Summary: 56 year old female with fibromyalgia/ankylosing spondylitis/rheumatoid arthritis alleging disability based on pain, stiffness and depression.
Client profile: 56 year old female (53 at alleged onset date)
Education: high school graduate
Past work: teacher’s assistant, day care worker, supervisor at janitorial company
Claim background: my client filed for benefits in May, 2010 alleging disability beginning in March, 2009. A hearing was held in the downtown Atlanta hearing office in April, 2012.
Medical background: my client had a long and consistent treatment record. Her internist diagnosed her with arthritis, then amended the diagnoses to fibromyalgia. My client had also sought treatment with a rheumatologist who diagnosed her with a form of rheumatoid arthritis with a genetic component called ankylosing spondylitis. Prior to her insurance running out my client had been receiving regular injections into her hip and knees as well as intravenous infusions of a powerful RA drug called Methotrexate. My client had also undergone three surgeries on her left knee (although the records of these surgeries were not in file) and she had undergone surgery to implant a bladder stimulation device to treat problems releasing urine. My client has been diagnosed with Reynaud’s Syndrome, an autoimmune condition which causes her to be cold all of the time, especially in her hands and feet. My client cannot walk without a cane or walker and the claims to experience constant, debilitating pain in her joints.
Factors in our favor:
- my client has an excellent work history
- we had two very supportive functional capacity forms from both the internist and the rheumatologist
- my client’s complaints have been consistent
- my client was more than 50 years of age at onset
- the judge in our case is a very reasonable and friendly judge who is more likely than average to approve cases
Factors not in our favor:
- the medical record was not entirely complete – for example we did not have the records for the bladder stimulation device, or for the multiple knee surgeries
- my client’s insurance ran out in 2011 and she has not been to the rheumatologist for several months
My strategy: I felt that the medical record spoke for itself. Assuming that the judge will find her testimony credible, I felt certain we could argue that her functional capacity for work was so diminished that no full time work could be possible. I also saw this as a possible grid case (Grid Rule 201.14 in that my client was over 50, has a 12th grade education, does not likely have transferrable skills and because of her need for a cane/walker would be limited to sedentary work.
Hearing Report: the judge’s hearing assistant came to the waiting room and lead my client and me back to the hearing room. My client needed to use a cane to walk and walked very slowly and carefully.
After we were seated in the hearing room the judge introduced himself and the vocational witness. He asked a few preliminary question to confirm my client’s address and contact information then asked me for an opening statement. I described my client’s past work and then identified each of her problems, including the neck, back and joint pain (either fibromyalgia, rheumatoid arthritis or both), knee pain (status post 3 surgeries), bladder stimulator device, Reynaud’s, and depression.
I then began my direct examination by asking my client why she left her last job as a part time attendant at a day care center. She replied that because of pain and numbness in her hands she almost dropped a baby and decided to resign. We then discussed the areas of pain in her body and the type of treatment she had undergone.
My client testified about her multiple knee surgeries and her difficulty standing, and walking, and discussed the stiffness and pain she experienced when sitting for more than 30 minutes.
We talked about bladder stimulator device and the resulting need to urinate every 30 minutes and we established that she could not lift 5 pounds, that she could sit for 30 minutes at time and needed 30 or more minutes to walk and stretch because of stiffness.
My client testified that she has become very depressed over her physical limitations and that she was totally dependent on her family for food and shelter.
The judge had no follow-up questions and he turned to the vocational witness and asked her about the claimant’s past work, which was identified as:
- teacher’s assistant – Light, skilled
- day care worker – light, semi-skilled
- janitorial supervisor – medium, skilled
Q: Do any of these jobs produce skills transferrable to sedentary work?
The judge then stated that he had no more questions and asked me if I had any . I did not. The judge then closed the hearing and thanked us for coming.
Conclusions: the judge will approve this case based on Grid Rule 201.14. Given my client’s inability to walk without an assistive device, and her inability to lift 5 lbs., she would be precluded from performing light work, thus, at a maximum her functional capacity would be sedentary work. Grid rule 201.14 mandates a finding of disabled in this circumstance.