Sunday, June 27, 2010

Gastroparesis

According to the Mayo Clinic, Gastroparesis is a condition in which the muscles in the stomach don't function normally. While strong muscular contractions are supposed to propel food through the digestive tract, in gastroparesis, the muscles in the stomach wall do not, which prevents the stomach from emptying properly. Gastroparesis can interfere with digestion, cause nausea and vomiting, and play havoc with blood sugar levels and nutrition.

I represent a 37 year woman with gastroparesis, who worked as a pastry chef and waitress. She retained me to obtain her Social Security Disability benefits right before her hearing, at which the ALJ scheduled Dr. Michael Falkove to testify as a medical expert. I argued that it was the synergistic effect between the claimant’s gastroparesis and diabetes that made her condition particularly disabling. Dr. Falkove then testified that he agreed, and took the issue one step further.

Dr. Falkove stated that while the claimant did not meet the listing for diabetes, he believed the claimant equaled that part of the listing that requires association with neuropathy. If a listing is met or equaled, then the claimant is presumed disabled, and there is no need to address the claimant’s ability to perform past or other work. Dr. Falkove explained that the claimant equalled the diabetes listing because the nutritional malabsorption from gastroparesis was a neurological manifestation that resulted in severe symptoms, as evidenced by the claimant’s hospitalizations.

When the disabling condition is somewhat atypical, you need to do some medical research to understand the nature of the problem. Diabetes is not usually disabling when it is controlled. By investigating the nature of the claimant’s medical conditions, I was able to explain why the claimant’s diabetes could not be well-controlled, which helped the medical expert explain why a listing was equaled.

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