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November, 2014: Two Examples of how a Skilled Lawyer can make a Difference

It is with great pride and a great sense of accomplishment that I am adding to the success stories page Marissa and Cathy’s stories. Both of these stories are remindful of the difference a skilled Social Security lawyer can make in one’s case.

Marissa is a college educated, former professional with an extensive work history, who became disabled from working as a result of problems associated with the treatment she required for eye cancer. Following radiation treatment for her eye condition, Marissa was initially able to return to her chosen profession. Unfortunately, over time, the damage to the surface of her eye from the radiation treatment made it impossible for Marissa to use her eye on any consistent basis. Rather than rushing to file a claim for benefits, Marissa hoped to return to work in some fashion. However, as her condition worsened and treatment options proved less than fruitful, it became increasingly clear to Marissa that she was not going to be able to return to any form of gainful work activity.

Unfortunately, convincing the Social Security Administration of Marissa’s inability to work remained quite difficult. Given it was not Marissa’s visual acuity that served to disable Marissa from working but rather the interruption of her day caused by her symptoms of eye discomfort and her need to treat the eye discomfort with periods of eye rest, medication and warm compresses, the Social Security Administration remained unwilling to provide her with benefits on her initial application (notwithstanding a supportive questionnaire from her eye oncologist). It is not unusual, in a circumstance where the problems causing disability are not readily apparent without statements from the claimant regarding the symptoms they experience and the interruptions to their day, for the Social Security Administration to require a hearing in order for an Administrative Law Judge (ALJ) to take testimony on these issues from the claimant. In this way, the ALJ can make a credibility determination as to how often the claimant experiences certain symptoms that would interrupt their day (or, in this case as well, the extent to which the treatment protocol would get in the way of a work day).

I’m happy to report that the hearing before the ALJ went quite smoothly for Marissa given our work together and that she has now received a fully favorable decision in her case. She is expecting significant retroactive and ongoing benefits which I know will cause her a great sense of relief given the financial insecurity that had been caused by her terrible condition.

Cathy is a fifty-five year old woman who struggled with her mental health for many years until such time as she became hospitalized as a result of her mental health difficulties and had to discontinue working altogether. Cathy had filed on her own in 2013 and received a denial letter. She became discouraged over the process and did not appeal that decision. She contacted our office in 2014 asking if there was some way to assist her with a claim.

Fortunately, while Cathy had become discouraged over the prospects of her Social Security disability claim, she did not give up on her treatment. Quite to the contrary, Cathy had remained in significant treatment with specialists (both a counselor and a psychiatrist). As has been a repeated theme in these success stories over the years, remaining in treatment with specialists who are supportive of one’s claim can be a key to receiving an approval of one’s Social Security disability claim.

Having worked closely with Cathy’s psychiatrist in the past, I was not surprised to see that he was willing to assist by providing a mental impairment questionnaire that addressed both 1) whether Cathy met one of Social Security’s medical listings of impairment and 2) the extent of Cathy’s residual functional capacity. Upon completion and submission of what was a very supportive questionnaire, Cathy received a partially favorable decision. As the Social Security Administration only provides both the attorney and the claimant with a summary of the decision, it was not clear the rationale behind the decision that while she was being found disabled as of her alleged onset date in April, 2012 they were only going to provide her benefits going 1 year back from her present application. While the general rule is that one may only receive benefits going 1 year back from the date of their application (assuming they have been found disabled going backwards in time such that they have met the 5 full month waiting period in addition to being found disabled at least 1 year following the 5 month waiting period), in this case Cathy had filed a prior application and it was amenable to reopening and additional benefits going backwards in time based on that application if new and material evidence had been provided. It was not clear in the summary decision that there was even recognition of the prior application.

Given this, I requested a copy of the detailed decision be faxed over and it became even more clear that the case worker had not properly addressed Cathy’s prior claim. Following a call to the manager of the Disability Determination Services unit, it became clear that he needed to get involved and look into whether a proper decision had been made. In fact, as a result of looking further into the decision, it became clear that Cathy was indeed entitled to an additional year’s worth of benefits (and the decision has been amended). Consequently, Cathy will not need to consider an appeal of her claim after all: she has indeed been provided with a fully favorable decision and a reopening of the prior claim she had filed by herself: she has been provided with retroactive benefits going back more than 2 years, along with Medicare insurance (which is available after one has received their 24th month of eligibility for a disability benefit). Needless to say, Cathy is feeling a great sense of relief as the holidays approach.