Accurately and completely portraying medical conditions and limitations on social security forms is vital to any successful disability application.  Sometimes this means providing more information than what appears to be being asked by the social security administration.

In the last two blog articles we looked at some of the considerations given and complexities faced when applying for social security disability and the definitions that carry a special meaning in a social security disability application; we then looked at when it may be beneficial to hire an attorney. This blog article will examine a real life example of a case with many of the issues addressed in those articles.

We recently represented a client who had applied for social security disability benefits. Like many, our client (who is called the Claimant) applied without hiring an attorney to assist with the initial application. During the initial application, a number of questionnaires were sent to the Claimant by the Social Security Administration to complete. With the best of intentions, the Claimant completed and returned these forms. Unfortunately, like the majority of social security disability applications, the claim was denied.

When we reviewed the case, we learned that the Social Security Administration had sent the Claimant for a physical examination with a doctor that the Social Security Administration had selected (this is not uncommon). However, because the Claimant was not alerted that the physician would be given no medical history prior to the Claimant's arrival, the examining physician would have less than all the facts available. This resulted in the physician giving opinions that the Claimant suffered from no physical restrictions. Also, two paper critiques of the Claimant's file by social security medical personnel also resulted in opinions that indicated that the Claimant was still capable of working. Lastly, on one of the Claimant's forms, when asked why the Claimant had stopped working, the Claimant simply said that Claimant's place of employment had closed. Understandably these considerations led the Social Security Administration to conclude that this person was not disabled.

After speaking to us, we investigated the client's disabilities further and obtained all of the medical records. We learned the Claimant had undergone two prior back surgeries and had returned to work in a very demanding environment after both surgeries. The Claimant had also been given a recommendation for a third back surgery but had declined since the scar tissue and arthritis were so extensive that the Claimant was concerned about the outcome. None of this had been shared with the Social Security Administration.

We also obtained medical testimony from our client's medical doctor who had treated our client, not on just one occasion, but regularly over the past 15 years, and had personally observed the patient's medical condition getting worse. The doctor was able to offer testimony to the true nature and extent of our client's disabilities. Although the Claimant had stopped working when the employer closed the business, the employer had made special work accommodations and allowed our client to continually reduce his work activities to maintain the client's seniority. We also learned that when our client came home from work each day, the client was “wiped out” and spent the entire weekends resting. In fact, our client had even placed a sheet of plywood underneath the mattress to provide additional support and relief.

When we went to the hearing, the client was wearing a back brace full time and shared with the judge that he used ice packs on his back three times a day, got very little sleep due to his extensive pain, and rarely went outside except to stretch his legs. None of this information was asked of him or provided by anyone prior to our investigation and representation.

The administrative law judge hearing this case found that the Claimant's testimony and reasons for sticking it out those last two years were very credible, considering “his impressive work of more than 30 uninterrupted years in a demanding physical work environment.”

After the administrative law judge heard our client's case, he issued a “fully favorable” decision, meaning our client was found disabled from the time he stopped working, when the plant had closed. From this scenario, one can see the effect of how an inadvertent comment or the failure to anticipate what information needs to be provided to the Social Security Administration can result in a detrimental effect on one's application. Also, when one is not alerted to the importance of getting information to health care examining sources to discuss the full effect of someone's disabilities and the impact that they have on their ability to work, it can lead to a faulty conclusion.

It is always up to the social security Claimant or his representative to insure that that Social Security Administration has all of the facts. Without the proper information presented in a way that clearly and concisely points towards the Claimant's inability to work, a deserving Claimant may not get the social security benefits he or she deserves.

We will be glad to answer any questions, and will be glad to discuss the social security disability claim.