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Bates v. Astrue – Persistence Pays in Battle for Federal Benefits

Proving qualification for federal benefits is almost never a simple matter.
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This is true whether you are applying for Social Security Disability Insurance in Massachusetts or Supplemental Security Income. The government almost never considers such determinations a simple matter, as the case of Bates v. Astrue well illustrates.

The U.S. Court of Appeals for the Seventh Circuit recently reviewed the case, which originated out of Indiana, where a widowed and orphaned mother of six had been denied SSI benefits – a decision that was affirmed by an administrative law judge and a district court before the appellate court reversed and remanded.

According to court records, the plaintiff had suffered a host of injuries when she was involved in a car accident in 2004. Specifically, she was diagnosed with a herniated disc, arthritis and spine problems – all of which collectively left her in constant pain. It also limited the degree to which she was able to care for her sons. While she retained the ability to prepare very simple meals, her sons had to help her open jars and packages. She couldn’t carry grocery bags or trash. She couldn’t tie her own shoes. She couldn’t drive. Basic household chores were a struggle.

Still, her examining doctor noted no obvious signs of joint inflammation and state her range of motion was within normal limits. He stated she had no trouble getting on or off the examining table and she could squat, although with some difficulty.

Another physician, who did not examiner her but reviewed her records and determined that she could lift or carry 20 pounds and had the ability to work a six-to-eight-hour day.

However, subsequent medical exams found that these conditions grew more debilitating as time went on.

Then in 2006, her fiance died. Three years later, her mother died. At this point, she began to seek treatment for depression and other mental health issues. She was eventually diagnosed with Bipolar Type 2. Medication appeared to help, but she still had trouble getting out of bed some days or controlling her anger.

When she initially applied for SSI, both her application and request for reconsideration were denied. It as at this point that she sought a hearing before an administrative law judge. It was at that time that she argued her physical pain, as well as her psychological struggles, made it tough for her to sustain employment.

After giving considerable weight to the physical aspect of her complaint, the administrative law judge denied her claim. So too did the district court, upon appeal.

However, the case eventually made its way before a federal appellate court. It was here that the rejection of her claim was reversed. The appellate court found that the court improperly discredited the plaintiffs testimony as it related to to the limitations she suffered as a result of her diagnosed medical illness. Further, the court failed to give proper weight to the professional medical opinion of one of her doctors, whose testimony had been all but dismissed because he had “only” been treating her for three months. This was improper under the treating physician rule.

While this case took years for approval to be won, it shows that persistence in these cases can pay off in the end.

If you are considering filing for SSDI in Boston, call for a free and confidential appointment at 1-888-367-2900.

Additional Resources:
Bates v. Astrue, Decided Dec. 2, 2013, U.S. Court of Appeals for the Seventh Circuit
More Blog Entries:
Social Security Process a Challenge – Vital for Those in Need, Oct. 24, 2013, Boston Social Security Disability Insurance Lawyer Blog