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March, 2016: Bonnie’s Case: A Successful Result at Hearing in Massachusetts for Fibromyalgia

Bonnie’s case is an example of a case where, regardless of how long and productive her work history or the extensive treatment one’s undertaken, it is sometimes necessary to go to a hearing before an administrative law judge (ALJ). Bonnie is a kind woman in her early 50’s who filed her claim out of the Portsmouth, New Hampshire District Office and was denied on her initial application with an indication that her conditions were not severe enough to keep her from returning to the types of past work she’s performed in the 15 years prior to becoming disabled (that is, her past relevant work). For many years, Bonnie had worked for one of the large phone companies in the New England region and, one would have hoped that her extensive work history from the age of 18 would have shown Bonnie’s wish to work and the fact that she would have only for Social Security disability benefits as a last resort.

Unfortunately Bonnie was suffering from Fibromyalgia as her major, disabling condition, and these cases can prove quite difficult to prove. Bonnie had trusted that with her long-term efforts to continue working through her pain would have made this a smooth process for her. Bonnie initially filed her claim without the benefit of a Social Security attorney and contacted our office upon receipt of her denial letter. Upon the filing of her request for hearing before an ALJ, we likewise provided our objection to proceeding by way of Video Teleconference: as is the case with all of your clients, we do not wish to appear on a television screen before the judge (as this quite an impersonal process).

What we learned upon review of Bonnie’s file is that the Social Security Administration (SSA) did not have a great view of Bonnie’s medical history and her struggle to continue working. As is ordinarily the case, SSA only requests medical records that would go back as far as 1 year prior to their alleged onset date. In Bonnie’s case, she had been treating with a Rheumatologist (who is a specialist in Fibromyalgia) for more than 5 years prior to the date she had become disabled but none of these records were available for review. Likewise, treatment records were missing from her multiple physical therapists over the years, her long-term treating neurologist and her long-term primary care physician (these records span a 5 year period where she had continued to struggle to work, but the history was simply not available for SSA’s review). What these records would likewise show is that her treatment providers’ opinions would carry significant weight with SSA as to the extent to which her condition had impacted her ability to function. However, SSA will not assist with obtaining helpful medical opinions from one’s treatment providers nor will they assist with obtaining the older treatment records.

Thus, upon getting involved, we sought these older records and sought opinions from both her primary care physician and her rheumatologist that addressed the clinical findings associated with her conditions, the symptoms (and severity of such symptoms) that she was experiencing, a detail of the efforts made to treat her condition and the extent to which her Fibromyalgia and associated medical conditions had impacted her ability to undertake physical activities that would be necessary for employment (that is to say, her residual functional capacity). Likewise, as it was clear that Bonnie was suffering from significant mental health concerns that were going unaddressed, we were able to provide Bonnie with the name of a well-respected psychiatrist in her area that she could contact to address these concerns as well. Once he had undertaken treatment over a period of 6 months and had seen that her mental health condition had remained severe and disabling despite his efforts, he became willing to assist with her claim by addressing a Mental Impairment Questionnaire.

Upon requesting a hearing, Bonnie’s disability claim was assigned to the Lawrence, MA Office of Disability Adjudication and Review. While we were able to provide a compendious amount of records along with a hearing brief to the judge many months before the hearing, we were unable to get a review of the file undertaken by the ALJ prior to the hearing (which was partly due to the overload of cases that has been assigned to the ALJ’s and partly due to a failure on the assistant’s part to send word to the judge of our brief).

The additional treatment records and the argument brief provided prior to the hearing served to make clear to the judge that Bonnie was deserving of a fully favorable decision on her claim.

If you are suffering from a medical condition that has been hindering your ability to work and find that your treatment efforts simply do not allow you to maintain a job, contact the Law Offices of Russell J. Goldsmith at (800) 773-8622 to see how we can assist you with your claim.