In a Social Security Disability benefit hearing, a medical expert testimony can make a significant impact on the outcome of your case. In this article, we’ll discuss what a medical expert is, their responsibilities, and why a judge may require their testimony. We’ll also cover what to expect when a medical expert testifies and how hiring an attorney can benefit your case.
What is a medical expert?
Social Security defines a medical expert as a qualified medical professional, such as a physician, psychologist, or speech language pathologist, who provides impartial expert opinion evidence that an administrative law judge considers when making a decision about disability. A medical expert must be knowledgeable about Social Security’s rules and regulations and have a thorough understanding of medical evidence in disability cases.
What is a Medical Expert responsible for knowing at a hearing?
A medical expert is expected to provide both a factual and expert opinion of the medical evidence in a case.
Medical experts are required to be familiar with Social Security’s rules. Medical experts must understand Social Security’s definition of a “medically determinable impairment” as well as Social Security’s definitions of symptoms and findings.
Further, the medical expert must understand that they must take into account the combined impact of all of a person’s impairments together.
Medical experts are required to have a knowledge of Social Security’s Listing of Impairments, which is a list of conditions with specific criteria that are considered severe enough to prevent an individual from doing any gainful work activity.
A medical expert should be versed in the concept of “residual functional capacity,” which is the type of evidence and physical and mental work related limitations which should be considered.
Why Might a Judge Require a Medical Expert to Testify?
There are some circumstances in which the administrative law judge is required to obtain a medical expert opinion. If your case was appealed successfully and sent back for a new hearing, the Appeals Council or Federal court may require that a medical expert provide their opinion on the case. In this instance, the judge is required to have a medical expert opinion, either at the hearing through testimony or in written form.
Another instance is when the administrative law judge is considering finding that your condition is severe enough that it meets or equals one of Social Security’s conditions on the Listing of Impairments.
In other instances, the administrative law judge may choose to have medical expert testimony at his or her discretion. A judge may want an expert opinion on the usual dosage and effects of drugs and other forms of therapy or assess a person’s failure to follow prescribed treatment.
The judge may need assistance with determining the degree of severity of someone’s physical or mental impairment. The judge may request a medical expert to testify to be able to suggest additional relevant evidence, clarify and explain the evidence, or help resolve any conflict they may see in the evidence. A medical expert may also be able to explain the significance of any testing in the medical records which may not be clear.
Further, a medical expert may be able to answer questions about the origins or course of a disease and how it can affect the person’s ability to engage in work activities. There are some administrative law judges who just choose to request testimony from a medical expert at all of his or her hearings.
If the person has both physical conditions and psychological conditions, the judge will likely ask both a medical doctor and a psychologist to testify regarding the person’s conditions.
What will the medical expert do at the hearing?
Although hearings follow a relatively standard format, every administrative law judge structures his or her hearing slightly differently.
In some instances, the judge will ask the claimant to testify, and then ask the medical expert to testify. Other judges prefer to have the medical expert testify first and then have the claimant testify.
The medical expert will be required to testify under oath. Once sworn in, he or she will be asked what the severe impairments of the case are.
After the severe impairments are named, the judge will ask whether the person meets or equals a listing – that is, whether any of his or her conditions meet the criteria set forth under Social Security’s Listing of Impairments, or if their condition is equal in severity to any of those conditions on the list.
If the doctor states that the person meets or equals a listing, he or she will go through the specific criteria and discuss how those conditions are met. If a person meets or equals a listing, they are automatically found to be disabled if the administrative law judge accepts his or her testimony, and the hearing will conclude at that point.
If the person does not have a condition that meets or equals a listing, then the administrative law judge will ask the medical expert to assess the person’s ability to perform things like standing, walking, sitting, lifting, carrying, kneeling, stooping, reaching with the arms, or use the hands for fine manipulation.
If the person’s conditions are psychological in nature, the judge will ask the medical expert for his or her opinion on the person’s ability to remember simple instructions, maintain concentration, or interact with others.
The medical expert will be able to testify as well as to his or her opinion regarding whether the person would need to be absent or need more breaks than a usual person.
Hiring an attorney is critical when a medical expert is testifying
After the judge questions the doctor, the attorney will be able to question the doctor.
An attorney who is familiar with Social Security’s regulations will be able to correctly identify the proper questions to ask the medical expert and know how to use his or her testimony in a manner which is favorable for your case.
If you are scheduled for a hearing with an administrative law judge, having an experienced attorney gives you the best chance for success with your case.
Give us a call at the LaBovick Law Group at (561) 625-8400. Our team is ready to fight for you to get the benefits you deserve.