Knee Pain Case Study #4
Prior Left Knee Replacement Deteriorating;
Right Knee Replacement Needed
Claimant: 50 year old male
Past Work: vending machine route driver
Education: high school graduate
Hearing info: this was a claim for disability benefits heard by a judge in the downtown Atlanta hearing office. My client applied for benefits in October, 2008, following unsuccessful surgery to repair his 2003 left knee, which had become unstable following surgery. My client had worked as a route deliveryman until August, 2008, when he was unable to perform his job duties (driving, loading and unloading trucks, loading and unloading candy bars and drinks into machines) because of severe pain in both knees and difficulty standing and walking.
The medical record in this case indicated that my client’s left knee, which had been replaced in 2003, had become unstable and that the 2008 revision surgery did not result in a return of function. The treating orthopedist also stated that my client needed a right knee replacement. Complications noted included his weight – almost 250 lbs and that his normal posture was bow-legged. My client had been using a walker and/or can since he last worked.
We were unable to get functional capacity or statement on the listing forms from the treating doctors, but the medical record in this case was complete.
Hearing Strategy: I felt that this was a good case and that we had a fair judge. As noted, I did not have a completed functional capacity form or statement on the listing but I did have a client with a long and consistent work history, and a thoroughly documented medical record. The record was clear that my client could not stand and walk without an assistive device, so the main issue here was whether I could prove that he could not sustain simple, sit-down work because of pain.
Hearing report: the judge in this case has a very unique style. He always reviews his files thoroughly and he expects a clear and concise opening statement. After dispensing with preliminary matters the judge asked me for an opening and I described my client as a hard working, reliable employee who underwent knee replacement surgery in 2003 that had become unstable. His 2008 repair of the right knee surgery was not successful in restoring his mobility and he was in current need of left knee surgery. I expected that my client would testify that he left his job reluctantly, and that his employer had left the position open at my client’s request until it became apparent that the repair surgery was not successful. I further argued that my client would testify that he experienced severe pain with movement, that he could sit on task for no more than 20 minutes at a time and for a total of no more than 2 hours during the course of a day.
The judge thanked me for my opening, and he turned to my client and said that he was convinced that my client could not work and that the judge would be awarding benefits.
Summary: I think that any rational judge would have approved this case. My client had (1) a stellar work history, (2) on-going and consistent medical treatment; (3) an objectively determinable impairment that reasonably gives rise to a high level of pain and limitation of movement.