Summary: 40+ year old male with long work history at high paying job alleges disability based on major depression
Client profile: 40+ year old male
Education: college educated with 2 graduate degrees
Past work: My client worked as a business consultant for the 2 years prior to onset. Prior to that he worked in an executive position for a company in the health care industry. He also has past work as an educator. In addition to his paid positions, my client also has a long history as a volunteer for various community organizations.
Claim background: my client applied for benefits in September, 2012 alleging disability beginning in mid-winter, 2012. A hearing was held in an Atlanta area hearing office in January, 2015.
Factors in our favor:
- my client has a long, continuous work history with earnings in excess of $100,000 annually
- the medical record in this case was very thorough and included numerous statements from his treating psychologist that he did not have the capacity to work
- the judge in our case is reasonable and compassionate
Factors not in our favor:
- my client is relatively young for disability
- the treating psychologist did not perform any formal psychological testing, so the record did not contain test results from the psychologist (although it did contain a report with testing from a neuropsychologist)
- the symptoms my client described – excessive sleep, mental confusion, inability to focus, loss of short term memory and panic attacks are a little outside the norm for a major depression patient and none of the medications or therapy seem to have helped much to date. The treating psychologist even noted his frustration that none of the treatments seemed to be working.
My strategy: I felt that this was a strong case because of the numerous functional capacity reports and letters in the file from the treating psychologist. My client’s long term disability carrier regularly wrote the psychologist to ask about his return to work status and the psychologist regularly wrote back or completed forms saying that my client could not work.
Hearing Report: my client and I entered the hearing room and were greeted by the judge. After introducing the hearing reporter and the vocational witness, the judge accepted the medical exhibits into evidence. He then asked me for an opening statement.
I started by noting that my client had a long and continuous work history and that he voluntarily left a job where he was earning over $100,000 per year. I also pointed out that my client would testify that in addition to his employment, he held numerous volunteer positions in the community and that stopping his paid and volunteer work was not consistent with his history or work ethic.
I also acknowledged that the exhibit file referenced earnings after the onset date and I advised the judge that these earnings arose not from work but from accrued vacation time and short term/long term disability payments.
At that point the judge interrupted me to say that these post onset earnings were of great concern to him and that he would want to look at that issue in more detail later.
I continued by summarizing the medical record – my client initially sought treatment with his internist for heart palpitations and chest pain. He was eventually referred to a psychologist who identified his problem as a mental health issue.
The psychologist then assumed control of the medical treatment by referring the my client to a neurologist and a neuropsychologist to rule out organic brain disease, and a psychiatrist to provide medical management.
I pointed out that the neuropsychologist, the psychiatrist and the psychologist had all issued opinions that my client had severe limitations to his capacity to work and that the totality of the evidence suggested that at around the time of onset date my client had a nervous breakdown and that his continuing anxiety, stress disorder and depression produced the symptoms claimed by my client.
After finishing my opening the judge turned to me and stated that he saw the numerous functional capacity evaluations in the file but he was having trouble reconciling these reports with the treatment notes. Specifically the judge noted that he saw no objective testing from the treating psychologist who was issuing all of those evaluations – could I help him reconcile the apparent conflict.
I responded by noting that there were test results in the file – one from the neuropsychologist and a second from the psychiatrist. Both of these tests showed a significant level of impairment and an absence of malingering.
Further, the treating psychologist served not only as a treating source but he had also assumed the role of medical treatment coordinator – sending his patient to a neurologist to rule out any organic disease and to a psychiatrist to facilitate medical management. More importantly the psychologist spoke to these different providers and served as the point person in dealing with the long term disability carrier (who was looking for a reason to cut off my client).
I pointed out that the psychologist could reasonably rely on his own observations as well as the observations and treatment records of the other providers and that as a treating provider his opinion should be give substantial weight.
The judge then turned to my client and said to him – “I see that you have had a long, consistent work history and that you were earning over $100,000 per year. I think it is a given that you could not return to your past work or something like it. The question in my mind – could you function as a greeter at Walmart or perform some other entry-level task. How do you respond to this?”
Fortunately my client and I had discussed this very question in our pre-hearing meeting: why would he be unable to perform the tasks required of a simple, entry-level task. My client responded to the judge by stating that he frequently experiences panic attacks when around more than one or two persons, that he has memory lapses, that he gets fatigued performing even simple tasks, and that some days he just does not have the energy to perform any task.
After considering the my client’s testimony the judge stated that he was prepared to find my client credible and accept the opinion of the psychologist. The judge continued by saying that during his initial review of the evidence in this case he was skeptical but that my argument had persuaded him (it is always nice when a judge does this!).
He did ask me to provide some proof that the post onset earnings were not the result of work and that he would leave the record open for 10 days for me to provide this information.
The judge then turned to the vocational witness and asked him a hypothetical questions containing extensive limitations, which, as expected, yielded the testimony that there were no jobs. The judge then concluded the hearing
Conclusions: this case is yet another example of how a claimant’s strong work history will enhance his credibility before a judge. This case also demonstrates that mental health claims are difficult because there are no “objective” test results but that these cases are viable with good treatment and a credible claimant.