Because you are disabled.

File for disability benefits.

Appeal your case.

How you presented your initial application was the best you could do at that time given what you knew and were told.

But, if you were not successful, appeal (1) because you are disabled and (2) because you can improve on your presentation.

Thursday, March 6, 2014

Degenerative Disc Disease and COPD

On appeal the only issue the claimant raised was that the Administrative Law Judge had erred in “not finding that plaintiff’s degenerative disc disease at L4-5 and her COPD combined to meet or equal a listed impairment.”  The claimant was not represented at her hearing, but had counsel for the federal court appeal.

In the five-step sequential evaluation of disability, at step 3, Social Security considers whether a claimant “meets or equals” a medical condition set out in the rules.

The claimant’s medical evidence included a December, 2009, MRI which “showed a herniated disc at L4-5 with compromise of the exiting nerve root.”  In an office visit in February, 2010, the doctor reported that the claimant “had a normal gait and was able to toe walk, heel walk, squat and arise, hop and get on and off the examining table with no difficulty. . .  . She had some limitation of the range of motion of her lumbar spine. Straight leg raising was negative in both the sitting and supine positions.”

In its confirmation of the ALJ decision, the court quoted the most relevant listing for the claimant’s back pain, Listing 1.04.  [See, 20 C.F.R. 404, Appendix 1 to Subpart P of Part 404—Listing of Impairments. 1.00 Musculoskeletal System.] The court stated that: “the evidence falls far short of establishing that plaintiff met all of the requirements of Listing 1.04A. There was no evidence of a neuro-anatomic distribution of pain. Listing 1.04A specifically requires evidence of positive straight-leg raising test in both the sitting and supine positions, which is absent here. Further, there is no evidence of motor loss, muscle atrophy, sensory loss or reflex loss.” 

The court did not discuss whether the impairments equaled a listing.  For the ALJ to find that the claimant equaled a listing, a medical expert testifying at the hearing would have had to say as much.  [See 20 C.F.R. 404.1526; Social Security Ruling 96-6p.]


Doctor’s notes will include observations on how a person entered an examination room and whether the person had any difficulty getting on and off an examining table.

The court noted that the claimant submitted additional medical records to the Appeals Council, but it could not use them as a basis for finding that the ALJ (who had not seen the records) had committed reversible error.

Williams v. Commissioner of Social Security, Civil No. 13-cv-492-DRH-CJP (D. S.D. Ill., Jan. 8, 2014).

No comments:

Post a Comment

Thank you for your comment. Comments may be edited. Only general interest comments will be posted. Please do not include personally identifiable information about anyone's actual Social Security case in your comments.