Case Study #1 – 55 year old male with past work as a welder. Approximately 15 years prior to applying, my client underwent two minimally invasive surgical procedures on his back called neuroplasties. These procedures were not successful and just a few years after surgery, my client was referred to a long term pain management doctor. He was able to work for over ten years but as he got older, his chronic pain condition worsened. Finally, he reached the point where he could not longer get through an 8 hour workday.
Back pain cases are the most common types of medical impairment claimed so Social Security has made the musculoskeletal listing very difficult to meet. As such a high percentage of back pain cases are decided under a functional capacity theory. I originally posted this case study on another website – you can read it here.
Case Study #2 – 43 year old male with past work as a short order cook, a telephone salesperson and a construction worker. My client was alleging disability based on depression and likely bi-polar disorder. He testified that several times a month, he experienced episodes of manic behavior where he would stay up to 3 or 4 days at a time, followed by episodes of deep depression whereby he would be in bed for 2 or 3 days. He has been prescribed and takes high dosages of anti-depressant medications. He contends that he was fired from several jobs because of poor reliability and that he was unable to handle the stress of even simple short order cooking work.
Mental health cases like these are usually decided under a functional capacity analysis. Since there is no imaging test for mental health issues, the judge has to rely on medical records from treating psychologist or psychiatrists, work records showing attendance and performance issues, medication lists, and testimony. In this case we had an added complication of my client’s history of street drug use and incarceration. You can read the full case study here.
Case Study #3 – 23 year old male with limited past work as a retail clerk. My client was alleging disability based on complications from diabetes. My client is a Type I diabetic, who was first diagnosed at age 6. By the time he reached high school he was having difficult controlling his blood sugar despite increased dosages of insulin. Two years prior to applying for disability he developed a condition called gastroparesis, which causes severe stomach and abdominal pain. Medications used to treat the gastroparesis caused even more difficulty with blood sugar control. My client has lost vision in his left eye due to a diabetic complication called retinopathy and he has numbness and tingling in his feet. He also has to urinate twice an hour (a common complication of uncontrolled diabetes).
The judge in this case included the frequent urination problem in his hypothetical question to the vocational witness along with a limitation whereby my client would need to take unscheduled breaks to check his blood sugar. These are functional limitations that limit my client’s capacity to function in a competitive work environment. The vocational witness testified that my client would not be reliable enough to sustain competitive employment and the judge announced at the hearing that he intended to approve this case. The full case study is here.
Case Study #4 – 65 year old female with many years of consistent work as a customer service representative. My client was alleging disability based on chronic fatigue and shortness of breath arising from congestive heart failure. She had been given a pacemaker but when the pacemaker was active it was very distracting. Her doctors turned off the pacemaker and her fatigue and shortness of breath returned. This is a case where there is no effective treatment for my client’s condition.
I submitted a pre-hearing brief in this case and the judge issued an “on-the-record” decision. The favorable decision noted that my client’s capacity to function had been so reduced by her fatigue and shortness of breath that even a simple, entry-level job was impossible. You can read the full case study and the pre-hearing brief that helped get this case approve here.
Case Study #5 – 58 year old female with over 20 years’ of work as a public school teacher. In mid-2017 my client began noticing numbness, tingling and pain in her lower back and radiating into her right leg. After pain medications, physical therapy and epidural injections did not help, she was referred to an orthopedic surgeon for a laminectomy and fusion at L2/3 and L3/4. Following surgery my client developed a blood clot in her lungs which delayed rehabilitation. Even after 18 months, my client was using a walker, had chronic leg and back pain and needed powerful Ocycontin two to three times per week for severe pain.
The judge asked two hypothetical questions to the vocational expert both of which elicited the response of “no jobs.” This case will be approved. Read the full case study here.