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December, 2015: Martha’s Case: Struggling to Get Better and to Return to Work is a Recipe for a Successful Social Security Disability Claim

When Martha came to our office, it became readily apparent from her strong work history and efforts to return to work that she, indeed, would look like a star before the Social Security Administration. I am happy to say that I am a good judge of character.

Martha is a fifty-three (53) year old woman with a 12th grade education and a past work history that included work as a cafeteria worker, cook, waitress, dietary aid, laundry and dry cleaning attendant and, finally, as a medication technician. Over time, Martha had developed medical difficulties that included degenerative disk disease of her low back and neck, with associated radiculopathy, along with problems involving her heart that included a valve disorder and irregular, rapid heart beat and Fibromyalgia.

At the time Martha becomes disabled from working, she initiates treatment with a primary care physician who undertakes a rather detailed physical examination that includes reference to specific tender points that are deemed to be consistent with a finding of Fibromyalgia. Her primary care physician not only undertakes a detailed physical examination on multiple visits, but likewise rules out other causes for her overall body pain by undertaking labwork to exclude rheumatological causes and lyme disease as a reason for her continued symptoms. Mental health medication is appropriately undertaken as a first attempt to address her pain difficulties. Shortly thereafter (and shortly after leaving work) she is seen in the hospital for rapid hear rate issues associated with her heart condition. Given her ongoing orthopedic difficulties, Martha was subsequently referred for additional evaluation and treatment with a neurosurgeon which evaluation revealed that at least one of the causes for her pain was significant degenerative disk disease which he felt required the need for a cervical diskectomy and fusion. Unfortunately, surgical intervention did not serve to address the significant back pain she was continuing to experience, that was traveling down her left leg. Martha continued to follow-up for answers, not only undertaking Gabapentin for treatment of both her radiculopathy symptoms and Fibromyalgia associated symptoms, but also seeking referral to physical therapy and to an orthopedic surgeon for additional answers to her problems.

As a result of her push for answers to her difficulties, she was referred for additional MRI testing of her low back which revealed bulging disk issues in her lower back which were causing her leg symptoms. She was subsequently referred for injection therapy, and for an evaluation once again by an orthopedic surgeon as to whether surgical intervention might be appropriate. The orthopedic specialist determined that her ongoing problems were not amenable to surgery and, thus, it became clear that there was limited treatment available to Martha that would allow her relief from her continued low back and leg problems.

Given issues she was experiencing with right hand numbness, she was first referred for EMG studies which revealed that she was likewise suffering from carpal tunnel syndrome (for which she subsequently undergoes carpal tunnel surgery). As difficult as her conditions were, and as depressing as it was for Martha to be relying on friends and family to survive, she never gave up on treatment or the hope that she would be able to get better enough to return to work. Her efforts did shine through the medical records and one could tell that this had considerable influence on the presiding Administrative Law Judge (ALJ) that was assigned to hear her case out of the Portland, Maine Office of Disability Adjudication and Review. Likewise, given Martha’s efforts, her treatment providers were likewise willing to address medical questionnaires in support of her claim that spelled out how significantly her conditions were impacting her ability to function. In light of the above, the presiding ALJ felt comfortable short circuiting the hearing so as to provide Martha with a full favorable bench decision (which allowed Martha to receive her favorable decision within a week of her hearing: thereby avoiding the need to worry about where she would be living during the holidays).

Martha’s lengthy work history and her consistent efforts to move forward with zealous treatment sent a message to both Martha’s treatment providers and to SSA that she was serious about getting better and returning to work: obtaining Social Security disability benefits was her last resort and not something she wanted to do, but had to for survival. Thus, both her providers and the presiding judge were anxious to provide Martha the assistance she needed. I’m happy to know that benefits came just in the nick of time for such a deserving individual.