January, 2012: Heartwarming Stories

Leslie and Jeff's cases: Examples of what makes it all worthwhile.

Two cases this month come to mind and simply warm my heart. They remind me how important and meaningful my work is to my clients (and in the end, to me). Both of these cases might best be titled “don't judge a book by its cover.”

Unfortunately, the Social Security disability claim process is not necessarily about finding out the truth: really, it's about making a determination whether an individual meets Social Security's regulations that define who is considered “disabled” based on an appearance of the truth. Given this, consideration needs to be given to following up as diligently as possible with medical treatment (which is, of course, difficult but not impossible if one is without insurance to get such treatment) as the doctors will document objective findings on examination. Medicaid insurance (known as Mass Health in Massachusetts, Mainecare in Maine and simply Medicaid in New Hampshire) is not always attainable, in which case it becomes important to look into free care treatment options (which are available, but not unless one is diligent in pursuing it).

In Jeffrey's case, he had worked with computers for years (ending up as an IT director for the last 2 businesses he worked for). He had been battling for years an anxiety disorder, which was controlled for the most part by medication (provided by his primary care physicians). Beginning in 2004, Jeffrey began experiencing heart palpitations, a racing pulse and skips which he took to be heart related (and testing did point to the fact that there were some heart-related issues, called PVC's or premature ventricular contractions, but nothing that was deemed to be severe). While medications were provided by his cardiologist and his ongoing primary care physician these conditions, he continued to experience escalating symptoms of panic and anxiety such that he found himself sitting outside in his truck during lunch time trying to relax enough to reduce his symptoms and make his way back into the office. He first lost one job, and then another as a result of his symptomatology, but heart testing was not showing any significant heart-related reasons which would explain why he was having such debilitating symptoms. Ultimately, it was becoming increasingly clear that Jeffrey may have been having more anxiety-related symptoms as opposed to cardiac-related symptoms. Unfortunately, Jeffrey lost his insurance and treatment continued to be maintained only through his primary care physician (with no referral to a counselor or psychologist for his anxiety-related mental health condition). We were able to guide Jeffrey back into treatment options available through his local hospital (which served to allow him to pursue additional treatment with the cardiologist he had not seen in a number of years, and with a counselor and a psychiatrist). By the time we went to hearing with the Office of Disability Adjudication and Review in Bangor, we were able to show that these two issues were combining to create a storm of problems Jeffrey (and remained uncontrollable “despite prescribed treatment”).

However helpful the medical documentation proved to be, Jeffrey proved to be his own best witness. Jeffrey's work history was a stellar one, and his testimony at hearing created a visceral picture of the problems he had been experiencing on a daily basis for years. The ring of truth became clearer and clearer the more he testified before the judge: that he had worked as long and as hard as he could through the anxiety, panic and palpitations that had been escalating in intensity over the years, and he simply could not make it back to the worksite.

I am happy to say that $80,000.00 in retroactive benefits is on its way to Jeffrey so that he can rebuild his life without the worries associated with living in poverty.

Leslie's case is not all that dissimilar to Jeffrey's case. Leslie was in her 30's, working a professional position for many years (and was showing a consistent work history since the age of 14). As Leslie's mental health problems (which have been diagnosed as bipolar disorder, along with an anxiety disorder and ultimately a social phobia) worsened, it became necessary for Leslie's employer to make accommodations for her: she was allowed to come in late, leave early and to miss work on more than just an occasional basis. Ultimately, it became necessary for Leslie to adjust her work schedule so that she was working a part-time schedule (and even this became a struggle for her). Leslie's employer got to the point where they needed to lay off an employee (and Leslie offered to take the layoff given the extent to which she was struggling to come into the office). Leslie subsequently applied for unemployment benefits given she was supporting her two young children (and given she did not quite understand that by applying for unemployment she was continuing to say she was “available for gainful employment”). When Leslie contacted my office, she was considering applying for Social Security and it was a very difficult conversation to have regarding the unemployment (as consideration needed to be given to the discontinuance of these funds, and prior to applying for benefits).

Leslie had been followed for quite some time by a psychiatrist, whose progress notes were very few and of very little substance (which is not to mention they were to some extent illegible). They did not establish a telling history of the problems Leslie had been experiencing. Given Leslie was no longer seeing a psychologist, we discussed the benefits both personally and to her case of getting back into treatment with her psychologist. Ultimately, Leslie's mental health problems became more severe and she required ECT treatment during the year leading up to her hearing. Given the additional documentation we were able to obtain from Leslie's psychiatrist and her psychologist, we were able to get Leslie's case reviewed prior to the need to go to hearing (and she was provided with a fully favorable on the record decision: meaning she did not have to go through the anxiety-ridden process of an administrative hearing). I am happy to say that Leslie has been provided with a significant amount of retroactive benefits for both her family and her. Life has taken a big turn for the better for this family, and I am feel fortunate that they had the trust and confidence in my advice and abilities to stay the course in what was close to a 2 year application and appeals process.

Needless to say, it has been an emotionally rewarding month.