Back Pain Case Study #2
Claimant: 59-year-old male
Past Work: The claimant was employed as a surveyor for engineering companies and has a record of over 30 years of continuous employment.
Education: The claimant was a high school graduate who also went to technical school.
Hearing information: The claimant filed in late 2005 alleging an onset date in August 2005. The first application and reconsideration were denied. Finally, a hearing was scheduled for June 2008. The judge hearing the case works out of the North Atlanta hearing office. Having worked with this judge before, I could testify to the judge’s fairness.
Hearing strategy: I found that this client had a very strong case. Not only did the client have a very extensive work history, but he is also well-spoken and a very credible sounding witness. After he began experiencing back pain in the late 1990’s, the client sought treatment. During the next four years, he tried many different treatments, including facet blocks, radio frequency nerve ablation, and epidural injections. Unfortunately, none of this solved the problem, so he had surgery in 2003 to fuse the discs at L5/S1. The surgery did not succeed either, though, and since that time, he has been a patient of a pain management physician. His treatment includes regular facet block injections and RF denervation. Even though the patient is also on a number of pain medications, it does not relieve the pain, and he is forced to stay in bed for 12 to 16 hours each day.
The client also has a secondary condition of being an insulin-dependent diabetic. He has had this problem for more than 40 years and has diabetic retinopathy, which has damaged his night vision and his day vision in the left eye. Additionally, he had diabetic neuropathy, which has left him with almost no feeling in his lower legs and feet and little feeling in his hands. Diabetic nephropathy has caused him to lose approximately 40% of his kidney function. A cardiologist has also treated the client for congestive heart failure, and he has been hospitalized because of heart problems several times.
When I reviewed the case and saw all of the problems that the client had, I was sure that the client deserved benefits and would win the case.
Hearing summary: There was a judge, hearing assistant, and vocational expert witness present at the hearing. A medical witness expert was also at the hearing over a video conference.
The judge greeted my client and introduced everyone. After questioning the client about previous work and when he stopped working, the judge let me question. I started by asking why the client quit working, which led to a discussion of his back pain and other problems. He explained his fusion surgery and how it failed to stop the pain, as well as his attempts to relieve pain by using medication and various other methods. Then I asked about the state of his diabetes and the complications including his neuropathy, retinopathy, and nephropathy. I also covered his heart condition and the stamina limitations that resulted from that problem.
Using a 1 to 10 scale, I questioned my patient about his pain level, and I questioned his ability to sit, stand, and walk. We also reviewed the side effects from the medications he is taking. Although the hearing had only been going on for about 10 minutes, the client had stood up and sat back down several times. He acknowledged that this was because of his back pain.
I could have used the client’s wife as a witness, but considering how well the hearing was going, I did not think I would need to use her.
At the judge’s request, the medical expert summarized the information in the claimant’s medical file. He identified a number of problem areas that resulted from my client’s medical condition. These problem areas were a result of diabetes, degenerative disc disease, reduced kidney function, and various issues from the numbness in his feet. When asked if he knew any Social Security listings that my client would qualify for, the medical expert told the judge that he was familiar with the listings and thought the client met listings 1.02, 1.03, and 9.08. Because of the extensive medical evidence, the judge felt there was no need to hear from the vocational witness, promising a decision shortly.
Observations: There was very strong medical evidence for this case, so much so that this case should never have lasted as long as it did. The problem was probably due to someone not reading the file carefully.