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Friday, June 29th, 2012

Disability Benefits For Nurse

As a medical professional, you would think that an intensive care unit (“ICU”) nurse would recognize when a person can no longer work. That seems especially true when that worker or person is the nurse herself. Certainly a nurse is better able to assess limiting effects of medical impairments than a clerk who works for the State agency that initially decides eligibility for Social Security Disability (“SSD”) decisions.

You would think that it would be obvious that when a person has worked at the same job for a quarter of a century, and says their medical condition prevents them from continuing to work, that their work ethic shows they are telling the truth. That seems especially true when the person is earning a high salary of almost $100,000 annually. What makes it even more obvious is that an ICU nurse has no transferable skills to sedentary work, and if the nurse is over 50, the medical-vocational rules require a finding of disabled even if the ICU nurse had a sedentary work capacity.

So when a 55 year old person tells the State agency that she can no longer work as an ICU nurse after 25 years, where she was earning close to $100,000 annually, and four different medical specialists provide detailed reports showing that the nurse cannot even do sedentary work, the SSD claim looks like a no-brainer. After all, why would the ICU nurse exaggerate her claim that she lacks the ability to work in order to receive SSD benefits that are less than a third of her working income? But of course then there are State agency examiner’s like F. Osorio who can’t fathom the obvious.

The State agency denied the ICU nurse’s SSD application because Osorio wanted the claimant to attend a consultative examination (“CE”) by IMA Disability. Osorio refused to address the reasons why the nurse objected to the CE; namely, that it failed to comply with the Social Security rules and regulations. Therefore, despite all the medical evidence overwhelmingly supporting the ICU nurse’s credible disability application, Osorio denied it.

Luckily, the Social Security Administration (“SSA”) immediately rejected and reversed Osorio’s denial. Earlier this month I submitted an on-the-record (“OTR”) request for a fully favorable decision, and yesterday, the SSA approved it. Therefore, the claimant avoids wait for a hearing and decision. Unfortunately, the claimant’s SSD benefits were still unnecessarily delayed by the State agency decision.

When State agency examiners deny applications because claimants refuse to attend CEs that are scheduled in violation of the rules and regulations it wastes time and money. Tax payer money. Your money. Is the State agency knee jerk insistence for CEs a boondoggle? Are CEs automatically required because State agency examiners are lazy and simply want to rubberstamp what a CE says instead of reviewing the entire medical file? By demanding a CE the State agency is saying it does not believe what the treating doctor says, which contradicts the SSA laws that say treating doctors’ opinions are supposed to be given extra weight.

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Disability Benefits For Nurse