The U.S. District Court recently vacated and remanded a decision by the commissioner of Social Security, emphasizing the critical importance of considering all relevant medical evidence, particularly reports generated within the context of a workers' compensation claim. 

Jon L. Gelman

The case, A.D. v. Commissioner of Social Security, highlights the court's analysis regarding an administrative law judge's failure to account for medical opinions from treating and examining physicians that were part of the claimant's workers' compensation file.

Court's analysis on overlooked evidence

The court found that the ALJ erred by not considering or even mentioning relevant medical evidence from several doctors, including those whose reports stemmed from the plaintiff's disputed workers' compensation claim. The commissioner argued that some of these reports were irrelevant because they were generated after the date the plaintiff was last insured or were not "treatment evidence" but opinions for workers' compensation purposes.

Impact on the decision

The ALJ's failure to consider the medical reports from the workers' compensation claim directly impacted the court's decision. The court found that the ALJ's determination of the plaintiff's residual functional capacity did not comport with the law because not all evidence was considered. This oversight constituted reversible error, leading the court to vacate the commissioner's decision and remand the case for further proceedings where the ALJ must properly consider all relevant medical evidence.

Key takeaways

• ALJs must consider all relevant medical evidence in the record, including reports and opinions generated for purposes other than treatment, such as workers' compensation claims.  
• If an ALJ chooses to discount or reject relevant medical evidence, he or she must provide a clear explanation for doing so. 
• Medical reports dated after the date last insured can still be relevant if they shed light on the claimant's condition during the insured period. 
• Medical reports from workers' compensation cases are considered relevant medical evidence in Social Security disability determinations and cannot be overlooked.

Claimants' attorney Jon L. Gelman is the author of "New Jersey Workers’ Compensation Law" and co-author of the national treatise "Modern Workers’ Compensation Law." He is based in Wayne, New Jersey. This blog post is republished with permission.