Schizophrenia Case Study #1
28 Year Old SSI Claimant With Hallucinations,
Delusions and Anger Control Issues
Claimant: 28 year old male
Past work: construction laborer, cashier, stockroom work
Education: high school graduate + 3 years of college
Hearing info: the claimant applied for SSI benefits in March of 2006 alleging disability beginning in February, 2006. The claimant had been denied at the initial application and at reconsideration and a hearing before an judge was scheduled for October, 2008. The judge in our case was a local judge who has been at the Atlanta downtown hearing office for several years.
Hearing strategy: in reviewing my client’s file, I noted a couple of problems – first, this was an SSI case, meaning that my client had a very minimal work history. Second, my client was only 28 years old, which is very young for a disability claimant. Generally Social Security judges prefer to see older claimants (at least in their late 40’s) and I think that there is something of an unspoken bias in favor of SSDI claimants, who have worked and paid money into the system.
In reviewing the file, I noted that my client had a couple of involuntary admissions to psychiatric hospitals in 2002 and that he has been receiving fairly regular treatment. There was also a supportive consultative evaluation in the file.
In speaking with my client prior to the hearing, I saw him as a fair witness. He does not speak with much emotion (the psychiatric term for this is “flat affect”) and he comes across as poorly motivated and passive, despite his assertions of anger issues and hallucinations.
Hearing Report: the hearing opened with the judge admitting the evidence from the exhibit file and asking if we had all the evidence. In fact, we did not have the most recent records from my client’s treating psychiatrist and I asked the judge to leave the record open.
In general it is far better to have all of the records – this was a hearing that I was handling for another law firm, so I did not have control of the record
I presented an opening statement in which I drew attention to my client’s abrupt departure from college after 3 1/2 years. I discussed his hallucinations and his anger control issues as well. I addressed the fact that he was a young man, but I argued to the judge that this appeared to be an organic brain problem that existed independent of my client’s age.
My client testified fairly credibly about his hallucinations and delusions. He was quite matter of fact about these issues, although he did note that his medications did not always work this well.
Following my client’s testimony I was not convinced that we had enough so I called in his mother to testify. Frequently I will use a collateral witness in mental health cases because it is often difficult for a claimant with a mental health problem to speak objectively about his problems. It is one thing to talk about a physical problem – if you have a bad back you can speak to your limitations, but if you don’t perceive or process reality properly it can be hard to speak about your limitations.
My client’s mother was an excellent witness. She was well dressed and very well spoken (it turns out that she is a federal governmental employee in a senior capacity). Because I had reserved the right to call the claimant’s mother, she had not been present during the hearing.
The mother testified about the claimant’s struggles getting through a regular day. She related incidents when he tore his room apart looking for an electronic transmitter because he was convinced that a television station was broadcasting his activities. She spoke about his fits of anger and his paranoia about neighbors who lived miles away. She also brought out that the claimant was a good student and his decision to leave college after 3 1/2 years was completely unexpected.
I believe that the judge found the mother’s testimony to be very credible. Following this testimony the judge announced that she would be sending the file to a medical expert along with interrogatories (written questions). What this said to me was that the judge had looked at the file prior to the hearing and was leaning against a favorable decision since she had not called a medical expert witness. However, after listening to the mother testify I think that the judge was convinced that there was a reasonable likelihood that a medical expert would be able to identify significant mental health issues.
We will, of course, have to see what the panel psychiatrist has to say, but I am hopeful that the judge is now leaning more towards approving than not.