September, 2017: Sheila’s Fully Favorable Social Security Decision out of Keene, NH and Manchester, NH ODAR
As a NH Social Security lawyer (handling disability claims out of Maine, MA and NH) for 32 years), we see so many different variations on a theme as to why individuals are denied on their initial applications. Sometimes, it can seem, pushing one’s self to work can be counterproductive: not only to one’s health, but also to one’s Social Security disability claim. Sheila’s circumstances are quite atypical in this regard, and the very fact that she applied as early as she did following a layoff ended up bringing about an initial denial of her claim probably unnecessarily.
Sheila had been experiencing pulmonary difficulties for more than 20 years stemming from a condition called Pulmonary Hypertension, which is a “type of high blood pressure that affects the arteries I your lungs and the right side of your heart.” The Social Security listings do contain a listing for this condition, Listing 3.09, which specifically calls for a finding during the course of a cardiac catheterization for a specific pulmonary artery blood pressure reading equal to or greater than 40 mm HG. Assuming, however, one cannot show that one meets the very specific criteria set forth by one of Social Security’s medical listings of impairments (which automatically qualifies one for a finding of “disabled” under Social Security’s rules), it becomes necessary to proves that one cannot return to any of their past relevant work (that is to say, any of the types of work they performed in the 15 years prior to becoming disabled) or any other work that exists in significant numbers in their region or in other regions of the national economy.
Sheila, who is in her 40’s and who had an extensive and productive career at a skilled position in manufacturing, had struggled to maintain her work for years, and during the last 6 months of her employment, she was missing multiple days per month as a result of her condition. To Sheila’s credit, she did not apply for unemployment following her layoff as she realized that she would not be able to say honestly that she was available for gainful employment (as is required, if she’s going to qualify for an unemployment check through the Department of Labor).
And so, upon being laid off, with the advice of her doctor, Sheila did put in an application for Social Security disability benefits on her own. She was denied, not surprisingly, given the fact that her job did not come to an end specifically because of disabling condition (even though Sheila did not feel as though she could begin looking for other work.
Upon getting involved, our office filed a Request for Hearing before an Administrative Law Judge (ALJ) which caused Sheila’s case to be transferred to the Manchester, NH Office of Hearing Operations, and began working on obtaining supportive documentation in anticipation of proceeding to hearing. What Sheila did not realize at the time that she applied (immediately after her layoff) is that she did need to prove that she had remained disabled (or would remain disabled) for what would be a year or longer, and that she would not be paid for the first 5 full months after being found disabled from working. What became more evident from her treatment records, however, as time passed, is just how debilitating her condition had become. Six months after leaving work, Sheila was hospitalized for her condition and her condition had deteriorated to the point where she was requiring supplemental oxygen and was being placed on a lung transplant list. What became more evident as well is that because Sheila had pushed to continue working, and did not lose her job as a result of her disabling condition but rather as part of a layoff, this set of facts was being taken by the Social Security Administration (albeit wrong) as an ability to work. What would become evident from the past treatment records we were able to obtain on Sheila’s behalf, however, is the fact that Sheila should have stopped working long before the point in time of her layoff,
Functional capacity questionnaires from both her treating pulmonologist as well as her primary care physician, not to mention the additional records provided which evidenced a precipitous decline following her discontinuance from working, made evident to the presiding ALJ that her condition had remained severe and disabling (such that she had been incapable of undertaking any manner of gainful employment) from the point in time she was let go.
Thus, Sheila was granted by the presiding ALJ what is called an OTR (or On the Record decision), whereby she was granted disability benefits without the need to go to hearing based on a finding that she had become disabled from earning gainful wages at the point in time of her layoff. Many times, in this very way, an aggressive and knowledgeable Social Security disability lawyer can help you avoid the need to attend a hearing.
And so, if you’ve been suffering from a severe medical condition that has been impacting your ability to maintain a work schedule, make the early decision to contact the Law Offices of Russell J. Goldsmith at (800) 773-8622 so as to receive a free, no obligation assessment as to how best to proceed in your individual circumstances.