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August, 2015: Denise’s Case at the Portland, Maine Office of Disability Adjudication and Review

Denise’s case makes it clearer than ever how a Maine Social Security Lawyer can correct errors made at initial and reconsideration levels, and can help guide your case to where it needs to go.

Denise is a forty-five (45) year old woman with a longstanding work history as a an administrative assistant in a law office, who became disabled in her 40’s from a structural defect in her brain that was causing unusual pressure and pain, resulting in severe migraine type headaches. At the time these headaches came on, Denise continued to struggle with an attempt at continuing to work. While she did lose her job at the law firm given her absences, she was able to find a position part-time at a non-profit organization that assisted individuals with disabilities (and in turn they were willing to assist Denise with the accommodations she needed in terms of absences).

Given Denise returned at a part-time level, her wages did not rise to the level of Substantial Gainful Activity and should not have been considered by the Social Security Administration as a successful return to work on her part. Unfortunately, the Social Security Administration field office did not correctly evaluate her return to work and failed to provide that an earlier onset date should be warranted. As we’ve explained in our blog (see our article entitled: Considerations by your NH Social Security Lawyer in Picking an Alleged Onset Date ). One of the important benefits of having a Social Security disability lawyer is that they can analyze your work and determine whether, if you do return to work following an absence, whether: 1) your wages even rise to the level of gainful wages (in which case your onset date should be established at the point you stop earning gainful wages or 2) if they do, whether it is discontinued in a manner which would qualify you for what is called an unsuccessful work attempt.

By the time we got involved in Denise’s claim, she was already proceeding through the appeals process. Upon entering our appearance in her case, the first thing we did was work with Denise to obtain a very helpful Headaches Residual Functional Capacity Questionnaire from both her longstanding treating neurologist and her long-term primary care physician. Unfortunately, Denise was having to go through the extensive wait time associated with the appeals processes. In the meantime, she was undergoing different treatment modalities, including different medications and different manners of injection therapy. None of these were proving to provide her with any lasting relief. Ultimately, it was recommended that Denise undergo surgery to repair the malformation in her head with the hope that this would provide her with relief.

During the time that Denise was waiting to be assigned to an administrative law judge for her hearing, it was our hope to be able to provide the hearing office with an argument brief on Denise’s behalf (so as to attempt to obtain a favorable decision for Denise prior to the scheduling of her hearing). Unfortunately, because she was undergoing new treatment option after treatment option (which only served to help her personally, and with her claim, as she was clearly continuing to show that she remained totally disabled from all forms of gainful employment despite prescribed treatment), we could not provide the argument brief as we knew the administrative law judge would be looking to see whether there was an answer yet as to whether the treatment might work. Administrative Law Judges do need to determine whether a claim is going to involve a closed period of time as the medical condition has improved such that they don’t need ongoing benefits, or, if treatment has failed, whether it’s clear that ongoing benefits are warranted. Thus, we were not in a position to provide the argument brief as long as the surgery was in the immediate horizon (as a judge would not want to provide ongoing benefits if she might be better in a month or two, or by the time of the hearing).

Thus, we waited for the surgery to take place, and to see the extent of Denise’s recovery from the surgery. Unfortunately, the headaches returned with a vengeance, and while additional injections were attempted during the months that immediately followed surgery, the pain was unremitting. Unfortunately, the doctors were at a loss as to why the headaches did not abate.

While it is highly unusual for a headaches case to be provided with a favorable decision prior to the need for hearing, I’m happy to report that our argument brief did indeed prove successful for Denise. She had shown over a lengthy time that she was continuing to struggle with both working and with her treatment, and despite her struggles to return to the type of productive life she had been living, the ALJ saw fit to provide her with a fully favorable decision. They were able to see through our argument brief how she should be provided a year of additional benefits, going back to when she initially had to leave the law firm, based on our argument letter.

Without an experienced ME Social Security disability lawyer at her side to hold her hand and guide her, it is highly unlikely she would have been able to not only win her case, but do so at such an early point in the process (and obtain the prior year’s worth of benefits).

Thus, it is strongly advisable if you are having difficulty maintaining your work due to a severe disability, such as Denise was, it is important you get the legal help you need and deserve. You should feel free to call the Law Offices of Russell J. Goldsmith at (800) 773-8622, or on line, for a free, no obligation consultation regarding your circumstances.