Friday, February 21, 2014

State Agency Reports Misrepresentations

When the State agency makes the initial determination on a Social Security Disability (“SSD”) application, it prepares a Disability Determination Explanation. The hearing office relies on that eCAT report.

I represent a 55 year old internship coordinator with back problems whose SSD application was approved today, despite the fact that “A. Washington,” the State agency examiner, prepared an eCAT report that a treating doctor was not contacted to perform a consultative examination (“CE”) because there was no treating doctor. However, in that very same eCAT report, Washington noted that the claimant had two treating doctors. 

I filed an OTR for the claimant, which was granted today. The OTR pointed out the eCAT discrepancy. If the discrepancy were not pointed out, it is likely that the claim would have sat until a hearing was held. Since the SSA spent a lot of money on eCAT, you would think that it would honestly comply with the SSA’s simple and unambiguous policy of asking treating sources to perform CEs.

Wednesday, February 19, 2014

Amending Onset To Avoid Hearing

Sometimes Social Security Disability (“SSD”) claims are denied in whole or part because of the date that the claimant selected as the onset of the disability, known as the alleged onset date (“AOD”). Stated differently, the Administrative Law Judge (“ALJ”) may agree that the claimant is disabled, but may disagree as to when the disability began. 

I avoided a hearing today because I amended the onset date forward a few months. Although amending the AOD decreased the size of the disability period, it did not reduce the claimant’s SSD benefits. There is a full five month waiting period for SSD benefits. An applicant can receive SSD benefits for a maximum of 12 months before the month of the application. Thus, if the AOD is amended prior to the 17 month period, then no SSD benefits are lost. 

Amending an AOD to a later date can make it easier for an ALJ to approve SSD benefits without a hearing for numerous reasons. The later date may be consistent with an increase in medical treatment. The later date could coincide with a notable medical record, such as an MRI. The later date may place the claimant into a different age category that facilitates granting SSD benefits, and so on. The major caveat is ensuring that the new AOD does postdate the date last insured.

Wednesday, February 12, 2014

Carpenter Avoids Disability Hearing

I was able to avoid a hearing for a 52 year old carpenter from New Jersey that was scheduled for Friday by filing an on-the-record ("OTR") brief. Like many claimants, the carpenter had strong support for his back problems from his spine specialist, whose opinion was supported by MRI testing. The claimant avoided the hearing because of the vocational facts. 

The OTR cited the case law holding that carpenters do lack transferable skills, which means that under Social Security’s Medical-Vocational Rules, the claimant had to be found disabled even if capable of sedentary work. Therefore, the only issue was whether the claimant has the capacity to do light work. 

The carpenter’s work history also helped the case. He graduated from high school in 1979, and spent his entire adult life, from 1979 through 2012, working as a carpenter. The OTR showed that the Third Circuit has established that a claimant with a good work record is entitled to substantial credibility when claiming inability to work because of a disability. More specifically, where a claimant has a long work history of continuous work at the same employer, he is entitled to substantial credibility. I contended that the claimant’s strong work history was objective evidence establishing his credibility, and there was no need for a hearing to assess it. The Administrative Law Judge agreed and approved the OTR.

Friday, February 7, 2014

Brugada Syndrome

According to the Mayo Clinic, Brugada syndrome is a potentially life-threatening heart rhythm disorder that is characterized by an abnormal heartbeat. Patients may develop cardiac symptoms, like loss of consciousness, abnormally rapid heart rhythm and even sudden cardiac death.Brugada syndrome is frequently an inherited condition, which can require surgical implantation of a cardioverter-defibrillator. Additional information can be found at http://www.brugada.org.

I represent a claimant with Brugada, who was seeking Social Security Disability (“SSD”) benefits. I submitted supporting medical reports from the claimant’s cardiologist. An article from the International Journal of Cardiology found that people with Brugada symptoms are at higher risk of sudden death if they have anxiety. A week before the hearing, I submitted a report detailing the claimant’s anxiety disorder. 

An Administrative Law Judge (“ALJ”) issued a fully favorable decision today, approving the claimant’s SSD benefits. The ALJ determined that the claimant was disabled by virtue of his anxiety relating to his Brugada Syndrome.