July, 2016 Zachary’s Social Security Disability Claim out of the Lowell, MA District Office
Zachary’s Social Security disability claim involves a gentleman in his late thirties who was determined to be suffering from the effects of both Ankylosing Spondylitis (AS) and Ulcerative Colitis (UC). Unfortunately, Zachary did not have the benefit of a MA Social Security lawyer that could have provided him with some legal guidance and assistance that might have avoided a very lengthy claims and appeals process.
Zachary was diagnosed with both AS and UC back in his late 20’s but was able to keep his condition under control and remain gainfully employed. Unfortunately, in his early 30’s Zachary found himself laid off from his prior employer for reasons that remained unrelated to his medical conditions and which reasons did allow him to collect unemployment benefits for a period of time while he was continuing to look for work. It’s important to remember that in order to apply for unemployment benefits one needs to assert to the Department of Labor that they remain available for gainful employment: thus, assuming Zachary had in fact been disabled from performing all forms of gainful employment as a result of his disabling conditions, it would not have been appropriate for Zachary to file for Social Security disability benefits. While during the period of time Zachary remained out of work he did have ups and downs with his condition, it took a turn for the worse after he had been out of work for what was approximately 2 years. There were other medical conditions that for periods of time did cause him to be short-term disabled, there were no medical conditions that could at that point be said to be severe and disabling for what was likely to be a year or longer.
At the point in time that Zachary undertook a claim on his own with the Lowell, MA Social Security district office, he was beginning to experience a worsening of his AS and his UC: the chronic pain caused by the AS was no longer being well controlled by medication and, likewise, the lack of health insurance had caused him to discontinue the medication he was taking to control his ulcerative colitis issues (causing a flare of his condition and hospitalization). At the time of his application, Zachary did claim that his medical condition had continued to disable him from the point in time he had gone out of work two (2) years prior. Unfortunately, this statement would not and could not be borne out by the records this early on with is exacerbation. Consequently, Zachary was denied at the initial level. He chose to request reconsideration on his own, and once again, upon review by Disability Determination Services, was denied on reconsideration.
At the point in time we got involved in Zachary’s claim, it became evident that there were efforts necessary to ensure that Zachary was receiving both the health insurance he required as well as the medical treatment needed. Given the emotional toll these medical conditions were taking, it was difficulty for Zachary to focus on seeking out additional treatment when his health conditions caused him to feel so pessimistic about his future. To his credit, Zachary did follow the guidance we suggested and, in turn, did establish a record of efforts that made clear that his condition had continued to remain severe and disabling such that he could not return to any manner of gainful employment.
In a case involving Ulcerative Colitis, consideration should always be given to the Social Security Listings of Impairment 5.00 Digestive System (and more specifically to Listing 5.06 Inflammatory Bowel Disease).
In Zachary’s circumstances, however, when one condition would flare and require treatment it served to have an adverse impact on the other: for example, treatment he would need for his Ulcerative Colitis would require that he discontinue the medications he was requiring for his Ankylosing Spondylitis. Thus, the conditions continued to be episodic, with flares of one condition being succeeded by improvement in that condition, only to have a flare in the other condition. Thus, proving entitlement to benefits based on a Listing of Impairment, or what is referred to as Step 3 of Social Security’s sequential evaluation process was going to prove difficult. However, it became quite obvious that Zachary should be found disabled at Steps 4 and 5, as he remained physically unable to work any of his past relevant work or other work that exists in significant numbers in the national economy. Zachary’s medical providers were willing to support Zachary’s claim by addressing medical reports addressing the extent to which his conditions were causing him to remain functionally disabled from maintaining consistent attendance (nonetheless, some consistent level of functioning) such as would be necessary for a work environment.
Given the above, we were able to assist Zachary by providing to the Lawrence, MA Office of Disability Adjudication and Review (and to the presiding Administrative Law Judge (ALJ) assigned to hear his case) not only substantial additional medical documentation from the additional treatment Zachary required, but also compelling reports prepared medical reports that addressed the nature and severity of Zachary’s functional limitations. Armed with this additional evidence, we were able to obtain for Zachary a fully favorable on the record decision in his claim (dispensing with his need to attend a hearing).
Thus, if you or a loved one find yourself long-term disabled and in need of legal advice from an experienced Social Security lawyer, contact the Law Offices of Russell J. Goldsmith at (800) 773-8622 for a free consultation.