Summary: 60 year old female alleging disability based on congestive heart failure, medication side effects, and gout
Client profile: 60 year old female
Education: 2 years college
Past work: substitute teacher, pet product demonstrator, graphic designer, zoo caretaker
Claim background: my client filed for disability in January, 2011 alleging disability beginning in November, 2010. A hearing was held in one of the Atlanta hearing offices in March, 2012.
Medical background: in 2007 my client went to the doctor complaining of shortness of breath, thinking she was having an asthma exacerbation. Tests revealed a blockage in her coronary artery and when angioplasty was not successful she was admitted for a double bypass.
Since that time her heart function has been suboptimal with her “ejection fraction” hovering between 25% – 30% (normal is 70%). She has frequent chest tightness and regular episodes of chest pain, for which she takes nitroglycerin. She is also diabetic and has gout. She has difficulty walking more than 10 minutes at a time and when she sits she must stand and walk around every 30 to 40 minutes to aid the blood circulation to her lower body and to avoid clots.
My client has been prescribed numerous medications including lasix which causes her to urinate every 30 to 40 minutes. The nitroglycerin pills give her a terrible headaches.
Factors in our favor:
- long and consistent work history
- consistent medical history documenting a severe impairment
- compliant with all medical treatment
- legitimate work activity limitations of excessive breaks (due to need to urinate) and reliability problems associated with shortness of breath and gout
- supporting functional capacity form completed by treating cardiologist
Factors not in our favor:
My strategy: In reviewing the medical records in this case, it was clear to me that my client had a very good claim. Her cardiac problems were well documented and the activity and reliability limitations suggested in the record and likely to be included in testimony would support a favorable decision.
Social Security has now decided that they will not tell us who the judges are prior to the hearings so I could not prepare for the specific judge, but I felt confident that any judge in the Atlanta area hearing offices would approve this case.
Hearing Report: my client and I entered the hearing room and sat down. I have tried many cases before the judge assigned to this case and I know him to be fair and reasonable.
After going through preliminary matters (but no opening statement) the judge questioned the claimant closely, going over her cardiac condition, her asthma, her gout, her diabetes and some of the side effects of medications. My client testified clearly and credibly and I felt that she and the judge established a good rapport.
After the judge completed his direct examination I asked several followup questions, mostly centered on the medication side effects and specific activity limitations (i.e., sitting, standing, walking) arising from her cardiac condition.
When my direct examination was completed, the judge turned to the vocational witness and asked the following:
Q: Please identify the claimant’s past work
A: the VE identified 6 different jobs, all of which were semi-skilled or skilled and ranged from sedentary to medium exertional level
Q: Consider the following hypothetical:
Assume an individual the same age as the claimant with the same work background and level of education. Assume further I find:she is limited to sedentary work
- she cannot work around any work hazards or dangerous machinery
- she cannot work around pulmonary irritants
- she can climb occasionally
- no climbing of ladders, ropes or scaffolds
- she is likely to miss 3 or more days of work per month
– Could such a person perform the claimant’s past work?
– Are there any transferrable skills to sedentary work?
– Are there any jobs in the regional or national economy that a person could perform with these limitations?
A. No – she would miss too much time from work to sustain competitive employment
The judge then asked me if I had any questions. I had one:
Q: if we take the judge’s hypothetical but substitute the limitation of needing to take a 5 to 7 minute bathroom break every 30 to 45 minutes during the workday due to the side effects of Lasix, and we remove the 3+ day of missed work per month, would your answer change?
A: No, your limitations would result in too many unexcused absences from work
I then advised the judge that I had no other questions. He asked if there was anything further and I replied that there was not. He then closed the hearing.
Conclusions: this was a very strong case in that my client’s cardiac condition was serious, well documented and the claimed limitations (both physical and the medication side effects) were entirely consistent with her treatment record. In addition we had a fully supportive functional capacity form from a treating cardiologist. The judge will be issuing a fully favorable decision in this case.