [00:19:13]:
 The answers to these questions have to address whether you can do the full range of sedentary work. Can you sit at a desk all day? Can you use your upper extremities to produce a certain amount of work? And the question ultimately, again is, can you do full time work? So because of your problems, regardless of what they might be, can you meet the pace and production requirements? Do you have to take breaks? Would you be absent from work? So in this case, the judge found that all of the medical evidence was key and really relied on that residual functional capacity form completed by his cardiologist. She found that he couldn't do his past work because of the, the lifting involved. And she found that he could only work at a sedentary capacity. That was basically step four. All right, now step five. She looked at his fantastic work history and noted that he had worked for many, many years, but the nature of his work was highly specialized. He installed appliances.
 
 Nancy Cavey [00:20:16]:
 Well, there are not necessarily a lot of skills that could transfer from being an appliance installer to other types of jobs. And what the judge found was that these skills, because of his restrictions, weren't transferable to other work and as a result she found that he gridded out and awarded benefits. You can see hopefully how this all starts with a good history of symptoms and functionality, consistency in your medical records, and hopefully residual functional capacity forms that support the level of physical functioning. Remember, sedentary is better than light, but potentially we can work with that if we can really establish the functional restrictions and limitations that interfere with a person's ability to meet the the pace and production requirements or attendance requirements. Lots of strategy here. Got it. Let's take a break.
 
 Speaker B [00:21:13]:
 Struggling with your Social Security disability case? The right attorney can make all the difference. Get our booklet the Key to hiring a Great Attorney for your Social Security Disability case. Discover how to find an experienced attorney who will fight for your rights and navigate the process with ease. Don't leave your future to change chance. Request your free copy@kvlaw.com today and ensure you have the expert support you deserve.
 
 Nancy Cavey [00:22:04]:
 Welcome back to Winning isn't Easy. Social Security judge awards benefits to an engineer who had cognitive and physical issues after suffering a seizure. Now, when you apply for Social Security disability benefits, the medical records are really, really crucial. First you have to be getting medical treatment, and secondly your medical records have to establish that you have what's called a medically determinable impairment. There has to be an objective basis for the diagnosis and your symptoms and the nature of your symptoms has to be consistent with the level of the intensity that you're complaining of in regard to your symptoms. So intensity, frequency, duration has to equal an objective medical determinable impairment. And that's the first thing that Social Security at the initial level did, the DDS level is going to be looking at. Part of this, of course also is dealing with potentially a consultative examination.
 
 Nancy Cavey [00:23:08]:
 If you are not getting medical treatment of a sufficient nature or there's a question as to what your functional restrictions limitations might be, the folks at DDS where the initial application is reviewed may send you out to get a consultative evaluation. They can be physical, psychological, cognitive. If you are scheduled for a ce, please understand that you have to attend. If you don't attend, Social Security is going to deny your claim just based on the failure to attend, and a judge will uphold that denial on the basis that you're simply not cooperating with the process. Now, not all CES are created equal. You should go and give your best effort even if they aren't competent or qualified. I know that sounds weird. I just had a case that I referenced earlier in this segment where my client with IBS was sent to A pediatrician, like really? We objected when we got to hearing and the judge overruled my objection because it is admissible.
 
 Nancy Cavey [00:24:12]:
 But it will go to the weight of that the judge will give to the opinion of a, of a pediatrician when they should have sent the, the doctor, my client to a gastroenterologist, so to the right kind of doctor. But in any event, what is going to happen is that ultimately Social Security, DDS is going to look at your medical records. Their doctors are going to assign their opinion as to your restrictions and limitations. More often than not, those restrictions and limitations really aren't consistent with your medical records. I find that many of these doctors are retired doctors, haven't practiced in a million years, or they're the wrong specialty. So I don't necessarily think I'm going to get the right opinion from a DDS doctor, which is why we always ask our clients if their doctors would complete residual functional capacity forms. That RFC form is a form that we lawyers have developed. Social Security won't tell you about those forms, which is why you should have representation.
 
 Nancy Cavey [00:25:21]:
 When we tried the case of Jeff, we got ultimately a residual functional capacity form. But let me tell you what the analysis of the judge was. Now, Jeff was an engineer. He had a seizure and he had cognitive issues with understanding and processing information. He couldn't drive, had weakness on the left side of his body with foot drop. Now, you would think that this was a slam dunk. The problem with seizure type cases, stroke type cases, is that Social Security thinks that people will recover within a year. And remember, at step one of the five step sequential evaluation, you have to establish that you have a disability that has lasted a year or will last at least a year or result in your death.
 
 Nancy Cavey [00:26:07]:
 Now, in this instance, that was problem number one. Problem number two was that the neurologist didn't assign any specific restrictions. But the report did establish that Jeff had severe and significant limitations from a physical standpoint. And ultimately we got from his psychiatrist a residual functional capacity for him. And it documented significant neurocognitive limitations with impairment in things like the ability to cook, take care of himself. Now, what happened was that the judge rejected the opinions of the state agency doctors and found the opinions of Jeffs treating physicians to be more persuasive. The neurologist hadn't really done a great job of documenting restrictions and limitations, had done a really good job of documenting his symptoms and his complaints. The neuropsychologist did a much better job with the documentation of the cognitive issues.
 
 Nancy Cavey [00:26:59]:
 But ultimately what happened was that the judge found the that all of this was consistent, the nature of his medical condition was consistent with his complaints both physically and cognitively. The severity of those complaints were well documented in the medical records and fortunately the neuropsych kind of tied it all together from a cognitive standpoint because obviously if you have trouble from a neurocognitive standpoint, you're not going to be able to do the work of an engineer at step four and you would have difficulty doing things at work, even simple, routine, repetitive type tasks. Ultimately, it was again the consistency of the physical and cognitive complaints, the consistency in the medical records, and fortunately a residual functional capacity form. So congratulations to Jeff on getting his benefits. You can hear I've been pounding on consistency, symptoms, functionality, tying it together with a residual functional capacity form. That's the winning strategy. That's worked for us for years and I'm sure that you now understand that and why you giving that great medical history about symptoms and functionality can make all the difference. Well, that's it for today's episode.
 
 Nancy Cavey [00:28:13]:
 I hope that these real life stories showed that it is possible to break through the red tape, challenge unfair assumptions and and to be seen and heard, especially when the right evidence is on your side. If you felt like your symptoms have been brushed aside, or that your entire case has been basically cherry picked, or on the opposite side, just sort of rushed through a very slow process without adequate consideration, there is hope. The right support from doctors, former employers, legal advocates can help Social Security come to make the right decision. Ultimately, I do find that judges can listen, and more often do listen, and they can change the course of your case and deliver justice. Whether you're just starting your disability claim, gearing up for a hearing, fighting the appeals process at the appeals level, remember, credibility and consistency are key and so is perseverance. Don't give up. I know that it's overwhelming and the journey can be long, but Social Security disability lawyers are here to help you make sense of it and stand by you at every step of the way. If you found this episode helpful, please take a moment to like our page, leave a review, share it with your family and friends, and of course subscribe to this podcast.
 
 Nancy Cavey [00:29:33]:
 I would love to hear from you at the beginning of each episode. Description, you're going to find the link where you can send us questions or make comments. I love to answer questions, so please leave us some questions. Look, let's join us next week for another insightful discussion because I'm going to go more into residual functional capacity and RFC forms That's where it all comes together. Thanks for listening.