Monday, July 8, 2013

Connect The Dots

When applying for disability benefits it usually it not enough simply to submit medical records. While medical records should provide diagnoses and identify symptoms, disability adjudicators normally want to see the nexus between the diagnoses and symptoms, as well as objective evidence that is not inconsistent with a severe disability claim.

 I represent a 59 year old former Disabled Adult Aide with esophageal varices and diabetic cirrhosis of the liver. Esophageal varices are abnormal, enlarged veins in the lower part of the esophagus — the tube that connects the throat and stomach. Esophageal varices occur most often in people with serious liver diseases. Esophageal varices develop when normal blood flow to the liver is obstructed by scar tissue in the liver or a clot. Seeking a way around the blockages, blood flows into smaller blood vessels that are not designed to carry large volumes of blood. The vessels may leak blood or even rupture, causing life-threatening bleeding.

Cirrhosis is a slowly progressing disease in which healthy liver tissue is replaced with scar tissue, eventually preventing the liver from functioning properly. The scar tissue blocks the flow of blood through the liver and slows the processing of nutrients, hormones, drugs, and naturally produced toxins. It also slows the production of proteins and other substances made by the liver. Cirrhosis is the 12th leading cause of death by disease. 

Besides being life threatening, cirrhosis and esophageal varices can cause fluid buildup in the legs and the abdomen , fatigue , varices in the digestive tract, belly pain or discomfort, all of which the claimant experienced according to his medical records. Those medical conditions can also result in jaundice , itching , nosebleeds, redness of the palms, spider angiomas, bruising easily, weight loss and muscle wasting, frequent infections and confusion. The claimant’s vascular surgeon provided restrictions and limitations that would preclude even sedentary work, and explained how the pain and fatigue were associated with liver disease. An abdominal ultrasound objectively established parenchymal liver disease, splenomegaly, indicative of chronic cirrhosis damage.

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