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Case Summaries

Osterhout Berger Disability Law > Case Summaries (Page 9)

Claimant Awarded $180,000 following Federal Court Remand

In this case, which I inherited after the claimant’s previous attorney discharged her, we successfully argued before a West Virginia district court that the ALJ had failed in numerous respects, including a failure to follow the agency’s protocol for evaluating pain cases (which, ironically, had its genesis to a great extent in several Fourth Circuit decisions in the 90s); failure to appropriately evaluate the opinion evidence which, in this case included several well-crafted treating source opinions, as well as two consultative examiners whose opinions generally supported the claimant’s claim. Because it seemed like every delay that could occur in a case occurred in this lady’s case, by the time we were before the ALJ on remand it had been six years, the claimant was a high earner and had two beneficiaries, resulting in the significant amount of pass to benefit she was awarded following the remand hearing.

Claimant Awarded $49,000 Following Remand

April 12, 2015. This case was remanded by the Eastern District of Michigan District Court to reconsider the ALJ’s nonsevere migraine headache finding, and to provide a legally sufficient discussion of the claimant’s longtime treating physician’s assessment of her mental and physical disabilities. At the supplemental hearing the ALJ offered a fully favorable decision in exchange for an amended onset date to the claimant’s 50th birthday (which claimant’s previous representative had actually suggested in a prehearing memorandum prior to the initial hearing), and the ALJ ruled from the bench in her favor.

Claimant Awarded $80,000 Following Remand.

April 17, 2015. In this case, this Maryland claimant obtained a fully favorable decision from the ALJ following a remand in which we successfully argued that the ALJ had improperly rejected the retrospective opinion of a longtime treating source that the claimant’s medical impairments predated the physicians actual treatment of the claimant, even though the claimant did not begin seeing the physician until after his date last insured. On remand the ALJ scheduled a medical expert to testify at the hearing, who confirmed that the claimant’s muscular sclerosis is historically a difficult condition to diagnose (essentially, a “diagnosis of exclusion”) and that the opinion of the treating neurologist was a reasonable one based on his review of the record; the ALJ ruled in his favor from the bench.

Texas District Court Reverses ALJ

April 21, 2015. In this case, on referral from a Texas law firm, we successfully argued that the assessments of plaintiff’s treating psychiatrist, SSA’s consultative examiner, and the underlying record did not support the ALJ’s RFC finding which excluded any social functioning limitations. Specifically, the consistent opinions of both medical experts described her ability to function socially as “poor”, or as “markedly limited”, opinions which were expressly supported by repeated mention in the medical records of her extreme social anxiety with obvious physical manifestations of same, including frequent crying, shaking, nervous tics, etc. The court remanded, over SSA’s objections, for rehearing.

Pennsylvania District Court Reverses ALJ

April 21, 2015. This case turned on the fact that in the Third Circuit SSA has agreed to be bound by these Third Circuit Court of Appeals decision in Sykes v. Commissioner, which held that except in very narrow exceptions, an ALJ must consult a vocational expert in the presence of nonexertional limitations (in this case, postural limitations and partially because of undiscussed mental limitations). Here, the government agreed to remand once advised of the Sykes violation.

Claimant Awarded $42,000 Following Remand

April 17, 2015. We had obtained a remand from the Massachusetts District Court last year on the basis that the ALJ had failed to give appropriate weight to the opinion of her treating rheumatologist and had failed altogether to discuss confirming documentation from her long time chiropractor. Also in this case, the court found convincing our argument that the ALJ had improperly ignored the fact that the claimant had worked for 29 straight years prior to her alleged onset date of disability when finding her not credible. At the hearing, we made a minor adjustment to the alleged onset date, to correspond to her achievement of age 55 and the ALJ ruled from the bench in her favor.

North Carolina District Court Reverses ALJ

April 17, 2015. Here the ALJ had found the claimant’s mental impairments to be “not severe” even though the treating source, the consultative examiner, and the state agency consultant all found mental impairments to be severe and result in at least some mental work limitations, and the district court remanded for further proceedings. Surprisingly, the government defended this case (although, maybe not so surprisingly; my opinion is that they did so because the Western District of North Carolina District Court tends to affirm virtually 100% of the time – – the government’s brief in response to mine was a jumble of evasions and half-truths, rather than anything like a direct response to the actual legal arguments).

Virginia District Court Reverses ALJ

April 16, 2015. In this case, the Appeals Council had rejected in one boilerplate sentence 150 pages of medical records as not being “material” to the ALJ’s decision, despite the fact that the missing evidence (which the claimant’s previous representative had explained to the ALJ she was having difficulty getting, and had asked for additional time after the hearing to obtain it – – which the ALJ denied) was relied upon in part in the ALJ’s decision as a basis to find that the claimant’s complaints were not credible. We successfully argued that the evidence were material and, in fact, SSA agreed voluntarily to remand the case to consider the evidence.

Claimant Awarded $120,000 Following Remand

April 11, 2015. We were able to obtain a remand for this claimant about six months ago in the Eastern District of Michigan based upon a flawed step 4 finding that claimant he could perform his past work as actually performed, and where the ALJ had failed to obtain any vocational expert testimony with respect to whether the job was performed differently as generally performed. In particular, the ALJ asked the claimant one or two questions at the hearing about his past job in the auto industry, and relied upon those two answers to find that the claimant’s past work was light work as actually performed, without considering the expanded explanation the claimant had provided on the Work History Report. On remand we had obtained a vocational report which 1) opined that the claimant’s past work as actually performed was medium and, significantly, 2) that this was also how the job was performed generally, contrary to the DOT description. Once the vocational expert at the hearing readily agreed that the job was medium AAP and AGP, the ALJ found in the claimant’s favor with a slight modification of the onset date. Since the claimant’s was awarded benefits with an AOD of March 2010 and a PIA of over $2000 per month, he will receive approximately $120,000 in PDBs.

Minnesota District Court Reverses ALJ

March 30, 2015. In this case, referred by a nonattorney representative firm, we successfully argued that the ALJ had failed to notice or discuss the claimant’s impending 55th birthday (three months) as of the date of her last insured. The Eighth Circuit has fairly detailed holdings on the subject of “borderline age situations”, Phillips v. Astrue, 671 F. 3d 699, 704 (8th Cir. 2012), which supported our position that the ALJ’s complete failure to discuss the issue was sufficient cause for remand; however, we were also able to show that the record established significant “vocational adversities”.