Summary: 48 year old female retired teacher with rheumatoid arthritis, Sjogren’s Syndrome, spinal stenosis and anxiety approved for SSDI benefits at hearing.
Client profile: my client is a 48 year old female with a college education and master’s degree, and past work as a teacher.
Claim background: my client filed for benefits in November, 2015. A hearing was held in the Atlanta area in May, 2018.
Factors in our favor:
- my client has a long, consistent work history
- there are numerous functional capacity evaluations from a treating rheumatologist (to an insurance company) stating that my client cannot work because of pain, limitation of movement and medication side effects
- there are objective orthopedic tests (MRIs) that document disc issues impacting the nerve root
Factors not in our favor:
- my client is highly educated
- the judge in our case is new to the hearing office and does not have a documented record (although he was very pleasant at the hearing)
My strategy: I felt that the medical record in this case is extremely strong and that my client wound be a very credible witness. I wanted my direct examination to focus on her long and successful work history and her desire to return to work. I wanted to ask her questions that would touch on each medical condition without overdoing the narrative. This was a case where the judge needed to be convinced that my client was credible and beyond that the medical record was strong enough to support a finding of disability.
Hearing Report: this case was originally assigned to another judge (who I know to be fair and reasonable) but when we got to the hearing office, a different judge was there. Fortunately the assigned judge was very pleasant and he, my client and I chatted for a few minutes before going on the record.
After swearing in my client and accepting the exhibit file into the record, the judge asked me for a brief opening statement. I always prepare a brief opening statement even in cases where I know the judge doesn’t ask for one because of these scenarios. I explained to the judge that my client had a long work history, with her last job being a unique teaching position where she was able to train high school junior and seniors who wanted to learn how to teach.
I explained that my client had been diagnosed with rheumatoid arthritis as a teenager but the disease had mostly been limited to her lower legs and feet and that she was able to work through the pain. In 2012-2013, however, the rheumatoid arthritis began to spread and began to cause pain, limitation of movement and stiffness in her hips and lower back. At that time she sought treatment from her rheumatologist and from an orthopedist who referred her to a pain management physician for medications and epidurals/facet injections.
At the same time the rheumatologist began to increase her RA medications which created very bothersome side effects.
My client was able to complete the 2014-2015 school year but had to leave 2 months into the 2016 school year and has not worked since.
I pointed out that the treating rheumatologist had issued multiple functional capacity reports (to a long term disability carrier) identifying significant functional limitations and stating explicitly that my client could not work. We also had a formal functional capacity evaluation in the file which indicated that my client’s capacity to work was “less than sedentary.”
I noted that my client was not a surgical candidate and that the injections provided by the pain management doctor offered short term relief at best.
The judge then asked me to question my client.
I began by asking her about her past work and she testified that her last teaching job was extremely rewarding and a very difficult job to get. She had hoped to retire from this position. We went though the exacerbation of her symptoms and her last attempt to work in the fall of 2015.
She offered specific testimony about her physical capacities – sitting for no more than 10-15 minutes, standing for 5 to 10 minutes and her need to lie down several times a day. We established that she could not climb ladders, ropes or scaffolds, nor could she crouch, kneel, or crawl.
She testified that her pain level could reach 7-8 or a 10 point scale and that at that point she had issues with memory and concentration.
After my direct examination the judge asked only a few question – mainly to establish that my client needed to lie down several times a day and would have trouble with grip.
During the hearing my client was fidgeting on the hard wood chair and repeatedly stood and sat, all while supporting herself with a cane.
After hearing testimony the judge turned to the vocational witness and asked her to identify and classify my client’s past work – my client was a teacher which is a light, skilled occupation. Then the judge asked one question:
Assume a hypothetical person the same age as our claimant with the same education and work background. This person is limited to sedentary work with the following limitations:
- because of pain and discomfort, this person has issues with memory and concentration and would therefore be limited to simple work with simple instructions
- this person would have trouble with grip and difficulty opening jars and lids
- this person would need a job with a sit/stand option with sitting limited to 15 minutes at a time, standing limited to 15 minutes at a time and would need to walk around to relieve her discomfort
- this person would need to lie down several times a day for up to 60 minutes at a time to rest
- because of medication side effects, this person would be nauseous for up to a day and a half per week
- because of medication side effects, this person would experience drowsiness that would impact attention and concentration
- this person could not bend, stoop or squat, nor climb ladders, ropes or scaffolds
- because of pain this person should avoid jobs that require interaction with the general public
- because of irritability this person would have problems with authority figures
- this person can lift no more than 5 lbs. occasionally
Could such a person return to past relevant work?
Could this person perform any other job in the regional or national economy?
The judge then turned to my client and said “I’ll get a decision out to you as soon as possible” and ended the hearing.
Conclusions: the judge is going to approve this case. As he asked only one hypothetical question that was very detailed with multiple restrictions and resulted in an answer of “no jobs” there would be no basis to deny this claim. And, of course, the medical evidence is overwhelming in my client’s favor.