November, 2017 Steven’s Portland, Maine Social Security Disability Claim
Steven’s Social Security disability appeal out of Portland, Maine was certainly one of the more challenging cases in recent times.. I preach throughout the website articles and blogs (and through my practice) that it is always in a disability claimant’s best interest to be in zealous treatment for any condition that they believe remains severe and disabling: and this means with specialists, not simply with one’s primary care physician. .
Unfortunately for Steven, who had worked for many years as a postal clerk, he had previously gone through many years of back pain and attempts at treatment with specialists and had become discouraged with treatment. Issues with degenerative disk disease of his entire spine (cervical, thoracic and lumbar) were discovered back in the mid-2000’s. While he had been able to continue working for a period of years, there were various points in time when he would have to go out of work entirely, and then gradually return to work on what was a light duty basis. Because little progress was made by way of injection therapy and physical therapy, and MRI studies did cause a neurosurgeon to determine that his condition was not amenable to surgery, Steven became disenchanted with treatment and came to the conclusion he would simply have to live with the pain (albeit with some modest amount of narcotics).
What became clear upon our involvement upon being retained to handle his appeal at the reconsideration level was that Steven had sustained a work-related injury to his back many years prior. And so, there was a workers’ compensation claim that went back many years. While some of the doctors were no longer around (not to mention their treatment records), there was a mechanism for obtaining helpful documentation by way of his workers’ compensation file. With this in mind, we set about retrieving the old file, which included practitioners reports that had at times referenced not only his need to be out of work altogether but also periods of time where he had to return to work on a light duty basis (for what was the last few years of his employment). What became evident from the file was that Steven faced quite a bit of pressure from his employer to return to work at either full duty or retire early based on his disability (which Steven ultimately felt forced to do as they would not adhere to the work restrictions he was being provided by his physician).
While there was not much in the way of ongoing treatment records, we were able to obtain for example Steven’s permanent light duty restriction letter from his primary care that made evident just how serious Steven’s condition remained. We were able to show the presiding judge the efforts Steven made to push through on what was modified duty status, despite the numerous setbacks he was experiencing trying to work. Ultimately, the final workers’ compensation note provided Steven with limitations of no prolonged sitting or standing, lifting up to 10 lbs, and no repetitive bending and lifting, with an additional letter at the time providing that “[h]e has not been capable of sedentary work as prolonged sitting caused severe exacerbations of pain.”
Moreover, the Veteran’s Administration rating examination findings were likewise quite helpful, lending further support for the notion that Steven had remained a a less than sedentary exertional level. In addition, we were able to convince the presiding administrative law judge (ALJ) to take another look at the consultative examination set up with one of the Social Security Administration doctors, and which found he would have a difficult time maintaining any manner of full time employment given his condition. While the conclusory language that Steven could not undertake full time work would not per ordinarily be permitted under Social Security’s rules (as conclusions as to whether someone can work is in the ALJ’s province not the doctor’s, the ALJ was willing to look at this in the context of Steven’s inability to show up 8 hours a day, 5 days a week, as is required for a determination that one is capable of gainful employment. See Social Security Ruling 96-8P. Moreover, the opinion of the consultative examiner was that it would be difficult for Steven to bend at the waist (which means, pursuant to Social Security Ruling 96-9P, that even if Steven was otherwise deemed capable of sedentary exertional level employment, the inability to stoop even occasionally throughout an 8 hour work day would significantly erode the sedentary occupational base and call for a finding of “disabled” under Social Security’s rules).
Fortunately, with these various legal and factual arguments culled together, the presiding ALJ agreed to issue a bench decision (that is, he was willing to find at the hearing, and announce from the bench, that he was granting benefits from the bench.
What should be clear from the above is that the Social Security regulatory scheme is a complicated one, and a disability claimant should always consider moving forward with the assistance of an experienced attorney. And so, consider a call to the Law Offices of Russell J. Goldsmith at 1-800-773-8622 for a free legal analysis of your case.