Marcella Myer, who is 52, was a clumsy child. Not that she remembers it that way. She shook her head when I asked if she ever felt there was something wrong with her. But her mother remembers. "She used to fall in the middle of the floor," said Delorse Knehans. ...She has lived with her mother her entire life. She never married. After graduating from Lutheran South High School, she worked at a gas station and then in nursing homes. Then she got a job in the warehouse at Famous-Barr, which, of course, became Macy's. She lost that job in 2008. She told me she just couldn't keep up anymore.
By that time, Lisa [her niece] had noticed [Marcella's] condition deteriorating. Her gait was becoming increasingly unsteady. Her speech was slurred. She has been diagnosed with cerebral palsy. ...
Lisa suggested she apply for Social Security disability. "You just can't work any more," she said.
Marcella applied for disability. She was turned down. She had a hearing on that denial in March of this year.
Attorney Jeffrey Swaney was at the Social Security office representing another client when Marcella's case was called.
"I was sitting in the waiting room when they called her. I knew it was an appeal, and I remember thinking, 'How could this woman have been denied?' You could see she was profoundly disabled," he said.
Later that afternoon, Swaney got a phone call from Lisa. She had seen his ad in the Yellow Pages about Social Security disability claims.
"She said her aunt had just had an appeal and had been denied and she started describing it, and I said, 'I was sitting right behind you.'"
So Swaney took the case. He said the problem was a lack of medical documentation.
Incidentally, by this time, Marcella had suffered a series of strokes. She had difficulty speaking. She had to use a cane to walk.
A hearing was scheduled for August.
By then, Marcella was in the nursing home. A doctor from the nursing home wrote that she would never be able to return to the second-story condominium. Lisa and Marcella felt confident that Marcella would finally be approved for disability.
The administrative law judge declared there was not enough information upon which to base a decision. He gave Swaney 30 days to gather more information.
Swaney told me he sent in the additional information this past week. He said he felt optimistic.
I visited Marcella on Friday. Because her speech is slurred, Lisa was there to help interpret for me. Marcella said she has gone through her entire savings since she last worked two years ago. After she exhausted her savings, she began living on a credit card. She is about maxed out, she said. ...
When I got back to the newspaper, I called Swaney. I said I was surprised the judge needed more medical records. Marcella clearly seemed disabled to me, I said.
"If she's faking it," he said, 'she should be an Academy Award-winning actress."
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Sep 28, 2010
And Some People Think It's Real Easy To Get On Social Security Disability
From Bill McClellan's column in the St. Louis Post-Dispatch:
Why should 50-60+ year olds who have a salary of $100,000+ care?
ReplyDeleteThat's a sad question but one worth considering.
As any caring person would, I feel very sorry for Marcella. There are a number of situatons though, when medical documentation that is submitted to SSA is inadequate. I hope all of you who represent these individuals do everything you can to ensure that the complete documentation is submitted the first time so that this type of situation doesn't happen.
ReplyDeleteThis is an embrassment to the Agency. The woman is in a nursing home, had a stroke has been diagnosed with cerebral palsy. She is 52 years old and her past relevant work sounds like it was at least light and most likely medium. Based on her inability (at a minimum) to walk without considerable difficulty, I would say she is limited to sedentary and would grid out. Judge, you should be ashamed of yourself.
ReplyDeleteyou should never rely on a newspaper to get the full story on an SSA disability case. there are many issues we don't know here: onset date issue, T2 vs. T16, adverse credibility factors, etc. even if she may be disabled now, an alj has to adjudicate the entire claimed period and balance all the facts.
ReplyDeleteAnon4,
ReplyDeleteI will concede that newspapers may not always get the facts straight or the backstory technicalities. However, in this case it stated that the ALJ wanted more medical records. There is too much of a jaded view on the Agency's part and this is one example of it. If the facts as stated are true, than the Judge should be ashamed of her/hiself.
"You could see that she was profoundly disabled." Is that all it takes? All the judge should have to do is look at somebody? What about regulations that require, yes, require medical evidence to support the claim, apparently lacking in the case. No shame here, just a judge doing the job he/she was sworn to do.
ReplyDeleteI agree with Anon#6. She had savings, so SSI might not have been at issue and there might also be a Title II DLI or retroactivity issue.
ReplyDeleteBesides, when folks in our business start making judgements based upon appearances, bad things happen.
For instance, we had a case early last year where the guy was "profoundly disabled" too -- he was confined to a wheelchair and communicated only in grunts, and was totally dependent upon family members to take care of him.
Only, the DDS examiner discovered a little discrepancy in his medical records. She referred the case to the CDI unit for investigation. On the day OIG agents tracked him for an informal interview, he was texting his girlfriend on his Blackberry while walking from the gym to his borrowed car after his daily workout. Suffice it to say the case didn't get paid, thankfully. However, if the examiner had gone on appearances alone, it would have been paid.
In this business, you can't take anything at face value. Which is why we have the regs in the first place to protect both the claimants and the taxpayers. Maybe this claimant is truly disabled - she wouldn't be the first that we've seen that literally forced themselves to work despite a serious medical condition. Of course, she could also be like the other claimant I described, too.
I cannot believe that there is a rush to defend this decision. The woman was a patient in a nursing home,she had a stroke and was diagnosed with cerebral palsey. Are you alleging that the documents that were already submitted were a fraud? There are too many mean spirited ajudicators from the DDS on up. The story clearly said "more medicals" so there was medical evidence. The ALJ could always recommend a CDR after a year. Further people are denied on their appearance, what say you about that? If it was your family member I bet you would have a totally different slant.
ReplyDeleteAgreeing agin that the newspapers rarely give the whole story, but looks like she only recently had the nursing home admission. Was any evidence submitted that would support the alleged onset? "Mean spirited?" The judge hasn't denied her- he's given the attorney 30 days to get the job done that he should have done before he went to hearing. And he's told the attorney what he needs to submit so the judge can pay the case. Just pay it (so you look good) and recommend a CDR so somebody else can do the work? That would be completely irresponsible.
ReplyDelete