Most people applying for Social Security disability have some sort of firm diagnosis. For example, if you have back problems, your doctor may have shown you an MRI report documenting a herniated or bulging disc. If you have heart issues you may have been diagnosed with congestive heart failure or coronary artery disease. And if you struggle with mental health problems, you may have been diagnosed as being bi-polar, or having PTSD, or anxiety disorder.
When you get to your hearing, however, you should not rely on these labels as you explain to the judge why you contend that you no longer have the capacity for “substantial gainful activity” (i.e., work).
First, understand that many times the label used by one doctor might be different than that used by another. In my practice, for example, I frequently represent clients with mental health issues who have been diagnosed with depression, anxiety, PTSD, and/or bi-polar disorder – all by different physicians or psychologists. One medical provider may choose the label “depression” while a second doctor may choose the label “bi-polar.”
Similarly, I have seen multiple doctors read the same MRI report and come to different conclusions. One doctor may see a herniation, while another may see a bulge or an extrusion.
Emergency room doctors might make a snap diagnosis, whereas a long-time treating doctor may use different terms.
Doctors of a certain age may use terms like lumbago or sciatica, whereas others may use more medically accurate terminology.
Judges Focus on Your Symptoms and How They Impact Your Potential Capacity for Work
Social Security defines the word disability in terms of how your medical problem or problems impact your capacity for work. Presumably the judge has read your medical record and he/she knows what the doctors have said.
Now, when you appear at a hearing, the judge wants to hear from you. What does that herniated disc mean to you? What does it mean to you to suffer with major depression or crippling anxiety? Realize that during the course of a week the judge may see ten or more claimants alleging disability based on a herniated disc or PTSD. The effect of such a diagnosis on each of these claimants may be different.
Claimant #1 may have a disc herniation at L5/S1 with severe, pulsating pain at the left hip joint. Claimant #2 may have a herniation at the same location with no left hip pain, but radiating pain from the lower back into the right leg. Claimant #3 may have an L5/S1 herniation and nerve dysfunction that impacts urination and defecation.
The point here is that a diagnosis of an L5/S1 disc herniation can result in very different problems for different claimants. A claimant’s age, prior health, weight and other medical problems can dramatically impact how a particular diagnosis will effect that person.
In addition, other medical problems you may have can impact what you experience. For example, if you have congestive heart failure and consumer Lasix (a diuretic) but you also have diabetes, the impact of possible dehydration on you will be different that it would be on someone who is not diabetic.
When You Testify, Focus on How Your Medical Problems Impact You
When you testify to the judge, you make the most of your time by explaining how your medical problems impact you. If you walk in and say “I have a herniated disc at L5/S1″ the judge will have no idea what this label (diagnosis) means in terms of how it impacts you. If you explain to the judge that your psychologist says you have PTSD, the judge will have no idea what that means in terms of how it impacts you.
You also need to remember that your doctors’ notes focus on treatment, not on work capacity issues. You have to fill in the blanks.
So if you have been prescribed medications that make you sleepy, or nauseous, or unable to concentrate, you need to describe those side effects in detail. I have won many cases for clients who consume medications that cause excessive (hourly or more) urination, or frequency and urgency of bowel movements.
Even if your doctor asks about side effects, he/she may keep you on certain medications because they treat a bigger problem despite bothersome side effects.
You can never assume that your judge, who will spend maybe 30 to 45 minutes with you, will understand what you are going through unless you tell him/her in detail. Labels are a starting point only. Use your hearing to tell a story where you are the reluctant but sincere claimant who needs a helping hand after fighting through years of struggle with serious medical problems.