Disability Claimant in Small Explosion Wins Appeal

Disability Claimant in Small Explosion Wins Appeal

Disability Alabama recently helped a client with their federal court appeal. The client was injured in a small explosion that left him with burns, pain, and difficulty moving about. When Social Security denied his claims and administrative appeals, he sought help from a federal court in Alabama and won a new hearing and a second shot at proving his case.

Appeals After a Hearing

When a Claimant is denied disability benefits after a hearing they can choose to drop their claim, file a new application, or appeal. Here the claimant took the next step in the appellate process and asked the Appeals Council to review his case.  When the Appeals Council declined, Disability Alabama stepped in to file an appeal with the federal district court.

A Multitude of Ailments

Having survived an explosion, the Claimant had a host of ailments, especially burns. Burns can cause a number of problems. Amongst those at issue here were how the burns restricted the claimant’s movement, and the continuing pain they caused. When reviewing whether someone qualifies for disability, any restriction in movement - especially in your arms, legs, or hands - can make it that much more difficult to find and keep work. Similarly, chronic pain can also keep otherwise willing and able bodies out of the workforce.

Failure to Comply with Treatment

Always try to follow a doctor’s instructions. It is of utmost importance that Social Security claimants follow the treatment plan prescribed by their doctors. If you fail to do what the doctor says - by taking medication, doing exercises, or getting help - your disability can be denied. If a judge decides you might have been able to work if you’d only followed your treatment plan, they’re going to deny your claim.

In this case, the Administrative judge tried to do just that. The ALJ faulted the claimant for not having done exercises to restore function to extremities that had been burned. Fortunately, on appeal, the Court took notice that there was no evidence the claimant had ever received instructions to do the exercises he was faulted for not doing.

Administrative Law Judge’s Mistake

In the end, the ALJ’s error was a legal one. The Social Security judge had disqualified the claimant based on a purported failure to follow prescribed treatment. In particular, the claimant was faulted for not doing exercises after leaving the emergency room. As described above, the claimant challenged whether he had ever been told to do exercises.

Whether he was told or not, the Social Security judge put the cart before the horse by disqualifying the claimant for failure to follow a doctor’s orders before determining whether the claimant was disabled. In doing so, Social Security misapplied the law to the claimant’s case.

Because of the ALJ’s mistake and the Court’s ruling, the claimant will now get a new chance to prove his case. Except for this time, he’ll have the benefit of more time, medical records, and experience to prove his claim.

Success on Appeal

If your disability case is denied after a hearing, that does not necessarily end your case. In fact, you can take the next step in the process online - though it helps to have an attorney’s help. If the Appeals Council denies your claim you have 60 days to plead your case to a federal judge.

Where to learn more:

  1. If you want to learn more about this case, you can read the federal judge’s decision here;
  2. Read more from Social Security about how the appeals process works;
  3. Use Disability Alabama’s disability calculator for an estimate of your benefit. While you do not need any special information to complete the calculation you may want to take a moment to think about your average yearly income and current household income before using the disability calculator; and
  4. Contact Disability Alabama to ask how we might help with your appeal in Alabama.