Appeals Council Success

Long Journey Goes to Appeals Council

Debbie Wins Benefits Where Only 2 Percent Do

Only 2 percent of cases that go to the Appeals Council result in favorable decisions. Debbie, represented at the Appeals Council by Attorney Neil H. Good, is one of those 2 percent. Her case took more than three years, plus the appeal to the Appeals Council in Falls Church, Va., but Debbie, 61, is now receiving Supplemental Security Income benefits.

In connection with the request for review, the Appeals Council received additional evidence and arguments from Attorney Good. The council also obtained a memo from a medical consultant with a specialty in neurology, who reviewed the evidence in the record at the request of the Appeals Council.

The Appeals Council agreed with the Administrative Law Judge that Debbie’s severe impairments do not meet or equal in severity an impairment in the Listing of Impairments. However, the council said it disagreed with the ALJ’s finding that she could return to her past relevant work as an office manager. “This job is not consistent with the claimant’s assessed residual functional capacity,” the council said in its decision.

Debbie has a long history of low back, knee and hand pain, plus vertigo. She also had decreased range of motion. A neurological examination showed she had left median neuropathy with decreased grip strength. Other issues included hypertension, under control; hypercholesterolemia, on medication; hypothyroidism, on medication; a history of peripheral vascular disease and right carotid replacement; and morbid obesity. Subsequent evaluations showed evidence of carpal tunnel syndrome.

An examination performed following the unfavorable decision at the hearing level revealed Debbie couldn’t walk 50 feet without support; she limped, had braces on one knee and both arms, had reduced grip strength and had difficulty with such chores as buttoning, zipping and tying shoelaces.

The council noted that there were findings of fact made by medical consultants in the initial and reconsideration determinations. Additional evidence had been obtained and entered into the record subsequent to those determinations and the council found that the original opinions “are not supported by the weight of the evidence now of record.”

The council ruled Debbie has the following severe impairments: degenerative joint disease of the lumbosacral spine, osteoarthritis of the knees, carpal tunnel syndrome; vertigo; obesity, with recurrent pains; parasthesias, with findings of decreased grip and hand sensation. These listings do not equal a condition in the Listing of Impairments.

The council found she’s unable to perform her past relevant work and, at 57, is an individual of advanced age, with a high school education. Because of her additional nonexertional limitations, she has no work skills that are transferable to skilled or semi-skilled occupations within her residual functional capacity.

Her additional nonexertional limitations “significantly affect her RFC to perform the full range of work at the light level of exertion. Consequently (Debbie) is unable to make a vocational adjustment to work, which exists in significant numbers in the national economy … The claimant is disabled.”

Debbie’s long journey–particularly her success at the Appeals Council where success is rare–highlight the advisability of having an advocate well-versed in the disability process.