Wednesday, July 23, 2014


Reflex Sympathetic Dystrophy (“RSD”), which is also known as Complex Regional Pain Syndrome (CRPS), is believed to be a nervous system malfunction that develops in response to trauma, and affects so many people that the Social Security Administration (the “SSA”) promulgated a special rule for it. 

I represent a 46 year old foreman working for a boat manufacturer with RSD whose application for Social Security Disability (“SSD”) benefits was approved today without the need for a hearing. While the claimant had submitted reports that documented the medical findings and resulting functional restrictions, the SSA did not approve the SSD benefits until the claimant submitted treatment records from the his orthopedist. 

The treatment records merely corroborated the evidence that had already been submitted. It remains unclear if the records were requested for the sake of completeness, or whether the SSA was attempting to see if there was anything in the records that would contradict the supporting evidence already in the file.

Monday, July 21, 2014

State Agency Waste and Delay

The State Agency makes the initial decision when you apply for Social Security Disability (“SSD”) benefits. Unfortunately, the vast majority of the time, it is a clerk, not a doctor, who makes the decision for the State agency. As you can imagine, those clerks usually make the wrong decision. Even worse, sometimes the clerks go out of their way to avoid approving SSD applications. 

I represent a 49 year old pharmaceutical manager with depression. The State agency clerk named T. Cotman denied the application on the grounds that the claimant’s psychiatrist did not send treatment notes to substantiate her opinions about the claimant’s mental limitations. The psychologist had submitted a report that specifically identified the medical findings supporting her restrictions and limitations due to the claimant’s depression. However, Cotman purged that report from the claimant’s file. On appeal, a copy of the report, together with the Electronic Records Express receipt showing that the State agency received it on November 23, 2012 at 2:51 PM EST, was resubmitted. 

The psychologist’s report showed that the claimant met the listing for depression. Based solely upon that report, the claimant’s SSD application should have been approved. The administrative law judge (“ALJ”) approved the claimant’s SSD application today based upon that report; as the psychologist refused to produce the treatment records on confidentiality grounds. The ALJ did have a Social Security psychologist review the report, who opined it showed the claimant met the listing. 

If Cotman had asked a Social Security psychologist to review the report, instead of purging it from the file, then the claimant’s application would have been approved more than a year earlier. Moreover, it would have prevented the hearing office and ALJ from having to expend their time and resources to do precisely what the State agency was obligated to do.

Saturday, July 12, 2014

Lyme Disease

Lyme Disease is an infection caused by bacteria called Borrelia burgdorferi, which can lead to chronic encephalomyelitis. There are laboratory blood test findings that can provide objective support for the diagnosis. However, whether Lyme is considered disabling is a function of the severity of its symptoms.

I represent a 48 year old woman from Virginia with Lyme Disease that worked as an engineer, whose Social Security Disability (“SSD”) application was approved today without a hearing. The key was that the claimant was treating with the right specialist, dual board certified in Infectious Disease and Internal medicine, who prepared a very detailed narrative report, which explained why the treatment, objective and subjective medical evidence, precluded the claimant from functioning in a full time capacity. 

Many disability adjudicators are predisposed to reject disability claims based upon Lyme Disease, and frequently even question the validity of the disease itself. The narrative report was expensive, but still represented less than one month’s SSD benefits.