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July, 2016 Alan’s Social Security Disability Appeal out of Portland, ME

Alan’s case is yet another example of how having a Social Security lawyer from the very beginning can make a big difference in one’s case. Alan did not have the benefit of an attorney at the time he filed his initial claim out of the Saco, ME Social Security District Office. Alan is a gentleman in his late 50’s who contacted our office following an initial denial (following review by Disability Determination Services out of Augusta, Maine). Alan had been suffering low back problems for many years, and while he had a very lengthy and productive work history for many years, his last job did not end as a result of his disabling conditions (and following the discontinuance of his work, he had made the choice to assist his ailing mother in law with her daily activities). Thus, Alan had been out of the work force for a number of years, unrelated to his medical conditions, prior to looking into a return to work. It was at this point he discovered his lower back condition had deteriorated to the point where he simply was not going to be able to return to work.

In order to be entitled to Social Security disability insurance benefits, it’s necessary to prove that one has remained totally disabled from all forms of gainful employment at all points in time since prior to his date last insured. Because Alan had not worked in a number of years, his date last insured was a date that preceded his actual application for disability insurance benefits. With this in mind, it became necessary to prove that Alan had remained disabled at all points in time since approximately two (2) years prior to filing his application for benefits.

Unfortunately, Alan made the choice to claim an onset date that went back many years (even prior to the point where he had stopped actually working): and so, the onset date chosen really did not make a lot of sense to the Social Security Administration (SSA) What became obvious upon our involvement is that it would be helpful to Alan’s claim to see about obtaining all of his medical records that showed the history of his low back problems and how he had managed to struggle through working his prior positions. The SSA had failed to gather the vast majority of his treatment history: unfortunately, an initial denial requires that one file a Request for Reconsideration, which carries with it a very high denial rate and the need to then file a Request for Hearing. These appeals processes can take the better part of 2 years.

Upon getting involved in Alan’s case, we went about seeking Alan’s workers’ compensation claim which had been settled just a couple of years earlier. This file carried with it a treasure trove of medical records that evidenced the fact that Alan’s back problems had gone back to the 1990’s. We were able to show years of effort on Alan’s part to address a disk herniation and nerve involvement, which problems would wax and wane. Fortunately as well, we were able to show that he had initiated treatment with his primary care physician just prior to his date last insured running out: this meant we would be able to show throughout this period her examination and treatment efforts (since prior to his date last insured) and see about getting a medical opinion from her as to how functionally limited she felt Alan had remained since she had initiated treatment with him. To his credit as well, once Alan’s problems had flared once again, he saw to it that he followed up with specialists to ensure he was aggressive with his efforts at treatment.

Alan’s claim was scheduled for a hearing before an Administrative Law Judge (ALJ) at the Portland, ME Office of Disability Adjudication and Review. At the hearing, we were able to prove that the adjudicator at Disability Determination Services had improperly failed to consider the new evidence we had forwarded to them from his primary care physician at the time of the reconsideration process. By way of this report and the compendious additional records provided at hearing, not to mention the compelling testimony of Alan, I am happy to report that we were able to prove to the presiding ALJ that indeed Alan had remained totally disabled from all forms of gainful employment since prior to his date last insured. Needless to say, Alan is resting a lot easier now that he has received the financial assistance he so deserved.

If you, or someone you care about, has been denied the Social Security disability benefits you or they deserve, contact the Law Offices of Russell J. Goldsmith at (800) 773-8622 to see how a ME Social Security Lawyer might be able to assist with your disability dircumstances.