FILE, FILE, WHO'S GOT THE FILE?

In federal workers’ compensation (OWCP) claims run by the US Department of Labor (USDOL), the claimant’s ability to prove her case against the USDOL hinges on what is in her claims file.
That claims file is provided to the claimant by the USDOL. The claims file may be on CD ROM, in paper, or both.
It is very common for the CD rom file not to match the paper file and vice versa. It is common for the paper file to be missing pages. It is common for the CD-rom to contain records from other unrelated claims.
So which file is the “official” file for a claimant in an OWCP claim? The paper file or the CD-rom?
I directly submitted this question to the Director of OWCP in Washington DC.
The response from the USDOL as to which one of the CD rom or paper file is the “official” record for the claim was …….. Neither.
According to the response received this week from the USDOL, the only “official” record for an OWCP claim is the electronically imaged file stored in the USDOL databank. Neither the paper file nor the CD-rom provided to the claimant or her representative is considered the official record.
Obviously, this presents quite a problem for the claimant when she must appeal her claim against the USDOL to the final authorities and she is never provided an “official” copy of her entire claims file by the USDOL. On such an appeal, the claimant may or may not have all the documents she needs to present her appeal against the USDOL, but only the USDOL which holds on to the only “official” file will be privy to the information.

FEDERAL COURT RECOMMENDS SSA’S DENIAL OF DIABETES DISABILITY CLAIM BE REVERSED; CALLS SSA JUDGE’S DECISION MEAGER AND WHOLLY INADEQUATE

I am very pleased to announce another favorable recommendation of a US federal court to overrule and throw out a denial of disability benefits by the SSA.
In this long and difficult claim, the claimant was a young person who filed for disability in 2002. He claimed disability due to his suffering from diabetes mellitus and hypertension.
The SSA judge denied his claim. The SSA judge found that the claimant’s diabetes did not meet the SSA’s definition of impairment.
On appeal to the federal court, we argued that the SSA judge was wrong. We argued that the SSA judge should have found that the claimant’s diabetes met the definition required by the SSA and that he was disabled for that reason. We argued that the SSA judge failed to discuss and explain in detail why the claimant’s condition did not meet the definition of diabetes and was not disabled.
The federal court has agreed with our argument and has recommended that the SSA denial be reversed and sent back for another hearing.
The federal court wholly agreed with our arguments that that SSA’s judge failed in her duty to discuss the evidence and “explain why” the claimant was not disabled due to his diabetes.
The federal court further found that the SSA judge’s “meager discussion of the evidence [was] wholly inadequate” and was a summary conclusion that failed to live up to acceptable standards of review.
The claim will go back to the SSA for another hearing where the SSA Judge has been instructed to “adequately discuss her conclusions” why the claimant should not be found as disabled.

SSA FINDS MULTIPLE CHEMICAL SENSITIVITY AS DISABLING; AWARDS BENEFITS WITHOUT FURTHER NEED OF HEARING

This was a complicated case for a young person that I represented. The claimant had filed for social security disability benefits with other counsel more than 5 years ago. He claimed he was disabled due to multiple chemical sensitivity. This a relatively new medical condition where he could not be around chemical fumes, odors, and irritants. Some members of the medical community are hesitant to recognize multiple chemical sensitivity as a disease. With his first attorney, the SSA judge denied his claim. The SSA judge simply did not believe the claim of multiple chemical sensitivity and ruled against the claimant finding him capable to working.
Upon coming to my office, we appealed the claim to the US federal Court. There we argued that the SSA judge wrongly favored the medical reports of the SSA’s paid medical doctors over those of the claimant’s own treating doctors. We also argued that SSA judge wrongly ignored the claimant’s multiple chemical sensitivity disorder and how that disorder kept him from working.
The US federal Court agreed with our arguments and sent the claim back to the SSA for another hearing.
We then proceeded to wait and prepare for another hearing with the SSA. However, our wait and preparations proved unnecessary.
After a few months time, the SSA judge, on his own, issued a decision on the record stating that, no further hearing was necessary and that the claimant was indeed disabled. The SSA judge found that upon “careful consideration of the entire record”, the claimant did not have the ability to work due to fatigue, confusion and cognitive dysfunction arising out of his underlying disorders. The SSA found that the claimant’s “chemical hypersensitivity” causes significant limitations in his ability to perform basic work activities.
Full disability benefits were immediately awarded with no further need of additional hearings.