March, 2016: Alicia’s Claim: A Successful Result at Hearing at the Portland, Maine Office of Disability Adjudication and Review for Multiple Sclerosis

Alicia’s case involves that of a hardworking young mother in her late 30’s who has a long and steady work history as a waitress and working in administrative positions. Alicia had been diagnosed years earlier with multiple sclerosis and remained in consistent treatment with her neurologist over many years. Unfortunately, while still undergoing initial rehabilitation, Alicia decided to file her initial Social Security disability income (SSDI) claim without the benefit of counsel out of the Saco, Maine Social Security Administration (SSA) Office. She did not understand at that time that she would need to show that her disability would last a year or longer, despite prescribed treatment, and was consequently denied on her initial application. Alicia was once again denied on reconsideration and did hold off on getting a Social Security disability lawyer involved in her case until such time as her case was well along in the process at the Portland, Maine Office of Disability Adjudication (ODAR) and was being scheduled for hearing.

What became clear upon Alicia’s initial involvement with our office was that issues with insurance (from the loss of Alicia’s job) had caused her to lose touch with her long-term treating neurologist. Given this fact, there were concerns with how we were going to provide the very detailed documentation of her ongoing problems without appropriate follow-up with (and examination by) her neurologist. With this in mind, we were able to assist Alicia with getting back in with her treating neurologist and likewise assisted her with applying for disabled status Mainecare (which is the state administered Medicaid program). This is turn allowed for payment of both the additional treatment and medication Alicia required.

Moreover, an examination of the Social Security record made clear that a great many of the medical records which would detail the problems Alicia had been experiencing were not obtained by SSA. Shortly after her initial hospitalization and inpatient occupational and physical therapy, she was referred for outpatient physical therapy. The additional outpatient physical therapy (including the additional course of therapy she required a few months afterwards, due to a second serious flare of her M.S. symptoms) had not been obtained.

Fortunately for Alicia as well, she had been continuing to follow with her primary care physician during the time that she remained disabled and unable to follow through with her neurologist as a result of insurance issues. Both the primary care physician and the treating neurologist were able, for the first time, to provide SSA with compelling reports as to how Alicia’s continuing flares of her condition would cause her difficulties with being able to stand and walk for periods of time (causing her to remain housebound for a number of days per month): simply these issues alone would make it impossible for any individual to be reliable enough to maintain an 8 hour per day, 5 days per week position (and thus constitute a basis for being found disabled under Social Security Ruling 96-8P). This is not to mention the fact that when she would suffer these flares, she would experience such profound fatigue that she would not be able to function in a meaningful manner at home (and certainly, would not be capable of making it through an 8 hour day without having to lie down for extended periods of time throughout the day).

I am happy to report that within a few short months and without the need for delay of her hearing (as she did contact our office very late in the game) we were able to obtain for Alicia a full favorable decision at hearing that has made a tremendous difference in terms of getting Alicia’s family back on their feet. As is ordinarily the case, Attorney Russell Goldsmith personally attended the hearing with Alicia and, the presiding Administrative Law Judge (ALJ) determined after a very short hearing that indeed Alicia had remained disabled since her alleged onset date and provided her with a fully favorable decision.

If you or a loved one has been struggling to deal with SSA and find yourself on the heels of a hearing, it’s not too late to hire an experienced Social Security attorney to assist you with the claim. Contact the Law Offices of Russell J. Goldsmith at (800) 773-8622 to learn how we may be able to make a big difference for you in your claim.