Case was born in Buffalo, New York and lived in nearby Hamburg, New York. He wrote his first song "Stay Away," in 1965, at the age of eleven. A veteran of several rock bands and the local bar scene as a teenager, Case dropped out of high school when he was fifteen (he would later earn a GED), and after several years of traveling arrived in 1973 in San Francisco, where he performed as a street musician. During this period a documentary about the local music scene, "Nightshift," directed by Bert Deivert, captured the young Case on film. In 1976, he teamed up with Jack Lee and Paul Collins to form the early punk-era band The Nerves in San Francisco. The group's 1976 EP track, "Hanging on the Telephone", was later recorded by Blondie.