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Ginsberg Law Offices

Month: December 2007

Two Disability Claims Pending and Nothing is Happening – What Can I Do?

My husband has Osteonecrosis (AVN), it is death of bone condition in both shoulders and both hips.  We initially hired an attorney in April 2003, claim was denied and it is in the Hearing Stage in Virginia.  We had to reopen a new claim in 2006.  We attached all information needed, even information from the National Assn of Osteonecrosis (this is a relatively new condition).  The claim filed in 2006 was denied once, but to date no other information.  We just called our attorneys office this week.  They are constantly saying in both claims "things are the same", nothing has changed.  Can you please help us?  Our medical bills are piling up. Prescriptions are expensive, etc.
–D

Jonathan Ginsberg responds:  D, there is no simple answer to your question.  It appears that you have two claims in process – an appeal to the Appeals Council (the Appeals Council is located in Falls Church, VA, which is what I assume you mean by "the Hearing Stage in Virginia") and a 2006 claim filed in Georgia, where you now live.

Claim #1 will cover the time period from alleged onset through the date of the first administrative law judge hearing and Claim #2 will cover the time period from the day after your administrative law judge hearing and on-going.

Here are a couple of observations:

1)  Social Security claims take a long time.  The two Atlanta hearing offices are the slowest in the country – it can take two years or longer between the time you request a hearing and the time a hearing is scheduled.  Your attorney has no control over this.  It is not fair, it is not right, but this the current situation in the Social Security Administration.

Let me also say that there is an effort by SSA to deal with these delays – they are increasingly using video hearings from a National Hearing Center to reduce the backlog – see this press release from SSA.

2) With regard to the case at the Appeals Council.  If you have a case at the Appeals Council or in Federal Court, expect to wait and wait and wait.  You could be looking at five years or longer.  Recognize that at the Appeals Counsel or federal court, the judges are looking at possible errors of law or analysis by the hearing judge.  Appellate judge rarely substitute their decision for the decision of the ALJ.  Instead, they are looking for situations where the hearing judge used the wrong standard or the wrong analysis.  Usually a successful appeal concludes with the appellate judge sending the case back to the ALJ for a new hearing to be decided under the correct standard.

3) My guess is that your claim #2 will be decided much sooner than claim #1 and that any money to be paid will be paid in claim #2 long before payment in claim #1.

57 Year Old Arthritis Patient Wonders if She Would Qualify for Disability

I am 57 I have been a RN for the past 30 yrs.  I have auto immune arthritis which is severe in my SI joints graded 3+ bilaterally.  I also arthritis in my hands, wrist, elbows, shoulders, knees, feet and ankles.  Along with DMII, IBS, Bilateral Carpal Tunnel, Bilateral Heel Spurs. My dominant hand is now becoming weak and painful to the point, I am having to learn how to redo ADL’s with my non dominant hand.  I can’t sit, stand or lay or long periods of time, I rarely sleep more than 3 hours at a time due to numbness or pain in a joint. I just recently stopped working.

Where would I fit on the Grid, or do I have to suck up the pain and continue to try and work. I only have enough reserves to last me 7-8 months. Thanks for your opinion.
–C

Jonathan Ginsberg responds:  C, thank you for your question.  I am not so sure that the grids would apply here.  Firstly the grids only apply when there is an exertional (physical) impairment.  Here you have both exertional and non-exertional (pain) impairments.   It would appear to me that pain is such a major part of your claim that you could not argue that your limitations are purely exertional.

Second, and most important, the grids factor in education and transferrable skills.  Look at the grid tables.  Even at age 57, an individual limited to sedentary (sit down) work is “not disabled” if she has transferrable skills or more than a high school education.

I think that a better argument would be a straight “residual functional capacity” argument.  Please also take a look at my Arthritis and Disability article on my Georgia Social Security disability web site.  I would focus on reliability issues and limited capacity to get through a workday in any form of competitive employment.

Your 30 year work history also gives you tremendous credibility.  You always want to approach your SSDI claim with the attitude that “I would work if I could, but I can’t” and not an attitude of “entitlement.”

Based on what you write, it appears to me that you have a good case.  You need to enlist your treating doctors for support but I would be surprised if you did not get approved.

Does Trial Work Period Start as of Onset Date or After Expiration of 5 Month Waiting Period?

I just got a fully favorable ruling from an ALJ, but the onset date has been amended.  Without going into a huge amount of confusing detail, I was supposed to get a partially favorable for a closed period, instead I now have a fully favorable with onset date starting Nov. 15, 2007.  To prevent losing my house, I had to start working some.  I am wondering if my trial period starts aftr the 5 month waiting period which would begin in April, or would the trial working period begin with the onset date?
–Jim

Jonathan Ginsberg responds: Jim, I believe that the trial work period starts as of your onset date.  The 5 month waiting period only has to do with payments.  I wrote about trial work periods on a fixed page on this blog – take a look by clicking on the link.

You should also speak with your lawyer about whether to appeal the decision.  If the judge stated on the record that he identified a closed period, and you start working, you may find yourself with a continuing disability review or an action to terminate benefits.

You only have 60 days to appeal a decision and you could lose your right to the closed period lump sum if you do not appeal.  Maybe it makes sense to appeal and maybe not.  I just think you need counsel about this issue and that you need to be proactive.

Can a Rare Medical Condition Like Dupuytren’s Disease Qualify Me for Disability?

I recently responded to a question on Yahoo Answers about a disease called Dupuytren’s Disease.  Dupuytren’s is a disease of the connective tissue in the palm of the hand.  The tissue becomes rigid and immobile, causing the patient’s hands to become fixed in a bent condition.

The person asking the question wanted to know if Dupuytren’s would qualify a claimant for Social Security disability.  My response was that it might depending on how severe the condition was and whether the claimant had one or more treating doctors who would help by completing a functional capacity form.

The question itself was phrased as follows: "is Dupuytrens considered a disability under the Social Security Administration?"  As I typed out my answer it occured to me that the person posting the question was asking the wrong question.  Social Security disability is not "about" any particular disease or condition.  Further, the issue is not whether Social Security recognizes a particular condition, the correct question is "how does my medical condition limit my capacity to perform work like activities."  I have been involved in cases where the medical record is quite vague – sometimes different doctors do not agree on the diagnosis and sometimes the doctor will acknowledge that there are is no test that can be run to definitively document a disease or condition.

Therefore, if you have a rare or unusual disease like Dupuytren’s Disease, you may very well qualify for Social Security disability.  You and your lawyer may need to educate your judge about the condition and you will definitely need support from your doctor.   The important point here is identify the main issue in your Social Security claim and to create a theory of your case that will convince a judge that despite your best efforts, you simply cannot work.

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