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How “Unremarkable” Treatment Notes can Sink Your Social Security disability case

A supportive medical opinion can help a disability case enormously. But your doctor’s statement that you cannot work does not stand on its own. Social Security reads it against your doctor’s own treatment notes, the examination findings, your reported activities, and everything else in the file.

Your testimony gets the same treatment. You can testify honestly and convincingly about fatigue, pain, or anxiety, and an administrative law judge can still discount what you said because other parts of the record look inconsistent with it.

A recent Ninth Circuit case, Yandrich v. Bisignano, No. 25-4027 (9th Cir. Aug. 11, 2026), shows both problems in one decision. It is unpublished and nonprecedential, so it does not bind Social Security judges outside the 9th Circuit (Alaska, Arizona, California, Hawaii, Idaho, Montana, Nevada, Orgeon and Washington). I am writing about it anyway, because in my opinion the rules it applies are national rules that reach every claim in every state.  Thanks to my colleague Adriana de la Torre who wrote about the Yandrich case on her excellent LinkedIn feed.

A strong opinion can be undermined by routine treatment notes

Mr. Yandrich’s attorney submitted favorable opinions from three treating providers – Dr. Jamito, Dr. Wingate, and PA Bolden. The ALJ found all three unpersuasive: they were inconsistent with the “longitudinal record,” including those same providers’ own “unremarkable treatment notes.” The ALJ then credited the opinions of three other sources, Drs. Sacks, Ahn, and Melamed, as better supported. The Ninth Circuit affirmed.

That sequence is the shape most of these cases take. The claimant’s own treating sources lost out to agency sources who never actually treated him, and what beat them was their own charts.

That should worry anyone with a pending claim. An opinion can look airtight in isolation. A doctor writes that you cannot maintain attendance, cannot stay focused, cannot get along with coworkers, cannot finish a normal workday. This seems compelling.  But you can still lose if the ALJ looks at the treatment notes and asks whether anything in them supports those conclusions. Continue reading →

Social Security’s Future – Turbulent Times Ahead

What is likely to happen to Social Security disability over the next five to ten years?  History may offer some guidance but Social Security’s looming trust fund problems will most likely dictate Congressional action.

Every year, SSA produces what is known as a “waterfall chart.”  Not sure what waterfalls have to do with this but this chart shows the approval rates for each stage of the disability adjudication process.  It is interesting to look at the waterfall charts over the past 1o to 15 years where you can see how approval rates have fluctuated.  Generally speaking approvals at initial have remained fairly constant – around 35% of initial applications are approved.  Reconsideration (the first appeal) fluctuates between 12% and 18%.  At the hearing level, however, we have seen approval rates (nationally) as high as 63% and as low as 45% (in 2023). In 2025, hearing approvals averaged 50% nationally.

There are many theories about why approval rates at hearings go up and down.  My own theory is that Social Security administrators are very focused on the state of the Disability Trust fund.  According to a “think tank” called the Bipartisan Policy Center, the Social Security trust fund will become “insolvent” in 2032. This  means that the funds coming in (via taxes) won’t be sufficient to pay benefits.  In theory (and this is unlikely to happen) this insolvency will trigger an automatic cut in benefits of 22%. Continue reading →

Over 55 with back, neck or knee problems? You are Likely to Win Your Disability Case. Here’s Why

Grid Rules a key to winning disability for those over age 55If you are over age of 55 with orthopedic/musculoskeletal issues, there is a very good chance you fit the profile that will result in an approval by Social Security disability.

As you may know, Social Security defines “disability” in terms of how your medical problem prevents you from engaging in “substantial gainful activity” or SGA. SGA can mean any activity roughly equal to a 30+ hour per week minimum wage job. The SGA table published by SSA says that in 2026, SGA is assumed if you are earnings $1,690 per month gross (this is equal to just over $20,000 per year).

So if you have the capacity to reliably perform a simple, entry level job like packing ink pens in a box or monitoring a conveyor belt, you could perform SGA and are not disabled. It does not matter to SSA what you did before – if you were a neurosurgeon or nuclear physicist earning $1 million per year, you are not disabled if you could pack ink pens in a box.

If you are under the age of 50, you have to prove to SSA that you do not have the capacity to perform any job that exists in the United States. Not impossible, but very difficult.

However…

When you turn age 50 and even more so at age 55 the rules change dramatically in your favor. Continue reading →

Denied at Hearing? Why You Shouldn’t Give Up!

Appeals Council judge reviewing ALJ denialOne of the most common misunderstandings I hear from clients and visitors to my Wednesday evening livestreams has to do with the role of the Appeals Council. As you may know, if the hearing judge (called the Administrative Law Judge or ALJ) denies your disability claim, the next level of appeal is called the Appeals Council.

Many people assume the Appeals Council is simply a next step in the process—a second chance to tell their story and hope for a different result.

That is understandable, but it is not quite right.

The Appeals Council does not act like a second ALJ. It does not rehear the case, and it does not decide disability from scratch. Its job is much narrower and more technical. In most cases, it is not looking for a better answer. It is looking for a legal mistake.

Understanding that difference can mean the difference between a strong appeal and one that is almost certain to fail.

What the ALJ Does

To understand the Appeals Council, it helps to first understand the role of the Administrative Law Judge.

At the hearing level, the ALJ is the main decision-maker. The ALJ represents the Commissioner of the Social Security Adminstration and serves as both the representative of SSA and the finder of facts in your case.  This is where the case is developed, reviewed, and decided. The ALJ listens to testimony, reviews medical records, weighs medical opinions, and decides what the claimant can still do despite their impairments. Continue reading →

The Age 55 Paradox: How Social Security Quietly Shifts Disability Outcomes

When disability claimants first learn that turning 55 can dramatically change the outcome of a disability claim, they often assume it’s some kind of loophole, a kind of “soft retirement benefit” quietly built into the system. But it’s not that simple. What happens at 55 is more subtle, more structural, and far more revealing about how disability evaluation actually works.

The rules don’t explicitly say that older workers deserve a different standard. They don’t even acknowledge that aging itself should matter. Yet something fundamental shifts in the disability process the moment a claimant crosses that milestone birthday—a shift from asking what’s possible to asking what’s likely.

This is what I call the “Age 55 Paradox,” and understanding it is essential to navigating the entire disability evaluation process.

Age Alone Changes Nothing in Terms of How SSA Defines “Disability”

Let’s be clear from the start: turning 55 is never, by itself, a reason for approval. The Social Security disability standard remains grounded in medical severity, just as it always has been. This isn’t like Social Security retirement, where you automatically qualify upon reaching a certain age. Continue reading →

Unlock Thousands in Social Security Disability Back-Pay with the Borderline Age Rule

One often-overlooked rule in Social Security disability cases can mean the difference between approval and denial—or even add thousands of dollars in back pay to your client’s award. That rule? The “Borderline Age” regulation. You can read the actual regulation at https://secure.ssa.gov/poms.nsf/lnx/0425015006

I’ll exactly how the borderline age policy works in Social Security disability cases, why it matters, and how strategic use of this rule can significantly increase a claimant’s past due benefits. I have used the borderline age policy in several recent cases without any push back from judges and the net result meant thousands of dollars added to lump sum payments for my clients.

WATCH A SHORT VIDEO ON THE BORDERLINE AGE RULE

What Is the Borderline Age Rule?

The Borderline Age Rule comes into play when a claimant is close to aging into the next higher age category defined by the Social Security Administration (SSA). These categories are:

  • Younger individual: 18–49
  • Closely approaching advanced age: 50–54
  • Advanced age: 55–59
  • Closely approaching retirement age 60+

SSA uses these categories to determine how easily a claimant can adapt to other work, which is a critical factor in disability decisions under the Grid Rules (also known as the “Medical-Vocational Guidelines).” I publish a website explaining how the grid rules work – you can find it at https://gridrules.net. Continue reading →

What Does October 2025 Government Shutdown Mean for Social Security?

As all of you are undoubtedly aware, the federal government shut down on October 1, 2025 because Congress and the President could not come to an agreement regarding funding to keep the government open. The early indication is that this may last for some time. Understandably, this creates concern for our clients. Below is the best information available right now about how this might affect clients who are in the process of applying for benefits.

Benefits to Current Claimants

Clients already receiving Social Security, SSI, or SSDI benefits will continue receiving payments without interruption. This has been true in all 20 previous shutdowns since 1976, and disability benefits remain funded as “mandatory spending” outside of congressional appropriations.

Pending Claims and Applications

Hearings: The Social Security Administration (SSA) will hold already scheduled disability hearings.

Initial Applications: State Disability Determination Services will continue processing initial claims, but processing speed may vary because each state controls its own staffing and funding during a lapse. Each state must independently determine whether it can maintain operations (pay its employees) during a federal funding lapse. This could lead to some states processing claims more or less as usual, but others, more affected by the funding lapse, may be processing claims more slowly.

Appeals/Reconsiderations: These will continue but probably with reduced support staff, resulting in extended processing times. Continue reading →

Winning Social Security Disability Claims for Lyme Disease: What Works for Me

Lyme Disease and Social Security disabilityAs a Social Security disability attorney, Lyme disease cases represent a complex, frustrating, and often misunderstood type of disabling chronic illness. While the acute phase of Lyme disease is widely recognized and typically responsive to antibiotics, a subset of individuals develop long-lasting symptoms—often referred to as “chronic Lyme disease” or “Post-Treatment Lyme Disease Syndrome” (PTLDS). These cases are challenging both medically and legally, particularly when pursuing Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits.

In this blog post I will discuss winning strategies that I have used over the past few years to develop a compelling case for benefits based on Lyme disease.

Lyme Disease – the Basics

Lyme disease is caused by a bacteria called Borrelia burgdorferi, transmitted by ticks. While early-stage Lyme disease is well understood, PTLDS is still gaining wider medical acceptance. A recent Johns Hopkins study found that 14% of early-diagnosed patients developed prolonged symptoms such as fatigue, musculoskeletal pain, and neurocognitive impairment. More recently the Wall Street Journal published an article entitled “Chronic Lyme Disease Acceptance Grows Among Doctors After Years of Debate.”

Interestingly, the aftermath of COVID-19 has offered the public and medical professionals a clearer picture of how infectious diseases can lead to persistent, debilitating post-viral syndromes. I believe that this context helps Social Security judges understand chronic Lyme within the broader framework of post-infectious disability syndromes. Continue reading →

Continuing Disability Reviews – What You Need to Know

continuing disability reviewWhen you are approved for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), that approval is not necessarily permanent. SSA is putting increasing efforts into conducting Continuing Disability Reviews (CDRs) to determine whether you still meet the medical criteria for disability. Members of Congress – both Democrat and Republican – are encouraging SSA to conduct more reviews because the Social Security trust fund is running out of money and they see CDRs as a tool to keep the disability trust fund solvent, and to avoid making difficult political decisions about actually fixing the problem.

In this post, I will explain what a CDR is, how the process works, the strategic decisions you must make if you receive a notice of intent to terminate benefits, and how ongoing medical treatment is your strongest line of defense.

 

Continue reading →

Why Your Long Term Disability Insurance Company Can Demand That You Turn Over Your Social Security Disability Lump Sum Payment

If you are receiving long term disability benefits, you can be certain that your LTD carrier will require you to file for Social Security disability. What is the practical effect of pursuing Social Security disability and how should you handle the insurance company’s request.

Most of the LTD policies I see are company provided. These company sponsored policies are sometimes called “ERISA policies” because the rules that govern how they are administered are set out in a federal law called the Employee Retirement Income Security Act of 1974 (ERISA).

If you worked for a company that gave you the option of purchasing short term and long term insurance as a payroll deduction, you almost certainly have an ERISA policy.

Under the terms of your ERISA policy you are required to apply for Social Security disability if your LTD claim is approved. Why? Because the insurance company has the right to offset what it pays you by what you receive from Social Security.

Here is an example – let’s say that your LTD policy pays you $2,500 per month if you meet the insurance company’s definition of disability. If your Social Security disability benefit is $2,000 per month, then the insurance company will reduce what it pays you to $500 per month since SSA is paying $2,000.

Your monthly payment remains at $2,500 per month but it will come from two sources instead of one. Continue reading →

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