Some hearings require extra effort than others, and right this moment’s listening to earlier than an Administrative Regulation Choose was one among them. It was a case the place I actually needed to work because the claimant’s legal professional to assist him win the declare, however the effort paid off.
The Problem: A Medical Knowledgeable Who “Missed” Key Proof
The listening to was initially continued in order that the Administrative Regulation Choose (ALJ) might receive testimony from a medical knowledgeable (ME). That is often not signal for claimants—MEs are sometimes used to justify a denial. Certain sufficient, the ME initially took the place that whereas my consumer had quite a few diagnoses, there have been few goal medical findings to assist them. He recognized solely a cervical backbone drawback as a medically determinable impairment (MDI), however opined that it wasn’t extreme sufficient to fulfill or equal an inventory or trigger any useful limitations.
Then the ALJ turned to me and requested if I had any questions for the ME. I did.
Discovering the Key Proof
I drew the ME’s consideration to a particular exhibit that contained an MRI of the cervical backbone. This MRI offered clear, goal proof of disc protrusion, abutment, effacement, and flattening of the ventral thecal sac—vital findings that the ME had utterly ignored.
The ME admitted that he had “missed” this notice.
The ALJ instantly jumped in and requested if this new proof modified the ME’s opinion. The ME reconsidered and admitted that the claimant did, actually, have vital useful limitations. He initially thought he was assigning “mild obligation” work restrictions, however upon additional dialogue, it grew to become clear that his analysis truly supported a sedentary work restriction—an essential distinction in Social Safety incapacity circumstances.
The ME apologized for lacking the file and truly thanked me for pointing it out.
Utilizing the Grid Guidelines Strategically
At this level, I requested to go off the file to debate technique with my consumer. His alleged onset date (AOD) was June 29, 2017and his date final insured (DLI) was March 31, 2023. The issue? His fiftieth birthday was simply 5 months after his DLI—on September 22, 2023.
Why does this matter? As a result of turning 50 modifications the best way incapacity circumstances are evaluated below the medical-vocational tips (the “grid guidelines”). At age 50, claimants can extra simply be discovered disabled if they’re restricted to sedentary work and don’t have any transferable abilities.
By altering the AOD to March 15, 2023we had been now inside six months of his fiftieth birthday. This allowed us to argue that the ALJ ought to apply the grid guidelines non-mechanicallytreating him as if he had been 50 on the time of incapacity.
Sealing the Take care of Vocational Knowledgeable Testimony
To verify this technique, we took testimony from the vocational knowledgeable (VE). The VE agreed that the ME’s revised opinion successfully restricted my consumer to sedentary work. This meant:
- No previous related work could possibly be carried out.
- With a sedentary restriction, the grid guidelines utilized.
The ALJ agreed with my evaluation and permitted the case however requested a post-hearing transient outlining the argument.
The Consumer’s Response
After the listening to, my consumer requested me how I knew to do all of this.
I merely replied, “20 years of expertise.”
And that’s precisely why expertise issues in incapacity hearings—as a result of understanding the foundations, recognizing ignored proof, and making use of the correct authorized technique could make all of the distinction.
Want Assist with Your Social Safety Incapacity Declare?
Successful a Social Safety incapacity case isn’t nearly having a medical situation—it’s about presenting the correct proof, understanding the foundations, and making use of the correct authorized technique. That’s the place expertise issues.
Should you’re combating a denied declare or need assistance navigating the Social Safety Incapacity Insurance coverage (SSDI) course of, we’re right here to assist. Whether or not you’re on the preliminary software stage, reconsideration, or making ready for a listening to, we will information you thru the method and struggle for the advantages you deserve.
Contact us on-line or name (888) 321-8131 right this moment for a free case analysis. Let’s talk about your case and the way we may help you win your declare.
