Disability Hearing

25 Jul

Susie and I had an Administrative Law Judge Hearing on the 19th of July.  She applied back in 2008 for Social Security Disability.  After chasing her claim for three years, we learned in 2011 that her claim was denied.  The SSA Examiner found she was medically disabled in 1999, but determined that her condition had improved by 2002.  I later learned that her condition improving and filing a claim within 14 months of said determination date was the crux of our technical issue and why attorneys later on would not take her case.

We should have filed for disability when Susie was diagnosed in 1999, and we should have appealed the 2011 decision.  As Susie was determined to try and work and she did not think of herself as disabled, we did not file an appeal.  At the same time, family knew she had memory issues, made strange noises at times, talked to strangers on the street and the list goes on, but we accommodated and embraced her unique behavior.  It was not until after a second unsuccessful work attempt in 2012, that Susie finally came to the conclusion that working again was unlikely.

With her cancer progression diagnosis as a Glioblastoma Multiforme in 2013, we were back in reactionary and survival mode.  So like before, we did not revisit the subject of disability until after she was done with treatment, specifically 2016.  We learned we could not appeal the 2011 decision, as the time to appeal that decision had long expired.  So we were forced to submit a new claim, which was quickly denied due to the aforementioned technical reason.  As we were unsuccessful at retaining a disability attorney to represent Susie, I learned how to navigate the appeal process, its denial and requesting an administrative law judge hearing.  Not until I requested a copy of her Social Security files did I realize the root issue behind the claim denial.

Many of our friends scratch their heads on why awarding disability was not a slam dunk.  In Susie’s case, I believe the technical issue is primarily around the SSA Examiner in 2011 and 2016 misinterpreting a neuro-oncologist clinical note.  The SSA Examiner determined that Susie “had no evidence of persisting disease or recurring disease for 3 continuous years”.  The 3 continuous years is what is known as the Closed Period.  However, the clinical note referenced stated “her surgical cavity was stable and did not show recurrent disease”.  As Susie had residual 2cm tumor due to subtotal resection, a stable surgical cavity should have been interpreted as “no progression of the unresectable persistent tumor”, i.e. no progression does not mean absence of persisting disease.

SSA Disability Agenda
Social Security Disability ALJ Hearing

We did have a letter from MD Anderson supporting us that Susie has persisting and recurrent brain cancer along with permanent physical and cognitive deficits.  I feel we effectively proved the SSA Examiner’s decision was made in error and that Susie’s cancer condition had never ceased, let alone improved.  We hope the Administrative Law Judge concurs.  Now we just sit and wait for the Judge’s decision, which is often 45-90 days after the administrative law judge hearing.

PS: Some links I found useful in our appeal include:

Guy Lipof

Accomplished Engineering Executive with deep consulting and sales expertise in healthcare and life sciences, particularly in oncology, driving business strategy, delivering innovative solutions, and improving patient outcomes. Care partner and advocate for raising awareness about and investment towards Brain Cancer Research, such as Glioblastoma Multiforme and IDH mutant gliomas.