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Case Summaries

Success Story: A Fantastic Win For Our FDC Team!

We write a lot about the challenges of getting Social Security disability benefits, but sometimes keeping the benefits can be just as difficult! There are many complicated medical and vocational issues that Social Security analyzes when reviewing whether a beneficiary can continue to receive their disability benefits. Sometimes during this “Continuing Disability Review,” or “CDR,” technical errors occur or claimants are denied due process. When a claimant receives a Notice of Termination they have the right to appeal and, just like when initially applying for benefits, a CDR case that gets denied by an ALJ can be appealed to the Appeals Council and, if necessary, to the Federal District Court.

In this case, a client in North Carolina was referred to our office on very short notice after her benefits were terminated following a CDR. We worked hard to make this timely appeal happen and were ultimately successful in winning her case at District Court! We applaud the representatives who worked with the client at the administrative level, Melissa Wilson and C. Jane Johnson, for stopping at nothing to advocate for her. We were honored to receive the following note relaying the happy news that the client’s benefits have been reinstated:

THANKS TO ALL AT OBL. Don’t mean to yell, but we are just ecstatic. Our former client just called me crying tears of joy that her backpay is coming and her benefits are being reinstated pending the remand hearing on her CDR. Hannalore was on vacation when we contacted OBL for the FDC appeal, but she still made this last-minute FDC filing happen. I think Amy did legwork getting the forms together, I don’t know who else to thank, so please spread the word today that OBL ROCKS and we are so grateful. Thanks Karl. What you do really matters. You may not always see how much, but it really matters.

Karl also wants to pass on this gratitude to the whole team, which literally worked overtime to get this done. Osterhout Berger Disability Law handles FDC Appeals all over the country. Call 866-438-8773 to see if we can help you or your client.

Lindsay Osterhout’s Technical Expertise Results in Another Case Win!

Lindsay Osterhout, OBL Partner, Administrative Division

When applying for Social Security disability benefits, many underestimate the importance of knowing Social Security regulations and policy.

Lindsay Osterhout recently worked on a case that had been denied at the application and reconsideration levels. The claimant’s impairment was a primary type of cancer. The initial cancer occurred while the claimant was still insured for Social Security Disability. Shockingly, SSA denied the claim, IMPROPERLY labeling it secondary cancer. With that misclassification, SSA IMPROPERLY found that the claimant did not meet the cancer listing.  Upon Lindsay pointing out the misclassification by DDS, it was clear the claimant met the listing.  The ALJ paid the case without a hearing.

Our firm specializes in Social Security disability claims at all levels, however, we strongly encourage anyone filing an initial application to at least contact us for a consultation first. Many times applicants think that their condition is severe enough that representation is not needed. We advise you to always have skilled representation by your side, no matter how severe the impairment is. Lindsay and her staff understand the technical details that make the difference between a case being approved or denied. Contact us today for a complimentary consultation!

Aetna Reverses its Decision to Terminate Long Term Disability benefits after Osterhout Berger file its Appeal

Aetna terminated the benefits of our client, an Executive Administrative Assistant, after she had been receiving disability benefits for only eleven months.  Our client suffered from significant limitations in the use of her arms and hands as a result of medical conditions to include neuropathy, carpal tunnel syndrome and cubital tunnel syndrome.

After the client retained us, Attorney Berger obtained updated medical treatment notes and medical opinions from our client’s treating physicians and a detailed vocational report.  Attorney Berger also filed an extensive brief arguing why Aetna was unreasonable in terminating benefits and after a review of all of our submissions, Aetna reversed its previous decision and reinstated benefits, resulting in our client receiving almost one year of past due benefits and ongoing benefits.

Please do not hesitate to contact our office to speak with Attorney Berger if you need assistance with your claim for Long Term disability benefits.

The Hartford Reconsiders its Termination of Benefits

Our client was a College Registrar when she became unable to work due to physical impairments to include fibromyalgia, vertigo, lumbar spondylosis, Post Traumatic Stress Disorder, Depressive Disorder and Panic Disorder.  She received benefits from The Hartford for approximately 14 months before it was determined that she could return to her own occupation. Attorney Berger obtained medical evidence from eight different physicians along with medical opinions from four different physicians.  He also obtained a detailed vocational report and, following a review of all of this evidence and Attorney Berger’s argument, The Hartford reversed its previous decision and reinstated our client’s benefits.

If your Short Term or Long Term benefits have been denied or terminated, please contact Attorney Berger for a free consultation.

Osterhout Berger assists Amazon Employee in her Claim for Benefits from The Hartford

The Hartford denied our client’s claim for Long Term disability benefits due to a lack of medical documentation.  Our client suffered from significant mental impairments, to include a persistent mood disorder and anxiety disorder.  After being retained by the client, who worked for Amazon, Attorney Berger obtained all of the medical evidence, along with a detailed statement from our client’s treating physician and a comprehensive vocational report.  This evidence was enough to persuade The Hartford to overturn its previous decision and award our client her much-needed Long Term disability benefits.

If your Short Term or Long Term benefits have been denied or terminated, please contact Attorney Berger for a free consultation.

Osterhout Berger Helps a Financial Executive Get His Benefits Reinstated from The Hartford

Our client had been receiving Long Term disability benefits from The Hartford for difficulties stemming from a sleep disorder for approximately 10 years before The Hartford terminated the benefits after finding he could return to work.  Our client immediately contacted Attorney Berger and after extensive development of his claim file, to include obtaining multiple statements from our client’s treating physicians, an Independent Medical Examination and a comprehensive vocational evaluation, The Hartford reversed its decision and reinstated our client’s Long Term Disability benefits.

If your application for Long Term disability benefits or your appeal of a decision denying or terminating has been denied do not hesitate to contact Osterhout Berger Disability Law for a free consultation.

Tenacious Representation Leads to Incredible Success Story Out of Minnesota

Disability appeals have, unfortunately, become standard practice for many claimants. Judges frequently make errors in hearing decisions. OBL partners with many firms who are fierce advocates for their clients, yet come to us with unfavorable decisions due to legal error. Disability Specialists of Minnesota is one company we work with on a regular basis. They recently delivered incredible news related to an appeal Karl Osterhout handled, all because they refused to give up on their client’s case! “This case really demonstrates the value of working with a group like mine, who offers all services related to appeals. In fact, the reality is that we never made a dime on this case, since we offer free of cost Appeals Council briefing to our regular referral sources, among many other services” explains Karl. Our partnerships with groups like Disability Specialists are special to us and we always try to help when I can, but this case really stands out!

Amy Pearson, President of Disability Specialists, describes the history of the case:

We filed her application for benefits in 2014, with an alleged onset date in 1/13, when she stopped working due to her conditions. A hearing was held in April of 2016, with the judge awarding her a partially favorable decision with an onset date of October of 2015- the date her neurologist completed a supportive medical source statement. I sought out the advice of an appeals attorney who reviewed her decision and strongly recommended appealing. After a discussion of the risks/benefit of appeal, the claimant decided to move forward with an appeal. There were several inconsistencies in the judge’s decision and little rationale for why he chose the date of a supportive opinion vs. her longitudinal treatment records supporting the opinion. It was appealed to the Appeals Council.

The AC remanded her case. Instead of being scheduled with the same judge from her prior decision, it was scheduled with a new judge (the prior judge was on military leave). The new judge denied her claim altogether and this resulted in the loss of her monthly benefits as well as an overpayment.  We were crushed.  I had never had this happen before, and we never imagined that this would happen.  I can’t count how many hours of sleep I lost agonizing about the outcome of her case.  My disappointment was nothing compared to the effect it had on her life.  She could no longer afford her apartment, so she and her daughter had to move into subsidized housing.  She went from receiving a substantial check every month to relying on county assistance.  

Clearly, this claimant went through a lot over the course of several years. Disability Specialists reached out to the original attorney who assisted with her federal court appeal but they declined to provide any additional help or guidance in this case. Disability Specialist then turned to Karl who accepted the case after hearing the case and the emotional turmoil it had caused the client. Amy adds, “I didn’t want to give up on this for her. I strongly felt that the judge made the wrong decision and that we could prove it. She was relieved that Karl agreed to appeal the decision to the Appeals Council. The denial was extremely upsetting for her, and she was glad to know that we were not going to give up on the claim- and that we would have Karl on our side.” After reviewing Karl’s appeal, the Appeals Council made a favorable decision and sent the case to an Administrative Law Judge who had never reviewed her case before.

Amy explains the procedural and emotional aspect of the new hearing:

I have been doing hearings for over 8 years, and I don’t think I have ever been as nervous about the outcome of a hearing as I was for hers. There was so much riding on this!  Another denial would be catastrophic for her well-being.  We just HAD to win. Her testimony was very compelling and she was extremely credible. The judge posed a hypothetical to the vocational expert for absenteeism at a rate of one day per week, including the need to leave work early or arrive late, and the expert said she would not be employable with this limitation. She further clarified that employer tolerance for absenteeism was 8-9 days per year. The judge stated that he felt this hypothetical was a true reflection of her limitations, and he would be awarding benefits! My client was relieved beyond measure.  This will improve her quality of life, allowing her to move into better housing and provide financial stability for herself and her child.

“I was really happy to hear from Amy; I ask all my referral sources to let me know how things turned out, and most probably get busy and forget, but it’s really awesome to hear that a case like this ultimately came out right. This is especially true when the claimant’s representative is someone I respect as much as Amy and her group at Disability Specialist. They are so committed to the best outcome for their clients, and consistently develop incredibly good records on their behalf. This makes the job of someone like me, coming along later and trying to demonstrate error in the judge’s decision, so much easier,” explains Karl. Amy adds, “I am extremely grateful for Karl’s assistance in this claim. I don’t know if we would have secured a second AC remand without his help. He knew exactly what issues to present to the AC to strengthen our appeal. I have helped thousands of clients in my 17 years working for Disability Specialists. This case is definitely one that I will carry with me for the rest of my career. I am glad she didn’t give up faith and trusted us to keep fighting for her.”

We commend Disability Specialists and representative Amy Pearson for truly advocating for their clients and we are happy to be a part of this success story!

OBL on FIRE: Three MORE federal court reversals with outright award of benefits!

A few months back my office had a run where we had obtained three federal court decisions which not only overturned a terrible ALJ decision, but also took the rare step of finding the ALJ’s errors so egregious that it ordered Social Security to begin paying our client benefits. Because by far the most typical outcome in a federal court appeal is a remand to Social Security for further proceedings, I remember saying at the time that I might not see another decision like it for a long time.

I’m happy to report that I was wrong; my team has managed to obtain three more reversals with an outright award of benefits just within the last 30 days. In California, our client’s case had been pending for almost 7 years, and she had not worked in over 10 years due to multiple medical conditions including fibromyalgia, diabetes, and degenerative disc disease. Moreover, because of the passage of time her date last insured had expired by the time of the ALJ’s second denial decision. The court awarded benefits, because it agreed that the ALJ had improperly ignored altogether (twice) the uncontroverted evidence demonstrating that she required a cane to walk and had wrongfully given little to no weight to the medical opinions of her rheumatologist, her PCPs (she had two during this very long stretch of time) and her physical therapist. The court awarded benefits outright, because of these errors and because, in its words, to remand for further proceedings would be to give Social Security a “mulligan.”

An Oregon district court considered the claim of our client, whose case has been pending over 6 years, and who is not worked in over 8 years, based on the ALJ’s failure to consider the VA’s finding of unemployability, inadequate analysis of treating source opinion evidence, and finding that her mental impairments were not “severe.” The court found especially compelling that the ALJ had given very cursory (and not even always factually accurate) reasons for rejecting the opinion of the claimant’s treating doctor, who had long familiarity with our client. Therefore, pursuant to the “credit as true” doctrine in the Ninth Circuit, the district court found that the treating physician’s opinion should have been found to be controlling.

Finally, in New York our client’s application was filed approximately 4 years ago, alleging disability based on severe depression and anxiety, in part related to concomitant gender identity disorder. The ALJ, possibly mistakenly, had adopted the RFC consistent with his first hypothetical assumption to the VE, but relied upon the VE’s response to the second hypothetical. At issue was the issue of “missed days”; in the first hypothetical the ALJ asked the VE to assume the claimant would miss work 2 days per month, to which the VE responded that this would eliminate all jobs. In the second hypothetical, the ALJ changed the assumption to missing only 1 day per month, and the VE testified that this would not preclude all work. But the RFC finding is that the claimant would miss 2 days per month. Although not strictly speaking, a federal court decision reversing and awarding benefits, the agency attorney contacted me and offered to remand the case to the Appeals Council, who will issue the favorable decision.

One of the most notable things to me about these decisions is that I personally had little to do with two of the three cases; rather, they were very capably handled by my supervising associate, Hannalore Merritt, in concert with other associates in my appellate department. It’s just literally true to say that we could not be as helpful as we are being (over 280 remands or outright reversals in the last 12 months) to folks in their last chance to obtain a fair decision in their Social Security case without the intelligence, compassion and commitment of our excellent team in the Appellate Department.

If you are a representative and would like to learn more about how we can help you obtain favorable outcomes for your clients, click HERE.

OBL on FIRE: OBL Win Results in Over $300,000 to Claimant

This case falls into the “it never hurts to ask” category. But, before you can ask, you really need to dig into a case, and Lindsay was very persistent with SSA about producing files related to applications for benefits the claimant told her he had filed in the distant past. Because she was so persistent and focused in her strategy for the case, she obtained evidence that SSA had actually found our client disabled in the late 90s (he never actually received any benefits because of excess resources). However, the finding of disability was made by SSA prior to our client’s 22nd birthday, a key date to establish that he was entitled to disability benefits based on his parent’s earnings record. Moreover, it had overlooked this fact when it had previously considered our client’s claim for these benefits in an application he filed many years ago.

Thus, Lindsay was able to convince the ALJ not only that our client was disabled on or before his 22nd birthday, but also that the previous application for benefits should be reopened because of the mistake made by SSA in failing to acknowledge and rely upon its own previous finding that he was disabled. As a result, he was awarded benefits based upon the much earlier application date and his past-due benefits are the largest amount OBL has ever obtained (or even heard of). Best wishes to our client, and big-time congratulations to Lindsay!

OBL on Fire: Allstate Overturns Its Denial of Benefits Under A Dismemberment Accident Policy and Awards Osterhout Berger’s client $100,000

Our client lost vision in one of her eyes and filed for benefits under her employer-provided Dismemberment/Accident Policy back in 2016.  After being denied numerous times she hired Attorney Berger and within weeks Allstate reversed its decision and awarded our client the maximum amount allowable under her policy – $100,000!

If you need help filing a claim for benefits under an Accident Policy or have been denied benefits Osterhout Berger will review your case free of charge. Call us today: 866.438.8773