I recently represented a 39 year old female who was alleging disability based on chronic gastrointestinal problems, complicated by back pain, fibromyalgia and depression.
In late 2008 my client underwent surgery to repair a hiatal hernia and to address longstanding GERD. Unfortunately, after the surgery, she began experiencing chronic constipation that was eventually thought to be caused by pelvic muscle dysfunction and “colonic inertia” (lack of urge to go). By mid-2009 my client was defecating approximately once a week despite massive amounts of laxitives and other medications.
Her physicians tried numerous medications and procedures without success and in August, 2012, she underwent coloctomy with placement of an external ostomy bag. Currently she is having a difficult adjustment to this procedure.
The hearing in my clients’ case was scheduled for December, 2012 in the Atlanta area before a judge who is very pleasant and reasonable. My client testified credibly about her chronic constipation, the associated pain and her decision to proceed with surgery. The judge did seem a little concerned about my client’s decision to undergo a very invasive, life changing surgery but my client explained that her discomfort during the past 2+ years was so great that she felt that she had no choice.
After taking testimony the judge asked the vocational witness a hypothetical question that included the following limitations:
- limited to sedentary work
- needs a sit/stand option at will
- needs ready access to a bathroom
- needs to be able to lie down up to 50% of the day due to symptoms and medication side effects
The vocational witness, of course, answered that this level of impairment would preclude past work or any other work.
Analysis: Social Security judges recognize that claimants with significant gastrointestinal complications such as chronic constipation or chronic diarrhea cannot function reliably because of excessive absences or breaks. In this case I sense that the judge felt that ileostomy surgery was an extreme measure but I believe that the judge found my client’s testimony credible in terms of they frequency and degree of her symptoms. This case will result in a favorable decision.