May, 2012: The Social Security Disability Process can be very Unfair

May's success stories remind me how unfair the Social Security disability process can be (and how important it is that one obtain the assistance of a zealous attorney who will stay the course and continue the fight). I am happy to report that David and Paul have stayed the course and that justice has finally been served to both of them (which will likewise serve to turn their families' financial circumstances around in a dramatic fashion).

David is a thirty-seven (37) year old gentleman who initially sustained a heart attack in May, 2009, which required cardiac catheterization and stenting. He recovered from the initial heart attack and cardiac procedure, and successfully returned to work as a welder, only to require additional catheterization and stenting in August, 2010. He did not recover well from this episode and he has remained unable to return to work since that time. Unfortunately, David was not represented at the time of his initial application and he was denied. Given his claim is out of New Hampshire, there is no reconsideration process and he is required to request a hearing (and wait approximately one (1) year to go to hearing). We were able to prevail upon David's cardiologist to provide a Cardiac Residual Functional Capacity Questionnaire, but following this questionnaire, David's condition appeared to improve (at least that's what his stress echocardiogram test seemed to suggest). As David explained to me, however, he remained quite functionally disabled (and his cardiologist was willing to support this very fact). As David explained to me, the Lasix that he was requiring during the day to address his congestive heart condition was causing him to go to the bathroom on a rather consistent basis (something that would not be conducive to a work environment). Ultimately, David suffered yet another heart attack requiring hospitalization, catheterization and restenting (which served to make the final statement to the hearing office that David should be provided benefits, short of the need to go to hearing). I am happy to report that David has one less worry on his mind given the Administrative Law Judge out of the Lawrence, Massachusetts Office of Disability Adjudication and Review granted David a fully favorable decision, which will provide substantial retroactive money to both his family and him. Unfortunately, David's health remains a great concern at this time and no amount of money will provide him with a good quality of life given the continuing problems he's experiencing.

Paul is a forty-four (44) year old gentleman with an extensive work history as a surveyor, who in March, 2010 was on a ladder at home cutting down tree branches when he fell from a ladder approximately 10 feet and sustained a severe, complex fracture of his right ankle. He required multiple surgical procedures to address his condition, but unfortunately he remained significantly limited in terms of his ability to walk and stand (and sit for any length of time: he has had to elevate his leg to reduce the blood flow to his lower extremity, which serves to alleviate the pain he experience). Paul continued to be followed by his orthopedic surgeon, who was quite kind when requested to address the extent to which Peter met a medical listing of impairment under Social Security's regulations and the extent of Peter's functional limitations. The doctor addressed a Listing 1.02/1.03 medical questionnaire which supported the notion that Paul met one of Social Security's listings of impairments and likewise addressed aPhysical Residual Functional Capacity Questionnaire which made clear that he remained functionally disabled from all forms of gainful employment. Likewise, Paul's mental health served to decline given his inability to support his wife and four (4) children, causing him to experience an exacerbation of bipolar disorder problems (which had never served to disable him from working in the past, but had been a source of concern at one point and indeed had caused a prior hospitalization). Paul became quite distraught over the fact that the mental health medications were not providing him any relief (and I'm sure it didn't help that he remained on welfare, without any relief in sight from the Social Security Administration). Given these facts, I submitted an argument letter on Paul's behalf to the hearing office that inexplicably was not granted. Following the denial of my On the Record request with the hearing office, Paul underwent yet another surgical procedure to have the hardware removed from his leg (that had been used to fuse his ankle). Even though he continued to experience significant difficulties with his leg (hindering his ability to sit or stand long enough to consider even going to a job site), he did not return to his surgeon (having heard that there wasn't going to be anything that the surgeon could do at this point for him). Likewise, Paul became frustrated with the mental health treatment he was receiving and dropped out of that treatment. He began to isolate himself from everyone, including his family and his attorney. Following the scheduling of his hearing, I was unable to hear from Paul (and the phone numbers I had for him were no longer in service). Multiple letters were not being responded to, and I became concerned that Paul was going to miss his hearing (and, ultimately, miss his opportunity to be heard in front of an Administrative Law Judge out of the Portland, Maine Office of Disability Adjudication and Review). Ultimately, I determined that it would be necessary to drive to his home and see if I could reach him: unfortunately, when I showed up, Paul was not there but a vicious german shepherd was there to greet me. Fortunately, Paul's daughter was quick enough to grab a hold of the dog's rope (and I was still young and nimble enough to grab my leg out of the dog's mouth) so that no injury was caused. Notwithstanding my trip and in person message for Paul to call, I still did not hear from Paul. Another 2 letters were sent to Paul before I finally received a phone call from him. I left word for Paul to contact me, but another couple of weeks went by with no contact (and 2 additional letters were sent). Finally, I am happy to report, Paul finally did call and speak with me and explained what was going on with him. Apparently, the mental health problems had made it too difficult for him to reach out to anyone (with the anxiety and depression causing him to simply isolate). We were able to work with Paul so that he could ultimately proceed to hearing in front of a very sympathetic Administrative Law Judge who has found fit to provide Paul with not only retroactive benefits for Paul and his family but also ongoing benefits. This money should serve to keep Paul's home from going into foreclosure, and it appears that this process may allow Paul a sufficient piece of mind to return to mental health treatment so as to help him move on with life as best as he will be able given the extent of his ongoing physical problems.

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