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Aguiniga v. Colvin: SSDI Appeals

Aguiniga v. Colvin, a case from the U.S. Court of Appeals for the Eighth Circuit, involves a 44-year-old woman who was injured as a result of a serious motorcycle accident. This accident occurred in 2007, and she suffered a broken pelvis (six fractures) and also a broken wrist.

gavel211A few months later, she had an MRI taken, and she was diagnosed with a disc condition in her cervical and lumbar spine.  She also suffered from tingling and numbness in her extremities. She went to doctors on multiple occasions for treatment for this condition in the years following her serious motorcycle accident.  However, she was terminated as a patient from her physical therapy provider when she missed three appointments and did not reschedule these appointments.

She was also taking steroids to treat her various medical conditions and then stopped taking the medication, asking that she be given painkillers instead. In addition to her physical conditions, she was also suffering from mental health conditions, but she chose not to seek treatment for these conditions for a significant period of time, according to court records.

When she first applied for Social Security Disability Insurance (SSDI) benefits in 2007, her application was denied. As our Boston disability attorneys have seen in far too many cases, when claimants file an initial application for benefits, the United States Social Security Administration (SSA) will often reject the application as a cost saving measure without regard to whether the claimant is actually disabled.

She did not appeal the denial of this application, which is typically the next step to take. Once a person is rejected the first time, they can apply for reconsideration, and then after that is likely rejected, they can eventually get a hearing before an administrative law judge (ALJ).  It is at the ALJ hearing when one has the best chance of getting an award of SSDI benefits.

The following years, she filed a new application for benefits. In this application, the SSA determined claimant’s Residual Functional Capacity (RFC) and determined that she had some physical and mental limitations. However, her application was again denied, as often happens, and it was then denied on reconsideration.  At this point, she requested a hearing before an ALJ.  The vocational expert (VE) opined that she could not return to work and was given a disability rating that entitled her to benefits. However, her date of disability was based upon the new application and not the first, which was denied. She appealed, requesting that the benefits be related back to her earlier application date.  She appealed based on this ground.

As a defense to this appeal, the SSA argued her claim was barred by the doctrine of collateral estoppel, which means, as a result of her actions, she was barred from making such a claim.  In this case, she did not appeal the initial denial of her earlier application, which could have done at the time, and she did not seek medical treatment when should could have.

If you or a loved one is seeking Social Security Disability Insurance in Boston, call for a free and confidential appointment at 1-888-367-2900.

Additional Resources:

Aguiniga v. Colvin, United States Court of Appeals for the Eighth Circuit, August 15, 2016

More Blog Entries:

Who is Getting the Most from Social Security Disability? July 2, 2016, Boston SSDI Lawyer Blog