October 23, 2019

Fibromyalgia Case Study 3

Claimant: A 46-year-old female

Occupation: Worked as a business consultant for a multinational consulting firm. Before disability, the claimant earned more than $100,000 a year

Education: The claimant has both a college degree and an MBA

Hearing information: The claimant applied for benefits in October of 2003 alleging disability as of June 9, 2003 (when she stopped working). The hearing was held in August 2007 in front of a California judge by video teleconference in an Atlanta North hearing office.

Background: The claimant, who formerly worked as a business consultant, is 46 years old and has a post-graduate business degree. As a business consultant, the client traveled extensively and frequently interacted with the senior executives of large companies. Despite being in a major car accident in 1991, she remained in pretty good health up until the late 1990s or so, some unusual symptoms began occurring.

In late 1999, my client started to have ongoing sinus infections and periods of unexplainable fatigue. She continued working, however, but within the next couple years started developing additional symptoms: namely, severe pain in her joints and upper back.

My client’s sinus infections were not healed by oral injections, so in late 2002, she  began taking intravenous antibiotics. With her recurring problems, the claimant found herself unable to meet the strenuous demands of her job. A client of hers actually requested that her supervisor remove her from a big consulting project at the time.  This was a first for the client, who was known in her fildl as a highly successful business consultant.

The claimant then started working from home, did that for a while, and then her problem worsened in June 2003 to include generalized body pain, worsening chronic fatigue, and severe headaches. Upon her physician’s advice that she should stop working, she took an indefinite leave from work to pursue medical treatment.

Since she stopped working in June of 2003, she has tried a number of different treatments. She visited numerous specialists including neurologists, allergists, pain management physicians, and psychiatrists. Despite her treatment, my client easily gets colds and infections. She also continues to experience pain, chronic fatigue, and severe headaches.

Although my client tried to volunteer at a an animal shelter in 2004, she was unable to stay for more than a few hours due to her condition. In order to care for my client, her mother moved to Atlanta and has currently stayed here for more than two and a half years.

Hearing Strategy: This is a classic fibromyalgia case. The client is a well-educated female with a Type A personality. A high achiever, she has done very well in her chosen career. The condition has been affecting her from eight to ten years, and she has been trying to find help from various doctors ever since the problems started. The claimant has an extensive medical history, which shows that she has visited numerous physicians and other specialists. My client has copies of all of her records and organized them, like many other fibromyalgia patients.

Unfortunately, fibromyalgia and chronic fatigue are not classified as listing impairments according to the Social Security Administration, which is why this case depended on both 1) functional capacity argument and 2) the claimant’s credibility. My client had several letters from different treating doctors that spoke for my client’s claim. A doctor who had treated 700 patients with fibromyalgia stated that in his opinion, my client’s symptoms were worse than 95% of fibromyalgia patients he sees. He was also willing to testify that as a result of severe pain and fatigue, the client could never hold a competitive job.

Since the Atlanta North hearing office has more cases than it can handle, my client’s case was assigned to a judge in California. The hearing was held through a video teleconference, and all parties could see each other over the big screen. There was a local vocational witness in the courtroom with us, and the judge had called a medical expert who testified over the phone. As a result of a bad connection or some other problem, the medical expert had a severe difficulty hearing me, and an even harder time hearing the client – who speaks softly. The medical expert had such a hard time hearing that the judge had to summarize my client’s testimony every few minutes for the medical expert. I kept in mind that if the ruling was unfavorable to us, that this would be grounds for an appeal.

After opening the hearing, the judge let me start questioning the claimant. I asked her various questions about her background including her medical history, past work, education, and lifestyle. I asked my client why she had not been able to work since June 2003, which was the onset date she had filed.

In her testimony, my client covered her various ailments and her medical history of headaches, body pain, chronic fatigue, chronic sinus infections. All of her medical problems and limitations were covered. Additionally, I brought attention to specific physical limitations, such as her inability to stand for more than ten minutes, to walk for more than twenty minutes, and the fact that she could only sit for an hour at a time. I also pointed out that she could not climb ladders or ropes and that kneeling was painful. Non-physical limitations including poor concentration, fatigue, and memory problems were also covered. In a testimony lasting 30 minutes, all of her problems were reviewed.

Then the judge asked the medical expert to summarize his evidence. The medical expert did not seem impressed and made comments that indicated he did not value the opinion of the physicians who had diagnosed the problem.

The judge asked the medical expert for a diagnosis on the severity of the claimant’s condition. The medical expert expressed his opinion that he did not think fibromyalgia or chronic fatigue were serious problems. He thought that they were merely elements of depression used by people for “secondary gain.” The judge pointed out that the claimant had been making over $100,000 each year, so there was no reason for her to quit working in order to get at the most $2,000 each month from Social Security. “Secondary gain,” in this case, was not a question!

The medical expert admitted that the primary diagnosis was chronic fatigue and fibromyalgia, but he could not say how severe the condition was or whether she actually experienced any pain.

When I was allowed to cross-examine the medical expert, I asked if there was anything that would suggest the claimant was looking for secondary gain. He admitted that was not the case. Then I used the letter from the client’s physician showing him the part where the doctor thought this was one of the worst fibromyalgia cases he had seen. I asked if he thought the physician who wrote this thought the client’s condition was debilitating. Although he tried to avoid the question, the medical expert was forced to admit that the doctor seemed to believe his patient.

After the judge excused the medical expert, he had the vocational witness testify regarding my client’s former job. Then he closed the hearing.

The judge did not announce his decision then and there, which is quite common in a Social Security case. I reassured my client that I was 95% certain that the ruling would be favorable. Not only did the doctors fully support my client, but there was also not contradictory evidence. Additionally, the claimant did a good job testifying. The judge also admitted himself that he could see no reason why a well-paid businesswoman would apply for small disability checks.