April, 2017: Krystal’s Social Security Claim out of Augusta, Maine and Portland, Maine ODAR

Tell your potential Maine or New Hampshire Social Security lawyer you’re in your early 40’s and suffering from Fibromyalgia and you may hear a very pessimistic response as to your prospects for obtaining Social Security disability benefits . Our most recent fully favorable decision came through for our client, Krystal, who reached out to our office in just such a circumstance. Her individual story of hard work and dedication to both her work and her treatment told me from the very beginning that indeed her case had merit and warranted my involvement: even though she was coming to our office following the receipt of a denial of the initial application she had filed on her own.

Our initial office notes from almost 2 years ago reflect the fact that Krystal had been working consistently since the age of 16 at jobs that included work as a PCA, CNA, beautician, fast food worker and, ultimately as a cashier at a convenience store. When Krystal’s orthopedic problems that consisted of both Fibromyalgia and trochanteric bursitis got to the point that she could no longer manage the physical work she had previously undertaken, Krystal turned to work at a convenience store: initially full time, and then, as her condition progressed, part-time. Little did Krystal know at that time about what was required to prove a Social Security disability claim. She did not have the benefit of a lawyer when she initially filed her claim out of the Augusta, Maine Social Security Administration (SSA) office. We assisted Krystal with both her reconsideration process, and what we knew at that point would involve the need for a hearing before an administrative law judge (ALJ) out of the Portland, Maine Office of Disability Adjudication and Review (ODAR) , which hearing would be held out of the Augusta, Maine satellite office.

At the time of the initial denial, SSA did request that Krystal undertake a work activity report as it was necessary to determine 1) whether her ongoing work was being performed at a Substantial Gainful Activity (SGA) levels and 2) if not, when did her wages fall below SGA levels. For 2017, SGA is defined as the ability to earn simply $1170.00 per month on an ongoing and consistent basis. A simple look at the wages at the time Krystal applied made it clear that she was earning less than gainful from the point in time of her alleged onset date, and, leading up to the actual hearing (which was a year and a half after we got involved), Krystal was continuing to maintain a very limited work schedule that consisted of initially 2 days per week, and then ultimately 1 day per week. The consistent treatment Krystal undertook with her providers reflected a lengthy history of orthopedic problems that preceded her need to reduce her work schedule. She was seeking out treatment not only with her primary care physician, but also an orthopedic specialist and, ultimately, with a rheumatologist (a specialist for her Fibromyalgia, which condition her primary care physician ultimately had diagnosed). Moreover, as we hope would be the case with each of our clients, she was exhausting treatment options in an effort to get well: from injection therapy and narcotics for her back and hip, to medications such as Gabapentin, Cymbalta and Lyrica for her Fibromyalgia. Clearly, Krystal was doing everything she could to get well and, likewise, was doing everything she could to maintain at least some level of employment (to the extent that her condition would allow).

It is very unusual to receive what is called a bench decision from the presiding ALJ following presentation of substantial additional medical documentation, an argument brief and presentation of her claim at hearing. A bench decision occurs when the presiding ALJ believes that the case is strong enough on its merits, given the evidence presented, for the ALJ to simply recite orally, in a summary fashion, his bases (including recitation of exhibit numbers) for providing a fully favorable decision. The oral decision is subsequently followed up by a summary, written decision by the ALJ that incorporates by reference the facts recited by the judge as the basis for the decision.

Just as rewarding for Krystal, at the time of hearing, were the kind words provided by the ALJ that expressed his acknowledgement of the hard work she’d undertaken to continue working (but likewise acknowledging to her his understanding that she remained limited by her condition from working at a gainful level). We couldn’t be happier for Krystal, who had been struggling for such a long time with both her condition and with her fight for financial assistance from SSA.

If you are trying to cope with serious medical issues and simply can’t manage going to a job on a regular basis and wish to know if Social Security disability benefits are appropriate for you, contact the Law Offices of Russell J. Goldsmith at (800) 773-8622 for a no cost, no obligation consultation.