Following a denial of Social Security benefits to a North Carolina woman living with HIV, a federal district court vacated the administrative law judge’s (ALJ’s) decision to deny benefits and sent the case back for further review.
One reason that the federal court found fault with the ALJ’s decision was the failure to base his decision on a factual analysis of whether the woman’s specific manifestations of HIV were effectively the equivalent of the conditions included in the relevant Social Security Act that determine whether an individual’s disability prevents them from working.
Another reason was that the ALJ discounted the unanimous assessments of three physicians familiar with the woman’s health condition, symptoms and care requirements rendered her permanently disabled due to, in part, fibromyalgia, HIV, chronic nausea; and that two of the physicians were specialists in their fields of infectious disease and pain management. The district court noted that the ALJ’s “attempt to discount the pain Plaintiff experiences” was suspect in view of the fact that the pain specialist was treating her with chronic opioid therapy because more conservative therapies didn’t work for her.
The decision emphasizes that it is the ALJ’s job to look at the facts of each particular case, objectively assess the evidence related to that individual’s disability, give appropriate weight to qualified health professionals who are engaged in that individual’s care, and base a decision on the totality of the specific circumstances that affect a person’s ability to work rather than on a literalist reading of the Social Security listings that looks only at whether the individual suffers from a specific opportunistic infection in the listings.