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Massachussets Bar Association
Maine state Bar

October and November, 2011: One Illness or Injury Away from Dire Financial Circumstances

Denise's case is a very unsettling reminder of how many of us are just one illness away from homelessness. Denise is a fifty-one (51) year old woman who moved up to New England from down south over the course of this past summer when she ran out of money (and had no choice but to move up here to live with family). Denise had a consistent work history from the age of 16 and unfortunately developed a very debilitating case of Diabetes (and diabetic neuropathy) which caused her to lose her most recent job in the summer of 2010 (and correspondingly lose her health insurance). While Denise was able to manage very basic treatment arrangements (which included medications) while she was down south, treatment did not include all of the testing that would confirm her diagnosis. Unfortunately, Denise's doctors down south were willing to write a letter suggesting that they were supportive of her disability but remained unwilling to address the functional capacity questionnaire her attorney had provided the doctor to fill out. Given this fact, her case was denied and she contacted me while awaiting hearing. Unfortunately, Denise's medical arrangements in New England were slow to develop and her family living arrangements quickly deteriorated to the point where she had no place to live (and she became homeless). While my contact with her prior doctors did not provide any better results, I am happy to report that an argument brief to the Lawrence, MA Office of Disability Adjudication and Review succeeded in getting Denise benefits within a few weeks' time. Denise has been awarded a fully favorable decision 8 months early (that is to say, 8 months before she would have anticipated getting a hearing date) and we have been able to succeed in getting her an expedited payment which will allow to get a place to live in short order.

David's case is the story of a 45 year old gentleman with a strong work history which for many years involved very physical work. David lost his job following a work injury which involved trying to catch a falling desk. While it was initially thought that David had suffered simply a back strain, additional testing revealed that David was experiencing significant degenerative disease of his hip. While doctors attempted injections and ultimately an arthroscopic surgical procedure, these did not prove sufficiently helpful so as to make David functional. Unfortunately, the Social Security Administration was of the opinion that because David was a younger individual with a couple of years of college that he could return to another job that would allow him to shift positions at will from sitting or standing. This did not account, however, for the time that David needed to spend lying down during the day (and in an awkward reclining position), nor did it take into account the pain and how this was impacting David's ability sleep at night (and concentrate during the day). I am happy to say that following hearing at the Lawrence Office of Disability Adjudication and Review we were able to obtain a fully favorable decision for David which will provide him with not only significant retroactive benefits which will allow him to repay his family that has been supporting him for quite some, but also with the Medicare insurance he requires so as to be able to obtain the hip replacement surgery he requires.

Tanya's case involves that of a 28 year old woman who was injured in September, 2008 in a serious automobile accident that caused significant back injuries requiring multiple level disk fusion surgery in February, 2009. Notwithstanding rehabilitation and pain management efforts, Tanya did not get any better. Ultimately, Tanya required a revision fusion in August, 2010. Notwithstanding this fact, Social Security still denied Tanya on reconsideration and required her to file a request for hearing before the Springfield, Massachusetts Office of Disability of Adjudication and Review. As is a recurrent theme with the Social Security Administration, they do not make it easy for anyone of a young age to obtain disability benefits (and Tanya's circumstance was no different). Given her dire financial circumstances, it became necessary to request an expedited on the record decision or, in the alternative hearing. I am happy to report that the brief submitted on Tanya's behalf did provide her with a fully favorable decision in time to make a very big difference for her family and her during the holidays (and it will not be necessary for her to proceed to hearing).

Ahmed's case was a rather sad story of how a serious accident can change the life of a man and his family in the blink of an eye. Ahmed was an extremely hardworking gentleman in his 30's who was working as a manager of a fast food restaurant when he fell asleep at the wheel and sustained a serious automobile accident that landed him in the hospital for many weeks recovering from very severe injuries (that included reconstructive surgery of his leg). Months of rehabilitation served to strengthen his leg to the point where he was able to walk without the aid of a cane or crutch, but, unfortunately, however this did not tell the full story of where he was left in terms of his functional abilities. He could not sit for periods of time with his leg properly placed in front of him without causing him significant pain. He likewise could not stand for long or walk for any periods of time without aggravating his condition. Unfortunately, prior to coming to my office, Ahmed had been denied by his long term disability carrier at work and he had failed to seek assistance to appeal the decision. He did not seek the assistance of an attorney until his appeal deadline for that matter had passed and until after her had been denied on his Social Security claim. In the meantime, his health insurance through his employer had likewise come to an end. Thus, ongoing treatment was difficult for Ahmed to undertake (and we did our best to guide Ahmed in the right direction in terms of treatment options for him given his financial constraints). Fortunately for Ahmed, his treatment providers were sympathetic to his circumstance and we were able to obtain very telling documentation in the form of residual functional capacity assessments (indicating the extent to which he was having difficulties with sitting, standing, walking for periods of time) and in the form of a Listing assessment (that is, showing that his medical condition met the requirements of one of Social Security's medical listing of impairments). Ahmed went to hearing at the Manchester Office of Disability Adjudication and Review and was very well prepared: he did an excellent job of explaining how his condition has continued to hinder his ability to support his family. This was likewise borne out by the work history the Administrative Law Judge had in front of her, which made clear that Ahmed was no stranger to hard work. I am happy to report that Ahmed is now in a position to support his family once again now that he has been provided with a fully favorable decision.