Fibromyalgia case study #4
Claimant: 61 year old female.
Occupation: engineering reports clerk for large telephone service provider. This job involved some internal accounting and administrative support for systems engineers. The claimant also served in the military for just over 1 year in the late 1960’s working stateside as a protocol provider
Education: high school education + trade school education as a medical assistant (which she never used in employment)
Hearing info: Claimant applied for benefits in June, 2004, alleging an onset date of November 1, 2001. The hearing was held in August, 2008 at the north Atlanta ODAR.
Background: My client was a 61 year old female with complaints of chronic pain arising from fibromyalgia. She had a long medical history that included several non-surgical procedures on both knees, and ultimately a left knee replacement. Since 2001, the claimant had been treated at a local pain management facility, where she was prescribed numerous medications. My client also complained of frequent migraine headaches, and shoulder pain. The record also contained a consultative psychological report ordered by Social Security in which the examining psychologist identified problems with attention and concentration and problems dealing with work stress.
Analysis: The judge in our case was well known to me. He is a very polite and pleasant person who is somewhat quiet and also somewhat formal. My past experience with this judge has been mixed – he appears to be somewhat conservative when it comes to granting benefits, although I have had success in cases where the claimant had a strong work history, regular medical treatment and a helpful form completed by a treating physician. All of these factors were present in this case.
After meeting with my client several weeks prior to the hearing, I felt comfortable that she was in pain and would have a great deal of difficulty holding down any job. I was concerned, however, about how she might testify. I felt that my client had pretty much decided that she was disabled and that she would have a hard time demonstrating a desire to return to work. Sometimes, judges read an “attitude of entitlement” into claimants who are psychological invested in their disability and I saw that as a risk here. On the other hand, my client would not be an appealing work candidate at age 61 with multiple medical problems.
Our judge does not say very much and as is typical with him, he asked me to “examine your witness, if you wish.” I started by going over her past work and education, then I moved the various medical problems. Overall, my client did a decent job, although she frequently lapsed into describing her capabilities in terms like “not that much” or “not very far.” She also testified that her pain level was a 9 on a 10 point scale, which most judges would not find credible.
I tried to focus more on activities as opposed to opinions and I think that we were effective in painting a picture of a woman who experienced chronic pain and poor sleep.
After presenting testimony, the judge asked a few questions, then he turned to me and asked if we would consider amending our onset date to December, 2004, which was the date of the psychological consultative evaluation. I asked for a brief recess and discussed this with my client and her husband. They were agreeable to this modification. The net result of this amendment would be to shave off about a year of past due benefits.
The judge accepted our amended onset date and he turned to the vocational witness to ask a hypothetical question. The question described a person of the claimant’s age, education and work background who was limited to light work (able to sit for 6 out of 8 hours during a day, able to stand 6 out of 8 hours during a day), able to lift 10 lbs. regularly and 15 lbs. occasionally. The hypothetical person also had non-exertional impairments as described the psychological consultative exam – marked problems with attention and concentration and a likelihood of decompensation due to stress in a work setting. Based on this hypothetical, the VE announced that the claimant could not perform past work or any work.
Basically the judge had focused his attention on the consultative psychological report. I sense that he has a somewhat conservative view of what constitutes fibromyalgia, and he felt more comfortable relying on a single medical report that described psychological limitations. I don’t think that the chronic pain evidence was irrelevant to him, but he was not prepared to rely on that evidence to approve this case.