August 20, 2019

Fibromyalgia Case Study 4

Claimant: The claimant is 53-year-old female

Occupation: The client was a medical transcriptionist who worked from home. Before her disability, she earned between $25,000 to $30,000 a year.

Education: high school graduate.

Hearing information: The claimant applied for benefits in April 2005, alleging an onset date of November 28, 2004 (when she stopped working). A judge oversaw the hearing in the Chattanooga hearing office in Chattanooga, Tennessee in October 2007.

Background: The client was a high school graduate, 53 years of age, who worked as a medical transcriptionist. This type of work is considered semi-skilled and requires heavy use of the hands (for typing).  Although she worked from home, she did have to log into a system which monitored her hours and productivity. I made sure to highlight the accountability associated with her job during the hearing.

Analysis: Although the client was diagnosed with fibromyalgia as far back as 1993, she was able to deal with the pain and fatigue and continue to work. She also had surgery in 2003 on her heart, in which they replaced a defective mitral valve. In 2004 and 2005, she had surgery on her heart again installing two stents.

The client informed me before the hearing that she was not having any significant problems with her heart condition at present. The only side effect of her medications was easy bruising as a result of taking a blood thinner. The client also told the judge that her cardiac problems were not an issue currently. A client admitting that a medical issue is not a current problem increases the claimant’s credibility. Admitting that a problem is currently under control impresses the judge because it shows honesty (most people tend to think that the more problems you bring up to the Judge, the better your chances. This is not always the case).

During the hearing, the judge only asked a handful of questions about the claimant’s fibromyalgia, and he only let me ask a few questions. The judge then called the vocational witness to testify after the claimant told him that the pain was mostly in her hands. First, he asked the vocational witness to classify the client’s previous work. The witness testified that being a medical transcriptionist was a sedentary, semi-skilled job. The judge also wanted to know any transferrable skills the client possessed. The expert said that the claimant was capable as a data entry clerk, credit card processor, and typist, all of which were sedentary and semi-skilled.

When the judge asked whether the client could continue working if her fingering skills were limited to what is called “frequent,” the vocational expert testified that she could not work as a medical transcriptionist, typist or data entry clerk because all of those jobs required “constant” fingering. The claimant still could work as a credit card processor because it only required “frequent” fingering.

The vocational witness was asked to evaluate the functional capacity form that we had submitted (before the hearing, I had gotten the client’s primary doctor to complete a fibromyalgia functional capacity checklist). This form ad a number of limitations, including the claimant having to walk for 15 minutes every 90 minutes, needing a job that allowed to her to sit or stand at will, and being incapable of working 8 hours without lying down.

After reviewing the form, the vocational witness said that, in his opinion, according to the limitations on the functional capacity form, there were no jobs the client could perform. The deciding factor was that the client would have to take a 15-minute break every hour and a half. Based on this, we were able to get a favorable decision.

Conclusion: In my opinion the claimant was credible as a witness because she was honest regarding her cardiac problems and her age and appearance also made a good impression. The judge looked at the evidence regarding how he could fit it into a positive decision after he had received a favorable impression of the client. In the decision, the judge referred to the functional capacity form. The case had all the evidence; I just needed to put it into the from preferred by the Social Security Administration.