Thursday, April 28, 2016

Kudos To ALJ Wexler

I represented a former valet with cardiovascular problems whose claim for Social Security Disability (“SSD”) benefits was approved today by Administrative Law Judge (“ALJ”) April Wexler. Unfortunately, the claimant died on February 27, 2016, from those health problems. 

The Social Security Administration (“SSA”) had insisted that the claimant attend a consultative examination (CE”) by Jerome Caiati, a doctor who claims to be an internist working for IMA Disability. According to the American Medical Association, American Board of Medical Specialties and New York State Department of Health, Caiati did not attend medical school in the United States, and is not board certified in any medical field. That fact alone should suffice to accord little weight to Caiati’s opinion. 

As discussed in my prior postings, the IMA CEs are frequently baseless. Some of my colleagues believe that the Caiati CE reports are the worst of all. ALJ Wexler’s decision is consistent with that opinion. 

Caiati diagnosed the claimant with history of "asymptomatic" hypertension/high blood pressure, while cautioning the claimant to follow up with his own physician after the CE revealed elevated blood pressure. As he virtually always does, Caiati opined that the claimant had no limitations in sitting, standing, walking, reaching, pushing, pulling, lifting, climbing, and bending. 

ALJ Wexler gave Caiati's opinion little weight because it was not only inconsistent with the record as a whole, but with is own CE findings as well. For example, the ALJ pointed out that the claimant could not only have a "history" of high blood pressure, implying that it was a thing of the past, while Caiati admitted that the claimant currently had high blood pressure, and even warned that the claimant had to follow up with his own physician. ALJ Wexler added that high blood pressure is etiologically related to the claimant's fatal cardiac failure. 

In rejecting Caiati's opinion, ALJ Wexler concluded that, “It strains credulity that, given the claimant's significant medical history and the positive examination findings for high blood pressure, the claimant would have had absolutely no physical limitations as opined by Dr. Caiati.” 

I am surprised that the ALJ gave any weight to Caiati's opinion at all. Anyone whose SSD application was denied based upon a CE by Caiati should file an appeal.

No comments: