Summary: this case involved the claim of a 46 year old man with recurrent episodes of DVT arising from an autoimmune condition called antiphospholipid antibody syndrome, as well as lupus. In addition to the recurrent DVT he has a chronic non-healing venous stasis ulcer on his leg, and not surprisingly also suffers from depression. This case resulted in a fully favorable bench decision.
Claimant: 46 year old male
Past work: leasing agent and marketing representative
Education: 4 year college degree
Hearing info: my client filed for benefits in August 2009 alleging a disability onset in May 2007 after he last worked. The hearing was held in January 2012 before a judge I know to be knowledgeable, prepared and very reasonable. Based on my personal experiences with this judge as well as the ALJ disposition database, this judge’s rate of approved cases is higher than average.
Background: my client has a consistent and uninterrupted work background dating back to the mid 1990’s. His past work was as a high level sales executive and business development manager. The medical conditions at issue included:
- DVT (deep vein thrombosis) – my client had his first blood clot in 2003 but did not recognize the seriousness of this condition. Thereafter his blood clots have increased in frequency to the point where he experiences at least one, and possibly two serious episodes of DVT per year. He testified that when he has a DVT flare-up, he will be bedridden for 2 to 3 weeks, then needs at least 2 months where he will need to keep his legs raised most of the time, with minimum walking and standing. My client also noted that his flare-ups have also been associated with diagnosed with Reynaud’s Syndrome, another medical condition of poor circulation
- When he is not having a flare-up, my client needs to take 30 minute break every 2 to 3 hours to elevate his leg
- Venous Statis Ulcer – as a result of his poor circulation, my client has an open sore on his left leg and ankle that has not closed and healed for over 2 years
- Antiphospholipid syndrome – this is an autoimmune disorder that causes excessive clotting of blood
- Lupus – this is an autoimmune disorder that affects the skin, kidneys, brain and joints. My client complains of “fuzziness” in his thinking as well as skin rashes and joint pain
- Depression – Social Security had sent my client to two consultative psychological evaluations (in different years with the same psychologist) and in both instances the examining psychologist identified job reliability as a likely issue with future employment
Factors in our favor included:
- we had a compassionate and thoughtful judge who always prepares for his cases
- the medical record contains references to several very debilitating conditions
- my client has a long, productive work history and the consultative psychologist noted my client’s frustration at not being able to work
Factors not in our favor included:
- my client is relatively young (age 46) for Social Security disability
- because of financial issues, the treatment record in this file has some gaps
Hearing Strategy: I felt that this was a very strong case and that our judge would not require an extensive hearing. However, I prepared my case for a full hearing in anticipation of the unlikely scenario that the scheduled judge assigned to this case might be ill and replaced with a judge who approves very few cases. This situation happened to me one time several years ago, and thereafter I always prepare for the unexpected. Further, Social Security has a new, misguided policy of not telling us who the judge will be so this type of preparation will be standard operating procedure.
I sketched out an outline for an opening statement where I would reference each of the medical issues in this case and I made note of several testimony points as well. Prior to the hearing, my client and spoke extensively and we practiced answering questions that contained specific activity limitations.
Hearing Report: my client and I entered the hearing room and the scheduled judge was there. After we sat down, the judge introduced himself and the vocational witness and explained briefly to my client what the hearing was about.
The judge in our case is a very warm person and I could sense that my client felt as relaxed and as comfortable as anyone would in a hearing situation. The judge asked me if I had any objections to the evidence and then he asked me for an opening statement.
I presented a fairly comprehensive opening statement, identifying the medical issues and the activity limitations that I expected the testimony to reveal. The judge had clearly prepared for this case as he explained that he had Googled the term “antiphospholipid syndrome” and understood what it meant.
The judge then turned to my client and asked him questions about the intrusion in his life when he experienced a DVT flare-up. My client testified just as he had discussed with me that a flare-up would result in a 2 to 3 week period of being bedridden, then a 2 month extended recovery period. The judge also asked my client to discuss his venous stasis ulcer and the difficulty he has had in getting it to go away. The judge asked a few more follow-up questions then he turned to the vocational witness and asked her to classify my client’s past work, which she did as:
- leasing agent – light, semi-skilled
- marketing representative – light, semi-skilled
The judge then asked the following hypothetical question:
I. Assume an individual who is the same age as the claimant, with the same education and work background. Assume further that he is limited to light work with the following additional limitations:
he must elevate his legs for 30 minutes one to two times per day
he is likely to require a six week period at least once a year when he is absent from work due to his illness
Would such a person be able to return to past work?
Would such a person be able to perform any other work in the regional or national economy?
The judge then turned to my client and advised him that the judge would be issuing a fully favorable bench decision granting benefits. The judge then read a brief bench decision and adjourned the hearing. The judge also stated that he would order a medical review in two years with the hope and expectation that my client would be medically improved and hopefully back at work.
Summary: this was a very strong case that involved a very serious and debilitating medical condition. The judge quickly satisfied himself as to my client’s sincerity and did not waste a lot of time going through the formality of an extended hearing.