Myasthenia Gravis Listing

Myasthenia Gravis is a chronic autoimmune disease that can cause severe muscle weakness and fatigue, making it difficult to work consistently or keep a regular schedule.

We recently helped a 50-year-old Portfolio Management Specialist from Brooklyn who has Myasthenia Gravis obtain Social Security Disability benefits. Her claim was approved just over three months after filing.

When Social Security evaluates a disability claim, it considers the severity of the claimant’s impairments. Its Listing of Impairments sets out the criteria a condition must meet or equal in severity for the claimant to be presumed disabled and entitled to SSD benefits.

In this case, we knew that a “Listing” letter from our client’s neurologist could help secure a quick approval. We sent the neurologist the criteria for Social Security’s Listing 11.12 for Myasthenia Gravis and explained that his letter needed to state clearly that our client met Listing 11.12 and why she met the criteria. This specificity was essential to prevent Social Security from misinterpreting the letter.  After we submitted the doctor’s Listing letter, the State Agency (“DDS”) asked our client to attend a Consultative Exam (“CE”) with one of its doctors. We immediately contacted the analyst assigned to the case and explained that a CE was unnecessary because we had already submitted the Listing letter, medical records, and a Medical Findings Summary. DDS agreed, and the claim was approved.

Every Social Security Disability case is different, and approval is never guaranteed within a specific timeframe. Some cases move quickly; others take much longer. This case shows why it is important to be proactive from the start and provide Social Security with the medical evidence needed to evaluate the claim.  It also highlights the important role treating physicians can play in a disability claim. A detailed letter from a specialist who understands the patient’s condition can strengthen the claim and help Social Security assess the severity of the impairment.

Our goal is to fully develop the record and give each client the strongest possible opportunity for a favorable decision.  If you are unable to work because of a serious medical condition, having an experienced disability attorney who knows what evidence to look for and how to develop your medical record can make an important difference.

Quick Approvals

One of the most common questions we get is, "How long will my disability case take?" The truth is, every claim is different. Some cases move quickly, while others take much longer. A lot depends on where the claim is in the process and how strong the medical evidence is.

We recently had two clients receive favorable decisions in a relatively short period of time once their claims were assigned to DDS. While their medical conditions were very different, both cases had one thing in common, excellent support from their treating doctors.

Both claims experienced the same frustrating delay at the beginning. After their internet applications were filed, they sat at the local Social Security office for several weeks before finally being transferred to Disability Determination Services (DDS), the agency responsible for reviewing the medical evidence and making the disability decision. While that was frustrating, once DDS received the files, both clients were approved within about two to three months.

My first client was a 57-year-old woman from Glendale, NY, who had worked for the United States Postal Service for many years. She was dealing with degenerative disc disease, COPD, and Sjögren's syndrome. Her medical records clearly showed how these conditions affected her ability to continue working, and her treating physicians provided detailed documentation supporting her disability.

My second client was a 60-year-old man from Plainview, NY, with bipolar disorder, a traumatic brain injury, and Parkinson's disease. His medical records painted a clear picture of the challenges he faced every day, including problems with memory, concentration, mood, and mobility. His doctors' opinions helped explain why maintaining full-time work was no longer realistic.

These cases are great examples of why strong medical evidence is so important. It's not enough to simply have a diagnosis. Social Security wants to understand how your medical conditions affect your ability to work on a consistent basis. When treating physicians provide thorough, well-supported opinions, it can make a real difference in the outcome of a claim.

Of course, every disability case is different, and no one can promise a quick approval. But these two recent cases are a good reminder that having experienced representation and strong support from your healthcare providers can help put your claim in the best possible position.

If you're considering filing for Social Security Disability benefits or have questions about the process, please contact our office for a free consultation.

DDS’s Unfair and Unequitable Practices

One of the most frustrating aspects of representing Social Security Disability ("SSD") claimants is when  a decision-maker forms an opinion about a case before fully reviewing the available evidence.

Recently, our office became involved with an SSD claim where the assigned Disability Determination Services ("DDS") analyst scheduled a Consultative Examination ("CE") on the first day the case was assigned to him. The analyst confessed that he always schedules a CE immediately.  The analyst was unable to explain why he did so without waiting for the claimant's medical records or review information from the claimant's treating physicians.  The analyst's actions directly conflict with the obligation of the Social Security Administration ("SSA") to provide the claimant with fair and equitable service, including seeking information from treating sources.

The situation became even more concerning when the analyst advised us that hospital records had been requested but never received. The claimant's file already contained more than 800 pages of hospital records that were readily available for review. When this was pointed out, the analyst shifted his position to asserting the hospital records did not support the claimant's disability claim.  The problem with that statement is obvious: since he never reviewed the records it was impossible for him to conclude they were unsupportive.

Our client has an established treatment history with his own physicians. His treating doctor has provided extensive treatment records as well as a Medical Findings Summary outlining the functional limitations that prevent the claimant from sustaining full-time employment. Those opinions come from medical professionals who have examined and treated the claimant over an extended period of time, and they are in the best position to evaluate the severity of his impairments.

The SSA's own policies recognize the importance of obtaining evidence from a claimant's treating sources whenever possible, as the preferred source for the CE.  Treating physicians have firsthand knowledge of a claimant's symptoms, treatment history, response to care, and functional limitations. While DDS has the authority to order a CE when evidence is unavailable or insufficient to make a determination, a CE is intended to supplement the record with information that could not be obtained from the treating sources--not replace a thorough review of the medical evidence already available.

Despite being reminded about the substantial medical evidence already in the file, and that additional supportive opinions from treating sources would be forthcoming, the analyst continued to insist that, "in my professional opinion, the claimant will still need to attend a CE."  That assertion is disturbing on many levels, but especially since the analyst is not a doctor, and is blatantly ignoring SSA’s regulation to handle this claim and every claim equitability.  Such assertions raise legitimate concerns about whether the disability determination process is being conducted in the manner intended by SSA regulations. A CE is not supposed to be a routine step taken before the available medical evidence has been reviewed. Claimants should not be subjected to CEs simply because that is what a lazy analyst "always does."

Every disability claim deserves an individualized review based upon the evidence, and to be treated fairly and equitably. Decisions should be guided by medical records, treating source opinions, and the facts of the particular case; not by preconceived notions or standardized assumptions. Claimants who have spent years treating with their doctors deserve to have those records carefully considered before CEs are scheduled or conclusions are reached.  It is no wonder that DDS now conceals the analysts’ names. 

Cases like this highlight the importance of experienced representation. Attorneys can help ensure that medical evidence is properly submitted, challenge inaccuracies in the record, and advocate for a fair evaluation of the claim. The disability process works best when decisions are based on a complete and thoughtful review of the evidence—not when conclusions appear to be reached before that review has even begun.

DDS Denials Overturned

A few of our recent blogs have focused on favorable On-the-Record (OTR) decisions, which has become a recurring theme for many of our cases. While we are always pleased when our clients receive the benefits they deserve, the increasing number of OTR approvals raises an important question; why are so many deserving claimants being denied earlier in the process when the evidence supporting disability is already present in the file?

Recently, our office represented a 43-year-old former retail store associate from Brooklyn, NY, who suffers from a combination of significant physical and mental health impairments. Her medical conditions include chronic physical limitations, severe migraines, bipolar disorder, and anxiety. As her conditions progressed, she became increasingly unable to perform even basic daily activities without assistance. She required a home health aide for approximately 35 hours per week to assist with daily routines and personal care. She had been issued a handicap parking permit due to her mobility limitations, and her treating providers consistently documented the impact her conditions had on her ability to function.

Despite the strength of the evidence, her claim was not approved at the initial application or reconsideration levels of the disability process. After the case was appealed to the hearing office, the evidence was reviewed more closely, and an OTR decision was issued, resulting in a fully favorable outcome without the need for a hearing before an Administrative Law Judge.

While every case is unique, we continue to see a pattern in many of these OTR approvals. In case after case, substantial medical evidence supporting disability is already contained in the file, yet the claim is denied at the Disability Determination Services level. By the time the case reaches the hearing office, the same evidence often leads to a favorable decision without any testimony being required.

This trend suggests that strong medical evidence is too often being overlooked or improperly evaluated during the initial stages of the disability process. For claimants, these unnecessary denials can mean months or even years of additional waiting, financial hardship, and stress before receiving benefits.

Cases like this serve as an important reminder that a denial is not always the end of the road. When the medical evidence supports disability, pursuing the appeals process can make all the difference.

If you are considering filing for SSD, call our office (888) 572-0861 for a free consultation.

 

 

Rare OTR

We recently helped a 31-year-old office assistant from East Meadow obtain Social Security Disability benefits after a serious motor vehicle accident left her unable to work. She sustained injuries to her wrist and hips, along with significant nerve damage, resulting in ongoing pain and functional limitations that prevented her from returning to full-time employment.

Despite extensive treatment, including multiple surgical procedures, her symptoms persisted. Her medical records documented ongoing pain, reduced mobility, difficulty using her hands, and limitations with standing, walking, and sitting for prolonged periods.

One factor that strengthened this case was the quality and consistency of the medical evidence. The claimant's treating physicians maintained detailed treatment records, and the operative reports from her surgeries provided objective evidence of the severity of her condition. The medical documentation clearly demonstrated that her impairments prevented her from sustaining full-time competitive employment.

Equally important was the claimant's diligence throughout the disability process. She consistently kept our office informed of every medical appointment, treatment update, and procedure. By promptly providing records and visit information, we were able to ensure that the Social Security Disability analyst had the most current evidence available throughout the evaluation of her claim.

Although a hearing had already been scheduled before an Administrative Law Judge ("ALJ") we continued to submit updated medical evidence as it became available. After reviewing the extensive record, the judge determined that the evidence overwhelmingly supported a finding of disability. Approximately two months before the scheduled hearing date, the judge issued a fully favorable On-The-Record ("OTR") decision, eliminating the need for the claimant to appear at a hearing.

An OTR decision is relatively uncommon and generally occurs when the medical and vocational evidence leaves little doubt that a claimant meets Social Security's definition of disability. Additionally, it is very rare for an ALJ to issue an OTR for a claimant that is under 50.  In this case, the combination of serious injuries, multiple surgeries, objective medical findings, and consistent treatment created a compelling record that supported approval without the need for testimony.

This case serves as a reminder that strong medical evidence and active participation in the disability process can make a significant difference. By keeping her treatment current and ensuring that all relevant records were submitted, this claimant helped build the type of record that allowed the judge to issue a favorable decision before the hearing even took place. 

Compassionate Allowance

A former client referred her husband to us to file a Social Security Disability claim after he was diagnosed with Stage 4 pancreatic cancer, a condition that qualifies for a Compassionate Allowance claim under Social Security guidelines. We were glad to assist with filing his claim on his behalf, even though we knew there would be no attorney fees.

Her husband, a 61-year-old mail handler from Laurinburg, North Carolina, was approved in less than two weeks. When we submitted the claim, we notified Social Security that it qualified for Compassionate Allowance treatment. Once the case reached the state agency for review, we promptly provided his pathology report, and the claim was approved

Hearing Loss Approval

Many people assume that hearing loss alone is not enough to qualify for Social Security Disability benefits. However, when hearing impairments are severe and accompanied by significant balance problems, they can have a profound impact on a person's ability to perform competitive work. Recently, our office successfully obtained disability benefits for a 56-year-old former union field representative from Deer Park, NY, whose long career was cut short by progressive hearing and balance disorders.

Our client developed profound bilateral otosclerosis, resulting in significant hearing loss in both ears. In addition to his hearing impairment, he experienced ongoing balance issues that affected his ability to safely navigate work environments and travel for his job duties. These symptoms made it increasingly difficult for him to perform the tasks that had been routine throughout his career.

The key to this case was strong medical evidence. His treatment records thoroughly documented the severity of his hearing loss, the progression of his condition, and the impact it was having on his daily functioning. Just as importantly, we worked with his treating physician to obtain a detailed Medical Findings Summary. The physician clearly explained how our client's hearing and balance limitations would interfere with his ability to sustain full-time employment on a regular and continuing basis and Social Security approved his claim for disability benefits.

When hearing impairments are severe, well-documented, and accompanied by symptoms such as balance disturbances, they can significantly limit a person's ability to work. Obtaining comprehensive medical records and detailed opinions from treating providers can make a substantial difference in the outcome of a disability claim.

If you are unable to work due to hearing loss, balance disorders, or another serious medical condition, please call our office at (888) 572-0861to schedule a complimentary call.