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A Few More Words From Charles Binder

I am not naive. My first job after law school was as a public defender. I represented a few thousand people accused of crimes and most of them pled guilty quickly. Needless to say, jail house lawyers, inmates who had been through the system, would tell everyone to deny to their court appointed lawyer that they had done anything -- that the lawyer "needed" to believe them or he would sell them down the river. Utter nonsense. While I always appreciated a client who would tell me immediately, "I did it, get the best deal you can get for me," that was pretty unusual. You do not need to believe your client, or even like him, to represent them. Doctors want to like their patients but medical treatment is not based on how much you like a patient, but rather how sick he is.

Representing the disabled is not really different, though it is much easier. Most of my clients are hard working people who have gotten unlucky; they have had accidents or gotten sick younger than most people. I believe my clients by and large, but I rely on their medical records for proof of their disability. It is the trained doctor whose assessment matters to me. I don't decide whether a client is disabled under the law or not, nor do I consciously discount clients who have more unusual or less objective cases. The ironic thing is that experts will tell you that many people have herniated discs and don't know it--they have no symptoms. Others have the exact same findings on a scan and are in so much pain they risk major back surgery. Objective disorders are not quite as simple as we think; difficult to diagnose disorders are every bit as complicated as we think. But the law wisely defers to the experts, the doctors who go through college, medical school, internships and continued medical education.

There was an Administrative Law Judge that I cared for very much. Unlike many of the recent Social Security Administration appointees who have spent their entire career working for a government agency, he had been an active single practitioner. He had represented clients in court, met a payroll, had listened to hundreds if not thousands of clients tell him their stories about their problems. He used to say to me that if someone had worked for many years, particularly for one employer or in one industry and after a long work history said he was in too much pain to continue, he would believe him. He always had more difficulties with younger people who had not worked long or people who had not worked steadily or had worked "off the books." He would say that people who had worked all their lives were hard working people; they were people to be believed and trusted. He would listen attentively to someone who made the minimum wage in a physical job for years say he could not do that work anymore, that he was too beaten down and sore. People like that, who sometimes are described as the working poor, can't afford the fancy doctors and testing since they often lack insurance. And because they made little money, their social security share was proportionately small, barely enough to live on. He would say to me "Why is a person making $18,000 going to stop work to collect social security which gives him $650/ month? Why is a person making $70,000 per year going to quit work to collect $1800 per month? They apply because they cannot continue to work. They are truly disabled due to their arthritis, or Multiple Sclerosis, or chest pain, or because their hips or knees are too painful to walk, or because work stresses are simply too much for their bodies to take." There are a myriad of disorders, but there is not a myriad of reasons to apply for SSD. It is almost always because my clients have to.

This is why it was so disheartening to find that we had a person working for us who did not understand the role of an advocate. You hire an advocate to be on your side, to articulate for you what it feels like to be disabled, and to prove in court what your body has been telling you. An good advocate does not decide that only people worthy of being represented are those with diseases she personally believes in. A good advocate is not a doctor. I am not a doctor. My knowledge of medicine is limited despite constant exposure to reports and opinions, plus whatever I am able to comprehend at medical conferences I attend. I did not go to medical school, do an internship, practice in a medical field. As a non-physician, I must defer to the true experts on medicine--the physicians who practice and research disease. I do not decide what medical conditions are more serious than others.

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