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Communication Rescues Claim

October 31, 2017

Sometimes the long wait for a hearing can be put to good use.  Jessica Woodhouse of the Bath office of LawNY used the eight months between meeting her client and his hearing to coach him on how to better communicate with his medical sources, resulting in a fully favorable decision.

When Jessica first reviewed the claim, she was prepared to reject it.  The claimant’s seizures did not occur frequently enough to meet the epilepsy listing, and there were repeated references in the records of his failure to take his anti-seizure medication.  Nor had  he pursued recommended shoulder surgery.  But when Jessica met the 40-year-old claimant, she learned that many of the problems stemmed from his lack of communication with his medical providers. He had been afraid to undergo shoulder surgery because his neurologist and orthopedic surgeon had not communicated with each other about how to control his seizures post-surgery.  He had stopped going to appointments, frustrated by his failed attempts to get his providers to listen to him.  He also ascribed his forgotten medications to severe short-term memory problems: seizures were “rotting his brain.”

Jessica encouraged her client to attend his appointments, and suggested ways in which he could articulate his concerns to his doctors so they would be   reflected in the medical records.  Although the orthopedic surgeon was not responsive, the neurologist became much more helpful.  He started the client on new medication, which unfortunately also proved ineffective, but was well-documented.  He also referred the client for an independent cognitive evaluation that revealed significant short-term memory and executive functioning deficits.  Ultimately, the neurologist wrote a letter to the ALJ supporting the claim based on the claimant’s breakthrough seizures.

With the updated medical evidence and testimony, including testimony by the claimant’s girlfriend who had witnessed his seizures, the ALJ crafted a very limited residual functional capacity.  Even though the ALJ limited the claimant to light work, he found many other exertional and non-exertional restrictions based on the claimant’s shoulder problems, intermittent seizures, and cognitive deficits.  The addition to the RFC of “unexpected, unanticipated and unpredictable periods of off task time 3-12 times a year which would require basic first aid level attention and a period of convalescence totaling up to 75 minutes and that would interfere with the ability of co-workers in close proximity to perform their jobs” led to a response of “no jobs” from the vocational witness.

Jessica clearly went the extra mile and beyond, resulting in a favorable decision and ultimately better medical care for her client.

 





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