Summary: 50 year old male who has chest pain and shortness of breath following 2 heart attacks, extensive psoriasis and an unrepaired hernia.
Client profile: 50 year old male
Education: 9th grade – poor reading, average math skills
Past work: 15 years as lead construction worker
Claim background: my client filed for benefits in October 2010, alleging an onset date in December, 2009. A video hearing was held in Columbus, Georgia on May 15, 2012.
Medical background: In August, 2008, my client was taken by ambulance to the local hospital with chest pain and difficulty breathing. A myocardial infarction (heart attack) was diagnosed and he underwent surgery to place 2 stents in his heart. He returned to work but was unable to perform his job duties and his company closed in December, 2009. He was still experiencing chest pain and shortness of breath with exertion and fatigue. Also around this time, he experienced a severe flare-up of psoriasis all over his body and he noted the appearance of a large abdominal hernia that protrudes from his stomach and upper abdomen.
Over the next two years he continued to experience occasional chest pain and shortness of breath. In April, 2011 he was diagnosed with another heart attack and 2 more stents were placed. He continues to experience chest pain, shortness of breath and fatigue. He notes that his legs become numb after sitting for 30 minutes and he can walk only a few blocks before having to stop.
Because he has no insurance and no money, my client has not had any significant treatment of his psoriasis or of the hernia. Prior to the hearing, I submitted a pre-hearing brief requesting that the judge order consultative evaluations of these two conditions.
Factors in our favor:
- there is objective evidence in the file that my client has significant heart problems
- my client has a long, consistent work history
- my client has a very limited education
- my client is over age 50
- my client appears quite ill, with extensive psoriasis sores over his body and a protruding hernia
- the judge assigned to our case is more likely than average to approve cases
Factors not in our favor:
- this case was a video hearing, meaning that the judge was not able to see my client’s psoriasis or hernia directly
- we did not have an RFC in the file
- my client’s medical treatment was less extensive than ideal because of financial issues
My strategy: I felt that my client’s age (over 50), his limited education (9th grade) and his long work history (15 years with the same company) established him as being credible. I felt that the cardiac issues gave rise to our strongest argument and I wanted to show how the heart problems along with the psoriasis and the hernia left my client with very limited capacity to work. My client comes across as someone who has a strong work ethic.
Hearing Report: my client and I entered the hearing room and were greeted by the judge. This was a video hearing, meaning that my client and I were in Columbus and the judge and the vocational witness were in Atlanta.
After accepting the evidence into the record and making a few introductory comments, the judge turned the questioning over to me.
I began by asking my client to describe his job and what he did there. I then asked him about his August, 2008 heart attack and its aftermath. My client testified that after his heart attack, he has never regained his strength or capacity to exert himself.
My client testified that he tried to return to work but that he was unable to perform his job duties and that he was kept on as a supervisor mainly due to his long tenure with the company. He then explained that he has continued to experience chest pain, fatigue, shortness of breath and problems with exertion ever since.
I asked him about his psoriasis and he testified that his most recent and extensive flare-up began around the time he last worked and that he has sores and scaly skin all over his body. His sores itch and are painful and he has not been able to afford treatment. He also noted that his fingernails had deteriorated due to the psoriasis.
I asked him about his protruding abdominal hernia and he explained that it developed over time and currently the hernia makes it impossible for him to bend over and pick up anything from the floor.
After I finished my direct the judge asked my client about his education – 9th grade and about his reading and writing capacity (limited).
The judge then turned to the vocational witness and asked her to describe my client’s past work, which she did as a lead construction worker – unskilled and very heavy.
The judge then asked the following hypothetical question:
Assume an individual who is the same age as the claimant with the same work history and education. Assume further I find that:can lift 10 lbs occasionally, 5 lbs. frequently
- can sit 6 out of 8 hours
- can stand 2 out of 8 hours
- occasional pushing and pulling
- occasional climbing of stairs
- no climbing of ladders, ropes & scaffolds
- occasional bending, kneeling, crawling, stooping, crouching and crawling
- frequent reaching, handling, feeling
- no work around respiratory irritants
- no work around hazardous machinery
- no work at unprotected heights
- limited to simple one, two or three step tasks
Q: Could such a person perform the claimant’s past work?
At that point the judge turned to the claimant and me and announced that he would be issuing a favorable decision based on Grid Rule 201.09, which calls for a finding of disability for claimants age 50-54 who are limited to sedentary work, with a limited or less education, unskilled work background.
Conclusions: I think that this case could have been decided under a functional capacity theory or under the grid rules. I believe that the judge found my client to be credible and my client’s cause was helped greatly by his limited education and his strong work background.