Mental illness and disability

September 17, 2008

How Gaps in Medical Treatment Can Result in an Unfavorable Decision

Last week, I wrote a post describing a case that will be denied because of my client's poorly worded testimony.  Today, I want to continue this theme and talk about a far more common basis for hearing denials – gaps in medical treatment or absence of medical treatment.

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June 29, 2008

Will Social Security Penalize Me if I Refuse Electroconvulsive Treatment?

In Dec. 13, 2007 you responded to my question on your Social Security Disability podcast about non compliance and electroconvulsive therapy (ECT). I had tried numerous antidepressant medications with no success. I was desperate for answers and sought out a new psychiatrist  who specializes in electroconvulsive therapy.  After he conducted my fourth of six ECT treatments. I started experiencing a very weird scary state of mind, almost like I was seeing things in a dreamlike state of mind. I stopped at the fourth ECT for this reason. Its hard to describe such feelings in words but it was a very eery scary feeling.  How will Social Security view my situation?

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October 8, 2007

My Work History Has Not Been Consistent – Can I Still Claim SSDI Benefits?

I was diagnosed last Thursday by my neurologist with post traumatic stress syndrome resulting from three MVA's.  I have other related injuries and have tried to do several jobs, after a long career, and cannot do it.  Is there any relief for me?

I did pay into social security from 1982 to 1989 but from 1988 to 2005 was in the school system that did not pay in.  We did pay in to medicare, etc. however. 

Am I eligible for any benefits?
–Jeff

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Filed under Earnings requirements, Mental illness and disability by

September 18, 2007

Vocational Rehab Says I Have No Marketable Skills – Is That Enough to Win a Disability Case?

I have been to vocational rehab and they ran some evaluationsand they found that i have no marketable skills and i am going to mental health and i am under a case manager and a phychiatrist. Can i win disability with those problems and i also have degenerative disc disease and scolosis  Can I win disability with those problems?
–Daniel

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May 9, 2007

How Does a Judge Resolve Unclear or Conflicting Medical Evidence in a Disability Hearing?

Mr. Ginsberg,
I am a dwm 45, no children, no criminal record, no drug/alcohol problems. I have been diagnosed to have Major Depression, Generalized Anxiety, Schizoid Personality Disorders. I have had 23 jobs in the last ten years with several gaps of unemployment. I have had two psychological tests with conflicting results but were all deemed valid/reliable. I just had my ALJ hearing two months ago and in addition to my ongoing psychiatry treatment for the past two yrs, has ordered a mental CE, waiting for the results and a final decision. My treating psychiatrist this month sent a letter to my disability judge stating that I am a 'diagnostic puzzle' and have tried all pharmacological agent groups with no success. He also stated that he has been treating me for the past two yrs. He suspects I have a pervasive developmental disorder. He concluded the letter by stating that there have been no signs of malingering and I have been very compliant.

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April 5, 2007

Survivor of Traumatic Brain Injury Considers Applying for Disability 35 Years After Accident

In 1972 at age16 I sustained head injuries from a motorboat propeller resulting in lobectomy to my right frontal and parietal lobes. I was left with epilepsy, which has been controlled with medication from '81 to 2004 when I had 2 seizures after I was let go from my last place of employment. The main reason I was given was a lack of flexibility. I turned 50 on July 17th. I didn't go to a neurologist as I couldn't afford to pay a doctor to tell me I had an accident. My medical records consist of my annual check-up so I could continue to get my medication and initial surgical procedure. As I have aged my attention span has shortened as well as my focusing ability. Am I facing too large of an ordeal?

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Filed under Mental illness and disability, Seizures and disability, Starting the disability process, Strategies for winning by

February 28, 2007

How I Won a Disability Hearing for a Deceased Claimant

With delays in the Social Security disability adjudication process taking as long as three years, it is inevitable that a claimant will pass away while waiting for a hearing.  Today, I tried a disability case for one of those individuals.

My client initially met with me in June of 2004 and he passed away in January of 2006 at age 60.  The hearing held today, therefore, covered a closed period of disability from his onset date (September, 2000) through the date of his death in January, 2006.  Although my client passed away, his claim for disability benefits remained active, with his wife being substituted as the claimant.

My client died of a heart attack, although cardiac problems were not the basis of his disability claim.  Instead, his claim for disability arose from mental health issues – severe depression, anxiety, panic disorder and bi-polar condition.  My client was a highly educated individual – and he had graduated from college and law school (although he never practiced law).  His past work was in the banking industry where he worked at a very high level position and was responsible for millions of dollars.

When I originally met with this gentleman he told me that he had been fighting symptoms of depression and panic for several years, but that by September, 2000, he had reached the point where he was unable to function.  After being fired from his last banking job, he had worked part time managing investments for a few relatives and close friends.

The medical record from the treating psychiatrist was fairly solid, and it showed regular, on-going treatment and high levels of powerful psychotropic medications.  The record also hinted at the occasional overuse of alcohol, although in my view the mental health problems existed independently of any alcohol issues.  As you  may know a claimant is prohibited from collecting disability benefits if the judge finds that alcohol abuse is a "material contributing factor" to a his disability.

I met with my client's widow a little over a week prior to the hearing and we practiced the questions she was likely to face.  I expected that the issue of alcohol use would be a primary focus of the judge.  The judge in this case, by the way, was a new judge so I was unable to describe in much detail exactly how the hearing would be conducted.

When we got to the hearing, I learned that the judge had requested a medical expert – in this case a psychiatrist – to appear and testify.  My experience with medical experts has generally been good although adverse testimony from a medical expert will pretty much spell doom for any case.

The judge started the hearing by questioning my client's widow about her observations regarding her husband's behavior.  I felt that as a witness, my client's widow was nervous and she almost seemed reluctant to speak badly of her late husband.  Although she hinted at several significant behaviorial problems, I felt like we needed to get some of those issues more clearly on the record.

Because she and I had spoken at length about specific incidents where my client had acted inappropriately or in a bizarre manner, I asked a few questions that were probably leading in nature.  Fortunately, my client's widow saw where I was headed with this and she clearly related several stories describing behavior that indicated a severe underlying mental health problem.

The medical expert testified that the psychiatric record was very comprehensive and entirely consistent with my client's testimony.  He also pointed out that the large number of medications my client was consuming would have significant work limitations.  He concluded by stating that he felt my client met the listing at 12.04 for bi-polar disorder.

The medical expert also took notice of my client's educational achievements and his work history.  In my mind the implication was clear – a highly educated and well compensated professional would not give up his career with the hope that he would recover Social Security benefits.s

The judge accepted the medical expert's testimony and issued a bench decision approving the claim.

I think that the factors that were extremely persuasive here included:
my client's work and education background – helped establish credibility
the medication list
the record of consistent treatment – monthly visits to the psychiatrist since the onset date
the witness' testimony regarding incidents of behavior inconsistent with competitive work

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