Benefits Despite a Return to Work
Description: A younger client with Lupus experienced severe complications that interfered with her ability to work gainfully for 12 months.
Outcome: A favorable hearing decision is issued granting benefits, a trial work period and continuing eligibility for medical benefits for 36 months during an extended period of eligibility so she can get the treatment she needs to stay healthy.
Application Error Equals Reconsideration Approval
Description: Review of a denied application showed that SSA's own assessment of a claimant's residual functional capacity should have resulted in an approval based on his age and prior work experience.
Outcome: Benefits were approved at reconsideration. The error was called to SSA's attention and the state agency reversed it's decision for my client. File reviews are important!
SSI for son helps whole family
Outcome: With development of additional evidence including assessments by state Vocational Rehabilitation services, the client was approved after a hearing for SSI and Medicaid. This gave him access to special living assistance and case management services, too.
On Verge of Homelessness, Hope
Description: A woman in her 40s with a history of emotional and physical problems was taken in by a relative. The client had not received medical services in over a year. When her benefactor became ill this year, she could no longer support the client.
Outcome: The client was brought to the health department for help with her problems and so they could be documented before her hearing. A judge found the client disabled as of 2007. She will be able to get better medical care and pay her own way after facing possible eviction in March.
Wise Compromises Can Win
Description: A homeless man has a chronic leg injury and trouble walking and standing for years. SSA rules, though, say if you are under 50, you are not disabled if you can do a full time job sitting. He has no problem sitting for long periods.
Outcome: March 2011--After getting supportive evidence for his limitations and educating the client about SSA's rules, I ask my client to consider amending his onset date. He agrees and we amend his onset of disability date to his 50th birthday in November of 2010. I submit a case summary and request for an on the record decision. A favorable decision is issued without his having to wait for a hearing.
Appeals Council Gives Unrepresented Client New Hearing
Description: A woman with inter-related physical and emotional problems and a limited education went to a hearing without a representative in 2009. She did not know she had to prove she was disabled before 9/30/2000 when her credits for the disability program expired. The judge asked a medical expert who was not a mental health professional to testify at her hearing. The woman was found to have no limitations attributable to her severe depression before 2000 and the impact of frequent migraines on her functioning prior to 2000 was not addressed by the ME or ALJ.
Outcome: I obtained an inference of functioning prior to Sept. 2000 from the client's current psychiatrist and prepared a detailed memorandum pointing out defects in the decision after reviewing a copy of her file and a recording of the hearing. The Appeals Council has instructed SSA to give the client a new hearing with a psychiatric or psychological expert witness and to consider evidence of migraine headaches as well as new evidence from her treating psychiatrist.
Overpayment Reduced By Reinstatement of Disability Benefits
Description: A man who received disability benefits returned to work after completing a trial work period years earlier. His 36 month extended period of eligibility already expired. He timely reported all work activity but SSA did not review his case until he was already off work again more than a year later due to his severe mental and physical health problems. He was found to be overpaid on his and a child's account by over $50,000.00
Outcome: I developed additional evidence about the client's impairments and how they affected him. A medical doctor --who was not a psychiatrist and who had not reviewed the entire file-- gave unfavorable testimony at the client's hearing. During my cross examination, he admitted to the legitimacy of many of my client's symptoms and and his lack of qualifications to evaluate the nature and severity of the client's mental impairment. The ALJ awarded benefits back to when the client last worked wiping out over a year of the overpayment, paying off the rest, and leaving the client with sizable a retroactive check.
