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Category Archives for Disability hearings

Heart Disease Case Study Posted

I invite you to visit my Georgia Social Security disability web site to read my latest heart disease disability case study report about a case I tried last week on behalf of a client with a longstanding cardiac disease complicated by decreased kidney function and diabetes.  Like many of the cardiac disease cases that I try, there were three viable theories of disability that could apply: (1) a listing argument; (2) a functional capacity argument and (3) a grid rule argument.

stethoscope and medical report 2I presented all three to our judge, and the judge decided to approve based on….(you’ll have to read the case study to find out).

Not surprisingly the judge looked very favorably on my client’s long, consistent work history.  The judge even put on the record his opinion that my client would never have stopped working but for his medical issues.  As I note in the case study, the medical record in this file was a little sparse – but a solid work history can go along way to greatly enhance a claimant’s credibility.

One of the arguments I had at the ready (although I did not have to use it) was the “frequent restroom break” problem associated with a drug called Lasix, that helps clear fluid from the bodies of patients with congestive heart failure.  Many of my clients are surprised to learn that I often win cases on the work performance problem of needing to go to the restroom several times an hour.   Although excess restroom breaks don’t sound like a medical issue, the practical import of this problem is excess missed time from work.

Are Claimants Required to Submit Unhelpful Medical Records?

There is no such thing as the “perfect” case.  Even the most deserving claimants may end up with a doctor who they don’t like or with whom they do not get along.  This is especially true in “pain” cases when narcotic medicines may be prescribed.  There are also doctors out there who do not believe in the concept of disability – as far as they are concerned no one is fully disabled and these doctors will not cooperate with a Social Security claimant at all (needless to say, it is helpful if you discover this trait in your treating doctors early enough in your case to find another doctor!).

What about unhelpful medical records?  I see this frequently in cases where there was a workers’ compensation case.  “Company doctors” often minimize symptoms and generate records indicating that a claimant has the capacity to return to work.   Other times I see unhelpful records in cases where my client just did not “click” with his or her physician or psychiatrist.

One of my blog readers wrote me to ask about his obligation to submit unhelpful records in the context of a continuing disability review:

I have been on SSI for 8 years for mental illness. One recently former psychologist would say I was never disabled while my psychiatrist, and my new psychiatrist (the present one is moving) say I am disabled. Continue reading →

Why You Should Hate the Idea of Applying for Disability Beneifts

“I am disabled and cannot work.”   Although this is a very short sentence, it’s implications are quite profound.  For many of my clients the decision to apply for benefits and assert in writing and verbally that they can no longer earn a living is perhaps the most psychologically difficult part of the disability process.

As humans, we are programmed to believe that things will get better.  For many people, the decision to file for disability is a kind of defeat – a recognition that their physical or mental condition probably won’t improve.

In my view, clients who hate the concept of disability are my best clients.  When you walk into that hearing room, you should have the attitude that “I don’t want to be here, and I am only here because I have no other choice.”   Judges pick up on body langauge, verbal and non-verbal cues.  If your judge senses an “attitude of entitlement” your chances for a favorable decision go way down.

Whenever possible, include in your testimony statements reflecting your desire to return to productivity.   Talk about the fulfillment that work brought you.  Discuss the financial hardship that not working has brought upon your family.  Speak about hobbies and activities that you can no longer do because of your medical condition.

Remember – your job at a hearing is to paint a picture – and the picture you want to paint should reflect a person who is a fighter, not a “taker.”

Avoid statements like “no one would hire me,” or “I can’t do anything since I became disabled.”   Your job is to provide the judge with an accurate description of your symptoms, not to make conclusions about your work capacity.   The work capacity determination is the judge’ s job, not yours.

Disability hearings often turn on the claimant’ s credibility – if the judge finds you believeable and a truthful witness, you are most likely headed for a positive result.

R.I.P. Judge Albert Feldman

I was reading this morning’s paper and I saw in the obituary section that retired Social Security judge Albert Feldman passed away this past Wednesday, July 22, 2009.   With your indulgence I would like to take a break from my usual blog posts – that speak about case strategies, changes in the law, etc. to reflect on the influence that this kind, compassionate and extraordinary man had on me, and I suspect many others.

Although my relationship with Judge Feldman lasted for only about 10 years and solely in the context of Social Security hearings, it was not difficult to sense immediately what type of person he was.  To claimants he was, without exception, polite and respectful.  Although I am sure that there must have been times when he would look at a file and recognize immediately that the claimant before him did not qualify for benefits, he was always willing to listen and give every one that appeared before him his or her day in court.

I remember one case in particular – I had a client who had been diagnosed with HIV, who, at the time of the hearing, was suffering debilitating symptoms of full blown AIDS.  Unfortunately, my client’s date last insured for Title II disability had run some five years previously and the medical and other evidence clearly indicated that this gentleman did not meet the requirements of disability at that time.   Social Security hearings provide for direct questioning by a judge to the claimant and that day Judge Feldman spent about 20 minutes talking to my client, patiently explaining to him why he did not qualify for Title II disability, and offering suggestions about community resources that might be avialable to him.  At one point the claimant needed a recess to go to the bathroom.   Judge Feldman could have ended the hearing right then and there as he had enough information to render a decision but instead he waited for the claimant to return to continue the hearing.

I remember thinking then, as I reflect now, how compassionate that gesture was.   The judge sensed (correctly) that my client had only months to live and that he deserved the dignity of being heard.   My client, emaciated, with skin lesions and a hacking cough, most likely did not get the time of day from most people.  But here was a federal administrative law judge, struggling with a busy schedule, who took a few minutes extra out of his day to look my client in the eye – human to human – and express empathy and listen to him.  This was the man that was Albert Feldman. Continue reading →

What “Theories of Disability” Work to Win Cases?

As a large federal bureaucracy, the Social Security Administration has a dizzying array of procedures and forms that it uses to process disability cases.   Social Security procedure manuals require disability adjudicators and judges to use something called a “sequential evaluation process” to evaluate every disability case.   In case you are interested, the five steps of the process are as follows:

  1. Are You Working?
  2. Is Your Condition “Severe”
  3. Does Your Condition Meet a Listing?
  4. Can You Perform Your Past Relevant Work?
  5. Can You Perform Any Work

Hundreds of words have been written about each step of this process and the Appeals Council and District Courts produce voluminous written opinions that explain what each of these words mean and how they should be applied.
As a busy attorney dealing with disability cases on a day to day basis, I don’t have the time or patience to deal with the minutia of Social Security jurisprudence. I worry about what it takes to win.

With apologies to the drafters of Social Security’s POMS – Programs Operation Manual System, it has been my experience that there are 3 ways to win a case:

  1. Meet a listing
  2. Prove that your functional capacity for work (i.e. Residual Functional Capacity) is less than sedentary
  3. Meet a grid rule

You can read more about how I apply these three “theories of disability” in a back case by clicking on the link.

In my experience about 15 of cases that end up at hearings are decided under a listing theory and about 15% are grid rule cases.  That leaves approximately 70% of the cases that I try as RFC cases.  Note that my percentages may be similar or different that what you might experience where you live.

In my view, Social Security disability practice fits fairly neatly into this three theory box.  I use this approach in every case in my office and I am always able to fit the facts of any particular case into one, two or all three of these arguments.

For this reason, it was a little troublesome when I received the following email from one of my readers:

I have a lawyer handling my disability case. My problem is that she doesnt seem to know some of the disability language. For instance she didn’t know what a RFC form was. She wanted to know where I get this language from.I told her that i research disability on the internet andthats where I get a lot of information. She said there is no such thing and that my doctor will make a narrative report on me. Is there any such thing as an RFC form or is the language different now?

My answer to the reader is “no, Social Security has not changed its language.”  An RFC form is a checklist that Social Security personnel use to evaluate a claimant’s RFC.   Here is a copy of the RFC form that Social Security uses internally.  In my practice I edit this form to include a number of additional questions that I know will help me win my case.  You can find a copy of my practice form along with suggested responses in my book, the Disability Answer Guide.

Now, a narrative report will work but I think that an functional capacity form is a superior instrument in that it conforms to Social Security’s internal procedures and “speaks SSA’s language.”   Narrative reports – in which a doctor writes a letter that identifies specific limitations and diagnoses – is a document more often seen in personal injury or workers’ compensation cases.

I would like to give my reader’s attorney the benefit of the doubt – perhaps she is familiar with Form 4734 and doesn’t call it an “RFC form.”    I would suggest, however, that any claimant or attorney not familiar with the term “RFC” may want to take a few minutes to learn about this concept since it is frequently the basis of Social Security hearing decisions.

A brief, shameless plug:  I am teaching a course about building a Social Security disability practice at Solo Practice University.  If you are a lawyer looking to add Social Security or one of a number of specialties to your law practice I would strongly suggest that you take a look at the SPU web site and consider enrolling.

Hearing Testimony Tip: Know How Much You Can Lift and How Far You Can Walk

In my law office, I always try to schedule a pre-hearing meeting with my client one to two weeks prior to my client’s hearing.  I use this meeting to discuss the “big picture” issues and to practice asking and answering questions that my client is likely to face.

One line of questioning that always comes up relates to my client’s capacity to perform various physical activities, such as lifting, sitting, standing and walking.  Physical activities like these are known as “exertional” activities by the Social Security Administration and one’s exertional capacity is almost always a factor in questions asked of the vocational witness.

For Social Security purposes, your exertional capacity is defined as follows:

Sedentary: Requires the ability to sit up to six hours in an eight hour work day, lift light objects such as files and paperwork frequently during the day, and objects weighing up to 10 pounds occasionally during the day.

Light: Requires the ability to stand up to six hours in an eight hour work day, lift up to 10 pounds frequently and up to 20 pounds occasionally.

Medium: Requires the ability to stand up to six hours in an eight hour work day, lift up to 25 pounds frequently and 50 pounds occasionally.

Heavy: Same standing as light and medium, lifting heavier than medium.

As you can see, each of these definitions includes some very specific numbers.  When you prepare to testify, you will need to be prepared to discuss your capacities. Continue reading →

Can Your Facebook Profile Hurt Your Social Security Disability Case

I recently ran across a very timely post on Jim Reed’s New York Injury Law blog entitled “When Facebook Isn’t a Friend to Your Personal Injury Case.”   Jim correctly points out that the default privacy setting on Facebook is essentially “no privacy” meaning that anyone in your geographic area can view your profile, your photos and comments made by and about you.

What does this have to do with your Social Security disability case?

First, remember that the main issue in most Social Security cases is whether you have the capacity to perform simple, entry level, low-stress, sit-down type of work.  Now, take a look at your Facebook profile.   Does it contain photos of you dancing at a wedding, or on the beach?  Are there comments from friends chatting about that family get-together or class reunion?

Some of my disability clients “friend” me and I always find it interesting to look at their profiles.   I am looking at one such profile right now and it reads as follows: Continue reading →

I Have to Wait How Long for my Hearing Decision?

Back in August, 2007, I wrote a blog post entitled “How Long Do I Have to Wait for my Hearing Decision.”   Back then I reported that in most cases, a claimant would have to wait two to three months for a hearing decision.

Fast forward to 2009.  That two to three month period is now four to six months.  Here’s why:  about 18 months ago, the Social Security Administration convinced Congress to allocate more money to hire new administrative law judges, and SSA immediately hired around 100 new judges.  At the same time, Social Security put into process its conversion from paper files to electronic files and they created the infrastructure to provide for video hearings.

In Atlanta, where I practice, SSA created a video hearing ODAR office in Marietta, Georgia with three hearing rooms available to handle video hearings.

The good news – Social Security is now equipped to offer claimants administrative hearings.  The bad news:  the hearing offices often do not have enough support staff to process all of the decisions being issued by new judges and judges appearing by video. Continue reading →

Will I Win if the Judge Does Not Use a Vocational Witness or Medical Expert?

what are your chances of winning a case at a hearing when there is no voc rehab guy or medical specialist to assist the alj in a decision.
–Lamont

My response: Lamont, I think that yes you can win if the judge does not use a VE or an ME.   Here is how I would analyze:

First, what is the custom in your hearing office?  In Atlanta, where I practice, all but one or two judges regularly use vocational expert witnesses.  There are a couple of judges who almost never use them.   If a judge who always uses a VE hears a case without VE testimony, it most likely means that the issue is fairly clear cut one way or the other.

In the Atlanta hearing offices, judges rarely use medical experts – in my practice I would estimate that ME’s appear about 15% of the time.  The absence of an ME would be of less concern to me here in Atlanta. Continue reading →

Sample On-the-Record Argument Available for Your Review

The first few weeks of 2009 have been extremely busy for me.  I have been appearing at 5 or more hearings just about every week this year.  I am trying to manage my caseload by submitting on-the-record requests in as many cases as I can.

My on-the-record request also serve as a pre-hearing brief for case that is on my calendar.  However, if I can convince the judge to approve my case without requiring me to drive or take the train downtown, my client can avoid the stress of appearing at a hearing and I can save myself several hours of time.

Recently I was schedule to try a case involving a 63 year old woman with documented back issues, diabetes and a neuromuscular disease similar to multiple sclerosis.  She was already receiving early retirement benefits, so the only issue was whether she was entitled to past due benefits from age 59, when she stopped working through age 62, when she began receiving early retirement benefits.

In my view this was a fairly clear cut case and there were several arguments to support our claim.  I set out my arguments in an on-the-record decision and emailed it to the judge, who I knew to be a fair and reasonable person.   A few days after I submitted my request I received an email back advising me that the judge was prepared to grant this claim.

The judge agreed to let me appear telephonically so on the morning of the hearing, the hearing assistant called me and we recorded a 5 minute hearing in which the judge announced his favorable bench decision.   Since I was at home that morning, I “appeared” by telephone while I was sitting in a comfortable chair in my t-shirt and gym shorts.

I redacted the personal information from the case, and published my on-the-record request on one of my Georgia Social Security disability web sites.   Click the link to read my argument.

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