I tried a disability case today and left the courtroom very frustrated.  My client is a 58 year old woman with uncontrolled diabetes, numbness in her feet (diabetic neuropathy) and frequent fatigue.  She has had two heart attacks in the last ten years and can barely climb three steps to get to her house.  She has a high school education but limited reading and writing skills and has past work as a sewing machine operator – which requires foot pedal use.

Sounds like a good case, right?  It should be a clear winner, but I have an uphill battle to win.  Here’s why:

First, my client has received very little medical treatment over the past two years.  She has a few emergency room visits and a few visits with a local medical clinic who previously provided indigent care, but no longer does.

When the judge asked her if she has sought other free treatment, my client rambled on a bit about the free clinic only being open from 1 to 3 on Thursdays, and she did not have a home phone, and her daughter did not get home from work  until 3, and she did not know why her daughter has not yet called to make her an appointment.  My impression was that she has not put a lot of effort into getting to a free clinic.

My client also testified that she has not been taking medications because she can’t afford them, and that she can’t see because her vision is blurry, but she hasn’t had an eye exam for new glasses in over ten years.

Basically, my client painted a picture of herself as someone who has some legitimate medical problems but who is too lazy or unmotivated to seek any sort of free treatment.  Yes, free clinics are not particularly desirable – you generally have to wait in line and the quality of care is very basic.  But Social Security judges expect someone who wants a check from the government to make an effort – and that is not happening  here.

What else is wrong with this case.  My client testified that she babysits her two grandchildren, age 4 and 18 months.  She is not paid for this work.  To a Social Security judge, this looks like day care work – if she can do it for her 2 young grandchildren, could she not do this for a daycare center.   It very well may be that this work – and remember, she is not getting paid for it – may be the reason her case is denied.

Finally, this claimant’s testimony was awful.  Despite extensive preparation, my client was unwilling to rule out returning to a sewing machine operator job.  "Maybe" she could still operate foot pedals.   "Maybe" driving 30 minutes at a time is not a big problem.

Here is the lesson to learn from all this.  When you apply for Social Security disability, you have to be unable to work.  "Maybes" don’t work.  Part time work suggests that you the capacity for employment.  Your main focus needs to be seeking medical care that will make you better, even if that means going to the emergency room every few months.  You have to find a way to get your medications, even if it means sitting in line at a free clinic.  You need to realize that if you volunteer your time at a work like activity, a judge will most likely think you could work.  The bottom line here – you have to act in a manner consistent with a disabled person.

I argued successfully to the judge that my client needed to be seen by a Social Security doctor for a consultative evaluation.  Non-mental health consultative evaluations rarely help a case, but who knows.  I feel bad for my client that she has done so little to help herself but sometimes that is the way it goes.  My sense is that she would not be a very reliable or effective employee – hopefully at the end of the day, our judge will sense that as well.

[tags] Social Security hearing, uncontrolled diabetes, consultative examination, Social Security disability, Social Security hearing [/tags]