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.
“I’ve tried everything, but the treatments are as bad as the condition.”
“It may sound strange, but the frequent trips to the bathroom aren’t even the worst part – it’s the pain,” Arthur, 37, had been diagnosed with Crohn’s Disease a few years earlier. “I’ve tried to hold down different jobs, and I’ve had a few bosses who have even put up with my frequent bathroom breaks, but in the end, I always lose the job sooner or later because I miss so many days of work. And even when I am there, I can’t concentrate. All I can think about is the pain!”
“And the pain meds! They’re almost worse than the pain – I can’t think, I sleep all the time, its like I’m a zombie. I hate taking them and I try not to unless it’s really bad.”
Maureen, Arthur’s wife, explained that Arthur was also dealing with depression. “He’d never admit to it, but that’s what it is. I’ve been trying to get him to talk to someone about it, but he won’t – he’s too proud. I think it’s related to his Crohn’s. He hardly ever leaves the house anymore. I just wish he would address it.”
The Lawyer’s View
Arthur’s case posed some difficult challenges:
1. Though he has depression as a result of his Crohn’s, Arthur is reluctant to admit to it and has not had much medical treatment for it as a result. This will make it difficult to argue that his depression affects his ability to work, although we know from Maureen that it is very debilitating. In a disability case, it’s helpful to have more than one significant impairment but you need medical evidence. Will the Judge find that the documentation of Arthur’s depression in the record is sufficient?
2. There is evidence in the record that Arthur had problems following the doctor’s prescribed treatment. In particular, Arthur has been bad about taking his medication. The Judge can use patient noncompliance with medication as a basis for denying a claim. Arthur has noted that the side effects of the medication are extreme, which may explain why he does not always take them consistently. How will the Judge view Arthur’s medication noncompliance in this case?
What happened?
At the hearing, the judge was quick to point out his noncompliance with medication. Furthermore, he immediately dismissed depression as a severe impairment as there was not enough evidence in the record.
At the hearing, Maureen provided important testimony about the way Arthur’s Crohn’s affects his daily life. We also provided a letter from Arthur’s gastroenterologist explaining the severity of his disease. The doctor stated that Arthur would miss more than 50% of workdays in a month and also explained why Arthur was not always compliant with his medications. Because Arthur’s doctor had treated him for many years, his opinion letter was very valuable. As a result, we won this case.