Back Pain and Doctor’s Report Lead to Win on Appeal

Back Pain and Doctor’s Report Lead to Win on Appeal

After working for years, a woman with a long history of lower back and leg pain filed for disability more than three and a half years ago. Even though she had pain sitting, pain standing, numbness, a limited ability to walk, and a limited ability to sit, she was denied benefits after a hearing. Disability Alabama filed an appeal on her behalf asking for a new hearing, and the Social Security Administration gave up without waiting for an order from the judge. After reading Disability Alabama’s argument, the Social Security administration agreed they had made a mistake, and that the claimant should get a new hearing.

A Helpful Doctor’s Report

Sometimes your medical records will be full of reports and opinions sufficient to tell Social Security the nature and extent of your disability. However, if you’ve been unable to get the help or specialists you need Social Security is likely to send you to one or more of its own doctors for an examination.

In this case, the claimant was seen by Social Security’s doctor. The doctor wrote a report that was very helpful and which favored granting disability benefits. However, the Administrative Law Judge (ALJ) basically chose to disregard the report. On appeal, the claimant was able to argue that the ALJ didn’t pay enough attention to their own doctor’s report.

A Missing Doctor’s Report

The claimant was sent to a second doctor, a specialist. However, she was never able to attend the visit. If you don’t attend a scheduled doctor’s visit Social Security can penalize you and sometimes deny your claim. In general, you need to attend appointments and doctor’s visits scheduled by Social Security.

However, in this case there was good reason for not attending the doctor visits. The first specialist assigned was someone with whom the claimant had a history. She refused to visit this particular doctor because they’d harmed a family member. When an alternative doctor was assigned, the claimant was given the wrong time and address. Then instead of rescheduling, Social Security tried to send the claimant back to the first doctor - with whom she had the bad history.

On appeal, the claimant was able to argue that she was being wrongfully penalized for not attending the specialist appointments, even though she had good cause not to do so. The ALJ should have ordered a new specialist appointment before ruling on the case.

Claimant Wins But Must Endure More Waiting

The claimant in this case has been waiting over three and a half years for their claim to be approved. Part of the wait is a result of the slow-down caused by the COVID pandemic. However, even in the best of times, disability cases can take a long time to be approved. Although some waits are inevitable, the best way to shorten the time it takes to get approved is to get help from a Social Security disability lawyer sooner rather than later.

In this case, the Claimant will still likely have several more months of waiting before they get a new hearing.

How To Get Help With Your Appeal

Your claim isn’t necessarily over when you lose your hearing. You need to talk to a lawyer about an appeal. If your claim is in Alabama, give Disability Alabama a call or fill out our contact form. We’ve got a history of fighting and winning appeals.