Back Pain Case Study #1

Claimant: 58-year-old male

Work Background: worked for years as a computer programmer for large corporations with an expertise in mainframe computers. The client was laid off after 9/11/01. The last month he worked was in October of 2001.

Education: The client had graduated high school and went to college although he did not obtain a degree. He also studied computer programming at a vocational school.

Background: The client was over 50 with a good work background. He had worked continuously for 20 years and only had 3 jobs in that time. The claimant sought continuous medical treatment for his problem. The client also informed me that he had back pain since childhood. His pain became so severe that during the last few months he worked, he had to change his workstation so he could sit or stand depending on how the pain was.

The client continued working regardless of the pain until he was finally laid-off when the company let many workers go.

The client had a heart attack in 2002, which doctors treated with medication and an angioplasty. Although he has had no on-going cardiac problems, the client’s medical record shows that he has issues maintaining a healthy blood pressure.

The back pain had gotten so bad by late 2002 that the client could only sit, stand, or walk for between 30 to 40 minutes at a time. The condition was also progressively getting worse. Even if the client could survive one day of work, there is no way he could go to work day after day and get through an entire work week without taking time off.

The Hearing: A newer judge, who had previously decided favorably for another client in a different case, was overseeing this hearing. Although I did not have much experience with this judge, she seemed to be fair and open-minded.

When I prepped the client, I realized that he was not doing a good job of giving his testimony clearly and directly. I explained the importance of giving good testimony and that judges would want answers to specific questions. The client explained that the problem was that his symptoms often differed day-to-day depending on how he was feeling on any given day. Taking this into consideration, I decided to formulate my questions so they took into account his cumulative symptoms. The question and answer session would follow a format similar to this:

Scenario: If he was on security detail at a mall and had to circle the mall continuously, then how long would he be able to walk if he was well-rested when he started out? The client estimated that he would be able to walk for approximately an hour and a half, but then he would have to lie down for at least an hour or two. I would then ask him if he could continue working after he rested. He would testify that he could maybe work for 45 to 60 minutes before needing to rest again. I would then ask him to estimate how many times he could do this cycle. Not only could the client repeat the cycle no more than 3 times, but the length of time he could work would be reduced each time. When questioned about how his shift would be the next day, the client says that the length of his first stint would be even shorter (around 45 minutes) because he had worked the day before.

For my opening, I explained that the client had a condition known as spondylisthesis, which happens when a vertebrae slips of place causing the spinal canal to narrow. Additionally, I explained the cumulative nature of my client’s condition and how he could perform certain activities on day one that he would be incapable of doing on the second day.

The Hearing: The judge first wanted to know about the client’s background before asking about his physical limitations. The judge also wanted detailed answers about specific activities, such as walking, standing, and sitting. Although the client tried his best, he did struggle a little on explaining his cumulative symptoms.

When answering the judge’s questions, the client admitted that he participated in a wide variety of church activities and was a lay leader for study groups. He also went to a yearly out of town convention with other members of the congregation. Furthermore, the client said that he could do some chores and he even could use a riding lawnmower for as many as 45 minutes. Additionally the client said that one physician had recommended surgery in case the pain became too bad to handle.

Although I tried to reverse any possible damage when I questioned the client, the judge did not seem very convinced. This is undoubtedly because of what the client had already admitted and all of the activities he was capable of doing. Even when I asked him to rate his pain level, he did not give a clear answer, stating that it varied.

The client had been getting continuous medical treatment from a family doctor, and the physician had even completed a residual functional capacity form. One of the files in his medical records showed only a moderate physical disability. The judge only asked the vocational witness one question about a hypothetical person with the same background who can only do sedentary work and must sit still. The vocational expert testified that such a person could work.

When I questioned the vocational expert using the functional capacity form, however, he admitted that the person could not work.

I think that there were several reasons why the trial did not go well. The client did not give a good testimony – he was vague and conditional. The client can still do many activities, such as church work, yard work, and work on his own computer. It did not come up in the hearing, but the client had told me that he had designed and created a large, interactive website for his church. The client had not had to quit any jobs. He had only been interested in more programming and computer jobs and had not tried less skilled work. The primary physician treating the client is not only not an orthopedist, but he also barely covers the back pain.

In my opinion, this case will be denied because the claimant did not have very credible testimony because it did not coincide with the doctor’s limitations. His activity level seemed much higher than what it should have been if he had such a severe disability.