59 Year Old Disability Claimant With “Failed Back Syndrome,” Diabetes and Reduced Kidney Function
Claimant: 59 year old male
Past work: surveyor for engineering companies (30+ year steady employment history)
Education: high school graduate + technical school
Hearing info: the claimant applied for disability benefits in late 2005 alleging disability beginning in August, 2005. The claimant had been denied at the initial application and at reconsideration and a hearing before an judge was scheduled for June, 2008. The judge in our case was a local judge who works out of the North Atlanta hearing office. I know this particular judge to be fair, reasonable and always well prepared to hear cases.
Hearing strategy: in reviewing my client’s file, I felt that this case was very strong. My client had a long work history as a land surveyor. He is very well spoken and comes across as being very credible. The medical record in this case was extensive and detailed. In the late 1990’s my client began to experience back pain, for which he sought treatment. For the next four years, he pursued non-invasive treatment, including epidural injections, facet blocks and radio frequency nerve ablation. None of this relieved his pain and in 2003, he underwent surgery to fuse his discs at L5/S1. The surgery was not successful in relieving his pain and since 2003, he has been a patient under a pain management physician, which involves regular facet block injections and RF denervation. He also consumes a significant amount of pain medication. None of this relieves his pain and he stays in bed for 12 to 16 hours a day.
In addition to the back problem my client has been an insulin dependent diabetic for over 40 years and suffers from diabetic retinopathy, which has resulted in diminished night vision and minimal vision in the left eye, diabetic neuropathy – he has no feeling in his lower legs and feet, and limited sensation in his hands, and diabetic nephropathy which has resulted in a loss of around 40% of his kidney function.
My client also treats with a cardiologist due to congestive heart failure and he has been hospitalized on several occasions for this condition.
In reviewing the medical record, I felt that my client was one of the more deserving claimants I had ever met or represented and I felt at the outset that this was a clear winning case.
Hearing Summary: when we entered the hearing room, the judge was present along with a hearing assistant and a vocational expert witness. The judge had also requested the presence of a medical expert witness, who was there, but appearing by video from a remote location.
The judge opened the hearing by greeting the claimant and introducing the parties present. He then asked the claimant about his past work and about the date he stopped working. Then, the judge turned the questioning over to me.
I began by asking the claimant why he stopped working. That led into a discussion of the history of his back pain and his decision to undergo fusion surgery. We then discussed the failure of the surgery to relieve pain and his ongoing efforts to achieve some pain relief through medications and direct injections.
Next, I turned to the diabetes and asked him about his complications. We discussed, his retinopathy and neuropathy and the kidney issues.
Finally I asked about the heart condition and the stamina limitations arising from that condition.
I then asked my client specifically about his pain level, using a 1 through 10 scale. I asked him about his sitting, standing and walking capacity as well as his lifting capacity. We also talked about the multiple medications and the fatigue and cognitive loss associated with these medications as well as the chronic pain. During the course of the first 10 minutes of the hearing my client had stood up and sat down several times and I confirmed that this was the result of back pain.
Although I had my client’s wife available as a witness, I chose not to call her because I felt that we had presented our case clearly and I did not see how the wife would add anything new.
The judge then turned to the medical expert and asked for his summary. The medical witness clearly and efficiently identified six areas of medical problems associated with my client’s degenerative disc disease, his diabetes, his reduced kidney function and orthopedic issues related to the numbness in his feet.
The judge then asked the medical expert if he was familiar with the Listings and whether the claimant met any of them. The medical expert stated that he felt that my client’s condition equaled Listing 1.02, 1.03 and 9.08.
The judge then stated that based on the medical expert’s testimony, there was no need to question the vocational witness and that he would issue a decision shortly.
Observations: this was a case that contained overwhelming medical evidence that supported my client’s claim for disability. This is the type of case that should have been approved at the initial application but was not because no one carefully read the record.