Headaches

Disability adjudicators are skeptical about approving claims for headaches because the pain cannot be seen, and there is no diagnostic test for them.  However, if a cause for the headaches can be objectively established, then the benefits should be approved.

We represent a 55 year old administrative clerk from Wantagh with pseudotumor cerebri.  Pseudotumor cerebri is a somewhat rare condition that causes increased pressure inside the skull.  As the pressure increases, so do a person’s headaches.  In preparation for a hearing with an administrative law judge (“ALJ”), we submitted medical treatise information identifying the symptoms of pseudotumor cerebri, and detailed reports from the treating neurologist, which explained the genesis and severity of the resulting headaches.

The ALJ issued a fully favorable decision, awarding the claimant Social Security Disability ("SSD") benefits.   Our client is overjoyed, and thankful that she retained us.  We highly recommend retaining an experienced disability attorney if you are applying for SSD benefits.  Call our office for a free phone consultations.  We are conveniently located on Long Island in Melville.

Transferable Skills

The number of on-the-record (“OTR”) approvals has decreased over the years, due in large part to the elimination of the treating physician rule allowance rate has correspondingly decreased.  Nonetheless, when the vocational facts align with the medical evidence, an OTR should be sought.

We represent a 58 year old from Port Jefferson Station with sleep apnea, cardiovascular and orthopedic impairments that stopped him from working in law enforcement.  During a hearing with an ALJ from Connecticut, a vocational witness (“VW”) testified that the claimant’s past work was light and had no transferable skills.

The claimant’s pulmonologists confirmed that Mr. Kline met the criteria of listing 3.02 A and B, based on an FVC of 1.68 and an FEV of 1.12.  The claimant’s pulmonary function testing revealed “severe restriction/obstruction.”

After the case was transferred back to the Long Island hearing office, the physicians treating the claimant’s musculoskeletal impairments and obstructive sleep apnea concluded the claimant could not even perform sedentary work.  Moreover, the VW had testified that leg elevation would preclude all work, and the claimant’s orthopedist stressed the importance for the claimant to elevate his legs.

In light of the above, we submitted a request for an OTR.  Even if the claimant did not meet a listing, his less than sedentary work capacity would require finding him disabled.  Furthermore, even if the claimant did not meet a listing, and did not have a less than sedentary work capacity, his need to elevate his legs would require finding him disabled.  Additionally, even if the claimant did not meet a listing, and did not have a less than sedentary work capacity, and did not need to elevate his legs, and had light work capacity, then the medical-vocational rules would require finding him disabled.  The ALJ approved canceled the hearing, and approved the OTR.

 

OTR Approved

The number of on-the-record (“OTR”) approvals has decreased over the years, due in large part to the elimination of the treating physician rule allowance rate has correspondingly decreased.  Nonetheless, when the vocational facts align with the medical evidence, an OTR should be sought.

We represent a 58 year old from Port Jefferson Station with sleep apnea, cardiovascular and orthopedic impairments that stopped him from working in law enforcement.  During a hearing with an ALJ from Connecticut, a vocational witness (“VW”) testified that the claimant’s past work was light and had no transferable skills.

The claimant’s pulmonologists confirmed that the claimant met the criteria of listing 3.02 A and B, based on an FVC of 1.68 and an FEV of 1.12.  The claimant’s pulmonary function testing revealed “severe restriction/obstruction.”

After the case was transferred back to the Long Island hearing office, the physicians treating the claimant’s musculoskeletal impairments and obstructive sleep apnea concluded the claimant could not even perform sedentary work.  Moreover, the VW had testified that leg elevation would preclude all work, and the claimant’s orthopedist stressed the importance for the claimant to elevate his legs.

In light of the above, we submitted a request for an OTR.  Even if the claimant did not meet a listing, his less than sedentary work capacity would require finding him disabled.  Furthermore, even if the claimant did not meet a listing, and did not have a less than sedentary work capacity, his need to elevate his legs would require finding him disabled.  Additionally, even if the claimant did not meet a listing, and did not have a less than sedentary work capacity, and did not need to elevate his legs, and had light work capacity, then the medical-vocational rules would require finding him disabled.  The ALJ approved canceled the hearing, and approved the OTR.

 

LTD Approvals

We obtained reversals of a long term disability (“LTD”) denial and a termination this week from Hartford and Lincoln.  What they had in common was submitting overwhelming objective and subjective medical and vocational evidence.  We advised each client in advance that the reports, records, tests, and letters we needed might seem like gilding the lily to them, but our track record for successfully securing LTD benefits speaks for itself.

Consultative Exams ("CEs") and the State agency ("DDS")

I get more questions about CEs than any other topic.  DDS schedules CEs before they even request records from the claimant's treating doctors, who according to Social Security's own rules are the "preferred source" for medical information.

I represent a 48 year old Medical Assistant from Bay Shore whose impairments cause suffering from debilitating pain.  The DDS representative handling the case told my office that this was a very strong case, with an overabundance of medical evidence.  Nonetheless, the representative still denied Social Security Disability ("SSD") benefits solely because the claimant did not attend a CE.

My client was approved today at her hearing.  The ALJ acknowledged all of the supporting objecting evidence I obtained from the claimant's treating doctors, which included MRI's, scans and other objective test results.  The ALJ found the claimant's testimony to be credible, consistent with the treatment provided, and the treating doctors' opinions to be persuasive.  The fact that the claimant did not attend a CE was not even mentioned.

DDS continues to practice the boondoggle policy of scheduling needless CEs for claimants.  The CE gives DDS the excuse to ignore the large amounts of medical information in the file, and deny the claim based on the vague CE opinions, which the federal courts uniformly deride.  CEs delay benefits as they force claimants to defend themselves against the typically fraudulent exams those doctors perform.

My client is extremely happy that she retained an experienced disability attorney who was able to obtain a favorable outcome for her, rather than trying to take on Social Security by herself. Please call my office for a free phone consultation if you are thinking about applying for SSD benefits.  My office is conveniently located in Melville, Long Island.

 

 

MS

The disabling effects of MS when it attacks the brain, spinal cord, and optic nerves is well known. Nonetheless, while the overwhelming fatigue, pain, numbness, and poor coordination that results from MS have not changed, the Social Security Administration (“SSA”) made it near impossible to meet the listing for MS. Therefore, obtaining Social Security Disability (“SSD”) benefits for MS depends on demonstrating that its functional limitations preclude being able to work, just as is true for most medical impairments.

I represent a 38 year old from Whitestone with MS who worked as a food service manager. The MS diagnosis was never questioned. However, the State agency denied her SSD application because it refused to believe that the claimant’s symptoms were severe enough to preclude her from working on a full time basis.

We obtained a report from the treating physical therapist detailing the claimant’s functional limitations. But the State agency denied the claim. We then submitted a report from the treating neurologist that corroborated the claimant’s functional limitations, yet the claim still was denied. Only after filing a report from the surgeon treating the claimant’s cervical and lumbar spine disorders, which concurred with the limitations assessed by the physical therapist and neurologist, were SSD benefits approved.

With the elimination of a meaningful listing, it took 11 months to get SSD benefits approved. While that may seem quick since it takes many SSD applicants years to secure approval, the application justified approval much sooner.

It is always in your best interest to retain an experienced disability attorney if you plan on applying for SSD. Please call our Melville office for a free phone consultation.

SSA Backlogs

We received the email below, from the Social Security Administration, notifying us that due to the backlog of initial disability claims, the wait time for a disability determination has increased from 90-120 day to 200-230 days. 

Dear Colleague, In the past, the notice sent to claimants when we  receive disability internet claims submitted by a third-party stated that claimants would receive a  disability determination within 90-120 days. However, due to the backlog of initial disability  claims, it has been taking an average of 200-230 days  for claimants to receive a disability determination. We understand this may be confusing to claimants  and can result in unnecessary calls to our offices.  To provide better expectations for when a claimant  should expect to receive a decision, we have updated  the notice to reflect the current timeframe of 200-230  days.We continue to review and update our notices to  ensure they are clear and accurate. This is the first  change with more expected to come. We appreciate your continued support. Sincerely, Dawn Bystry Associate Commissioner Office of Strategic and Digital Communications