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Chicago Social Security Law

Two Seventh Circuit Court of Appeals cases of note:

In Hughes v. Astrue, (7th Cir. 2013) the Seventh Circuit Appellate Court found that an ALJ was wrong to deny benefits to the 57 year old woman suffering from a frozen shoulder and chronic obstructive pulmonary disease. The claimant last work was as a hotel night clerk.

The court found that the ALJ made several glaring errors:

• ALJ ignored the findings of an examining physician, stating that the doctor’s report was not consistent with the medical evidence. However, the ALJ did not explain what evidence medical was inconsistent with the doctor’s report;

• ALJ incorrectly assumed that an uninsured and impoverished claimant who cold not afford medical care could get free get medical care at hospital emergency room;

• The ALJ found she could return to her work as a hotel clerk, but ignored that part of her duties involved lifting a 20 pound coffee urn although the evidence showed she cold only lift ten pounds;

• The ALJ held it against her that she did chores but failed to understand that household chores do not equate to employment activities. Employment requires a minimum standard of performance overseen by the employer, as opposed to chores that can be done slowly over a longer period of time or with the help of friends or family; and

• The ALJ ignored her testimony that she quit smoking 30 years before the hearing.

The court noted that”[r]eally, the Social Security Administration and the Justice Department should have been able to do better than they did in this case,” and remanded the case back for a new hearing.

In Kastner v. Astrue, (7th Cir. 2012), the Seventh Circuit Appellate Court, the claimant was a 48 year old former truck driver who suffered from back pain. He had surgery in 2006 to remove a severely herniated disc in his cervical spine. After the surgery he had numbness in his left arm and he could not raise it. He also had chronic nerve damage in his left shoulder confirmed by an EMG test. He had low back pain as well, and numbness and weakness in his legs. He had a second surgery and after a brief pain-free period, his nerve pain returned.

The ALJ found that the claimant did not meet the Listing of Impairments for disorders of the spine, and denied him benefits because the ALJ found he could do sedentary work.

The Seventh Circuit found that the ALJ did not provide adequate reasons in her decision to support her conclusion that the clamant did not meet the Listing. Further, the ALJ ignored medical evidence from his treating doctors that supported the claimant’s claim. The court remanded the case back for a new hearing.

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A case decided July 24, 2015 by the Seventh Circuit Court of Appeals noted the important distinction between “substantial gainful employment,” meaning competitive work and work around the home. In Price v. Colvin, the court noted that “it’s easier … to work in one’s own home, at one’s own pace, at one’s own choice of tasks, than to work by the clock under supervision in a place of business.” No. 15-1444, page 8. The ALJ was incorrect to infer that because the claimant could “perform simple household chores, such as cooking food in a microwave oven and mowing the lawn, that he could be gainfully employed. Page 7-8. The court remanded the case for a new hearing.

In a different case also decided on July 24, 2015, the Seventh Circuit Court noted that the hypothetical question posed to the vocation expert was flawed. Vocational experts (VEs) are used by administrative law judges at hearing to determine if there are jobs that exist in the economy that a claimant could perform. The ALJ posed a question that did not include the claimant’s “moderate limitations in concentration, persistence and pace” and thus committed an error that required reversible and remand. Varga v. Colvin, 14-2122 at page 9.

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Chicago Personal Injury Law

Chicago Personal Injury Law

Negligence has no favorite target. Unfortunately, those without health insurance are often the victim of wrongful conduct. An ambulance ride, emergency room treatment, surgery or physical therapy is often too expensive for those without health benefits.

During my years of fighting for the underdog, I have a developed a special desire to help those who are injured and who do not have health insurance. There are options that may assist in getting reasonable and necessary health care covered for those injured by wrongful conduct.

First, most automobile policies have medical payments coverage, that cover the occupants of a car involved in a crash. The benefits are available regardless of who is at fault. An attorney may also be able to have payment of medical bills delayed until the case is resolved. Although such payments diminish the injured victim’s recovery, this process can often get the type of care necessary to recover from an injury. Many times collection companies can also be held at bay.

Insurance companies and their attorneys are often able to argue out of both sides of their miserly mouths in injury cases. If you can afford and get reasonable and necessary medical care, they will argue without hesitation that you have over-treated to increase your bills and potential recovery. If you cannot afford medical care, they will argue that you weren’t really hurt, because if you were, you have more treatment.

Luckily, a recent Illinois Appellate Court decision, Vanoosting v. Sellars, 2012 IL App (5th) 110365, allows the jury to hear testimony that plaintiff’s lack of health insurance was the reason she did not received medical treatment for last three years before the trial. Insurance is generally not admissible due to fears that a jury will not award fair and reasonable compensation, but instead sock it to the insurance company. In Vanoosting, the defense attorney knew that the real reason why plaintiff had stopped treatment (her lack of insurance), but he repeated emphasized during his cross-examinations of witnesses in front of the jury that she had not followed up on her care. By emphasizing that point, he was trying to convince the jury the plaintiff had no ongoing problems. The appellate court determined that the trial court was wrong to stop the plaintiff from telling the jury the real reason why she was not seeking medical. care and sent the case back to the trial court for a new trial.

In a different appellate court case, Klingelhoets v. Charlton-Perrin, 2013 IL App (1st) 112412, the appellate court determined that the trial court was correct to allow plaintiff’s testimony that the costliness of physical therapy was the reason that she did not continue with her PT. Evidence of a plaintiff or defendant’s wealth or poverty is generally not admissible; so a defense attorney will argue that evidence that someone could not afford treatment is likewise not admissible. Again, the defense attorney knew the real reason why the plaintiff stopped her treatment (the cost), but asked her if she had any upcoming PT appointments. The plaintiff explained that she did not because of the cost and the appellate court determined that the trial court was correct to allow the jury to hear that testimony. The court noted that the defense attorney “repeatedly insinuated to the jury that the plaintiff has stopped . . . physical therapy after the accident of her own accord because she was not really in pain anymore and felt she no longer need this treatment. Such intimation was in direct contradiction to the evidence and the testimony that plaintiff presented, i.e., that she need ongoing and future care for her persistent injuies from the accident.”

In my experience, jurors do what is right, and usually award fair and reasonable compensation if proven. Over the years during my many jury trials, jurors routinely asked questions during deliberations about insurance, and it is preposterous to think that among 12 individuals picked to decide a case, none would think that the defendant’s attorney was being paid for by an insurance company or health care figured in the treatment decisions. Juries will do the right thing, so long as the presentation is truthful and credible. These two cases show how defense tactics may try mislead the jury, and that the judges will ultimately get things right if the proper arguments are made.

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