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Maine state Bar

March, 2012: An EMT and a School Teacher

This past month has been extremely busy and gratifying: it's been difficult choosing which cases to post. I decided that Edward and Marjorie's stories deserved to be told: how could I go wrong choosing the stories of a gentleman who devoted himself for so many years as an EMT (that is, Edward) and of a woman who spent her career working with preschool children (that is, Marjorie).

Edward is a 43 year old gentleman whose medical conditions developed following TIA (minor stroke incidents). At first, Edward was able to return to work doing the job he loved for so many years. However, following what was a more major stroke episode, while seemingly resolving his deficits by way of rehabilitation, he developed a significant pain syndrome involving his low back and lower extremities that became difficult to explain by way of medical diagnoses. While he had been diagnosed previously with Diabetes, his pain syndrome did not fit a classic pattern allowing for easy diagnosis. What was clear, however, is that Edward was requiring additional treatment modalities to address very significant pain issues that were becoming more and more debilitating (and ultimately requiring the use of a cane, and causing him to have significant balance issues). Given the Social Security regulations require that a severe medically diagnosed impairment be recognized, it was difficult to satisfy the agency with the test results (given they were not providing objective evidence as to why Edward was having the extreme symptoms he was complaining of). Edward was fortunate insofar as he had long term disability insurance that helped financially bridge the gap while he was facing denials requiring him to appeal to the Portland, Maine Office of Disability Adjudication and Review. We were fortunate insofar as Edward had a number of medical providers who were willing to provide their opinions as to the extent of his continuing physical limitations (and he was likewise sent to a physical therapist who was able to quantify in very objective terms the problems Edward was having in terms of his ability to maintain a steady gait). Ultimately, these providers were able to establish sufficient objective clinical findings on examination and with reference to his functional deficits that we were able to prevail upon the presiding Administrative Law Judge (following Edward's very compelling testimony) to provide Edward with a favorable decision in his claim.

Marjorie's claim was a bit easier than Edward's, once we were able to explain to the long-term treating physician (who happened to likewise be a rheumatologist) of the importance of her involvement in the claims process. Marjorie is a fifty-three year old woman who had devoted her entire professional career to working as a preschool teacher. Over time, her difficulties with osteoarthritis of her spine, hands and feet, insulin resistant Diabetes and a herniated thoracic disk took its toll on her ability to maintain employment. Unfortunately, because she had been able to work for so long notwithstanding these conditions, the Social Security Administration was not so willing to believe that she had become totally disabled from all forms of gainful employment all of a sudden at the age of 50. What likewise did not help Marjorie's claim is that her primary care physician (who happens also to be a rheumatologist, whose opinion would carry significant weight if only she would express it) remained unwilling to get involved with addressing her opinion as to the severity of Marjorie's claim (nor the extent to which she remained functionally disabled as a result of her various conditions). Fortunately, advocacy on her part (and ours) served to cause a change of heart (which made a huge difference in Marjorie's claim as she was approaching hearing at the Lawrence, Massachusetts Office of Disability Adjudication and Review). I am happy to say that an argument brief, including the opinions of her primary care physician (along with supportive opinions from a neurologist, an orthopedic surgeon for her thumb and an additional rheumatologist) served to convince the Administrative Law Judge that a hearing was not necessary (and that a favorable decision was warranted for this very deserving claimant). I am happy to say that for Marjorie no longer needed to worry about the prospect of a hearing (and the concerns and anxiety that surrounds this process).