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Here are the most notable posts this week from the Social Security disability law blogs:

Chronic Fatigue Syndrome is a basis for Social Security disability, and Social Security Ruling 99-2p sets forth the policy for evaluating disability claims involving chronic fatigue syndrome.

One of the problems with chronic fatigue syndrome is that no one really knows what causes it. However, the New York Times has a fascinating article today, entitled Is a Virus the Cause of Fatigue Syndrome? 

It is definitely worth reading, and while your on the New York Times site, check out the health quide for chronic fatigue syndrome.

Sometimes in a disability case, the medical evidence lags behind the disability. There is often not a strong medical record as of the day an impairment became disabling. Over time, however, with repeated doctor visits, the medical picture usually becomes clear.

So the problem is: how do you prove disability as of the alleged onset date?

To provide the judge with medical evidence regarding onset, I will often add the following language to the medical source statement form that I send to the claimant’s treating physician:

Based upon my training, education and experience, and based upon my treatment of <claimant’s name>, the limitations set forth above reflect my opinion of <claimant’s> functional limitations from <alleged onset date> to Present.

That language gets typed just above the doctor’s signature line, where the doctor will definitely see it. If the doctor disagrees with the alleged onset date, he crosses it out.

Once the form is signed, the treating source is giving an opinion that the claimant’s functional limitations have existed since onset.

Should the judge ask “well what about the onset date?” at the hearing, you can point out that language on the form, and that the treating source opinion relates the claimant’s functional limitations back to the onset date.

There was terrific interaction this week among the Social Security disability blogs. There was a guest post (all too rare in our niche). And there was a post expanding upon an article from another blog. That's the way it's supposed to be! Such cross-pollination makes our work more accessible to those looking for information regarding Social Security disability law.

Here are this week's most notable posts from the Social Security disability blogs:

It has been a little while since the Best Practices for Claimant’s Representatives was published on the SSA’s website. It is one of those lists that is full of useful reminders, and is therefore worth revisiting every 6 months or so. So please take another look.

One of the best practices is:

ESTABLISH A GOOD WORKING RELATIONSHIP WITH HEARING OFFICE STAFF AND MANAGEMENT.
You should participate in periodic group meetings with the Hearing Office Chief Administrative Law Judge and Hearing Office Director in the offices in which you practice. Open dialogue allows both representatives and hearing offices to exchange suggestions as to how to improve service in the local area.

These group meetings can be very helpful, and we are about due for a meeting for the Portland, Maine ODAR and the Manchester, NH ODAR. Since the fiscal year just ended, it seems like a good time.

However, I want to highlight the importance of having a good working relationship with the hearing office staff. We interact with these folks all the time, and everything works just so much better when you have a good relationship with them.

I recently had to postpone a hearing on very short notice due to a personal matter. The client was fine with it, but I was concerned about the short notice at the hearing office. But the judge’s assistant and the judge could not have been more gracious, and I am very grateful to them. The situation may have been helped by the fact that I have a good relationship with these professionals.

Here is the Friday roundup of recent posts from the Social Security disability blogs. After you click on a featured link below, please explore the rest of that site. You will find other interesting material there.

It was another good week for notable blog posts:

Vocational rehabilitation records can provide persuasive evidence for a Social Security disability claim.

First, the records show that a claimant has been trying to find work, in spite of his or her impairments. This can be important, because an ALJ often considers the claimant's motivation to work when determining a disability claim.

I also like voc rehab records because they add a practical element to the disability process. The disability process – particularly with vocational expert testimony at a hearing – can be so theoretical. The vocational records shine the harsh light of reality onto the process. The vocational rehabilitation records almost scream out: We can't find a job that this person can perform. We tried. Couldn't do it.

I cannot remember a claim I lost when I had strong vocational rehabilitation evidence. So get the vocational rehabilitation records. And ask the claimant's vocational rehabilitation counselor for an opinion letter regarding the claimant's employment prospects. It can be persuasive evidence in support of a disability claim.

At step 4 of Social Security’s sequential evaluation, the SSA considers whether or not you have the ability to return to your past relevant work. The SSA considers your past work, both as you performed it (and described it in your Work History Report), and how that work is generally performed in the national economy. See Ruling 82-61.

To determine how the work is generally performed in the national economy, the SSA looks to the Dictionary of Occupational Titles (DOT) for a description of your job. For example, if you were a cashier, the SSA would look at the requirements of that job both as you described it and as it is described in the DOT.

The work history report doesn’t have much space to describe your job duties. Most claimants just give the title of their previous jobs, and don’t fully describe their job duties. The SSA will then try to match the title of that job to a listing in the DOT. This is where the problems begin, because the job descriptions in the DOT are often not an exact match to the job performed by the claimant.

I have one such claim right now. The claimant worked as a safety coordinator. He described the job as light to medium exertional work, requiring him to make site visits regularly and carry heavy materials from time to time. DDS denied the claim at step 4, stating that the claimant could still perform that job as generally performed.

However, when I reviewed the claim file, I learned that DDS used the DOT description for safety manager for its analysis. Safety manager was the claimant’s boss’s title, not the job the claimant performed. Safety manager is a sedentary job, and does not involve site visits or carrying heavy materials occasionally. The job of safety coordinator, on the other hand, is more physically demanding.

The claimant is over the age of 55. If past work is ruled out, he would then grid “disabled” under the Medical-Vocational Guidelines. So this error by DDS is the difference between winning and losing the claim.

Related Article: Past Relevant Work: the Composite Job

I follow a lot of Social Security disability blogs. When I see an interesting article, I will often link to it from my twitter account. Those twitter updates are displayed on the sidebar to this blog. That way, there is always something new when you visit this site.

Several notable articles have been posted just this week on the disability blogs that I follow. So here is a roundup of recent posts regarding Social Security disability. And by the way, I am very pleased that there are now enough of us writing on this topic to publish a list like this.

Fatigue is a frequently encountered symptom in Social Security disability claims. Fatigue can be a component of many conditions, including fibromyalgia and Lyme disease. Fatigue is often secondary to conditions involving chronic pain, because it is exhausting to be in pain all the time. Fatigue can also be secondary to severe depression. And of course, there is chronic fatigue syndrome.

Fatigue can certainly be a disabling symptom, and a record of your fatigue and its effects can help to establish your disability claim. However, your fatigue must be documented to strengthen your claim. Unfortunately, fatigue is often not well documented in the medical record. 

So consider keeping a journal. And tell your doctor about your fatigue, and how it limits your ability to function. Ideally, your treating physician will complete a medical source statement setting forth your functional limitations, including those due to fatigue. That is the best evidence of all.