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November, 2016: Continuation of Amelia’s 8 Year Odyssey for Social Security Disability Benefits out of the Portland, Maine Hearing Office

In our prior entry, we left off with Amelia proceeding to hearing before an Administrative Law Judge (ALJ) at the Portland, Maine Office of Disability Adjudication and Review. At the hearing, the treating psychiatrist testified as to the particulars of her involvement in Amelia’s care and of the history she had obtained from Amelia. She explained in rather detailed terms how Amelia’s mental health condition did in fact meet the requirements of Listings 12.04 Affective Disorders and 12.06 Anxiety-related disorders, while at the same time explaining why she would find it difficult to show up to a job 8 hours a day, 5 days per week. Amelia testified as well as to how her condition made it difficult for her to function in any meaningful manner outside of her home (safe) environment: how she would have panic attacks to the point where she would feel it necessary to park outside the hospital as she was fearful she was having a heart attack.

While both the treating psychiatrist and Amelia compelling testimony as to how her condition was impacting her, the psychologist called to testify by the ALJ rather surprisingly took a different take on Amelia’s condition. She contradicted the treating psychiatrist by giving her opinion that Amelia evidenced an ability to function outside of her home or safe environment as reflected by the doctors’ appointments she regularly attended and the fact she was able to leave her home with friends and family to go to the store or, for example, visit at their home. This was despite Amelia’s and the treating psychiatrist’s prior testimony that she was able to attend her medical appointments as she felt it was necessary for her survival and would help her, and the fact that her visits to the store or to a home were only in the company of trusted, long-term friends and family.

While the judge’s medical expert did not agree that her condition met a medical listing of impairment, or that her functional limitations remain severe enough to keep her from working, she did clarify on cross-examination indeed Amelia would find it difficult to leave her home on a regular and consistent basis. Likewise, when asked her opinion as ot whether Amelia suffered from a “Somatoform disorder,” she testified this was certainly a possibility.

The presiding ALJ, however, in issuing his denial, not only ignored the specifics of the treating psychiatrist’s testimony (failing to address any of them in his decision), he also took out of context his own medical expert’s opinions. He utterly ignored the psychologist’s opinion that Amelia would find it difficult to show up 8 hours/day, 5 days per week and likewise cited the psychologist as stating the Somatoform disorder was “only a possibility” versus “certainly a possibility.” Moreover, the presiding ALJ ignored entirely, as if it didn’t exist, the medical reports that the treating psychiatrist has prepared in support of Amelia’s disability claim.

Upon receiving the denial of the claim, we prepared on Amelia’s behalf a Request for Review of Hearing Decision/Order before the Appeals Council in Fall Church, Virginia. Upon review of the arguments made by her counsel, the Appeals Council indeed turned the decision around to the same ALJ for a second hearing. At that time, the ALJ was ordered to provide proper consideration of the treating psychiatrist’s report, among a number of other actions. Upon rehearing of the case, however, what became clear is that the presiding ALJ was simply looking to deny Amelia’s claim once again in a summary fashion. While an appeal to the Appeals Council proved fruitless on this occasion, many avenues for further appeal remained clearly open and available. Fortunately, Amelia was willing to allow an appeal to Federal District Court, given this lengthy, contentious process was only worsening her mental health condition.

With no funds for filing fees and service costs, we filed her case with the Federal District Court in Portland, Maine and sought to proceed in forma pauperis. Indeed, such fees were waived. Our detailed brief to the court cited very compelling errors evidencing the presiding ALJ’s clear intent to deny this poor woman for no good reason. I am happy to report that the U.S. Attorney’s Office, the attorneys for the Social Security Administration, took a hard look at the arguments made in the appeals brief. They agreed, without the need to present oral argument to the Federal Court judge, that the presiding ALJ did err in his conducting of the hearings and remanded (sent back) Amelia’s case for a 3rd hearing before a different ALJ. We likewise succeeded in recovering attorney’s fees for Amelia under the Equal Access to Justice Act (which provides attorney’s fees to be paid by the Government in circumstances where their position is found not substantially justified.

Following a rehearing of her claim, in front of a new ALJ at the Lawrence, MA Office of Disability Adjudication and Review, Amelia’s claim was approved, with a reopening of her initial claim resulting in 9 ½ years of retroactive benefits.

Amelia is breathing a lot more easily these days now that she has won her claim, and is . quite relieved that she stuck with her claim and our office as, clearly, persistence paid off.

If you or someone you love is facing denials of their Social Security disability claim and requires a zealous Social Security disability lawyer, contact the Law Offices of Russell J. Goldsmith at (800) 773-8622. Our offices out of Maine, Massachusetts and New Hampshire have been fighting for New England’s long-term injured and disabled for 27 years.