Case Study: Mild Intellectual Disability and Social Security Disability

Last week we got a fully-favorable decision in a mild intellectual disability case for a 20-year-old gentleman, "Gerald." Gerald had tried to work but his best job -- working in a butcher shop -- was too physically demanding.
He had a Scheuermann's disease diagnosis, or adolescent kyphosis (meaning "hunchback"). In older people, especially small women who are already at risk for osteoporosis, kyphosis is often caused by vertebral compression fractures. As osteoporosis takes its toll on bone density, the vertebral discs collapse in upon themselves.
In younger people, adolescent kyphosis happens when the bones of the spine are wedged together. Doctors don't know why it happens, but Gerald believed his own problems began with a four-wheeler accident several years ago.
The problem with Scheuermann's disease in disability cases is that it's usually not sufficient to get a 20-year-old approved for benefits. Gerald wasn't able to work in the butcher shop because a big part of his job was carrying heavy meat boxes all day from the cooler to the cutting tables. He could help with lighter tasks, but the boss needed someone who could do everything. Gerald had a "severe" impairment that would get him past Step Two, but it wasn't severe enough to meet the musculoskeletal listings. A good rule of thumb is that if you're under 50, you have to meet or equal a listing.
Gerald's case didn't look good. He had a real and significant physical impairment that affected his ability to work, but not bad enough to stop him completely.
Social Security's view of this is that even though you might not be able to do physical work, while you're younger you can still train for a job that doesn't require as much physical effort. So why wasn't Gerald able to find something? Or at 20, why wasn't he enrolled in a technical school or college?
It was fairly obvious if you bothered to sit and talk with Gerald for more than a few minutes. He was a good kid, wanted to work, and was terribly frustrated with his circumstances, but once you got to know him, it was clear his mental limitations had the worst impact on his ability to work.
We ordered Gerald's high school records and discovered he had a full scale IQ between 60 and 70. That's not sufficient by itself to meet the listing for mild intellectual disability, but Gerald had one additional significant work-related impairment -- his Scheuermann's kyphosis.
It sound's simple enough, but Gerald's case required a hearing before the ALJ and then a six-page legal brief to the ALJ on the interpretation of the term "significant" as used in Listing 12.05C. This is a case we're especially proud of because our hard work paid off for a young man who otherwise would have been faced with a bleak and hopeless existence.