Laura’s circumstances bring to mind how difficult some cases can be when long-term treating specialists simply cannot find the time or the heart to assist their patients with addressing necessary paperwork in a Social Security disability claim. Unfortunately, the failure of one’s doctors (and most significantly with one’s specialists for conditions that remain the most severe and disabling) can prove to be disastrous down the road if not somehow rectified by other facts that can be brought to bear.
Laura came to our office in her mid forties (40’s), with a high school education and a consistent work history in the past that consisted of work as a behavioral health specialist with children, as a secretary and as a home health worker: Laura always worked and never shied away from hard work. What the record also makes clear is that Laura had been struggling from neck and back problems that went back ten (10) years prior to becoming disabled. As far back as the early 2000’s she was seen suffering from low back problems that were affecting her left leg and requiring lumbar epidural steroid injections. She was noted to be suffering from a herniated low back disk at that time. While a series of injections in 2003 helped resolve matters initially, she was seen in 2008 with neck pain issues that were determined by MRI to be related to degenerative disk disease of her neck. As a result, the pain was traveling down her left side of her neck and into her arm. Efforts at physical therapy and a TENS unit were undertaken at that time, but none of her problems were deemed amenable to surgical intervention. Occasional flares of her condition would take place which would require her to return for injection therapy. Unfortunately, in 2011, the problems only worsened as a result of an increased workload placed upon her at work.
Indeed, as result of the extreme pressure she was placing upon herself to keep working, she ended up suffering from what was diagnosed as a gastric ulcer which required that she be taken off the pain medication she was relying on to continue working. At that time, she was driving a significant distance to and from work. Instead of applying for Social Security disability benefits, Laura made the decision to try a job where she would be traveling less and working half the hours. Likewise, she was placed on additional medication management that included Cymbalta for the Fibromyalgia she was now diagnosed as suffering from by her family nurse practitioner. Additional injection therapy was likewise required and, ultimately, over the next couple of years, her condition deteriorated to the point where she had to discontinue working. Likewise, the degenerative disk disease issues with her neck deteriorated to the point where she ultimately required a cervical fusion at C5-6. Laura’s pain in her neck only increased following the surgery (although the surgery did assist with the radiating pain she was experiencing down her arm). Injection therapy for both her back and for her neck did continue to be required on an alternating monthly basis (one month it would be for her back and the next for her neck), with additional medication management and psychological counseling required.
Unfortunately, despite all of the treatment she was requiring, not one of the treating specialists, not her surgeon nor any of her long-term pain management specialists were willing to address a supportive medical questionnaire for purposes of the Social Security disability benefits she so desperately needed. Fortunately, her primary care provider (who happened to be a family nurse practitioner) was quite supportive, and was willing to assist with the claim by likewise enlisting the aid of the supervising physician at the clinic. Because the family nurse practitioner was the one making a diagnosis of Fibromyalgia without the benefit of a full-fledged rheumatological evaluation, including trigger point injections, by a specialist in rheumatology, it was important that Laura undertake an evaluation with a rheumatologist to ensure that she was being properly diagnosed. The Social Security regulations do not allow for diagnoses to be established by providers other than those that are deemed to be treating sources (such as an M.D. or D.O.).
The additional treatment history provided from 2003 through 2013 (evidencing Laura’s continued efforts to work prior to going out of work), the clarifying rheumatology evaluation (which confirmed by way of a detailed assessment by a well-respected rheumatologist that she was experiencing the severe effects of Fibromyalgia) and Laura’s testimony at hearing (which made quite clear her wish to be working if she only could), served to convince the Administrative Law Judge out of the Portland, Maine Office of Disability Adjudication and Review (who had traveled up to Bangor for an in person hearing) that Laura was certainly deserving of all of the benefit she had been asking for in her application and consequently rendered a fully favorable decision in her case.
A simple call to the Law Offices of Russell J. Goldsmith at (800) 773-8622 can help you determine whether you or a loved one should be pursuing a Social Security disability claim and how a Social Security lawyer may be able to assist you with that process.