Summary: 23 year old male with Type I (childhood) diabetes. This was an SSI only claim since my client has minimal work history
Client profile: 23 year old male
Education: high school graduate
Past work: retail clerk
Claim background: my client filed for benefits in August, 2010 alleging an onset date in June, 2010. A hearing was held in Atlanta in April, 2012
Medical background: my client was diagnosed with Type I diabetes at age six. By the time he reached high school, he was having a difficult time controlling is blood sugar despite a restricted diet and compliance with his insulin regimen. In the fall of 2008 he began experiencing severe stomach and abdominal pain, which was diagnosed as gastroparesis. His gastroenterlogist referred him to a pain management physician who prescribed narcotic pain medication. The pain medication caused severe constipation and bloating. Also in 2009 my client was fitted with an insulin pump but his sugar levels swing wildly. By the fall of 2011 my client began experiencing severe headaches and then seizures twice a week, likely from the wide variations in his blood sugar. He has very limited vision in his left eye due to diabetic retinopathy and he experiences numbness and tingling in his hands and feet. When his blood sugar is too high or too low he has to urinate frequently – sometimes twice an hour.
Factors in our favor:
- my client’s severe diabetes is well documented and under poor control
- my client experiences significant complications from his diabetes, including neuropathy, retinopathy, excessive urination, gastric pain and seizures
Factors not in our favor:
- my client is very young for Social Security
- he has almost no work history
My strategy: because my client was very young and had no significant work history my only real argument in this case was to focus on the severity of his diabetes, the poor response to prescribed treatment and his worsening symptoms.
Hearing Report: my client and I entered the hearing room and were greeted by the judge. After accepting the medical record into evidence the judge asked me for an opening statement. I noted that it was unusual for such a young person to be applying for disability but I argued that this was a deserving claimant due to the severity of his diabetes, the lack of success with treatment and his worsening symptoms.
The judge then directed me to examine my client. In my direct examination I established that my client was diagnosed with childhood (Type I) diabetes at age 6 and that his blood sugar control since that time has been suboptimal. He testified that even with an insulin pump his blood sugar levels fluctuated wildly. We then discussed his various complications and I had him testify about his stomach pain, bloating, constipation and restroom issues. We then talked about the seizures, their frequency, diration, and other complications. I asked him specifically about his capacity to sit, stand, walk, lift and carry – all which were limited because of numbness in his extremities and pain. We also discussed the fact that my client has lost over 50 pounds over the past 2 years and that he is significantly underweight.
The judge then asked my client about his daily activities and his capacity to perform various tasks. The judge in our case also had my client stand and walk around the hearing room – I have appeared before this judge and he frequently considers a claimant’s appearance and movement in the actual hearing room.
After concluding the questioning of the claimant the judge turned to the vocational witness and asked her to describe the claimant’s past work as a retail clerk, which was light and low-end semi-skilled. The judge then asked the following hypothetical question:
Q: Assume we have an individual who is the same age as the claimant, with the same education and work background. Assume further I find:
- he is limited to sedentary work
- cannot perform jobs involving ladders, ropes or scaffolds
- he is significantly underweight and walks at a very slow pace
- occasional use of ramps or stairs
- he should avoid repetitive overhead reaching or pushing
- he should avoid extremes of heat or cold
- he should avoid crawling, crouching
- occasional stooping, kneeling, balancing
- he will need to take frequent unscheduled breaks to check his blood sugar
- medicine he takes causes fatigue and anxiety
- because of depressive symptoms, he would have poor capacity to maintain attention and concentration
- because of chronic pain, he would have poor focus and would have a poor ability to maintain a schedule
Could such a person perform the claimant’s past work?
Could such a person perform any work in the regional or national economy?
The judge then read a favorable bench decision into the record, with the provision that Social Security re-evaluate my client’s medical status in 3 years.
Conclusions: I rarely accept cases for claimants in their 20’s. Here, I felt that the medical record was compelling that my client’s diabetes was both out of control and that is resulted in numerous complications that would compromise his capacity to work. My client came across as credible and believable and the solid medical record was sufficient for this judge.