Crohns and Colitis Case Study No. 1

Crohn’s and Colitis Social Security
Disability Case Study #1

Claimant: 54 year old male

Occupations: housekeeping supervisor at high end downtown hotel, security guard supervisor, office manager, cook, professional musician

Education: high school graduate

Hearing info: my client applied for benefits in September, 2006, alleging disability as of February, 2005.  His last day of work was in February, 2005 when he was fired from his job with a security company following a dispute with a co-worker.  My client believes that an underlying reason for his employer to fire him was his chronic medical condition.

Hearing strategy:  my client's underlying medical problem Crohn's disease, a disease that causes inflammation of the digestive or gastrointestinal tract, and colitis, an inflammation of the colon.  In my client's case, his disease causes cramping and pain, and painful bowel movements.  He has also developed anal fissures which are chronic.  

I have generally had good results in cases of documented Crohn's disease.  Affected individuals frequently experience a great deal of pain in the restroom and have a difficult time getting through the workday without needing unscheduled restroom breaks that can take up to 30 minutes.  In addition, I have found that most judges recognize that gastrointestinal irritation can and does cause a great deal of pain and discomfort.

 

The medical record in this case was solid - it documented my client's history of treatment for Crohn's disease dating back prior to the onset date.  In addition to the Crohn's disease by client has chronic back problems that arise from years of standing type of work on a hard floor.  MRI reports from several years ago reveal at least one herniated disc, and my client needs a cane for ambulation.

My strategy here was to present a clear and compelling opening statement then to ask my client several "big picture" questions about what it is like to live with Crohn's disease and/or chronic back pain.

I also recognized that the judge in our case was a no-nonsense judge who would conclude the hearing in 5 minutes if he had what he needed.  I prepared my client by walking him through a "regular" 60 minute hearing but I advised him not to be surprised if we were done in less than 10.

The Hearing: the judge called the hearing to order and quickly went through preliminary matters.  There was no vocational witness present, which suggested to me that the judge had read the file and did not see a need for vocational testimony.  The judge asked me to make an brief opening statement and I explained that this case involved a 54 year old individual with a solid work history who was unable to work because of his gastrointestinal problems.  I noted that he needed to take frequent, unscheduled restroom breaks and that he might need 15 to 45 minutes of restroom time three or four times a day.  I also pointed out that he walked with a cane because of back problems but that the most significant and medically supported issues related to the Crohn's disease.  The judge listened to my opening and then asked me to present my case.

I turned to my client and asked a "big picture" question - "can you describe for us what it is like to live with Crohn's disease."  My client explained about the pain and frequent restroom breaks as well as the embarassment at a previous job arising from his personal needs.  The judge quickly interrupted and asked him about his medication and if it was helping.  My client testified that he had been on Prednisone for many months and that other medications to control the inflammation might work for a while, but then would lose effectiveness, necessitating a new medication. 

At that point the judge turned to me and said that he had heard enough and was approving the case.  As predicted, we were out of the hearing in less than 10 minutes.

Observations:

  1. this was a very strong case - I cannot think of too many judges who would have turned it down.
  2. I think it was helpful that I knew the judge and his habit of conducting 10 minute hearings.  Whereas my normal opening statement covers past work, applicable dates and anticipated testimony, I know that this judge wants a concise argument and a 2 minute opening.
  3. gastrointestinal disease cases generate multiple vocational issues - as silly as it may sound, unscheduled bathroom breaks can make it impossible for an entry level worker to get and keep a job.

 
 
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