SSDI - WEIGHT OF MEDICAL EVIDENCE

Reynolds v. Commissioner of Social Security, 14

The plaintiff filed an application for DIB benefits, alleging cervical and lumbar degenerative disc disease with residuals of surgery. Dr. Smith was her treating neurosurgeon from 1999-2000; he performed the first of her four back surgeries. In 2000, the plaintiff discontinued treatment with Dr. Smith. Six years later, with Dr. Smith now employed but the American Board of Independent Medical Examiners, the state agency hired him to perform a consultative exam of the plaintiff and to produce an RFC assessment. Following the plaintiff’s first hearing, the Administrative Law Judge (ALJ) denied benefits, relying heavily on the reports from Dr. Smith in his CE role. “The Appeals Council recognized the potential conflict in Dr. Smith functioning as a consultative examiner and making a determination adverse to Plaintiff’s interests. Tr. 566-67. Dr. Smith previously treated Plaintiff, and even performed surgery on her back. As such, his interest diverged from Plaintiff’s in that an assessment of ‘disabled’ could possibly speak to his prior participation in her treatment.” Following an Appeals Council remand to “re-evaluate all of the medical opinion evidence in light of the pre-existing relationship” between the plaintiff and Dr. Smith, another ALJ held a hearing. Unfortunately, the ALJ did not comply with the AC’s remand instructions, and performed the same analysis of the medical evidence as had the first ALJ. The ALJ’s RFC finding is therefore not supported by substantial evidence, and the case is reversed and remanded for an immediate award of benefits.