Case Study Archives

The Social Security Disability Attorneys at the San Diego Disability Law Group recently represented a 47 year old woman with Breast Cancer. When she first contacted our office her claim for disability benefits had already been denied by the  Social Security Administration and the time limit to file a Request For Reconsideration had already passed. To make matters more complicated, most of her treatment had occurred in Mexico and most of her medical records were written in Spanish. Her claim was essentially dead in the water.

In reviewing her disability papers, our attorneys  noted that she had filed part of the documents necessary  for a Request For Reconsideration in a timely  matter but had failed to file an essential form ( SSA-3441 – Disability  Report-Appeal). We immediately prepared and forwarded the form and then contacted the Social Security  Administration on her behalf. We were able to convince  them to accept her untimely appeal and her Spanish medical records without the usual requirement that they be translated into English. This was especially important since her mastectomy surgery had been performed in Mexico.

We then began the process of documenting her condition for the Social Security Administration. Our client has recently received  some treatment in San Diego. We obtained copies of her records which contained a pathology report showing that her breast cancer had  spread to her lungs. We then contacted  her San Diego oncologist and convinced her to complete a Residual Functional Capacity  Questionnaire detailing our client’s inability to function in a work environment. The Residual Functional Capacity Questionnaire, the pathology report and several letters from our client’s friends and family  detailing her inability to function in a work environment were forwarded to the Social Security Administration.

The San Diego Social Security Disability Attorneys at the San Diego Disability Law Group were able to get our client her Social Security Disability Benefits within a matter of weeks after she contacted our office.

The Social Security Disability Attorneys at the San Diego Disability Law Group  wrote to the Social Security Administration and asked that they consider their client’s claim under a Compassionate Allowance . The Social Security Administration has acknowledged that it “has an obligation to provide benefits quickly to applicants whose medical conditions are so serious that their conditions obviously meet disability standards.” Compassionate Allowances are a way  of quickly identifying diseases and other  medical conditions that invariably qualify under the  Listing of Impairments based on minimal objective  medical information. Compassionate Allowances allow the Social Security Administration to target the most obviously disabled individuals for allowances based on objective  medical information that they can obtain quickly. Compassionate Allowances is not a separate program from the  Social Security Disability Insurance or Supplemental Security Income programs.

According to the Social Security Administration, Compassionate Allowance conditions “are selected using information received at public outreach hearings, comments received from the  Disability  Determination Services, counsel of medical and scientific experts, and research with the National Institute of Health (NIH). ” They also consider which  conditions are most likely to meet their current definition of disability. There are currently over 200 conditions that can qualify for Compassionate Allowances.

Individuals with Compassionate Allowances conditions may  receive a decision on their  claim in a matter of weeks instead of months or years. The time varies depending on how quickly Social Security can obtain copies  of the medical records, whether a medical exam is necessary, and whether the claim is  randomly selected for quality assurance.

If you, a friend, or family  member would like to discuss any  of the over 200 conditions that qualify for Compassionate Allowances just call any of the San Deigo Social Security Disability Attorneys at the  San Diego Disability Law Group at 619-338-9000.

San Diego Social Security Disability Attorneys Comment on Obesity and SSDI/SSI Benefits

The attorneys at San Diego Disability Law Group recently  had a case involving a young claimant who was five  feet six inches tall and weighed over 350 pounds. She had a BMI over 50. In addition, she had  been diagnosed with scoliosis (a sideways curvature of  the spine associated with pain but  not neurological impairment),lumbar spondylosis (stiffening or fixation of the vertebrae) and hypo joint mobility. She had a high school diploma but no work experience. She took daily pain medication but still woke up  several times per night due to the pain. This caused her to be groggy and not mentally focused during the  day.

One of the issues in the claim involved what effect her obesity was having on her underlying orthopaedic  conditions. In order to properly present her claim we had to research to  what extent obesity  is  considered by the Social Security  Administration. According to the Social Security Administration, obesity is a complex, chronic disease characterized by excessive  accumulation of body fat caused by a combination of factors i.e. genetic, environmental and  behavioral. Obesity is a risk factor that  increases an individual’s chances of developing impairments in  most body systems.

The National Institutes of Health established medical criteria for  the diagnosis of obesity. These guidelines classify overweight and  obesity in adults according to Body Mass Index (BMI). BMI is the  ratio of an individual’s weight in kilograms to the square of his or height in meters.  For adults, both men and women, the guidelines describe a BMI of 25-29.9 as overweight and a  BMI of 30.0 or above as obesity. The guidelines further recognize three levels of obesity. Level I includes BMIs of 30.0 – 34.9. Level II includes BMIs of 35.0 – 39.9. Level III, termed extreme obesity includes BMIs greater than 40.

Prior to October 25, 1999, there was an actual SSA listing  for obesity (9.09). The  listing was deleted because the Social Security  Administration believed that the criteria in the listing were not  appropriate indicators of listing-level severity in that they did not represent  a degree of functional limitation that would prevent an individual from engaging in  any gainful activity.

Although the listing was  deleted, the Social Security  Administration still recognizes obesity as a medically determinable impairment. On September 12, 2002 they  issued a Policy Interpretation Ruling (SSR 02-1p) regarding the  evaluation of obesity.

In the  ruling SSA reminds adjudicators that “obesity  is a medically  determinable impairment and that adjudicators should consider its effects when evaluating disability”. The  ruling also reminds adjudicators that the combined effects of obesity  with other impairments can be greater than the effects of each of the  impairments considered separately. They also instructed adjudicators to consider the  effects of obesity when assessing an individual’s residual functional capacity.

The ruling provides that the Social Security Administration will find that “obesity  is a severe impairment when, alone or in combination with another medically determinable physical or mental impairment(s), it significantly limits an individual’s physical or mental ability to do  basic work activities.” They  will also consider the  effects of any symptoms  (i.e. pain or fatigue)that could limit  functioning.

In our case we believe that we were able to show that the claimant’s obesity combined with her underlying orthopaedic conditions significantly limited her physical and mental ability to do  basic work activities.

The San Diego Social Security Disability Attorneys with  the San Diego Disability  Law Group will help you present the strongest claim possible for Social Security Disability  based  on obesity  and other limiting conditions.

If you or a friend or family member has a Social Security Disability claim or question, contact the Social Security Disability Attorneys at the  San Diego  Disability Law  Group for a free consultation at 619-338-900.