Summary: this case involved the claim of a 50 year old woman with bilateral carpel tunnel syndrome, a bulging disc in her neck, arthritis in her right foot, left knee and back, and urinary incontinence dating back 15 years. She also experiences symptoms of depression.
Client profile: 50 year old female
Education: high school + 1 year (of a 2 year program) in a criminal justice vocational program
Past work: 20+ years for the same employer as a scheduler, a benefits manager and a customer service representative
Claim background: my client filed for benefits in May, 2010 alleging an onset date in September, 2009. This case was heard before a live administrative law judge in February, 2012. I have tried many cases before this judge and I have always found him to be fair and even-tempered and about average in terms of his tendency to approve cases.
Factors in our favor:
- My client has a long and consistent employment history – 20+ years with the same employer
- The medical record shows treatment for carpel tunnel syndrome for more than 5 years
- The medical record documents that my client underwent surgery on her right foot around 10 years ago and continues to have problems with pain where the tendon was attached too tightly.
- My client’s allegations of depression are documented by psychiatric treatment records.
Factors not in our favor:
- My client filed a workers compensation case for her carpel tunnel so many of the medical records describing this condition display an anti-employee bias and minimize the seriousness of her condition.
- The physical consultative evaluation describes only mild limitations.
My strategy: when I met with my client for her pre-hearing conference, it was obvious that she was in a great deal of pain, both in her hands and in her back and legs. I saw this case as one of chronic pain in the hands, legs, back and foot. Chronic pain causes problems with attention and concentration, focus and pace in any work setting. The depression appears to be a consequence of living in chronic pain. I felt that the best strategy here was to paint a picture of hardworking person who lives with chronic pain that prevents her from functioning due to the multiple locations of the pain and the residual effects – notably depression and fatigue.
Hearing Report: the hearing opened with the judge introducing himself and the vocational witness. The judge did not ask me to make an opening statement and he started the hearing by asking my client about background information. I got the sense that my client was somewhat nervous at first as some of her answers were less complete than what she had told me in our meetings. For example when the judge asked her why she could not work, my client talked about the pain in her hands and her foot but did not discuss her depression or incontinence issues.
Fortunately the judge seemed to understand this and he asked a number of more leading questions to help my client get information out.
The judge then turned the questioning over to me and I asked specific questions about the hands, the back, the left knee, the neck, depression and the incontinence. My client and I had gone over these areas the week before during our pre-hearing meeting and again that morning prior to the hearing and she did a good job giving me specific answers and painting a clear picture of her struggles.
I made sure to ask my client about her need to take multiple and frequent bathroom breaks and I asked her if not being able to work was frustrating and she testified about how depressing and upsetting it was for her not to be able to work.
After I finished my direct examination the judge turned to the vocational witness and asked him to identify my client’s past work, which he did as:
- scheduler – sedentary, semi-skilled
- benefits assistant – sedentary semi-skilled
- customer service rep – sedentary, skilled
The judge then asked the following hypothetical questions:
I. Assume a person of the same age as the claimant with the same education and work background. Assume further I find that she can perform light work with the following limitations:
- limited to simple and detailed tasks
- she should have a reduced level of interaction with the general public and co-workers
- her work tasks should contain no ambiguity
- climbing, stooping and bending are limited to occasional
- overhead reaching is limited to occasional
- repetitive pushing, pulling, gripping and grasping is limited to occasional
- she has no dexterity limitations
A: Based on these limitations, this person could return to her job as a scheduler
II. Assuming I find the claimant’s testimony credible, are there any work limitations that arise from her testimony and, if so, what are their implications in terms of work
A: The claimant identified a number of limitations:
- weakness in the hands – this would preclude the use of a computer
- no handling and gripping – this would preclude jobs that require handling and fingering
- her schedule of sitting for 20 minutes then standing and walking for 10 would cause undue interruption in the worksite
- her panic attacks would cause her to leave the work environment and thus take too many unscheduled breaks
The judge then asked me if I had any questions.
I asked the vocational witness if the claimant’s need to take a restroom break every 20 to 30 minutes would be a problem. The VE testified that such a schedule would result in too many unscheduled breaks and would preclude all work.
Conclusions: based on the judge’s questions, it appears to me that he will award benefits in this case. If he intended to deny he would have asked hypothetical questions of the vocational witness that included mild limitations based on the complaints testified to during the hearing. The absence of multiple questions from the judge suggests to me that he found my client believeable. I can only see him denying this case if he did not find my client credible at all, which I think is unlikely.