Discussion in 'Fibromyalgia Main Forum' started by JLH, Nov 9, 2004.

  1. JLH

    JLH New Member

    This is a long read, but I think you will find that it is worth it! It is very informative and will be helpful if you are considering filing for Social Security Disability here in the U.S.

    It was published in this month's "Arthritis Today" magazine and therefore, most references to the disability being filed for is arthritis.

    The Disability Maze
    by Amy Brayfield

    Disability cases are won and lost on the strength of the application. We'll help you through the process, step-by-step.

    Shawn Sluder knew it wasn't going to be easy to give up her job. She'd been an executive assistant for almost 10 years and loved the busy pace and constant multi-tasking her work required. But Sluder, 38, who has lupus and fibromyalgia, found herself struggling more and more to get her job done. After six months of collapsing onto her couch at night, running through all her time off and more than one breakdown in the office bathroom, Sluder had to accept the fact she couldn't keep doing her job. She took her doctor's advice and filed for disability. Four months later, she was denied.

    "As frustrating and embarrassing as it is to have to file for disability, it's about 10 times worse to have your claim denied," says Sluder. Almost 24 months after her initial application, Sluder is still fighting her way through the Social Security Administration (SSA)'s appeals process.

    She isn't alone. Of the approximately 1.5 million Americans who file for disability benefits every year, 65 percent are denied on their first try. Even people who aren't rejected often feel confused and overwhelmed by the process, which seems arcane at best and tortuous at worst. For people like Sluder, the system can seem designed specifically to batter their already fragile emotions, making a difficult situation even worse.

    "There have definitely been times when I feel like the SSA thinks I'm just trying to get a free ride," says Sluder.
    There's no magic spell to make applying for disability benefits suddenly easy, but you can reduce your frustration - and maybe even increase your chances of getting a fast approval - by understanding the process before you apply, says Bob Keck, an attorney with the national disability advocacy firm Allsup Inc.

    Alphabet Soup

    Scanning your disability application may bring on a headache as you try to make sense of the myriad forms with their alphabet soup of options. Is the Disability Report the same as the Symptom Questionnaire? What remarks go in section 9? And does the SSA really think you can finish this paperwork in the half-hour estimated completion time named on the application?

    The answer to that last question, at least, is no, says R.M. Bottger, a former Social Security disability specialist. "We used to joke that anybody who could actually fill out that disability report in half an hour automatically didn't qualify for disability," says Bottger.

    The application can be intimidating, but it's important, says Keck, who encourages his clients to focus most of their energy on the Disability Report. "The SSA uses the information in your application to evaluate your case at every stage of the process. Even on appeal, they'll compare the testimony you give on appeal to that first application."

    For someone with arthritis, the application can be even more important, says Bottger, because of the variation in arthritis symptoms. "Every case is different, but you have a pretty good upfront understanding of what limitations a person in a wheelchair has. Arthritis is different -- there's no 'basic' effect of arthritis. The burden is on the applicant to show that his arthritis is disabling."
    This may be why the application for disability is such a dichotomy: on one hand, a just-the-facts, fill-in-the-blanks form; on the other, a personal and infinitely variable story of the effects of arthritis on your life.

    It's important to keep both aspects in mind when you're filling out your application, says Keck.
    The emotional component is often most difficult. Most people with arthritis focus on staying positive, but working on your disability application means focusing on the things you can't do. Be too stoic or Pollyanna-ish, and your case manager won't have all the information she needs to evaluate your case.

    "I think that's where I went wrong," Sluder says. "I spent so much time trying to figure out how to keep doing things that I didn't want to say I couldn't do something."
    People like Sluder who've adapted their routines because of arthritis may no longer even notice the accommodations they've had to make. Keck recommends inviting a friend to watch you do a few household chores. "Seeing how your arthritis affects one task, it's easier for you to see the accommodations you make in other tasks, too," he says.

    It can be emotionally taxing to spend a lot of time dwelling on your limitations. Try not to work on your application for more than a few hours at a time -- it's OK if it takes you a week or so to complete it - and keep in mind the reason you're going through the process at all is to get the support you need to live a better, healthier life.

    Inside the Application

    Bottger and Keck agree that the part of your application that deserves the most attention is the Disability Report, a 16-page, nine-section form in which you describe your arthritis (or other illnesses), its symptoms and effects on your work."

    When I denied an application, it was because it lacked compelling medical or vocational evidence. The disability report is where you can give that information," says Bottger.

    The secret to success is simply knowing what information your SSA representative is really looking for in each section, says Keck. We asked our experts to take us through the Disability Report, section by section, to help you make the most of your application.

    Section 1 -- Information About the Disabled Person

    Why they're asking: The SSA needs this basic information -- your address, Social Security number, etc. -- to contact you and request case information. The SSA also uses it to see if you qualify for special programs based on your age or weight.

    What you should know: This section asks you to provide a personal, or non-work, reference familiar with your condition. Think carefully about who you choose, says Keck. The best choice is someone who's seen the impact of arthritis (or your other illnesses) on your life and who is close enough to share your struggles with. It's OK to pick a family member. Give the person you choose a heads-up that the SSA may contact her about your case, says Keck.

    Section 2 -- Your Illness, Injuries or Conditions and How They Affect You

    Why they're asking: The SSA needs to understand two things to evaluate your case: what your condition is, and how it affects your ability to work. This section connects the two.

    What you should know: Both Keck and Bottger recommend answering this important section last.

    The key here, says Keck, is to break down your job, task by task, to explaining how your condition limits your ability to do it. Say you're a customer service representative, and part of your job is filing order records. To do this, you must label folders; kneel, reach, bend and stoop to file; occasionally carry 10- to 15-pound boxes of file folders to restock your supply; etc. Break down each task into its specific components, then explain how arthritis (or your other illnesses) makes each one a challenge: kneeling, reaching, bending and stooping are painful because, for example, osteoarthritis (OA) in your hips and knees makes bending at the knees and waist difficult. Do this for every task.

    Section 3 -- Information About Your Work

    Why they're asking: Knowing what tasks your job regularly requires helps the SSA decide how your arthritis (or other illnesses) affects your ability to do that job.

    What you should know: Remember your job title doesn't necessarily reflect your actual responsibilities, says Keck. One insurance customer service representative may do little more than field incoming calls; another might stock office supplies, visit claim sites and do the office filing. Explain the specific responsibilities of your position. Keep in mind, too, that the more specialized your position, the more likely it is your representative might believe you can continue working -- in another position, says Bottger. If your job is highly specialized, highlight its more universal facets, such as sitting, standing, walking, carrying, bending, and so on.

    Section 4 -- Information About Your Medical Records

    Why they're asking: You can provide copies of your medical records, but the SSA requests its own copies from your doctors, using the information in this section.

    What you should know: Make sure all the information is correct so your application doesn't get delayed, says Bottger. He also recommends writing in each doctor's specialty on the space beside his name, even though the application doesn't ask for it.

    Section 5 -- Medications

    Why they're asking: Before granting disability, the SSA confirms you've tried medical intervention.

    What you should know: List your current meds, plus all medications you've tried, whether they worked or not, says Keck.

    Section 6 -- Tests

    Why they're asking: The SSA looks for a test to confirm your diagnosis - for rheumatoid arthritis (RA), it's usually a blood test; for OA, an X-ray.

    What you should know: If you have a form of arthritis, such a fibromyalgia, that doesn't have an accepted diagnostic test, make sure your medical records include tests to support your condition's symptoms, says Bottger. The presence of several symptoms that aren't debilitating on their own can be considered debilitating when they co-exist.

    Section 7 -- Educational/Training Information

    Why they're asking: Understanding your education and professional experience helps the SSA determine other jobs you might be able to do.

    What you should know: This section is important for borderline applications, says Bottger. The more specialized your experience, the less likely it is that the SSA will recommend you try another form of employment before reapplying.

    Section 8 -- Vocational Rehabilitation, Employment or Other Support Services Information

    Why they're asking: The SSA considers what steps you've tried to continue working.

    What you should know: The younger you are, the harder it is to prove you can't work at any job, says Bottger. People younger than 55 must show that they can't work even at a mostly sedentary job. Participating in a vocational rehab program can show the SSA how your limitations really do impair your ability to work at any job. And -- of course -- there's always the chance that a rehab program might be able to help you find a job you can actually do.

    Section 9 -- Remarks

    Why they're asking: As big as the application is, you might run out of room on some sections. Section 9 lets you continue information from other sections.

    What you should know: Many people find they need more space to list their medications and on-the-job challenges than the form provides, and it's better to continue in section nine than to leave out important information.

    The Aftermath

    Most disability applications are determined within five months. If your claim is denied, you may start the process over by appealing for reconsideration. If it's accepted, you may wonder, "What's next?"

    Filing for disability can be so time-consuming and emotionally draining that you don't have time to deal with the implications of not working. In a society where people define themselves by their careers and many view "disability" and "laziness" as synonyms, it's hard to cope with the personal and social pressures of being unemployed. No wonder 40 percent of people report feeling depressed after being awarded disability benefits.

    Sheryl Cohen-Alexander, 48, who applied for disability in 1990, wasn't prepared for the sadness she felt when her application was accepted. "It finally hit me what being on disability really meant."

    Cohen-Alexander didn't want to sit around feeling sorry for herself. Cohen-Alexander has the right idea, says Keck, who asks his clients to plan for their lives post-disability and to stay active during the application process. "It can consume you if you let it," says Keck. "So don't let it."

    Are You Ready for Disability?

    Ask yourself these questions before you decide to file:

     Are you working? You must have been unable to work for at least a year or show that you won't be able to work for at least a year before applying for disability. If you earn more than $810 each month, even if you can't work full-time, you're not eligible for benefits.

     Does your arthritis (or other illnesses) make it impossible for you to do basic job tasks? Your arthritis (or other illnesses) must be severe enough to limit your ability to perform the basic tasks that most jobs require, such as standing, reaching, sitting, carrying and walking.

     Do your limitations keep you from doing your specific job? If you can continue to do your job, even if you're in pain while you're doing it, you're not eligible for disability benefits.

     Are there any other jobs you can do? Just because your arthritis (or other illnesses) keeps you from continuing work as, say, a construction foreman, does not automatically mean you can't do a more sedentary job. The SSA will consider your work history, age, education and physical limitations to determine what other work you can perform.

     Does your diagnosis match the Social Security Administration (SSA)'s medical listing? The SSA's Blue Book lists the criteria for disability for all medical conditions. For rheumatoid arthritis (RA), for example, the Blue Book says applicants must show persistent pain, swelling and limited joint mobility to qualify.

    The Appeals Cycle

    Only about 35 percent of applicants are APPROVED for disability benefits on their first try. If you're denied, you enter another maze: the appeals process. If your initial application is DENIED, you can file for reconsideration.


    Reconsideration is basically just resubmitting your application, but you should take the opportunity to make sure you're being as specific as possible on the sections describing your condition and limitations. Your claim can be APPROVED or DENIED. If it's denied, you can appeal.

    Administrative Judge Law Hearing

    At this local hearing, you can give testimony in person. The judge can APPROVE, Deny or REMAND your case back to reconsideration. If it's denied, you can appeal.

    Appeals Council

    You must appear before the Appeals Council in person. They can APPROVE, Deny or REMAND your case back to the Administrative JUDGE. If the council denies your claim, you can appeal.

    Federal District Court

    As a last resort, you can appeal outside the SSA's jurisdiction in Federal District Court. This is your final appeal -- if your claim is denied here, you have no more appeal options.

    ****End of Article****
  2. chemisstree

    chemisstree New Member

    thank you so much for this. i will apply.
  3. JLH

    JLH New Member

    Everyone is always asking questions about applying for disability, so I thought this info would be informative for them!

    AUNTPICKLE New Member

    and was denied and so now I have been playing the waiting game for a court date to appel. I have been waiting for over a year and a half. I can't believe the courts are that backed up.

    So here I am patiently waiting for my court date and praying to get approved. By your posting I already know of things I did wrong. I too try to do too much but certainly feel it for days afterwards.


    Thank you for your very imformative post
  5. suzbee

    suzbee New Member

    Thanks for sharing.

    Just one comment. The article said that if the Administrative Law Judge denies you after a hearing, and you appeal to the Appeals Council (in Virginia): "You must appear before the Appeals Council in person. They can APPROVE, Deny or REMAND your case back to the Administrative JUDGE."

    I never had to appear in person before the Appeals Council. I wonder if that's new (or outdated) info. The Appeals Council in my case has remanded it back to the judge. Oh, I dread seeing that guy again ...

    (almost 5 years into the disability process)
  6. mistress-o-pain

    mistress-o-pain New Member

    I disagree with number 7 re: education. My second denial stated that since I have so much education then they believe I can find a job doing something in the same field. My first denial stated that they knew I could not use my hands for a long period of time but I could find employment that dose not require my hands.. I can not think of any non-prosecutable jobs that do not require my hands.
    I believe they just deny you no matter what. I find SSD people to be very discrimitory if you have an education. I worked hard and raised two boys by myself without any child support or government assistance. I worked two jobs for years. Now I have to pay $765 a month for the medicaid card and am shun by the people in the medicaid office and in my field of nursing for being on medicaid. So I am left not being one group or another. It is lonely to have Fibro.
  7. RxAngel

    RxAngel New Member

    bumping for my info
  8. Suekoo

    Suekoo New Member

    Bumping for all to see
  9. JLH

    JLH New Member

    for the weekend crowd to see!
  10. readalot

    readalot New Member

    for sharing this with us. My printer is out of ink, so I can't print it. I will find the magazine. Also they have a website. I had applied and had been denied. I am now getting ready for the appeal. I hope to get the support I need in my area to get through it. Just have to keep going.

    Thanks again

  11. JLH

    JLH New Member

    good luck on your appeal.
  12. lin123

    lin123 New Member

    I live in Ohio and filed June 2003 and have been denied twicw now and waiting on ALJ Hearing date. Been told by my Attorney it could be 18 to 24 months. I have several illiness including have to have back surgery. I think Ohio denies you faster then other states right now due to some many job losses we have faced.
  13. tweets

    tweets New Member

    I was told that while they agree that I cannot do my past job, it does not prevent me from doing other work which is routine and not strenous and does not require me to work (their words!)Not require me to work? How does that work? I dont know what to do now. Should I reapply as I first or appeal their decision? Any help? I am new to this and even wrote to that site that ppl talk about that they have worked in SS and not heard back. Am I stupid? How can I work and not work? Does that make sense?Do I have a leg to stand on if I go on what they said? Sorry all, I am jusy so well I dont know what I am, hurt angry,so many feelings. It was hard enuf to do in the first place ya know? And be turned donw? Ouch. If I could work wouldnt I do it and make more money? Get up in the morning and have self essteem?Gosh so many feeling, and I am sure that most understand what I am feeling.Sorry to ramble and vent here. Anybody haVE
  14. tweets

    tweets New Member

    I was told that while they agree that I cannot do my past job, it does not prevent me from doing other work which is routine and not strenous and does not require me to work (their words!)Not require me to work? How does that work? I dont know what to do now. Should I reapply as I first or appeal their decision? Any help? I am new to this and even wrote to that site that ppl talk about that they have worked in SS and not heard back. Am I stupid? How can I work and not work? Does that make sense?Do I have a leg to stand on if I go on what they said? Sorry all, I am jusy so well I dont know what I am, hurt angry,so many feelings. It was hard enuf to do in the first place ya know? And be turned donw? Ouch. If I could work wouldnt I do it and make more money? Get up in the morning and have self essteem?Gosh so many feeling, and I am sure that most understand what I am feeling.Sorry to ramble and vent here. Anybody here think that I am nuts in trying to keep on when Im just about redy to give up!Help! Just need ome kind words of advice from some who has been there!Thank u and God bless you all for reading and taking time to read this! Tweets!!!!!!
  15. JLH

    JLH New Member

    I am so sorry that you were turned down. I think they are crazy when they tell you that they think you can still work ... just get a job where you don't have to work!!! I don't know of any employer who is willing to pay an employee NOT to work!!!! If that were the case, we all would love to "work" on those jobs and for that employer!!

    I think you should appeal their decision. You might want to contact an attorney who specializes in Social Security Disability. I think they do not charge anything unless they win the case for you, then they take 25% of your back pay.

    Make sure you check your denial letter and file the appeal within their time limit. So that means you must take action now ... you have to allow plenty of time for a lawyer to work it up.

    You will need to provide the lawyer with into on why you think you are not able to do any other type of job. The more info you give him, the better.

    Good luck.
  16. tweets

    tweets New Member

    Sorry about the dbl posts, must have done something wrong. Like I said, I am new to this and nervous. I do want to thank the one answer to my post! Oh and we are both born in feb! I am just 3 years younger than u!Wow when I read about you, I had to think, what have I done, this lady has done so much with her life! WOW! I did make a call to Allsup I think its caled, the ppl that are sposed to be in the know about SS. The lady said I qualify, and they would take my case if I fax them an earnings thing, to show that I would make at least 400$ a month. I havent told DH yet. I know that I have to do it b4 dac7 to make it 60 days. I would like to know of a job or does anyone know of one that I dont have to WORK? haha! i find it ironic.Thanks again for the post! Oh and about the city girl, I too am from a big city and now live on 38 acres in the midle of nowhere! But have to say, besides missing my DC, its great. Take care all, Gentle huggs.From a newbie who is still learning! Tweets!
  17. rigby

    rigby New Member

    I was approved the first time around but mine went to some kind of peer group or something like that so it took a long time to hear from them. If you had problems with your job and had changes due to illness this helps also Sharon
  18. Kourysgranny

    Kourysgranny New Member

    Yeah, that's how I feel. I applied, was denied. Appealed, was denied. Went before the judge, was denied. Appealed, was denied. My lawyer was livid. What good does that do me?? I've been out of work for 5 years now. My family suffers. Now I can't even apply again because I no longer "qualify" for the money I paid in!!!!! Been out of work too long!!!!!The denials claim that I should still be able to do "light work", such as restaurant manager, like I used to. Any managers out there with a light load. I'd like to know!!!!!! What does a person do now.???? I'm only 42. I know a couple of people drawing disability for back trouble and one of them is doing landscaping on the side! Disabled? I don't think so! So, you see, it's a crap shoot.

  19. tweets

    tweets New Member

    I did think about appealing. So I called the Allsup (sp) paople and they say that they will take me on cuz I have a good case (whatever that is). And I also talked to the super nice lady who works for ssi and decided to give her a call. She could not believe that I was turned down. She said tofight it and said she could not tell me more, but seemed positive about my chances of appealing. So I guess that I will appeal, but dont know if it will help or not to have a lawyer.Oh and when I asked if the lawer could help, they said that they needed a copy of my benefits from when I worked, so she could see if I would get more than 400$ a month, cuz if not, then they wouldnt help me ,cuz it wouldnt be worth their time.HMM! I never heard anyone say that before about their lawyers wanting to be sure of how much or little they would get.So yes I will appeal, But does anyone here know about how long it takes to get a hearing? Is is right away? The nice lady fromm ssi says that I would have a better chance because they dont have the leeway that the ppl in the hearing have.Oh well, keep on keep on huh? Who says that "Get er done?) Thnx Tweets
  20. toadgoddess

    toadgoddess New Member

    I have been waiting for my appeal for over a year and a half!! I thought it would take 60 to 90 days or something. This process has taken since Dec. of 2000...4 years into this. It's enough to make one sicker...


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