Depression, Anxiety and Anger Control
Social Security Disability Case Study #5

Analysis: In reviewing the file, I noted that we had a thorough record of on-going mental health treatment with a psychiatrist.  I also had a very supportive functional capacity form completed by my client’s long term internist.  My client was also 60 years old which is considered “advanced age” for Social Security purposes.  Judges often give claimants in their late 50’s and early 60’s some benefit of the doubt since early retirement kicks in at 62, meaning that an approved claimant will not be drawing from the system indefinitely.

Working against us were a consultative psychological evaluation that suggested mild limitations that would not necessarily preclude entry level work. In addition, my client comes across as a very mild-mannered gentleman.  He is from India and he is exceedingly polite and pleasant - it is hard for me to picture him in an uncontrolled rage.  In conversation he speaks coherently and logically and does not “appear” distressed or overly anxious.  Judges are not supposed to engage in “sit and squirm” jurisprudence but, in reality, many do just that. 

We did have a good judge in this case, however this is definitely a case that might have been a real problem had we drawn a different judge.

Hearing Report: The judge opened the hearing by accepting into evidence all of the medical records in the file.  The vocational witness assigned to the case was a new VE which made me a little cautious.

The judge asked me to present an opening statement and I summarized the source of my client’s depression and anxiety and I argued that my client had lived the American dream and had been successful, but that his rapid downfall had been extremely traumatic and and negatively affected his mental health.

The judge then asked the claimant a number of questions about his mental health condition and some of the practical problems he experienced with daily functioning.  The judge in our case was a good judge but he tends to follow something of a script - asking every claimant in every case the same questions.  Often not every question is relevant to the particular case.  For example, here, the judge asked my client about his sitting, standing, stooping, crawling,etc. capacity, which was not really a major issue here.

After the judge asked his questions he turned the direct examination over to me.  I asked my client about how the loss of his business affected his self esteem and I asked him why he felt that he had been “manipulated” by the system.  I asked him several questions about how his depression and anxiety affected his capacity for attention and concentration and I asked him what types of stimuli created anger control issues for him.

As I expected, my client testified in a very pleasant, unemotional tone of voice although and he came across as somewhat matter-of-fact.  He did answer my questions and the judge’s questions clearly and did not ramble.

Following the direct examination the judge turned to the vocational witness and asked for a description of past work.  The VE answered that the claimant’s past jobs were skilled and either sedentary or light.  I noted that the VE gave a description for the claimant’s last work attempt, which lasted only 2 months.  This told me that the VE was inexperienced as a 2 month job tenure is most likely not “substantial.”  A more experienced VE would have noted that a 2 month job could be considered an unsuccessful work attempt and would have asked the judge if it should be considered as past work.  This likely error by the VE had no import in this case but knowing that the VE did not recognize this distinction could come in handy in case down the road.

The judge then asked the VE two hypothetical questions:

I. Hypothetical I:  Assume an individual who is the same age as the claimant, with the same education and work experience.  Assume further:

• he can lift and carry 10 to 20 lbs. occasionally
• he can walk 15 to 20 minutes at a time
• he can stand for 10 minutes at a time
• he must lie down for 5 minutes after walking or standing
• he can sit for 20 to 25 minutes at a time but needs a 10 minute “walk around” period following sitting for 20 to 25 minutes
• he cannot engage in pushing or pulling required of medium level work
• he cannot repetitively bend at the waist
• he cannot climb ropes, ladders or scaffolds
• he can use stairs occasionally
• he should avoid crouching, crawling and kneeling
• he has a “poor” capacity to withstand work stress (“poor” defined by the judge as “no useful ability”)
• he cannot sustain attention and concentration for extended periods of time (extended periods of time defined as 2 hours or longer)

Based on these limitations, can the claimant perform

past work:  Answer - “no”

any other work:  Answer - “no”

II. Hypothetical Question II:  Assume an individual who is the same age as the claimant, with the same education and work experience.  Assume further:

his functional capacity is that which is described in the form provided by the treating physician, which includes the following limitations:

• he often experiences interference with attention and concentration
• he has no tolerance for even low stress jobs
• he can occasionally lift 10 lbs. or less
• he can walk and stand for less than 2 hours
• he should avoid climbing
• he can occasionally bend, squat and crawl
• he should avoid work at heights, or near hazardous machinery
• he should avoid exposure to marked temperature extremes
• he should avoid exposure to dust, fumes, gasses and noise
• he would likely miss 3 or more work days per month
• he would frequently experience difficulty interacting with the public, co-workers and/or supervisors

Based on this set of limitations, could the claimant return to:

Past work:  Answer - “no”

Any other work:  Answer - “no”

The judge then asked if I had any questions - I did not, and he closed the hearing.

Summary:  the judge will approve this case based on the vocational witnesses response to his questions.  Hypothetical I reflects the judge’s acceptance of the claimant’s testimony as being fully truthful and credible.  Hypothetical II tracked the functional capacity form we submitted.

Another judge might not have been so generous in accepting all of the claimant’s testimony as true and accurate but our judge did.

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