Topic: Legal Cases Support OUR tests, docs & CHRONIC Lyme- SS Disability
Tincup
Honored Contributor (10K+ posts)
Member # 5829
posted
BG kindly sent me an announcement today about a case in a federal court that approved disability (Social Security) for a Lyme patient. The legal argument was based on other cases that did the same.
Unfortunately, after wading thru the most recent case I realized it did not provide the details of what the announcement had spelled out. Like trying to match 2 totally different documents. ??
And it was important because that announcement was good news for us, but we needed to check the sources.
So, grrrrrrr.... I spent all night researching to find where we might get the previous case wording with actual details that will help us with SS disability and finally found one.
Here are quotes from a Kansas case that you should review and share with your doctor and an attorney if you have one.
For the first case (Kansas) I pulled out quotes that should help. Both documents are very LONG and difficult to read. so if you are going to read one, read the first one with quotes.
I also posted the case that took place in the federal court (with link) for an additional reference.
Now I'm done with this legal stuff, finally! Ice cream anyone?
I am new here, so I hope it is not inappropriate to jump in....
It took me a while to figure out what is going on in this document....
Basically my take would be....
Someone applied for lyme disease, got denied at least 4 times, decided to sue in federal court.
The federal court remanded the case. they didn't make a decision. they sent it back to the judge to review again. That is all we know at the moment.
Maybe this person will get approved in the end (lord I hope so), but this won't change the social security policies. (I do hope they change some day)
Bottom line. I totally think is possible to get approved when someone has Lyme disease, I met many people who have.
But no one I have met focused their cases on lyme. They got approved for other related conditions.
Hope this is helpful in some way, if not, please ignore me
[ 02-06-2017, 12:56 PM: Message edited by: lilysilver ]
Posts: 13 | From us | Registered: Feb 2017
| IP: Logged |
ConnieMc
Frequent Contributor (1K+ posts)
Member # 191
posted
Lyme is still not a "listed" impairment so IMO, proving disability for Lyme, whether a claimant has a positive test or not, is still troublesome.
Once the disabling condition is established, there still needs to be objective evidence of functional impairment which meets a listing, especially in someone under 50 years old.
For example, a neuropsych showing cognitive dysfunction, x-rays over time showing inflammation in joints, cardiac testing showing heart complications from Lyme,
trigger point exam showing fibro (there is a SSA ruling on fibro), etc. The list is endless and every claimant has different manifestations of Lyme.
Generally these are tough cases, especially if the claimant is under 50 and the major symptoms are pain and fatigue (both are nearly impossible to measure objectively,
Tincup
Honored Contributor (10K+ posts)
Member # 5829
posted
Hey lily,
Welcome to LN. Certainly jump right in. All comments welcome.
I am no lawyer and don't know all the details, but I want to be sure we have the right conclusion so others can use it to their benefit.
You said.. "The federal court remanded the case. they didn't make a decision. they sent it back to the judge to review again. That is all we know at the moment."
Actually, they did win the case. Hard to determine because as I said earlier the press release doesn't match the actual legal document- wording is "off" and difficult to break down into real people talk.
I can't get the site up right now (ok just got it), but from memory the judge supported the Lyme patient and sent the case back (supported) to the lower court to handle the details.
The last section states, and please see # 2, 4 & 5. The # 5 decision is the one that says the patient won.
QUOTE- "The ALJ's failed to apply the properly legal standard and the decision was not supported by substantial evidence. Accordingly, it is hereby ORDERED that:
1. Plaintiff's request for oral argument on the cross-motions for summary judgment, ECF No. 20, is denied;
2. Plaintiff's motion for summary judgment is granted;
3. The Commissioner's cross-motion for summary judgment is denied;
4. The matter is remanded for further consideration consistent with this order; and
5. The Clerk is directed to enter judgment in plaintiff's favor."
Hope that makes it easier to understand. ?? I spent way too long trying to "get it" myself, but finally think maybe I did?
Tincup
Honored Contributor (10K+ posts)
Member # 5829
posted
So you know, I cheated a bit here. I communicated with the attorney to get some answers because people wanted to know things I wasn't sure about.
This case will not by itself rewrite policy on SS disability. It can be referenced in CA in other cases where it took place and other states too, but especially in other states it isn't always thought to be "the final word", simply a reference.
The fact that several states now are approving Lyme cases "on the record" is very encouraging. That's why I shared the Kansas case so we could see how and why the patient won.
Hope this helps you and others and it can be used in the future with success when needed.
posted
Hi tincup and connie, I am very grateful for this input!
And so quick. thank you.
I came back because I wanted to say that I would be DELIGHTED to be wrong in what I said above about lyme patients being approved based on other conditions.
That has been true for the lyme patients I have met, but...
If there is anyone here who has been approved based solely on Lyme I would truly love to hear your story.
OK, let me take a moment to look back at the document. Perhaps I jumped to the wrong conclusion when I saw the word "remand". Thank you for pointing that out.
Posts: 13 | From us | Registered: Feb 2017
| IP: Logged |
posted
Ok. I'm back. my head is swimming. I don't have much experience reading federal court decisions.
The one thing I did discover.... and maybe I am wrong.....
I think there are at least two different cases on this page?
Possibly three.
I see what you mean, it looks like they remanded but also instructed to approve in both cases? I will have to look more later.
I'm interested in what you said about this ruling being referenced in future cases. Is this something a lawyer can do in an ALJ hearing or in a hearing brief? Reference federal court cases to influence judges decision?
Also, I would love to hear more about cases being approved on the record. Have you met people who were approved OTR for lyme?
Posts: 13 | From us | Registered: Feb 2017
| IP: Logged |
posted
p.s. you were super to contact the attorney!
Posts: 13 | From us | Registered: Feb 2017
| IP: Logged |
ConnieMc
Frequent Contributor (1K+ posts)
Member # 191
posted
quote:Originally posted by lilysilver: Ok. I'm back. my head is swimming. I don't have much experience reading federal court decisions.
The one thing I did discover.... and maybe I am wrong.....
I think there are at least two different cases on this page?
Possibly three.
I see what you mean, it looks like they remanded but also instructed to approve in both cases? I will have to look more later.
I'm interested in what you said about this ruling being referenced in future cases. Is this something a lawyer can do in an ALJ hearing or in a hearing brief? Reference federal court cases to influence judges decision?
Also, I would love to hear more about cases being approved on the record. Have you met people who were approved OTR for lyme?
ConnieMc
Frequent Contributor (1K+ posts)
Member # 191
posted
If there is a listed impairment associated with Lyme which is present and objectively documented, it is possible to get an OTR decision. The current climate in general is not real favorable to claimants at this point, but the tides turn constantly in SSA land.
For example, inflammatory arthritis - Immune System Disorders (14.09); Neurocognitive Disorders - Mental Disorders (12.02); Peripheral neuropathy - Neurological (11.14).
There are also rulings on CFS (SSR 14-1p) and Fibromyalgia (SSR 12-2p)
There are many other examples and every case is different. SSA is more likely to pull cases over age 50 for OTR review. But if you think you meet any SSA listing, it is a good idea to ask for an OTR if at hearing level.
No guarantee SSA will address it, but on the bright side, once the OTR is submitted, you can use the same brief for the hearing itself if it progresses that far.
(breaking up a paragraph for easier reading for many here)
ConnieMc
Frequent Contributor (1K+ posts)
Member # 191
posted
quote:Originally posted by lilysilver: connie,
are you the same person that wrote the sample letter and doctor instructions posted here?
they are brilliant!!
Wow, I forgot all about that. I still use that info. I haven't been coming to Lymenet regularly over the past 6 years or so, but now am winding down in prep for retirement.
So maybe i will have a little more time to help those here when i see posts about SSA disability.
Only have 1 Lyme case active at this point but have probably helped 30+ get their benefits over the past 13 years.
I consider myself one of the lucky ones as I have been able to stay in remission for years after several years of severe illness. But it takes lots of effort to keep the beast at bay.
(breaking up the post for easier reading for many here)
I'd love to hear more about what your role is with helping people with cases. Is this something you do professionally or as a volunteer?
I am starting a website gathering resources for people with cfs/me and related conditions.
I am wondering if:
1. would it be ok to post your letters there? I know it would help many people. it's superb.
2. do you have any suggestions / revisions for this page on lyme. I know it is not very good at the moment, but I just started it last week. I would love to hear your ideas.
btw, it is non-commercial. nothing for sale. I am disabled myself.
Posts: 13 | From us | Registered: Feb 2017
| IP: Logged |
ConnieMc
Frequent Contributor (1K+ posts)
Member # 191
posted
quote:Originally posted by lilysilver: Hi connie,
I'd love to hear more about what your role is with helping people with cases. Is this something you do professionally or as a volunteer?
I am starting a website gathering resources for people with cfs/me and related conditions.
I am wondering if:
1. would it be ok to post your letters there? I know it would help many people. it's superb.
2. do you have any suggestions / revisions for this page on lyme. I know it is not very good at the moment, but I just started it last week. I would love to hear your ideas.
btw, it is non-commercial. nothing for sale. I am disabled myself.
I am an Accredited Disability Representative and handle SSDI and SSI cases. Ironically, I used to do workers comp and LTD work but after losing my career to Lyme I later got into this once I started doing better. You can use anything I have posted. It isn't easy getting disability for Lyme and I will help those with this miserable disease any way I can. Website is www.nc-disability-advocate.com.Posts: 2275 | From NC | Registered: Oct 2000
| IP: Logged |
Do you want me to include a link to your website and write that you have personal experience with lyme and now represent lyme cases --- or you are retiring and not looking for more clients?
Posts: 13 | From us | Registered: Feb 2017
| IP: Logged |
Tincup
Honored Contributor (10K+ posts)
Member # 5829
I put your letter here. thank you so much for sharing it. it's really well done and I know it will help so many people.
Posts: 13 | From us | Registered: Feb 2017
| IP: Logged |
The Lyme Disease Network is a non-profit organization funded by individual donations. If you would like to support the Network and the LymeNet system of Web services, please send your donations to:
The
Lyme Disease Network of New Jersey 907 Pebble Creek Court,
Pennington,
NJ08534USA http://www.lymenet.org/
UBBFriend: Email this page to someone!
![[Big Grin]](biggrin.gif)
![[Smile]](smile.gif)
Printer-friendly view of this topic