Submitted by Esther Gomez, Staff Paralegal, Public Benefits Unit

Tracy (fictitious name) is a 44-year-old woman who suffers from hidradenitis suppurativa (HS), a chronic inflammatory skin condition that causes painful skin lesions, abscesses, and scars. Along with HS, Tracy also suffers from diabetes and chronic heart failure. Tracy takes multiple medications, has mental health concerns, and has had various life-threatening diabetic ketoacidosis incidents that have taken her to the emergency department.

Tracy was receiving Supplemental Security Income/Social Security Disability Insurance (SSI/SSDI) benefits from 2013 until her benefits ceased in 2017 after the Social Security Administration (SSA) alleged there was medical improvement in her conditions. Tracy appealed her benefit cessation and attended an administrative law judge (ALJ) hearing on May 20, 2021. Tracy’s appeal was denied by the ALJ on November 24, 2021. However, Tracy did not give up. She appealed the adverse ALJ decision to the Appeals Council.

Seeking support and assistance

The Appeals Council initially denied her Request for Review in February 2023, but to Tracy’s pleasant surprise, the Appeals Council reversed course the following July, vacating their previous denial and remanding the case for a new hearing. Tracy did not understand what the legal terms of the notice meant and came to CLA SoCal on October 2, 2023, and our team agreed to represent her at her pending hearing.

Case development

An intense seven-month period of case development by attorney Sarah Mays and paralegals Alton P. Donatto and Esther Gomez took place. This team worked together to analyze and develop the best argument for Tracy’s appeal. Much effort was spent gathering medical records, conducting extensive research on Tracy’s conditions, communicating with her, and preparing a pre-hearing brief. Unfortunately, it was also during this period that Tracy had to grieve the sudden and unexpected passing of her beloved son.

The representation and the result

On May 16, 2024, Alton Donatto represented Tracy before the ALJ. Per our request, a medical expert appeared at the hearing. Upon extensive questioning, the medical expert concluded that she met an SSA Adult Disability listing effective 2018, as argued in our hearing brief. A vocational expert then testified, and in response to Alton’s questioning admitted there were no jobs Tracy could perform in the national economy due to her significant limitations. As a result, the ALJ issued a fully favorable decision on May 31, 2024, finding that Tracy continues to be disabled as of March 1, 2017, thus entitling her to significant retroactive back payments