I used a new type of case strategy this afternoon in a disability case I tried in one of the Atlanta hearing offices.  My case involved a 56 year old woman who suffers from multiple medical problems, including decreased kidney function, diabetes, hypertension, asthma, fatigue, coronary artery disease and the need for frequent urination.  She also consumes about 15 different medications, the main side effect of which is drowsiness.

Normally, when thinking about how to present my case, I try to identify one or two main medical problems and focus on those.  Often, if you try to question your client about five or six medical problems, the judge ends up confused and might conclude that none of the conditions are severe enough on their own to prevent the claimant from working.  As the old saying goes, "a confused mind always says no."

In addition, my client’s treatment has all been at Grady Hospital, which is the public hospital in downtown Atlanta.  Grady records are handwritten and hard to follow and the doctors rotate as Grady is also a teaching hospital.  Getting functional capacity forms or statements from treating doctors can be challenging at best.

Because my client suffers from so many interconnected problems, there was no way to identify only one or two as the most important.  I also had a somewhat limited package of records – there were treatment notes but no real reference to work capacity.

I decided to forgo trying to question my client about her medical problems individually.  Instead, I asked her about her life, what she did during the day, and about her frustrations arising from not being able to do various activities.

My client did a very good job expressing her frustration about having to use the restroom 15 times a night, and about not being able to babysit for her 2 year old granddaughter.

I also had her talk about her past work and about her pride in supporting herself and her family.

We ended up painting a picture of a person whose health began declining about 10 years ago, who tried to work through the pain and discomfort, and who eventually had to stop working because her body would not let her.

The judge only asked one follow-up question and his questions to the vocational expert suggested to me that he found her credible and believeable.

This is probably the first time that I really did not address the record specifically and it will be interesting to see how the judge writes his decision. 

[tags] social security hearing strategy, atlanta office of hearings and appeals, atlanta office of decision and review, Atlanta ODAR [/tags]