Seizure Disorder Case Study #1
Claimant: 33 year old female
Occupation: machine operator at carpet manufacturing company
Hearing info: Claimant applied for benefits on May 3, 2005, alleging disability since November 16, 2004. A hearing was held in Rome, Georgia on August 28, 2007, but was continued because the judge wanted to get the testimony of a medical expert. A second hearing was held in January, 2008, with the medical expert testifying by phone.
Background: My client is a 33 year old female who previously worked as a machine operator for a carpet manufacturing company. She left school in the 11th grade, but did get a G.E.D. During the last 6 to 8 months of her employment with the manufacturing company, she began experiencing seizures. The onset of seizures also coincided with a pregnancy. As a result of the seizures, the claimant alleges memory loss, fatigue, decreased cognitive function and mood swings. In addition, because of seizures, her treating doctor directed her to stop working around machinery and not to drive.
The claimant has seen a number of doctors who attempted to treat her seizure disorder with medications. The medications were not effective. In November, 2004, the claimant was diagnosed with a condition called bilateral periventricular nodular heretropia. As explained by the neurosurgeon expert witness, this is a condition arising from tumors in the brain that cause the seizures. These tumors are not operable and there is no known cure at this time.
Analysis: As noted above, this case was originally heard by the Administrative Law Judge in August, 2006. The judge was not prepared to make a finding at that time because he felt that the record did not clearly identify the claimant’s exact diagnosis, nor did the record clearly address how often the claimant would likely experience seizures.
At the second hearing in January, 2008, the judge called a neurosurgeon to testify by phone. The neurosurgeon, a Dr. Cloniger, quickly identified the condition and expressed his understanding of its implications. The medical expert testified that the claimant’s testimony about a regular seizure pattern was entirely consistent with the medical record and that her condition was not treatable with medication or surgery.
Dr. Cloninger also testified that the claimant’s condition meets the listing at 11.02 because the claimant has experienced seizures continuously for three months despite medication.
This is a case that was approved primarily on the basis of the medical expert’s testimony. The judge was prepared to accept the claimant’s testimony as credible but only to the extent that the medical record supported what the claimant said. Some judges will give a claimant’s testimony significant weight, while others are more focused on a clear diagnosis and prognosis as set forth in the medical record. The judge in this case stated to me back in August that he needed a compelling medical record and, fortunately, the medical expert was able to pull together a medical record that was not entirely clear.
The claimant’s condition is somewhat rare and she has been to several doctors for treatment. Initially she was treated for epilepsy, but, as her disease is not epilepsy, that treatment regimen did not help her. She has been to two other doctors, one of whom apparently assigned the proper diagnosis and the other who was not so clear.
Arguably the judge could have arrived at the same conclusion if either of the treating specialists had been willing to state clearly that (1) the claimant’s allegations of seizures was consistent with the working diagnosis; (2) that current medical science does not offer a cure and (3) that the claimant will continue to experience a regular pattern of seizures.
Unfortunately the treating doctors were not willing to complete forms for me or to otherwise go on record and we had to rely on the medical expert.