Meet Sarah

She used to work as a special needs professional.  She has not been able to work for over a decade because she is so severely disabled.  She experiences a variety of ailments, with painful symptoms from head to toe.  Her name is Sarah.

My job is to help Ana prepare Sarah and her case for a Social Security Administration (SSA) hearing before an Administrative Law Judge (ALJ).  Sarah was exposed to poisonous airborne particulates resulting in an immune disorder that has systematically broken down her body.  Prior to onset, Sarah worked as a special needs teacher.  She taught, but she also listened to and comforted her students.  Tears rolled down her face as she recounted her working days.  As stressful as her job was, it was also joyful.  She was able to help people.  But now, she needs the help.

Applicants for benefits through the SSA must detail their disabilities to prove severity.  The SSA provides listings of disorders that you must “meet or equal” to be considered disabled.  If your disorder does not meet the listing, you have to show that it is equal in severity.  Essentially, there are boxes to be checked off and if your disease or symptoms don’t fit in a box, you are not considered severely disabled.  To be fair to the SSA, they need these boxes and solid evidence standards in order to prevent fraud.  As with most any benefits screening, however, there is always a deserving person who slips through the cracks…like Sarah.

But, there is more to Sarah’s predicament.  Sarah can’t afford co-pays.  She can’t afford to go to the doctor, but the only way that we can prove her disability is with medical records.  Not only do we need medical records, we also need diagnoses.  Hospitals that cater to poverty-stricken patients are often crowded and overwhelmed.  As a result, the doctors may not have the time to complete a thorough work-up and arrive at a diagnosis. Instead they may be forced to treat only the presenting symptoms.  A record of symptoms is not the preferable way to prove a disability case.   We need diagnoses!  However, I’ve quickly learned that you never get a perfect case.

Sarah came in today to talk about her medical history.  My supervising attorney, Ana, and I have been reviewing her file and medical records all week.  I have made a number of charts detailing her medical chronology and all of the doctors that she has seen over the past decade.  The goal of our meetings is to fill in the medical gaps from when Sarah could no longer afford to go to the doctor.  Once we have a comprehensive medical chronology, we will lay it out in the brief in a manner that calls out for diagnoses that have yet to be made.

I’ve never worked on a disability case before, but Ana pointed me in the right direction and offered me the reins, asking if I would like to conduct the client interview.  Normally, I would jump on such an opportunity; however, Sarah’s hearing is rapidly approaching and there is still so much ground to cover.  I knew that another opportunity would come about this summer and I wanted Sarah to get the best help possible.  So, I declined lead interviewer this go around, but was still able to chime in with burning questions.  I was very much a part of the interview, and it was tough.

Stay posted!

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4 thoughts on “Meet Sarah

  1. Anusia —

    As a LAB alum (’04), I think this blog is a great idea. It can serve to introduce current and future law students to the world of clinical education as well as introduce the wider public to the challenges inherent in practicing law in a public interest setting. Keep up the good work!

  2. As a much older LAB alum (class of ’85, LAB during ’83 – ’85) (although I am younger than Paul Tremblay) I agree with Kevin Carboni. Clinical education was very important to me as a student. The world of poverty is an eye-opener to anyone. I will follow with interest.

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