Why Medical Records Matter in Disability Appeals

Every disability appeal has two moving parts: the law and the record. The recent Ninth Circuit decision in Thomas v. Bisignano (decided just two weeks ago) reminds us how closely courts scrutinize the medical record.

The Core Issue

Thomas argued that the Administrative Law Judge (ALJ) wrongly discounted:

• Multiple medical opinions

• His own testimony

  
  

The Ninth Circuit disagreed and affirmed the denial of benefits.

Why the Ninth Circuit Affirmed

The ALJ relied on two key factors when weighing medical opinions:

• Supportability → Was the doctor’s opinion backed by objective clinical findings, or based mainly on the claimant’s subjective reports?

• Consistency → Did the opinion align with the broader longitudinal record?

  
  

Findings in This Case

• Dr. Morgan’s opinion: Relied too heavily on Thomas’s subjective complaints.

• Dr. Petaja’s opinion: Depended largely on Dr. Morgan’s conclusions.

• The overall record showed:

  • Normal attention and concentration

  • No hospitalizations since 2018

  • Reports of improvement

  • Robust daily activities, such as:

    • Running a sober home

    • Ushering at church

    • Volunteering

    • Preparing five-course meals (surprisingly!)

      
      

The Ninth Circuit noted that while reasonable minds might differ, that alone isn’t enough to overturn the ALJ. Substantial evidence supported the ALJ’s interpretation.

Lessons from Thomas v. Bisignano

This decision is another reminder: the battle in disability cases is often won or lost in the medical record.

Q&A: Strengthening the Medical Record

Q: How can claimants and attorneys make medical opinions more persuasive?

A: Tie opinions to objective findings—encourage treating physicians to cite clinical notes, test results, or observable symptoms, not just patient reports.

Q: What kind of documentation is most effective?

A: Focus on consistency over time. Sporadic references won’t cut it; the record should reflect a longitudinal picture of impairment.

Q: How should daily activities be addressed?

A: Anticipate “daily activity attacks.” If claimants engage in activities that seem inconsistent with alleged limitations, contextualize them in the record—note frequency, supervision, or required recovery time.

Q: What about situational stressors or flare-ups?

A: Make sure the medical record captures those nuances, especially if symptoms worsen under specific contexts.

Key Takeaway

Courts give ALJs broad leeway to choose between two rational interpretations of the evidence. Your job is to make the interpretation most favorable to the claimant not just rational, but unavoidable.

Got any questions? Schedule a consultation with us. I’m here to help. It’s a lot to take in, but we’ll get through it together. After all, navigating these waters is always easier when you’ve got someone to chat with.