May, 2016: Karen’s Struggles with the Consequences of Type II Diabetes Mellitus
Karen’s story is a very sad one of a young woman who has been stricken with the severe consequences of Type II Diabetes Mellitus. She became disabled from working following a rather sudden and severe onset of the condition that caused her to be hospitalized initially with what was a severe episode of high glucose levels that resulted in the need for her to be placed on first an oral diabetic agent and then subsequent to this an insulin regimen. Unfortunately, the medication attempts did not prove helpful and she was referred for an evaluation with an endocrinologist who noted that problems with both fatigue and vision issues were continuing to take place and, likewise, that Karen was experiencing edema, that is, swelling of her legs, that was causing her to keep her legs elevated throughout the day. A referral to an eye specialist resulted in an additional diagnosis of a very serious eye condition called diabetic retinopathy, which was deemed to be the cause of her blurry vision condition.
Karen opted to file for Social Security disability benefits through the Keene, New Hampshire Social Security Administration (SSA) District Office simply 4 months into her disabling condition, without seeking the advice of a Social Security disability lawyer as to whether this would have been wise. Given the fact that Karen remained in the initial stages of her treatment and, given the fact that it would be difficult for her to show that she would remain disabled from all forms of gainful employment for a year or longer as result of her disabling conditions, it would have been advisable for Karen to wait a number of additional months before applying for benefits. In this way she would be in a better position to prove to SSA that she would be likely to remain totally disabled for a year or longer. Assuming Karen would ultimately need to apply for Supplemental Security Income (SSI) benefits as well, which welfare benefit would be payable the month after she applied for benefits if ultimately found disabled a year or longer, an early application would have been a good idea. However, Karen is married and her husband’s income did bring Karen above the poverty line: thus, she would not qualify for SSI benefits. Thus, her only entitlement would be for SSDI benefits, which benefit is not payable until a 5 full month waiting period is payable, and, consequently, Karen would have no reason to rush in an application for benefits given what she needs to prove.
As it turns out, Karen was denied on her initial application and did contact our office to assist her with the Request for Hearing process, given there is no reconsideration process out of the State of New Hampshire. The additional treatment records as time passed made clear that Karen’s vision deteriorated to the point where she ultimately met medical listing of impairment 2.02, given her central visual acuity in her better eye after correct was 20/200 or less). What became apparent before this point in time, however, is that she developed a rather severe peripheral neuropathy that affected both her legs/feet and her hands. She found it increasingly difficult to stand and walk as a result of her condition, and likewise, she found her ability to use and feel with her hands became increasingly difficult for her. As a result, it became more and more clear that her condition progressed to the point where she met Listing 11.14, for a peripheral neuropathy.
The point to remember in Karen’s case, however, is that the condition was progressing to the point where the severity of her condition was meeting these particular listings. However, it is just as important to look at whether one is capable of proving that the listed impairment is met going back to when Karen became disabled from working in the first place.
Thus, it became all the more important to show a basis for disability at the Step 4 and 5 level of the sequential evaluation process versus the step 3 process: that is to say, since she did not meet a medical listing of impairment at step 3, since the very beginning, were we capable of showing that she had remained disabled from performing both her past relevant work at step 4 of the evaluation process, and any other work that exists in significant numbers in one’s own region or other regions of the national economy at step 5 of the evaluation process.
Fortunately, both Karen’s primary care physician and her endocrinologist were willing to detail how the lower leg edema required her to elevate her legs for periods of time during the day, how the peripheral neuropathy affected her ability to stand, walk and use her hands meaningfully throughout the day, how her brittle sugar levels impacted Karen’s energy level throughout the day and, finally, how her vision likewise impacted Karen’s ability to focus on tasks during the day. These reports, provided to the presiding Administrative Law Judge (ALJ) in advance of the hearing set at the Manchester, New Hampshire Office of Disability Adjudication and Review served as more than sufficient evidence that Karen had remained incapable of both her past relevant work and other work in the national economy, as required at step 5 of Social Security’s sequential evaluation process, since the time of her alleged onset date.
If you or a loved one are looking for guidance as to how to proceed early on with your disabling circumstances, consider calling the Law Offices of Russell J. Goldsmith at (800) 773-8622 to ensure you are proceeding on the right track from the very beginning. It may very well save you some headaches down the road.