June, 2015, Part II: Rochelle’s fully favorable On the Record Decision at the Boston, MA Office of Disability Adjudication and Review

Rochelle’s case involves that of a woman in her early 50’s with a consistent work history of 27 years working for the United States Government. Rochelle, as with many of our clients, had come to our office following the denial of her claim. As we explained to Rochelle, there is a very high rate at the reconsideration level and, given this, we believed her best chance for winning her case was at the hearing level. Thus, it became necessary that we appeal her case initially for her and then appeal her case once again to the hearing level upon the issuance of a second denial of her claim.

Rochelle had been suffering from very severe gastrointestinal difficulties that appeared to coincide with some very serious mental health difficulties that had troubled Rochelle for many years. Recent personal stressors had only caused both of these conditions to worsen and to exacerbate to the point where she had to leave work altogether. As we advise all of our clients to do, Rochelle did ensure she was maintaining treatment with specialists (both a gastroenterologist and a psychiatrist) for those conditions that she felt were severe and disabling (that is to say, were disabling her from working). Given the long-term nature of this treatment and the willingness of these treatment providers to speak on her behalf, we were able to obtain very telling medical questionnaires that explained the nature and severity of her conditions and how they were impacting her ability to function: this was from her primary care physician, her gastroenterologist as well as from her treating psychiatrist. While the Attorney Adjudicator reviewing the case did not provide significant weight to each of the questionnaires provided (finding that the treating psychiatrist had not treated Rochelle for a long enough period of time to carry as much weight as some of the other providers), she did provide significant weight to the opinions of the long-term primary care physician and gastroenterologist. These questionnaires made clear (as did the lengthy and consistent treatment record) that Rochelle had struggled with her conditions for years, but that recent events had certainly triggered a flare-up of her conditions that simply made it impossible for her to attend to a job on a regular and continuing basis.

Given Rochelle was of an age considered under Social Security’s Medical Vocational Guidelines (that is, the Grid rules) to be closely approaching advanced age, that she had a GED for a past education, and the fact that her past relevant work had required her to undertake a more physical type of position for many years, the hearing office found that there were significant barriers to reemployment (referring to the Grid rules in their determination). The hearing office found, prior to the need to proceed to hearing, that even if Rochelle was capable of returning to even full-time sedentary types of work, she would not be expected to be able to find such work existed for her in significant numbers given her age, education, past work experience and transferable skills: a finding of disabled was deemed called for under Social Security’s grid rules and benefits were granted prior to the need for a hearing.

Unfortunately, not all lawyers will undertake such efforts to obtain the additional evidence necessary, well enough in advance of a hearing, and then undertake an argument brief to the hearing office so as to attempt to avoid the need for hearing. Without such efforts, however, a claimant is not being provided with all of the tools available to win their case. Thus, hiring a lawyer that handles each case with such meticulous care is essential if one wants to give themselves the best chance at prevailing before the Social Security Administration.