This feature appears from time to time as a means of illustrating the challenges that many applicants for social security disability benefits experience, in their efforts to be approved. These challenges include the many levels of decision-making for a social security disability claim (Initial application, Reconsideration, Hearing, Appeals Council, Federal Court), the specific issues raised by alcohol and drugs, the need to demonstrate that you cannot do past work or sometimes, any work at all, and the like. Cases are derived from actual clients I have represented but their names, details and key facts are changed to protect privacy.
“The pain in my face was horrible, but I thought it was from dental work.”
“It started a few years ago – this horrible burning pain on the left side of my face. Because it was near my jaw, we thought it was dental pain. I went through so many different procedures and appointments trying to figure out what was wrong, but nothing made it better. At first the pain only lasted for an hour or so and went away, but then I started to have the pain for longer and now it’s almost constant.”
Megan was only 51 years old and had spent much of her life working as a legal assistant. But the pain from her condition made it impossible to focus on her work.
“I had never seen anything like this,” noted Roger, Megan’s husband. Roger was a construction worker who accompanied her to her many dental appointments as they tried to figure out the cause of her pain. “I had never heard of trigeminal neuralgia when she received the diagnosis. Apparently neither had much of the medical community – it took us seeing three different doctors to finally find a neurologist who diagnosed her correctly.”
Trigeminal neuralgia is a condition that affects the trigeminal nerve – the nerve that runs through the face and jaw. For Megan, trigeminal neuralgia caused severe pain that was constant sometimes lasted for days, other times, for hours. Her condition made it very difficult to do basic tasks like read, drive, and go to the grocery store. The pain was also exhausting, causing her to take naps almost daily. The cause of this condition is not known, and the only treatment is often ineffective medication or a risky surgery.
“While it was a relief to finally know what was wrong with me, it was also terrifying,” Megan added. “It’s not a well-understood condition and there are so few treatments. The pain is so distracting and excruciating, but the meds are also awful. I’ve tried a few different things, but none of them have worked. I feel like a zombie when I take them, like I’m living in a fog, and most of the time they don’t even stop the pain!”
The Lawyer’s View
Megan’s case posed some difficult challenges.
1. Megan’s medical records did not document her condition as well as would have been helpful to her case. She saw many dentists before she finally found a neurologist who recognized it. She received the diagnosis a few years after her symptoms started. Will Social Security let her claim disability as far back as the start of her symptoms or will they move her onset date to the date of her diagnosis?
2. Her medical condition, trigeminal neuralgia, is not well known, even among the medical community. Furthermore, this condition cannot be diagnosed through any objective medical tests. Luckily, Megan is now seeing a doctor who is an expert in this particular condition. Will the written testimony of Megan’s treating physician be enough for Social Security to find her disabled?
What happened?
Based on an excellent letter from her treating doctor, at her hearing, Megan was found disabled. However, the judge amended her onset date such that her back benefits were much less than they would have been otherwise. The judge amended her onset date to the month of Megan’s diagnosis when her records more clearly demonstrated the severity of her condition. Because it would be hard to prove she was disabled prior to this point at the hearing, Megan decided not to appeal the reconsideration decision and is now receiving benefits.