(This article first appeared in the newsletter for the Minnesota State Bar Association Social Security Section)
Claimants are often approved for disability based on the impairments they believe to be primary such as chronic pain, arthritis, or mental illness – but not always. Some individuals stand a better chance of winning disability based on secondary impairments, and a relatively weak case can be strengthened and become a winning case by focusing on what may appear to be “lesser” impairments.
For example, one of my clients was a woman in her 20s with three children, some moderate depression and anxiety, low-average IQ, and who was functioning relatively well. Her treatment of her mental illness was sporadic, and medical records sparse. This young woman also struggled with celiac disease, an autoimmune disorder, in which ingesting gluten damages the small intestine.
Upon meeting her, I noticed that she seemed quite thin. The medical records revealed that her Body Mass Index (BMI) ranged from 17 to 19 over a period of several months. For some medical visits, no BMI was calculated, although height and weight information was given, and so BMI calculation was possible using online BMI calculators. The BMI calculations confirmed that she met Listing 5.08, “Weight loss due to any digestive disorder,” which directs a determination of disability when a BMI is 17.5 or less, at two evaluations 60 days apart in a six-month period.
Likewise, a number of clients have presented with depression, anxiety and back pain – but won their cases based on 8.00, Skin Disorders Listings. These Listings typically require the presence of lesions present in the underarm, groin, and anal region, which very seriously interfere with use of the hands or legs/feet – despite prescribed treatment.
For one client in her 20s, with mild depression, morbid obesity, and skin lesions, medical source statements focusing on skin lesions, photographs of the lesions, and compelling testimony resulted in an approval. Another client in his late 40s, with some mild back pain and depression, won his case because of his extensive skin lesions, which were well documented in the record, and compelling testimony about the end of his 20-year relationship because of odor from the skin lesions.
It pays to look beyond the presenting impairments as clients will not always be aware that their secondary impairments could be disabling based on a Listing.
J. Asha Sharma
Disability Partners, PLLC