Can this Case be Won?

This feature appears from time to time as a means of illustrating the challenges that many applicants for social security disability benefits experience, in their efforts to be approved. Cases are derived from actual clients but their names, details and key facts are changed to protect privacy.

“The worst part was when I read what they said about me in the denial—that I was lying.  I didn’t ask for this to happen to me.  I didn’t ask to have MS.  It’s not my fault that I need help.”

If you passed Jenny on the street, you wouldn’t know that she has Multiple Sclerosis.  She’s 30 now, but she was diagnosed in her mid-20s.  Jenny had always been a hard worker and even after her receiving diagnosis, Jenny kept working.  Her job involved sales, which meant that she had to think quickly to close deals.  Before she got sick, she was very good at it.  After she got, sick she started to struggle.  Over a period of time, her thinking got foggy and she lost the ability to closely track conversations.  Her sales numbers took a dive.  Eventually, Jenny was terminated.  When she was terminated, she lost her health insurance. Consequently, she went nearly two years without regular medical care.  During that period of time, she applied for social security disability.  Jenny was denied twice.  Then, she came to us.

The lawyer’s view

Jenny’s case posed some difficult challenges.

Jenny was not receiving regular care for a period of about 2 years because she had lost her insurance.  A well-prepared case tells the judge a story about the claimant’s life.  There should be no gaps in the story, and the story should raise no unanswered questions. The primary tool that a lawyer uses to tell a social security claimant’s story is her medical records.  Unfortunately, Jenny’s story had a big hole in it, because there were no medical records for the most relevant period of time.  Moreover, most of Jenny’s records were from a period of time when she was not disabled because she was working.

What happened?

Nearly two years after first applying, Jenny was finally in front of a judge.  Her lawyer had consulted with her doctors about the medical records that did exist and had briefed the judge and a medical expert–whom the judge had called upon to testify–about Jenny’s condition and the gap in her medical records.  The medical expert agreed with the attorney’s brief that, despite the gap in treatment, Jenny’s medical records showed that she was disabled.  The judge accepted the medical expert’s testimony.

We won the case.