George Piemonte

Last time, I discussed the six good grids and how you can prove your claimants meet them. But most claimants don’t meet a grid rule, so today, I will discuss how you can win your claimants’ cases that do not meet a grid rule.

First, let’s cover what types of proof you can use to prove your claimant is disabled. In addition to your claimant’s testimony, other types of evidence are:

• Written statements and testimony
• Medical records reporting the client’s statements
• Medical opinions
• Clinical and laboratory findings
• School records
• Photographs

You want to try to prove all limitations in multiple ways. The more ways you prove your claimant’s limitations, the more likely the ALJ will find that they are limitations.

Always emphasize the significance of the claimant’s testimony to prove disability. Your claimant must testify about their limitations and how they impact their daily functioning. By doing so, you’re empowering your claimant to play a pivotal role in their case. If your claimant does not testify to these limitations, there’s a risk that the ALJ may infer that they are not significant. This could potentially weaken your case.

Always make every possible effort to have medical opinions that prove disability. Sometimes, this is easier said than done, but you must always try to get a medical source statement(s) of your claimant’s functional limitations. Be sure to tell your claimants they must tell their doctors and other health care providers everything that is wrong and not to minimize what is happening (but don’t exaggerate). Remember, per SSR 16-3p, the ALJ is supposed to evaluate how consistent the claimant’s testimony is with the medical evidence.

Always get the VE to say that proven limitations eliminate all jobs. If the ALJ does not adequately explain why any proven limitation was not included in the RFC assessment, then you have grounds for appeal, but you must prove that that omission was harmful. If the ALJ does not include proven limitation X in the RFCA, the VE says proven limitation X precludes sustained work; the ALJ did not explain why proven limitation X was not included in the RFCA; therefore, the claimant was harmed, and remand is necessary.

Also, lay evidence supporting disabling limitations should be obtained. Friends and family statements/testimony will show consistency. For example, I once had a claimant’s neighbor, who also happened to be a pastor, come and testify to my claimant’s panic attacks and how he would come to his aide when he was having one. That neighbor’s testimony corroborated my claimant’s testimony about his disabling limitation and won his case.

And do not hide from weaknesses in your case; defeat them. Be sure to address every fact in the record that could be twisted or distorted to be contrary to disability. In other words, search for the dog that didn’t bark in the night. You can’t just close your eyes and hope the ALJ doesn’t find it because, in all likelihood, they will, which could blow up your claimant’s case. Practice paranoid thinking and assume the ALJ will see it, leading to a denial of your claimant’s claim. Meet it head-on to prove it is not contrary to disability, make a record of everything, and trust no one (even your claimant).

When you get past the grids, your job is just starting. Next time, I will focus on what to prove and how to prove it by reviewing some of my favorite limitations.

Remember, you can never provide too much proof of disability or prove too many winning theories.