I need help in identifying the things in regards to this fact pattern I am a little confused, I am going to post it on here:

You have just met with Shirley Caretaker about her potential disability claim. Review the Shirley Caretaker fact pattern located in Doc Sharing. Prepare an internal memorandum to your supervisor discussing the relevant facts and identify at least five issues you believe will be important to his case. Additionally, identify any further information or documentation you feel may be necessary in order to further develop his case, should the firm agree to accept it.

Submit your written Assignment to the Dropbox by the end of this unit in the basket titled Unit 1: Written Assignment.

Mrs. Shirley Uber Caretaker

Mrs. Shirley Uber Caretaker is 56 years old. She has been working since she was 16 years old, when she dropped out of high school to get a job to help her single mother take care of her three younger siblings.

 Her first job was working at a local grocery store as a janitor. She also worked as a bagger. While working at the local grocer she earned her GED. After earning her GED at 22, the store manager offered to train her as a cashier. She worked as a cashier until she was 27. She got a job at a local nursing home answering phones and serving food to the residents. At night she worked towards her Certified Nursing Assistant license, which she achieved when she was 30. She served as a CNA at the local nursing home for 15 years. Her job duties included caring for a group of residents. Each resident’s needs were different, depending on his or her level of independence. However, she sometimes had to help patients into and out of beds and showers, and onto and off of the toilet. She would bring them their food, change their sheets, and would keep vitals for the LPN to observe and monitor. Just after her 40^thbirthday, she earned her Associates Degree in liberal arts. Just before her 45^th birthday she obtained her LPN license after two years of additional night coursework. Upon earning that certification, she obtained a position at the local hospital as an LPN. Her job as an LPN required that she be on her feet 80% of the day. She often had to do the same work that she did as a CNA. However, she also monitored patient’s vitals, dispensed medication to patients under the supervision of a Registered Nurse, and provided basic triaging of basic assessments. She worked in this job for 10 years.

Mrs. Shirley Uber Caretaker has been married to Mike History, a junior high history teacher. She met him when she was 16 and he was 20, while they would bag groceries together for customers. He was in college at the time and working part-time as a bagger. They married two years later after he graduated from college and obtained his job at the local junior high. Her children are in their 30s and live within two miles. They often do the chores around the house so she and her husband do not have to struggle with them. Her husband died last year at the age of 59 from a massive heart attack. She had been depressed since she stopped working due to her work related fall, but after her husband died she has become severely depressed. She feels suicidal and has days where she can’t even manage to get out of bed. She has a hard time focusing and concentrating. Two to three times each week, she simply lies in bed. Her children have to coax her to get out of bed. Her primary care physician, Dr. Robert Prime, has prescribed her anti-depressant medications and recommended that she see a therapist and psychiatrist. However, Mrs. Caretaker said that the cost of that treatment was prohibitive and she was focusing on fixing her knee and back issues first. She does, however, visit Dr. Prime every month and they discuss for 15 minutes her mental health issues before he prescribes her the anti-depressant medications.

When she was 49, she started to have significant pain in her knees. For two years, she worked through the pain by taking over the counter medications, wearing shoes with extra padding, and applying Icy Hot cream on her knees. However, the pain became unbearable so she saw her primary care physician, Dr. Robert Prime. He later referred her to a specialist, Dr. Teresa Knees. Dr. Knees had an MRI taken which revealed that the cartilage had worn down in her knees. Dr. Knees advised that she would need two total knee replacements, but that she could wait a couple more years. Mrs. Caretaker wanted to wait because she really enjoyed her job, she and her husband were trying to save towards retiring when she turned 60, and she was worried about the risks of the total knee replacements. In the meantime, Dr. Knees would give her cortisone shots every three months, and increasingly stronger pain pills.

One day at work, when she was 55, she had dropped a bottle of pills on the floor, and the medicine scattered on the floor. As she started to kneel down, her left foot slipped on a pill. She grabbed the filing cabinet next to her, twisted her knees and ankles, and pulled the cabinet down as she fell forward. The filing cabinet crashed onto her back just seconds after she landed on her stomach. She did not get Worker’s Compensation or unemployment insurance benefits. But she did receive Short Term Disability for six months. After that she was terminated from her job, because she was unable to return. At that point, she was awarded Long Term Disability from her company’s insurance provider.

She complains of severe pain in her back in two places, her lower back and upper back, which are the approximate edges of the heavy filing cabinet that landed on her at work. The pain in her upper back radiates from her neck to the tips of her fingers. Her fingers and arms periodically feel numb. She states that at times she drops things and she is unable to reach above her head or out in front of her. If she tries the pain in her arms quickly becomes unbearable. She has a stabbing, pulsating sensation in her lower back. The pain is along her waist-line and radiates down her right buttock to her toes. The feeling is stabbing, burning, and pulsating. She always feels a pulsating, throbbing pain in those areas. She also complains of pain in her right hip. This she also blames on the slip and fall at work. She had an MRI done of her hip and it did not reveal any damage from the fall. However, it does reveal arthritic changes in that hip. The MRIs of her lower back and upper back came back inconclusive, according to Dr. Knees, Mrs. Caretaker cannot afford to get them redone. Dr. Knees has determined that she must have the total knee replacements, but is unwilling to do so until her back issues are resolved. Her neurosurgeon, Dr. Thor Lumbar, suspects that she has nerve root compressions, one in her neck and one in her lower back. He wants to do another MRI, because he is worried that her delay in the surgery will permanently damage her spinal cord.

She complains that she is unable to sit for more than 30 minutes at a time, stand for more than 30 minutes at a time, and walk for more than 10 minutes at a time, without causing herself severe pain. Dr. Prime has filled out a handicapped sticker for her, and prescribed a walker and cane for her.

She tells you that her second child, who is a microchip engineer at North Carolina Chip Company, pays her $350.00 every week to have the grandchildren stay at her house after school for two hours. She uses this money to help pay for her extensive medical expenses. She is hoping to be able to get the second round of MRIs, and all necessary surgeries, before her COBRA expires. The two children are 15 and 17. They are both on the swim team and arrive to her home at 5 p.m. after practice. She prepares them a snack (usually fruit or something sweet). Their mother picks them up after work, usually at 6:30 p.m. Mrs. Caretaker feels guilty as usually on Fridays during this time, the boy ends up doing yard work for her and the girl washing the dishes and laundry that have piled up in the house over the