Back Pain and High Blood Pressure Case

58-year-old man with past work as an electrician/mechanic and high school equivalency education, had degenerative disc disease, hypertension, and cataracts in the eyes.  He last worked in June 2005.  Medical records were sparse going back to his alleged onset date in June 2005, so that I recommended amending the onset date to six months before a consultative examination dated in March 2010, or September 2009, when my client was over 55 years old. In order to get Social Security Disability Insurance benefits, my client had to show that he was disabled before March 31, 2011, a date which had passed at the time of the hearing.  Even if we proved he was disabled on April 1, 2011, he could not receive Disability Insurance Benefits because his insured status expired as of March 31, 2011.  This is a harsh rule, and it is imperative when selecting an amended onset date to make sure that the client is eligible at the time of the amended onset date.

The hearing proceeded uneventfully, except for the fact that the consultative examiner’s note observed that my client was walking unimpaired from the office to his car, when he did not know that the examiner was watching him.  I argued that there were lots of reasons why my client might appear to be walking better, including the fact that he was able to stretch and warm up a little bit.  Furthermore, a one-time observation of my client should not be given more weight than the majority of the treating medical records, which supported his claim of a limitation to “light” work.  When the hearing was adjourned, I could not tell by the judge’s demeanor if we were going to be successful or not.  We waited only a few days before we got the fully-favorable decision.

The ALJ noted that even if my client could perform the full range of “light” work, the Medical Vocational Rules that Social Security uses would direct a decision of “disabled” for a person like my client.  We had a Medicaid decision from a North Carolina State Hearing Officer in the file, which also found my client disabled as of November 2009.  This document, with the amended onset date, helped to persuade the ALJ to decide the claim in my client’s favor.

What you can learn from this case:  this hearing illustrates the importance of selecting a reasonable onset date for the beginning of disability.  It also shows how a favorable Medicaid decision can be used to the advantage of a client.  Finally, it shows how the ALJ can be persuaded to grant a claim even where there is some unfavorable material in the medical file.

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