WHAT THE UNITED STATES SSA SAYS IT DOES COMPARED TO WHAT IT ACTUALLY DOES, ARE NOT ALWAYS THE SAME

The year 2005 closes out on a positive note as in final review the United States Federal Court has agreed with our arguments and has recommended that a denial of disability benefits by the Social Security Administration to our client be thrown out.

In this social security disability claim, the claimant was a young man who had suffered a closed head injury and developed severe mental impairments as a result of his injury. He only had a high school education and a limited work history. A hearing was held on his claim for disability benefits. The SSA judge denied his claim for disability finding that the claimant could still work at other jobs in spite of his severe mental impairments.

Following that denial of his benefits, the claimant filed his appeal with the SSA Appeals Council. After filing his appeal, the claimant submitted new additional medical evidence to the Appeals Council showing that his medical condition had become much more severe such that he was admitted to a crisis center for treatment. The Appeals Council issued another denial of his claim after stating that it had reviewed the evidence in the claim.

As we soon discovered, this statement by the United States SSA Appeals Council was not exactly true.

On appeal to the Federal Court, in reviewing the complete transcript of the claim, we found that the Appeals Council not only failed to review all the evidence in this claim, but totally ignored the new additional medical evidence that had been submitted by the claimant directly to the Council on appeal. We argued to the Federal Court that federal rules and caselaw require the Appeals Council to consider all the evidence in the record. Here the new additional medical evidence submitted by the claimant to the Council clearly showed that the claimant was totally unable to work at any level due to his severe mental impairments. We argued that the Appeals Council’s ignoring of this crucial evidence was wrong.

The Federal Court has agreed with our arguments. The Federal Court found that there was no reason or explanation provided by the SSA Appeals Council as to why it did not consider the claimant’s new medical evidence. The Federal Court found SSA is required to consider all the relevant medical evidence in a claim and the SSA Appeals Council’s failure to consider the claimants’ medical evidence was substantial legal error. As such, the SSA’s denial of disability benefits to this claim was wrong and the decision denying benefits is to be thrown out and a new hearing granted to the claimant.

With that very good news received as the year 2005 comes to a close, I would like to wish you a Happy New Year and look forward to continuing to serve your needs throughout 2006!

FEDERAL COURT RECOMMENDS THROWING OUT SSA DECISION DENYING BENEFITS

Once again, I am pleased to announce that a federal court has recommended another denial of social security disability benefits decision be thrown out.

Here, our client was a younger woman who suffered from low IQ, severe bipolar disorder and mental depression. The claimant had less than a high school education and virtually no work history except for menial labor jobs. In making her claim for social security disability benefits, the SSA’s own medical examiners found that the claimant would have difficulty working around other people and difficulty maintaining concentration. Despite these medical findings of severe mental impairment, the SSA Judge rule that the claimant could return to performing her past work and was not disabled.

We appealed the SSA denial to federal court. We argued that the SSA Judge’s decision was wrong in that the SSA Judge totally failed to recognize the impact of the claimant’s severe mental impairments on her ability to work. The federal court agreed. The Federal court noted that since the SSA Judge had found that the claimant could perform past work, then the SSA Judge had the obligation to make a written finding as to the mental demands of the claimant’s past work. The SSA Judge had not made any written finding or inquiry into the claimant’s past work. In view that the claimant suffered severe mental impairments, and without any finding of the mental demands of the claimant’s past work, the SSA Judge could not have possibly found that the claimant could perform her past work. The SSA Judge was wrong to deny benefits to this claimant and this denial should be thrown out and sent back for re-hearing before the SSA.

APPEAL WON; OWCP ORDERED “TO SEE THAT JUSTICE IS DONE” FOR INJURED CLAIMANT

I am pleased to announce that the Federal Employees Compensation Appeals Board (ECAB) has ruled in favor of another client. The ECAB found that the Office of Workers’ Compensation (OWCP) had failed to properly develop the medical evidence before issuing its decision.

Our client, the claimant in this case, was a federal employee who had developed severe bilateral carpal tunnel syndrome to both his hands as result of repetitive work activity. His claim for carpal tunnel was accepted by OWCP and medical benefits were paid. Following his release from treatment the claimant submitted a request for permanent impairment of his hands. The claimant submitted medical evidence showing 29% percent impairment of his right hand and 30% impairment of his left hand. The OWCP however awarded him only 17% and 18% impairments, respectively. The OWCP based its award on the findings of its own internal medical examiner.

We appealed the OWCP as in error. The ECAB agreed with our appeal arguments finding that the OWCP was not supported by medical evidence. While noting that the claimant bears the initial burden to establish entitlement to compensation, the ECAB ruled that the OWCP shares responsibility in the development of the evidence. The ECAB ruled that the OWCP “has the obligation to see that justice is done.” Accordingly, the ECAB ruled that once the OWCP undertook to develop the medical evidence in this case by having this claim reviewed by its own internal medical examiner; the OWCP then bore “the responsibility to do so in a proper manner.” In this case, the ECAB ruled that the OWCP should have sent the claimant to a Board certified medical specialist to determine the extent of the claimant’s impairments. Failing to do so was error and the OWCP’s decision was set aside for further development for an appropriate decision as to the claimant’s permanent impairment award.