Some hearings require extra effort than others, and at the moment’s listening to earlier than an Administrative Regulation Decide was one in every of them. It was a case the place I actually needed to work as the claimant’s legal professional to assist him win the declare, however the effort paid off.
The Problem: A Medical Skilled Who “Missed” Key Proof
The listening to was initially continued in order that the Administrative Regulation Decide (ALJ) might acquire testimony from a medical knowledgeable (ME). That is normally not signal for claimants—MEs are sometimes used to justify a denial. Positive sufficient, the ME initially took the place that whereas my shopper had quite a few diagnoses, there have been few goal medical findings to help them. He recognized solely a cervical backbone downside 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 selected exhibit that contained an MRI of the cervical backbone. This MRI supplied clear, goal proof of disc protrusion, abutment, effacement, and flattening of the ventral thecal sac—vital findings that the ME had fully neglected.
The ME admitted that he had “missed” this be aware.
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, in actual fact, have vital useful limitations. He initially thought he was assigning “mild obligation” work restrictions, however upon additional dialogue, it turned clear that his analysis truly supported a sedentary work restriction—an essential distinction in Social Safety incapacity instances.
The ME apologized for lacking the document and truly thanked me for pointing it out.
Utilizing the Grid Guidelines Strategically
At this level, I requested to go off the document to debate technique with my shopper. His alleged onset date (AOD) was June 29, 2017, and 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 adjustments the best way incapacity instances are evaluated below the medical-vocational pointers (the “grid guidelines”). At age 50, claimants can extra simply be discovered disabled if they’re restricted to sedentary work and haven’t any transferable expertise.
By altering the AOD to March 15, 2023, we have been now inside six months of his fiftieth birthday. This allowed us to argue that the ALJ ought to apply the grid guidelines non-mechanically, treating him as if he have been 50 on the time of incapacity.
Sealing the Cope with Vocational Skilled 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 shopper 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 authorized the case however requested a post-hearing transient outlining the argument.
The Consumer’s Response
After the listening to, my shopper 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 neglected proof, and making use of the appropriate authorized technique could make all of the distinction.
Want Assist with Your Social Safety Incapacity Declare?
Profitable a Social Safety incapacity case isn’t nearly having a medical situation—it’s about presenting the appropriate proof, understanding the foundations, and making use of the appropriate authorized technique. That’s the place expertise issues.
If you happen to’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 getting ready for a listening to, we will information you thru the method and combat for the advantages you deserve.
Contact us on-line or name (888) 321-8131 at the moment for a free case analysis. Let’s focus on your case and the way we can assist you win your declare.
