Aline Gaba is a Founding Partner in a law firm that represents Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) claimants.
Under the Social Security Act, a claimant is considered “disabled” if (1) she is unable to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less that twelve months and (2) the impairment is of such severity that she is not only unable to do her previous work but cannot, considering her age, education, and work experience, engage in any other kind of substantial gainful work which exists in the national economy.
On October 26, 2012, the 9th Circuit Court of Appeals issued its ruling in the case of Hill v. Astrue, 2012 DJDAR 14911. In this case, the ALJ found that Ms. Hill had not engaged in substantial gainful activity and that she had severe medical impairments but, when considering her residual functional capacity, he ignored the evaluation of Hill’s treating psychologist who found that Hill’s combination of “mental and medical problems makes the likelihood of sustained full time competitive employment unlikely”.
The 9th Circuit Court of Appeal found this to be an error. It ruled that, in order to reject a treating physician’s opinion, the ALJ has to give clear and convincing reasons because the opinion of a treating doctor can be rejected only for specific and legitimate reasons that are supported by substantial evidence. The court found that the ALJ failed to give any reasons for rejecting the treating doctor’s opinion let alone clear and convincing reasons. The case was reversed and remanded for further hearing.
This case points out how important it is for claimant’s to establish and maintain a relationship with their treating doctor’s since the ALJ must consider and give greater weight to the treating doctor’s opinion. The disability attorneys, Aline Gaba and Geroge Heppner with the San Diego Disability Law Group find that treating physician’s are more likely to complete a Residual Functional Capacity Questionnaire when they have seen the patient regularly. Additionally, the information needed to complete the questionnaire will generally be in their medical records. In the questionnaire, the physician states what the patient can still functionally do; i.e. how long can she stand, sit or walk; can she kneel, stoop, bend or climb stairs; how many pounds can she carry or lift; does she need to take frequent breaks. It’s an important piece of evidence and might make the difference between receiving your benefits and having your claim denied.
If you or a family member need a San Diego Disability Attorney or have a question regarding Social Security Disability please contact the San Diego Disability Law Group at 619-338-9000 or contact us through our website.
SSA and Fibromyalgia: Is it Difficult to Obtain Social Security Benefits?
A recent issue of the NOSSCR (National Organization of Social Security Claimants’ Representatives) Social Security Forum had a interesting article on why claimants with Fibromyalgia and Chronic Fatigue Syndrome(CFS) oftentimes have a difficult time obtaining social security benefits due to the lack of objective medical findings inherent in these conditions and how a new Social Security Ruling could help overcome this obstacle.
On July 25, 2012 Social Security Ruling (SSR) 12-2p was issued. SSR-12p states that fibromyalgia may be a “medically determinable impairment” when it is established by appropriate medical evidence and can be the basis for a finding of disability. Once fibromyalgia is established as a “medically determinable impairment” it will be considered in the sequential evaluation process to determine whether the person is disabled. It is still the claimant’s burden to provide “sufficient objective evidence to support a finding that the person’s impairment so limits the person’s functional abilities that it precludes him or her from performing any substantial gainful activity”.
Now in cases involving fibromyalgia and chronic fatigue syndrome, once fibromyalgia and chronic fatigue syndrome have been established, SSA will consider all of the evidence in the case record to evaluate the intensity and persistence of the claimant’s pain or other symptoms to determine the extent to which the symptom’s limit the person’s capacity for work.
In addition to the physicians diagnoses based on objective criteria, Attorneys with the San Diego Disability Law Group make sure that their clients provide the administrative law judge with as much longitudinal evidence of symptoms and treatment as possible, as well as reports from family and friends of how the claimant’s impairments affect his/her activities of daily living or ability to work.
If you or a family member has a question regarding Social Security Disability please contact the San Diego Disability Law Group at (619) 338-9000.
For more information regarding Fibromyalgia visit: www.niams.nih.gov/Health_Info/Fibromyalgia; www.mayoclinic.com/health/fibromylagia; or www.rheumatology.org.