Fibromyalgia case study #2
Claimant: 53 year old female.
Occupation: Work at home medical transcriptionist- pre-disability income of $25,000 to $30,000 per year
Education: high school education
Hearing info: Claimant applied for benefits in April, 2005, alleging an onset date of November 28, 2004 (date she stopped working). Hearing held in October, 2007 in Chattanooga, Tennessee before a judge in the Chattanooga hearing office.
Background: My client is a 53 year old female with a high school education and past work at a medical transcriptionist. During the last two years of her work, she had to log in to her employer’s computer system and her hours and pace of work were monitored. Prior to 2002, she worked at home at her own pace. This is significant because more and more “work at home” jobs are structured this way, where the employer has to log in to a remote system and the pace of work is more closely monitored. The Dictionary of Occupational Titles does not necessarily recognize this change in operational procedure so I made sure to question the claimant about the more controlled home work environment.
Analysis: My client testified that she was first diagnosed with fibromyalgia in 1993 but was able to work through the pain and fatigue. Her medical history is also significant for surgery to replace a defective mitral valve in her heart in 2003 and surgery to install two stents in her heart in 2004 and 2005.
Prior to the hearing my client advised me that she was not experiencing any noticeable problems with her cardiac condition and that her medications worked well without any noticeable side effects except for some bruising issues because of a blood thinner. She testified before the judge that her heart issues were under control.
This type of testimony – that a particular medical problem is under control – serves to enhance a claimant’s credibility. Judges appreciate the honesty of a claimant who can acknowledge that a past medical problem is not causing current issues.
In this hearing the judge asked only a very few questions to the claimant about her fibromyalgia and stopped me after a short period of time as well. After the claimant testified that her pain was concentrated in her hands, the judge stopped taking testimony from the claimant and turned to the vocational witness. He asked the vocational witness the following questions:
Classify the claimant’s past occupations. Answer: medical transcriptionist, which is a sedentary, skilled job.
Identify any transferrable skills. Answer: data entry clerk (sedentary, semi-skilled; credit card processor (sedentary, semi-skilled); typist (sedentary, semi-skilled)
The judge then asked if the claimant could return to work if her fingering was limited to “frequent.” The vocational witness responded that the following were eliminated: medical transcriptionist, typist, data entry clerk – in these jobs, fingering is constant. The credit card processor job would not be eliminated because fingering is “frequent” not “constant.”
The judge then asked the vocational witness to consider the functional capacity form that we had submitted. Prior to the hearing I had sent the claimant’s primary care physician a fibromyalgia functional capacity checklist and the completed form included the following limitations:
claimant required to walk every 90 minutes
claimant required to take 15 minute walk at every 90 minute break
claimant needs a job which permits shifting position at will between sitting and standing
claimant unable to get through an 8 hour workday without lying down.
The vocational witness testified that with the limitations set out on the functional capacity form, there were no jobs that the claimant could perform in a competitive work environment. He felt that the 15 minute break every 90 minutes was too much.
I think that the claimant quickly proved herself to be a credible witness, both because of her age and appearance and because of her truthful answer about the lack of cardiac problems. Once credibility was established, the judge began looking for a way to fit the evidence to his conclusion. Here is a copy of the favorable decision. Note that the judge refers specifically to the functional capacity form I obtained from the treating doctor. My goal here was to translate my client’s medical problems into Social Security’s language – the language of work activity limitations.