Summary: 36 year old female with rheumatoid arthritis, blood clots, diabetic complications, and a subsequent cancer diagnosis
Client profile: 36 year old female
Education: college graduate
Past work: my client had an extensive work background including jobs as a teacher’s aide, shift manager at a restaurant, fast food worker and day care worker
Claim background: my client filed for benefits in June, 2012. Her hearing was held in October, 2014.
Factors in our favor:
- well documented severe medical issues
- my client is well spoken and makes a credible witness
- my client attempted to return to work but was not successful
- cancer diagnosis resulted in chemotherapy and radiation
- the judge in our case has a higher than average approval rate
Factors not in our favor:
- my client is relatively young for SSD benefits
- we did not have a completed functional capacity form
- the consultative physical medicine exam report was not especially helpful
My strategy: I felt that this was a solid case because of the extensive medical record. I was a little concerned that the judge might try to amend the onset date to the date of the cancer diagnosis (and thus eliminate 2 years of past due benefits), although I felt confident that we would be approved at least as of the date of the cancer diagnosis.
My hearing strategy was to present the case in chronological order to demonstrate the cascading effects of my client’s mounting medical problems and treatment.
Hearing Report: the judge welcomed my client and me into the hearing room and quickly went through preliminary matters of introducing the participants and accepting the medical record into evidence.
The judge then asked me for a brief opening statement. Interestingly, in previous hearings before this judge, she had not asked for an opening statement so I had not prepared a formal opening. My notes were well organized but I found that I presented my opening with a little less polish than normal.
I then proceeded to ask my client about her medical issues dating back to about 6 months prior to the end of her last full time (teaching) job. My client testified that because of pain and inflammation and medication side effects she missed excessive days from work and ended up taking a family medical leave starting in February of 2011, which was in the middle of the school year. She attempted to return to work in May, 2011 but was unable to maintain regular attendance or focus on her job so her supervisor suggested that she resign and file for disability.
My client then discussed her treatment for rheumatoid arthritis over the next 2 ½ years. She noted that the medications prescribed for her inflammatory arthritis were either ineffective or caused significant side effects – for example, prednisone caused blood sugar spikes, which caused bleeding behind her eyes (diabetic retinopathy).
My client then testified that in September, 2013 she was preparing to try to return to work as a day care assistant when she developed a blood clot. Diagnostic testing associated with the blood clot revealed a cancerous lymph node, which required immediate treatment (and temporarily stopped treatment of the rheumatoid arthritis).
I ended my direct exam by asking my client about her capacity to sit, stand, walk, lift and carry. She testified that her physical capacities were limited due to weakness, numbness and pain.
The judge asked a few followup questions before turning to the vocational witness.
The vocational witness described my client’s past work as mostly light and including skilled and semi-skilled work.
The judge then asked the VE the following hypothetical question:
Assume a hypothetical individual who is the same age as our claimant, with the same educational and work background. Assume further that this individual is limited to sedentary work with the following additional restrictions:
- occasional balancing, stooping, kneeling, crouching and crawling
- occasional climbing
- occasional use of ramps
- no use of ladders, ropes or scaffolds
- frequent handing and fingering with the upper extremities, bilaterally
- no exposure to workplace hazards such as unprotected heights or hazardous machinery
- this person would be off task for 20% of the workday
Could such a person perform the claimant’s past work or any other work?
VE: such a person could not perform past work or any other work because being off task 20% of the time is excessive
The judge then asked me if I had any questions – my response was “no.” The judge then wished the claimant well and closed the hearing.
Conclusions: the judge will approve this case. I did find it interesting that the judge used the somewhat mild limitations from the state agency functional capacity form (which was used to deny the claim at the initial application stage) in her hypothetical with one added element – the 20% off task limitation. I am thinking that the judge’s desire is to issue the narrowest possible approval. Basically the only limitation she considered from testimony was the 20% off task limitation.