March 1, 2016
Hon. _______
ODAR North Atlanta
3105 Clairmont Rd.
Atlanta, GA 30329-1015
RE: 111-11-1111
John Smith
Pre-hearing brief
Dear Judge ______:
I represent John Smith with regard to his claim for SSDI benefits. A hearing in this matter is scheduled for March ___, 2016 at 2pm before your Honor. Please allow this letter to serve as my pre-hearing brief in this case.
Background:
The claimant filed for benefits on February 25, 2014 alleging an onset date of November 11, 2008. The claimant is insured for SSDI benefits through December, 2014. At the time of onset the claimant was 42 years old and he has a high school education with technical school training in auto body repair.
The claimant was last employed as a roof repair technician. The claimant began working for his employer in 2007, and was injured in a work accident on March 20, 2008. The claimant was returned to work light duty following lumbar surgery and remained employed through October, 2009 although all work performed after March 20, 2008 was light duty, part time and at a “make work” type of job.
Prior to working at the roofing company, the claimant was employed as a commercial printer pressman for over 14 years.
Medical History:
As noted above, the claimant was injured on the job in March 2008 and was provided treatment under the Georgia workers’ compensation system. Initially the claimant was prescribed conservative treatment in the form of physical therapy, injections and exercise to address his complaints of low back pain radiating into his legs bilaterally, leg weakness and poor balance.. Despite this treatment the claimant did not experience any significant improvement.
In February, 2009 the claimant was referred to orthopedist Thomas Singer, M.D. who diagnosed disc herniations at L3/4 and L4/5 and recommended surgery (2F/16).
On July 10, 2009 the claimant underwent laminectomy and disc material excisions at L3/4 and L4/5 by Dr. Singer (2F/16).
Following surgery, the claimant continued to have severe pain, leg weakness and numbness and saw little improvement from his pre-surgical condition.
In May, 2010, the claimant’s workers’ compensation authorized treating physician was changed to Dr. Scott Woodware who noted spinal canal stenosis, disc degeneration with diskogenic pain syndrome and bilateral leg pain. Dr. Woodware recommended a second surgery and on August 16, 2010 the claimant underwent a spinal fusion from L4 through L6 (the claimant has a rudimentary disc at the L6/S1 level) (4F/9).
Following this second surgery, Dr. Woodware sent the claimant to physical therapy at Comprehensive Therapy Solutions (1F), but saw no improvement in pain levels.
Dr. Woodware treated the claimant’s ongoing pain with epidurals (7F/32) and nerve blocks (5F/4) in April and May, 2011. When these therapies were not successful in controlling the claimant’s pain, Dr. Woodware referred the claimant to long term pain management, which has continued until the present time (5F/3).
Since May, 2011 the claimant has been treated with pain medications by Dr. Blaine Smiley at Oakwood Spine Physicians and by his internist, Dr. David Small at North Columbia Family Medicine. The claimant continues to experience throbbing low back pain, radiating into both legs (left worse than right) from hip to the knees.
At counsel’s request, Dr. Smiley completed a functional capacity evaluation, which can be found at Exhibit 11F. This evaluation includes a number of reliability limitations such excessive (3+ days per month) absences from work, inability to get through a workday without lying down and frequent episodes of constant pain that would preclude competitive work.
The claimant will testify that he cannot bend, kneel, stoop, crouch or crawl. He will testify that he can sit for 10 to 15 minutes at a time before his entire left leg goes numb, requiring him to stand and walk for approximately 10 minutes. The claimant contends that he can sit for a total of 60 to 90 minutes during the day, and that he can walk for approximately 60 minutes total during the day. The claimant cannot stand in one place for more than 5 minutes without support.
The claimant will testify that he can lift no more than an 8 lb. gallon of milk occasionally but only if he holds the gallon jug close to his chest. The claimant also contends that in order to relieve his low back and leg pain he needs to lie down with feet extended in a position that takes weight off his lower back/hips.
The claimant will also testify that his pain medications leave him fatigued, dizzy and unable to concentrate. He contends that the pain medications slow his pace of daily life and leave him with short term memory impairment. The claimant also notes that his pain medications are constipating, requiring 30 minute restroom visits every 2 to 3 days.
The claimant sleeps poorly because of his chronic pain, waking every 2 hours, and he contends that if he overdoes his daily activities, such as excessive walking or sitting, he will be bedridden for 2 to 3 days.
In addition to chronic back pain, the claimant has also been struggling with depression associated with his physical problems. Internist Hall’s notes at 6F/5 document depressive symptoms and SSA’s psychological consultative examination at 8F by Fred Fraser, Ph.D notes that the claimant is struggling with depression and is encouraged to pursue mental health assistance.
Argument:
Claimant Smith has a failed back. Two surgeries have failed to alleviate chronic pain and now he is on long term pain management. Pain medication reduces the claimant’s pain levels but have left his with a reduced capacity to concentrate and focus. While pain medication can help with breakthrough pain the claimant has to constantly move, fidget and lie down to take pressure off his spine.
The claimant has a long and consistent work history and an objectively documented work accident that has produced chronic medical problems consistent with the accident and follow up medical treatment.
As a result of his chronic back pain, medication side effects and depression, the claimant would be off task for more than 20% of a workday and would need excessive unscheduled breaks throughout the day if he was able to get to work at all.
Thank you for your consideration of this claim.
VERY TRULY YOURS,
GINSBERG LAW OFFICES, P.C.
____________________________
by: JONATHAN C. GINSBERG
JCG:aa