May and June, 2014: Success can come at any Stage: Initial Filing, Reconsideration, Prior to Hearing and at Hearing

The last two (2) months have seen numerous success stories at all stages of the process: the initial, reconsideration, at hearing (both prior to hearing and at hearing post hearing). Below are 4 such cases which have one thing in common: a happy client at the end who is experiencing both financial relief and emotional relief as a result of their fully favorable decisions.

Debra is a fifty-seven (57) year old woman with a consistent work history that goes back to the 1980’s who has struggled over the past several years with multiple rheumatological conditions that include both a connective tissue disorder and Fibromyalgia. When her employment came to an end at the end of 2011, it was in the setting of missing time from work, receiving special dispensation from her employer in terms of hours and days missed from work. When her absences became untenable to her employer, Debra was laid off from her employment. She continued to receive unemployment for a period of time as she contemplated what type of job she might be able to perform given the inconsistency of her day and days. Ultimately, Debra applied for Social Security disability benefits as her condition only continued to deteriorate (which began to adversely impact her mental health).

While a case involving Fibromyalgia and generally rheumatological conditions are not necessarily easy ones, Debra had a number of factors going for her. For one, she continued to struggle to work rather then running to collect a disability check (which is consistent with the work ethic Debra has always shown). The Social Security system looks to see that one is doing everything possible to continue working. Two, she has always maintained zealous treatment: she has always seen a specialist for any condition she believes is severe. The Social Security rules require that one show they are disabled despite prescribed treatment: in this way, doing everything possible to remain employed.

Ultimately, Debra’s treatment providers (which included her long-term treating rheumatologist and primary care providers) were willing to address questionnaires that spoke to the severity of her condition and how it impacted her ability to undertake work activities. Likewise, when her condition continued to deteriorate despite the efforts of her long-term treating rheumatologist, she sought out a second opinion from another rheumatologist: again, showing her willingness to do everything possible to get better (and hopefully better enough to return to work).

While Debra was denied at the initial determination level (not surprising given the nature of her medical impairments: that is, primarily Fibromyalgia), we requested a hearing at the Manchester Office of Disability Adjudication and Review. I am happy to report that following submission of a comprehensive brief to the Administrative Law Judge (ALJ) handling her case and a very short hearing, the presiding ALJ saw fit to stop the hearing short and made clear her intention to provide Debra with a fully favorable decision. Following the hearing and favorable decision, I received the most heartwarming thank you note from Debra making clear the huge sense of relief she’s experiencing both financially and emotionally as a result of her favorable decision.

Donna’s claim is another example of how undertaking an application with an experienced and aggressive Social Security disability lawyer can make all the difference in one’s case. Unfortunately, many disability lawyers will turn you away if you’ve not been denied initially. The reason for this is simple: your lawyer is getting paid out of the retroactive benefits they recover for you. Therefore, if you are undertaking an initial application, many times the retroactive benefits at issue are not significant (and this, in turn, creates less of an incentive for the attorney to take your case). Unfortunately, these attorneys are only looking at the financial reward versus the benefit to the client). I hear of many circumstances where attorneys have expressed a policy of not handling initial claims (and, it’s apparent, for this reason). Those attorneys will send the client away, telling them that if they are denied then they should call back and they will consider representing them. Unfortunately, this policy does not serve the client but rather serves the attorney. Our philosophy is to help the client when they request it: if we’re helping on the initial application, we’re helping to ensure that everything is being done to avoid what could be a 1 ½ to 2 year appeals process. In this way not only saving the emotional toll that the appeals process takes on the client but also the financial toll. Our policy is: if we’re able to assist the client with obtaining a favorable decision on their initial claim, we save the client from having to go through the appeals process: while the fee may be less, so is the amount of work involved. Thus, it’s really a win, win situation for all involved.

Donna’s circumstance is that of a 57 year old woman who had an extensive (30+) year work history as a pediatric nurse before sustaining a series of accidents while in her 50’s that caused her increasing problems with her back. When conservative measures such as chiropractic care and physical therapy not longer provided sufficient relief, she had to undergo 2 back surgeries within a 6 month period of time. We assisted Donna with the initial filing, including the application material to ensure that this material correctly reflected the extent to which she remained functionally disabled throughout the day. In addition, we worked with both the client and Disability Determination Services to ensure that the Social Security Administration had all of the pertinent medical documentation for review. Finally, we worked with Donna to obtain helpful documentation from her treatment providers. I am happy to report that we were able to obtain for Donna a fully favorable decision inside of three months of undertaking her application (and she has successfully avoided what could have been a 2 year appeals process). Needless to say, Donna was thrilled with how smoothly things worked for her claim.

Rachel is a 38 year old woman who was last working as a developmental specialist in 2008 when she was she was rushed to the hospital suffering from chest pain. While she continued to experience chest pain following her hospital visit, her doctors remained unable to determine what was causing her pain. As a result of the doctors’ inability to substantiate why she is continuing to experience chest pain, she was denied on her initial application and on her subsequent appeal (on reconsideration). Attempts were made by Rachel to address the pain through injection and medication therapy but failed to provid her with relief (and all the while she remained unable to get answers as to what was causing her problems).

What becomes apparent over time is that there are a number of heart concerns for which Rachel requires surgical procedures: first, she undergoes an implant of a cardiac device meant to help regulate her problems with arrhythmias. She is likewise noted to be suffering from cardiomyopathy which requires her to undergo what is called a septal myectomy. While these procedures are noted to prove successful, she continues to experience chest pain that causes her to undergo repeated hospitalizations (with what are noted to be a lack of findings as to what, if anything, is causing her to experience these problems).

Fortunately for Rachel, both her long-term treating cardiologist and primary care physician were willing to assist us with medical questionnaires that addressed the extent to which she remained functionally disabled as a result of her various cardiac conditions and chronic pain syndrome. Notwithstanding this fact, and the literally thousands of pages of medical records provided by our office from her hospitalizations since the time of her reconsideration denial, the presiding Administrative Law Judge (ALJ) felt it necessary to hold a hearing so as to hear from Rachel what she was continuing to experience that caused her to return to the hospital on a regular basis.

I am happy to report that the presiding ALJ was convinced by the substantial additional medical documentation provided (and Rachel’s testimony) that she had remained disabled from working, and saw fit to provide Rachel with a fully favorable decision. Fortunately, Rachel is now able to focus on her condition rather than how she was going to be able to survive financially.

Diana’s claim is another example of how quickly and effectively an application for disability can proceed when working closely with the right lawyer. Diane is a forty (40) year old woman who contacted our office at the very end of January, having discontinued work back in 2009 when her employer’s company was bought out (and she was consequently laid off). At that time, she was experiencing difficulties with her bowel that included irritable bowel syndrome and gastritis (and the symptoms associated with that condition) along with migraines, anxiety, depression and fatigue. Diana’s condition only worsened after she discontinued working in 2009, such that she believes her condition became severe and disabling as of August, 2011. Because she had waited so long to apply, Diana had already lost months of benefits: one can only recover benefits going 1 year back from the date of their application assuming they’ve met a 5 full month waiting period. Thus, assuming Diana had become disabled as of September 1, 2011, she could only receive benefits as of February, 2012 (after a 5 full month waiting period of September, 2011 through January, 2011), assuming she had filed by February, 2013. Thus, we ensured that Diana initiated a claim as of the end of January, 2014 (the same day she contacted us) to ensure that no more benefits were lost: she had already lost potential benefits for the months of February, 2012 through December, 2013. We assisted Diana with completion of the initial disability report paperwork, along with the Adult Function Report. These forms are especially important. Errors in these papers can ultimately prove fatal to the initial application (and can come back to haunt one’s appeal efforts as well). Fortunately, Diana chose to get our firm involve from the outset of her claim. Not only did we ensure all of her application material accurately reflected how functionally disabled she remained, but also ensured that Disability Determination Services had the benefit of all of her past medical record history (along with a helpful medical questionnaire from her long-term treating gastroenterologist).

Our teamwork served to obtain for Diana a fully favorable decision (along with a lump sum of disability benefits) at the very beginning May: a little over 3 months after our involvement began. Needless to say, Diana is quite relieved that everything worked as smoothly as it did.

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