Case Strategy for Disability
Claims Based on Arthritis

Your arthritis case has to focus on how your arthritis prevents you from being able to work.   Arthritis is the medical reason why you can’t work, but to satisfy SSA requirements, focus has to be given specifically to your inability to perform basic job tasks based on your arthritis.

Are Your Medical Records Sufficient?

Typical doctors’ notes – which provide basic information about your condition – are not sufficient for a disability case. Rather, you need records which indicate how your arthritis causes limitations on your ability to perform on the job.  In Social Security lingo, these limitations are known as work limitations, or functional capacity limitations. In your SSA case a judge will most likely deny your claim unless specific work limitations are stated in your records.

Using Social Security’s Special Language

Since your goal is to show your limited ‘functional capacity’ to the judge, you should be sure to talk to your doctor about filling out a form which specifically states your work limitations. A good attorney will be able to assist you in putting together a form or checklist, based on the Social Security forms, that you will be able to give your doctor.  Seasoned attorneys know from experience that occupational and work factors have the most influence with judges.  They are more important than even your medical condition, since being considered “disabled” means not being able to work in Social Security’s eyes.

Some occupational factors might include: not being able to sit or stand for extended periods of time; a need to lay down frequently; not being able to lift more than 10 pounds ever; and many, many more…

Getting Cooperation from your Doctor

Often your doctor will not be familiar with Social Security practices and will not know what information they need.  He or she may believe you cannot work, but they may simply not know an approach to convey that message to the Judge.

Other doctors may be reluctant to get involved in a disability case at all.  Perhaps they have been burned in the past by some bad experience with lawyers, or perhaps they believe it might come back to trouble them later if they get involved in legal matters. You can relieve their apprehension by telling them that they will not have to testify on your behalf; a letter or written statement will suffice. A doctor being called into court is exceptionally rare, and besides, in disability hearings, there is no ‘cross-examination’ like there is in a lot of other legal proceedings.

Furthermore, your doctor might appreciate the fact that if you are approved for disability (Title II) benefits, then you will also be eligible for Medicare – which would in turn be a source of payment for them.  So they could eventually benefit from you winning your case as well! Past cases have shown most compassionate physicians will agree to spend 10-15 minutes filling out a form to help you.  You should consider replacing a doctor unwilling to do this.

Hearing Issues Unique to Arthritis cases

Be aware that many disability claimants-about half all filed claims-complain of arthritis symptoms (even if their main reason for applying for disability is something else).  This is because mild arthritis is a typical ailment in most people over age 40. As a result, a judgemay have seen a number of claimants who suffer from arthritis pain. Thus, due to this experience, a number of judges are likely to undervalue arthritis as a debilitating condition. They are sort of “de-sensitized,” if you will.

If your particular case involves an unusually advanced case of rheumatoid arthritis, inflammatory arthritis, osteoarthritis, or any other rare form of this disease, then you really need to inform your particular judge in order to better your chances of winning.

Preparing your Case File for a Hearing

It has been an experience that at times your physician may just use the term “arthritis” when he just should use a particular medical term, which depicts the specific diagnosis. Again, your physician may not come to realize that another individual will read his office notes; thus, terminology, specificity and accuracy may not be a preference. Either your Social Security representative or you should review every office note completely ahead of the time of the hearing to insure the medical records make perfect sense.

Would it be a surprise to know most notes from a doctor are difficult to read or handwritten? In some instances, people have had to cooperate with a physician’s office to make a translation from notes so they could even comprehend them.

This is not to suggest a physician with illegible handwriting or office notes that are sketchy isn’t a caring, solid practitioner. On the contrary, your physician’s chief focus is his/her treatment of the patient. His notes tend to be reminders to review prior to your visits. For purposes of Social Security, however, the physician’s office notes can either make or break the case. Thus, the role is perceived as one whereby medical discoveries are “translated” into occupational limitations.

How You Should Prepare for your Hearing

As attorney representatives, we feel that Social Security claimants are better off with lawyers than without.  Since most cases do not involve up-front fees, money should not be an issue.  On the other hand, you are required to appear and argue your case on your own or with a non-attorney representative.  If you proceed without an attorney, you will get the best results if you do the following:

• Make sure you review your file thoroughly – make sure that all records of medical treatment are present and up to date.
• Think about a theory of disability – why are you unable to work. You should be able to boil this down to two or three sentences.
• Make sure to give the Judge specific information. Testimony that “it hurts a lot” or “I can’t walk very far” doesn’t say much. Testimony that “I can only stand and walk for 15 minutes every three hours” gives the Judge a specific vocational limitation.

In our law office, we prepare in advance for hearings by reviewing your claims file two to six weeks prior to the hearing and summarizing the claims information and medical records into a 2 or 3 page typed summary.  By reviewing your file early, we have enough time to update records.

All pertinent treatment notes are entered in date order and all are referenced by the Exhibit page number.  Thus, if we are discussing a particular medical record, we can identify it specifically for the judge.  At your hearing, therefore, you will note that our hearing worksheet is a neat two or three page document rather than a bulky file.

We usually bring the laptop computer to the hearing and enter hearing notes directly.  We use these annotated hearing notes to track the questions typically asked by a particular judge and the “hot buttons” that help us win cases.  We would like to think that this method will help us serve you better.