Disability denial highlights credibility issue

Erica Mandrell’s story of failing to convince a judge that her mental trauma qualified her for disability benefits is so common that her attorney said the denial reflects the “default culture” of the Social Security Administration.

The Hoosier was serving in the U.S. Coast Guard when she was raped by a fellow service member. Although she received an honorable discharge, she still struggles with anxiety and depression caused by the assault.

Mandrell applied for Social Security Disability Insurance about a year after her Department of Veterans Affairs benefits stopped. She went before an administrative law judge in Louisville, Kentucky, with reports from her therapists and doctors, detailing physical and mental limitations.

However, the ALJ denied her claim, and the Southern Indiana District Court affirmed.

Matthew Richter, an attorney at Keller & Keller and a member of Mandrell’s legal team, said he has seen so many cases similar to Mandrell’s get denied, he thinks the Social Security Administration needs to change its approach.

“The default culture within the agency is to approach the individuals who ask it for help with sort of an immense skepticism, to not believe them, to not believe their doctors and not believe the actual evidence that’s right in front of them,” Richter said. “Unfortunately, this is especially true when we’re talking about mental health conditions.”

Mandrell turned to the 7th Circuit Court of Appeals, where the panel overturned the denial of benefits in Erica A. Mandrell v. Kilolo Kijakazi, Acting Commission of Social Security, 21-1121. Writing for the court, Judge Diane Wood asserted the ALJ overstepped his expertise and entered the “forbidden territory” of playing doctor.

But the circuit court stopped short of ordering the approval of Mandrell’s benefits, remanding the case back to the ALJ for further proceedings.

Timothy Burns, the Keller & Keller attorney who represented Mandrell in the administrative hearing, said his client is not the kind of person who walks away after getting a “no.”

After making her case to the ALJ, Burns said Mandrell told him she was not surprised by the rejection.

“She was explaining to me, ‘I felt like in front of that judge that I was getting treated the same way that I got treated when I was in the Coast Guard,’ which was an, ‘OK, this bad thing happened as you say, now get over it and move on’ type of thing.”

Both Richter and Burns said disability denials are common, especially in cases of mental health conditions or, as with Mandrell, post-traumatic stress disorder.

The key hurdle applicants for the benefits have to overcome is the subjective nature of their medical evidence, the attorneys said. As they noted, a physical impairment can be proven with, for example, an X-ray or the results of a blood test. But debilitating trauma does not show up on an MRI or heart monitor.

Moreover, the individuals struggling with severe mental and emotional distress are inconsistent. Richter and Burns explained the individuals can have good and bad days and tell different therapists and psychiatrists different things.

“One thing I thought that Judge Wood highlighted in her decision that was just really important is when she said the ALJ didn’t provide an explanation why someone suffering from a mental illness like PTSD should be expected to behave rationally with respect to counseling and consistent treatment,” Richter said.

Rewired

Polli Pollem, Military Assistance Project director at Indiana Legal Services in Indianapolis, called PTSD “an invisible illness.”

Pollem pointed to herself, a retired captain in the U.S. Air Force, and her own fight with PTSD. So easily is she startled when someone walks into her office unannounced that her colleagues will knock on the wall as they come down the hallway to let her know they are approaching.

“It’s almost like you’ve been rewired,” Pollem said.

Military sexual trauma such as what Mandrell has suffered is especially difficult. Pollem said survivors of sexual assault can relive the incident when they encounter a particular smell or hear a voice, which makes avoiding the so-called triggers almost impossible.

Pollem, who does not know Mandrell and has not provided her legal assistance, said the Coast Guard veteran should get disability.

“She served in the military, she was raped, she suffered the consequences … ,” Pollem said. “She is entitled to disability. I would hate to see it get to a situation where (the Social Security Administration) says, ‘Well, you’re veteran, you’re getting Veteran Administration benefits so you don’t need Social Security disability, so we’re going to cut you off.’”

Richter and Burns explained that in applying for disability benefits, the cause of the disability, no matter how horrible, is not the issue. The ALJ will be looking at how the individual functions at present.

Mandrell inadvertently showed the court the depths of her trauma. While describing what happened to her, she became so upset that she had to leave the hearing room to collect herself.

With the remand, she is now facing another administrative hearing and the possibility of again reliving her trauma.

“These are very complicated issues and I know how overburdened the agency is and how underfunded these operations are,” Richter said, “but on these complicated issues, we’ve just got to find a way to start thinking about them and really considering them instead of just not believing people.”•