At 37 years old, Michelle had stopped working as a teacher due to complications with gastro paresis and rheumatoid arthritis. Gastro paresis is a disease that prevents her stomach from correctly digesting food. Because her stomach muscles did not work properly, she could not digest food. Michelle contacted me in May of 2015. She came into the office with her mother because she needed to file for Social Security Disability. Quickly into the conversation, Michelle and her mother made it clear that her debilitating disease was the gastro paresis from which she had no relief.
She suffered from intractable nausea and vomiting daily. She could not keep food down. Over the course of our two-year representation, she was hospitalized nine times in 2016; six times in 2015 and ten times in 2014. By 2016, she received all of medicine and nutrition through surgically implanted gastric port called a GJ- tube for short. Her days consisted of infusing a specialized high protein prescription formula and medicine into two different ports; cleaning the ports after use; and dealing with some very difficult bathroom issues. If she was not in her bed, she was in the bathroom, resting on the cold tile floor for relief from her nausea.
One would think that Michelle’s case would have easily been approved at application. It was not. In May of 2015, we filed an online application for Michelle and sent in a mountain of medical records. We continually faxed over medical records to SSA and spoke with the adjusters each time Michelle entered the hospital. Despite her ten hospitalizations in 2015 and favorable doctor’s statements, the disability review team at the SSA determined that she could stand and walk and lift and carry as necessitated by her job as a preschool teacher and her claim was denied.
We requested reconsideration of this denial in September of 2015 and that was denied again in March of 2016. In the time period from September of 2015 to March of 2016, Michelle had five additional hospitalizations. Her disability file indicates that the second level of review was denied because during one hospitalization, the treating doctor prescribed Humira (a drug to treat her rheumatoid arthritis) and the reviewing SSA doctor thought that would work and she would improve. Also, the reviewing team ignored her treating doctor’s statements that she met a medical listing. A medical listing is a list from SSA of conditions that are considered to be disabling. Continue reading →