This is a question from a non-attorney claim’s rep:
My client’s claim was denied "no proof of 12 months disability proved etc etc, case in appeal status, 2 medical reports signed by doctor saying claimant could NEVER return towork, another saying "he is not suitable for any job"
and totally disabled since 2002, ALJ judge setting hearing requesting a vocational expert, and now requesting medical records prior to hearing, lastest medical record is 2 months ago stating unable to work in any job??
why the challenge of records? and disability is cancer, and numerous other factors, claimant is 61 and has paid into the system over 40 years, any opinion would be appreciated…….thanks arlene
Jonathan Ginsberg responds: Arlene, I think that the most likely scenario here is that no one at Social Security has bothered to read the claimant’s records. I cannot tell you how many times I have gone to a hearing where the claim should have been approved years before, but no one ever sat down to actually read the records.
At the State Agency level, the adjudicators are overworked and understaffed. If they do not see "magic words" (i.e. that the claimant meets a listing, or if there is any doubt in their minds, they will simply stamp "denied" and pass the file on down the line.
Often what you will find in these cases is a judge who apologizes on behalf of the Social Security Administration for bringing your client in and for making the claimant wait so long for benefits.
Recognize that some judges like to see the claimant face to face and some judges feel as if they have a personal stake in keeping SSA’s money in Ft. Knox. Hopefully that is not what is going on here, but you should be prepared to present your case regardless.
Two other possibilities come to mind. First, is there any issue as to the onset date of the disability? If your client was working part time or if the medical record does not support the alleged onset date the judge may be prepared to grant the case, but may want to amend the onset.
Along those lines, realize that SSA looks at the 10 years prior to disability onset to decide if a claimant is insured. His 40 years of work is only relevant to retirement Social Security. Is it possible that his insurability for Title II has run out?
Another question – are there any records that do not support the claimant, such as records that mention malingering or records that refer to alcohol or drug use. That might be a reason why the judge wants to eyeball the claimant.
Finally, realize that medical records often do not address vocational issues – and work capacity is what Social Security disability is all about. Be prepared to prove your case – conclusory statements from a doctor that the claimant is "unable to work in any job" may not be enough. I like to use functional capacity forms to identify the specific work activities that the claimant cannot perform.
Hope this helps – Jonathan
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