Group I, Category 19 Incorrect RFC Decision
ISSUE
DDS proposed a denial determination using Vocational Rule 203.15 as a framework for the determination. The evidence in file supports a more restrictive RFC, which results in an allowance.
CASE DISCUSSION & POLICY ANALYSIS (INCLUDING SPECIFIC REFERENCES)
This 66 year old is filing a DIB claim alleging disability due to stroke, fatigue, headache, mixed hyperlipidemia, hypertensive heart disease, benign heart failure, cerebrovascular left hemiparesis, allergic rhinitis, pollen induced, acid reflux disease, depression, benign hypotrophy, PTSD, elevated PSA, abnormal glucose, and a Vitamin D deficiency of 04/11/2014.
The evidence shows the claimant has a history of a right parietal occipital cerebral vascular accident (CVA) on 4/11/14. The CVA resulted in right
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The evidence in file supports a more restrictive RFC. The claimant could not be expected to lift 50 lbs. occasionally and 25 lbs frequently on a sustained basis. At most, he could lift up to 20 lbs. occasionally and 10 lbs frequently and would be limited to occasional posturals; he should avoid ladders, dangerous machinery, and unprotected heights.
DI 24510.006 indicates the RFC must be based on all of the available medical evidence including medical history, medical signs and laboratory findings and effects of symptoms including pain that are reasonably attributed to a medically determinable impairment. The RFC is the most the claimant can perform/sustain during an 8-hour workday/40 hour work week. In this case, in view of the advanced atherosclerosis of bilateral internal carotid artery and associated symptoms of dizziness related to cerebrovascular a more restrictive RFC is supported.
There was further evidence of a mental impairment. The DDS determined the claimant is mentally capable of simple, routine work tasks. The evidence in file supports this
Mr. Fix-it is a 59 year old man with a history of alcohol abuse and diabetic hypertension. Mr. Fix-it has been currently experiencing symptoms such as: rambling speech, poor short-term memory, weakness on the left side of his body, neglects both visual and auditory stimuli to his left side, difficulty with rapid visual scanning, difficulty with complex visual, perceptual and constructional tasks, unable to recall nonverbal materials, and mild articulatory problems. The diagnosis for Mr. Fix-it’s problem is most likely a right-hemisphere stroke. A right-hemisphere stroke is occurs when a blood clot blocks a vessel in the brain, or when there is a torn vessel bleeding into the brain. “A right-hemisphere stroke is common in adults who have
20. A patient was in an automobile accident and is complaining of a minor headache and no other apparent injuries. History gathered from bystanders states that the patient was not wearing a seat belt and hit his head on the windshield. A 15-minute loss of consciousness was noted. The patient was then admitted for 24-hour observation to rule out head injury. A comprehensive history and exam are performed by the physician. The MDM is of moderate complexity.
Mr. Williams submitted his application for Medicaid benefits on August 5, 2015. The Gulfport Regional Office (RO) forwarded a Disability and Blindness Report to Disability Determination Services (DDS), who has the responsibility of making disability decisions for the Division of Medicaid (DOM), on August 13, 2015. DDS notified the RO on October 16, 2015, that Mr. Williams was not disabled for Medicaid purposes. The RO issued a Notice of Adverse Action on October 23, 2015.
Dr. Swartz then indicated based on the questionnaire completed by the injured worker at the time of his evaluation in or about June 2016, the applicant’s activities of daily living were not significantly effective. It is noted on the record the injured worker claimed he was able to do various activities. Based on the
On Monday, 11-16-2015 she recalled the claimant had punched in early for work that morning and did not say anything to her until shortly later around mid-morning when the claimant came into her office. She said the claimant was brief with her when she requested to file a Workers’ Compensation claim for her alleged right wrist injury coupled with pain to her right fingers. She claimed that her injury was work-related, and her injury occurred on 11-12-2015.
Ms. Carter submitted an application on April 17, 2017, to the Philadelphia Regional Office (RO) for Medicaid benefits through the Working Disabled program. On the same day, the RO forwarded the medical records for Ms. Carter to Disability Determination Services (DDS), who has the responsibility of making disability decisions for the Division of Medicaid (DOM). DDS notified the RO on May 24, 2017, that Ms. Carter was not disabled for Medicaid purposes. The RO issued a Notice of Adverse Action on May 26, 2017.
We found that both witnesses claimed that there was no correlation to suggest that any of these alleged injuries specified by the claimant’s attorneys and by the claimant himself occurred or where the claimant suffered a stroke. Also, both witnesses were unaware if the claimant was experiencing any non-industrial stressors or if there were any outside non-work related factors that would suggest the claimant was suffering from any psychological problems and/or issues because of his employment.
On Thursday, 10/22/2015 the claimant stated he reported for work pain-free and was not suffering from any pain or discomfort from four other work related injuries that he reported as claims and received judgments. The claimant was unable to account for the real dates of his past work-related injuries that occurred between 2010 and 1/2013. The claimants past industrial-related injuries ranged from a left wrist injury, head injury and two separate right wrist injuries which he says did not include any injury to any other body parts.
A. Is Shirley Caretaker disabled within the meaning of the Social Security Act in that she meets the requirements of the disabling listing for 12.04 affective disorders in 20 C.F.R. Appendix 1 to Subpart P of Part 404-Listing of impairments? With respect the answer is yes for the reasons stated in the Argument section of this brief.
Respondent sought compensation from her employer Comcare under the Safety Rehabilitation and Compensation Act 1988 (Commonwealth). It was argued that she suffered injuries during the course of her employment.
In the emergency room, Rudd was connected to the cardiac monitor, labs were drawn and a 20-guage peripheral IV was started in the right arm. An IV infusion of nitroprusside was started and vital signs were recorded periodically. The Pain was assessed using a PQRST pain assessment method and Rudd rates throbbing pain bilaterally in the head with a pain score of 8 that aggravates with moving and does not radiate to elsewhere other than the head. The orthostatic BP shows no changes. The E.D physician decides to admit Rudd in CCU to further monitor his blood pressure and watch for any signs of organ damage. The E.D physician writes an order for pain management and transfer to CCU. The ER nurse
Allow as 99222, cc b/c the submitted record does not support the billed service of 99223 which requires the three following components: a comprehensive history, a comprehensive examination and a high medical decision making. The documentation scored as a 99222 with the following components: a comprehensive history, a comprehensive examination, and moderate medical decision making. For the next level of appeal, you will need to provide documentation to support a high medical decision making. The Centers for Medicare & Medicaid Services Manual, Publication 100-04, Chapter 12, Section 30.6.1 Selection of Level of Evaluation and Management Service, was utilized to make this determination.
1. Occupation and working ability of the Claimant, if this has changed, since the injury, previous occupation of the Claimant.
Per the Function Report- Adult- Third Party (11/16/2014), a claimant’s friend reported that the claimant lived with friends, had “explosive anger” and did not get along well with others. He also had brain damage from a car accident. He spent 12-14 hours a day playing video games and reading.
The first rejected argument is Robins having an actual traceable harm. The court has already accepted wallet injury as an actual injury. Hein case. Robins fails to create a strong argument or prove the misinformation led to his failing job prospects. The court understands the difficulty in proving that he would be denied a job because of what