The Role Of A Medical Expert In Your SSD Case in Macomb County

Medical expert for disability hearing.

If your Social Security Disability (SSD) application was denied, you have the right to appeal and take your case before an Administrative Law Judge (ALJ). The ALJ may call upon a Medical Expert to testify at your hearing. This individual will play a critical role in determining the outcome of your case. But what exactly does the Medical Expert do?

Disability Law Group helps clients apply for and receive disability benefits. We can answer any questions you have about the process and will fight for the compensation you need.

Appealing Your Case To The ALJ

If Social Security determines you are not eligible for disability benefits, you can file an appeal. Doing so will eventually land your case in front of an ALJ. You will be required to attend a disability hearing, during which time the ALJ will review your claim and determine whether Social Security’s rejection of your application was correct. More particularly, the ALJ will decide whether to overrule the initial decision and therefore determine you are eligible for SSD.

What Does A Medical Expert Do?

The ALJ’s job is to basically decide if your medical condition qualifies you for disability. But this requires the input of a specialist known as a Medical Expert. The primary role of this individual is to help the ALJ better understand the medical evidence that is at issue in the case. The ALJ may request the testimony of a Medical Expert, or the applicant’s attorney may ask for one. However, the decision of whether to allow an expert to testify rests solely with the ALJ.

There are a number of scenarios in which a Medical Expert’s testimony may be requested:

  • To decide whether your condition “equals” (is essentially the functional equivalent of) something contained in the Listing of Impairments
  • To explain the nature of your limitations and how they affect your employment
  • If the claimant has a complicated, unusual, or rare medical condition that needs explaining
  • To review and give an opinion about the medical evidence presented by the claimant
  • To testify as to the severity of the medical condition
  • To help the ALJ determine the onset date of the disability, for purposes of deciding the amount of benefits owed to the claimant

What Is The Listing Of Impairments?

As mentioned above, one common reason a Medical Expert is called to testify is to explain whether the applicant’s condition matches one contained in the Listing of Impairments. The “listings,” as they are often called, describes – for each major body system – impairments considered significant enough to prevent someone from engaging in meaningful employment.

If you have a condition contained in the listings, that is usually sufficient to qualify you for SSD. But the absence of one doesn’t automatically invalidate your claim. That’s where the Medical Expert often comes in, to explain that your condition meets or equals those guidelines.

Can My Doctor Be A Medical Expert?

No. The Medical Expert is supposed to be a neutral third party, meaning he or she has no connection to you or your claim. At the same time, this is not an individual employed by Social Security or with any bias in favor of the agency. The Medical Expert may be a physician, psychologist, or psychiatrist who is experienced enough to give a professional opinion on matters related to your claim.

What Is My Attorney’s Role?

Regardless of whether your attorney or Social Security calls the Medical Expert, your attorney’s role is to scrutinize the testimony this individual gives during direct examination by the ALJ.

At the outset of the hearing, the ALJ will qualify the Medical Expert. That means the expert will be asked about his or her experience and professional expertise. Because the Medical Expert has to be impartial, your attorney can question anything that would suggest he or she is not.

Also, there may have been additional records that you or your attorney submitted between the time you applied and your hearing. These records are usually added to your file as supporting evidence of the severity of your condition. It’s therefore critical that the Medical Expert has reviewed these records, and an experienced disability attorney will make sure he or she did.

Your attorney will have the chance to cross-examine the Medical Expert after he or she gives their testimony. The ALJ may also cross-examine the Medical Expert. During cross-examination, your attorney can ask questions related to the severity of your impairment and how it affects your ability to work.

Cross-examination is usually necessary to give more context to whatever the Medical Expert testified during direct examination. For example, the ALJ may ask the expert only if he or she believes you, the claimant, meets one of the conditions contained in the Listing of Impairments. During cross-examination, your attorney might need to ask enough questions to demonstrate that your condition “equals” those contained in the listings. In other words, you can’t assume that the ALJ’s questions will be enough to draw out the evidence needed to support your claim.

How Can Disability Law Group Help Me?

Remember, the primary objective of a disability hearing is to show the ALJ that your condition makes you incapable of working. The Medical Expert’s testimony can either support or undermine that argument. An experienced disability benefits attorney understands not only how these hearings are conducted, but also the type of evidence needed to demonstrate you are disabled. That means familiarity with the Listing of Impairments and other Social Security disability rules. It also means understanding what to look for in the Medical Expert’s testimony and how to elicit information from that individual that can help you.

There’s a lot on the line in your SSD hearing, so you need a knowledgeable disability benefits attorney by your side. Count on the team at Disability Law Group. Give us a call today to discuss your case.