The New York State Office of Temporary & Disability Assistance, Division of Disability Determinations (the “State agency) needs to fire Lourdes T. Marasigan. I have spent years having to overturn decisions that denied Social Security Disability (“SSD”) benefits based on irresponsible reports by Marasigan.
According to both the American Board of Medical Specialties and New York State Department of Health, Marasigan is not board certified in any specialty, went to medical school in the Philippines, and was trained as an anesthesiologist. Nonetheless, the State agency has Marasigan review every type of medical problem under the sun, including hearing loss, lumbar radiculopathy, brain injuries, vision impairments. As a result, in those rare instances where a consultative examination (“CE”) by Industrial Medicine Associates actually supports an SSD claim, Marasigan comes to the opposite conclusion.
I represent a 53 year old former truck loader who had seven heart attacks, five stent surgeries, a triple cardiac bypass surgery,
hyperlipidemia, hypertension, polycythemia, sleep apnea, and diabetes, that caused weakness, fatigue, vertigo, shortness of breath, and a grand mal seizure. The CE noted the claimant even needed to hold onto the table in the exam room. The CE concluded that the claimant was markedly limited in the ability to walk, stand, climb, or lift anything.
It is very unusual for a CE to assert that a claimant has any marked limitation, which essentially means precluded for that activity. There is no possibly rational way to interpret the CE to conclude the claimant could stand and walk for even 2 out of 8 hours, or lift any weight for up to a third of the day. Nonetheless, Marasigan opined that the claimant could stand and walk for 6 out of 8 hours and could lift and carry 20 pounds for up to a third of the day, and could lift and carry 10 pounds for about 6 hours a day.
The State agency denied the SSD claim based on Marasigan’s opinion, even though she never examined or even saw the claimant, and even though the claimant’s cardiologist limited the claimant to sitting for 1 out of 8 hours, standing/walking for less than 1 out of 8 hours, and lifting and carrying somewhere between 0 and 5 pounds for up to a third of the day. The claimant’s internist provided similar restrictions. The bad news was that even though every doctor who examined the claimant, included the CE, provided restrictions that precluded the claimant from any full time activity, the State agency denied the claimant SSD benefits.
The even worse news was that the case was reconsidered by the State agency quality control, which is fairly rare, yet the claim still was denied. The average wait for a hearing is now well over 600 days. The good news is that rather than remaining idle all that time, the hearing office reviewed the claim about a month later, and reversed the decision.
There simply is no excuse to continue to spend the State agency’s limited resources by employing non-examining doctors, with inapt medical qualifications or backgrounds, to review SSD claims. That injudicious expenditure of resources then wastes the hearing office’s resources too.
Sunday, April 15, 2018
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