I filed an "on the record" request yesterday for a client with severe Charcot-Marie-Tooth disease. Charcot-Marie-Tooth (named after the three doctors that first identified the disease) is a hereditary neurological disease that affects the peripheral nerves. The resulting peripheral neuropathies cause loss of function and, in the case of my claimant, chronic pain.

The unusual thing about this claim file is the RFC assessment from Disability Determination Services (DDS). Of course, the DDS physical RFC assessment did not consider the primary care doctor's opinion regarding the claimant's functional limitations. That happens all the time. But additionally, the DDS physical RFC also contained this summary:

With medical evidence as above, expectation is for gradual worsening… . However, it is our sense that, at least currently, claimant’s musculoskeletal status has not (as yet) quite reached the point where all work is not possible.

As I worked on the OTR request, I read that summary over and over again. I mean, come on! Naturally, the staff at DDS must ascertain whether or not a claimant has the capacity to work. But this RFC assessment goes too far, and they knew it when they wrote it. I have never read a more apologetic RFC.

The claimant can't work. He states that his life has been ruined by this hereditary disease and the accompanying chronic pain and loss of function. 

The claimant's primary care doctor expressly listed numerous work related activities that the claimant could not perform. Not considered by DDS.

Now that the claim is at the hearing level, we also have a medical source statement from the treating neurologist, setting forth limitations precluding work at step 5 of the sequential evaluation.

There is no contrary evidence in the claim file. The claim should have been granted by DDS. Now, it will hopefully be granted on the record, so that this claimant does not have to wait for a hearing.

{update: this claim was granted on the record on 9/24/2009}