FOR those of us APPLYING / FIGHTING for Disability....

Discussion in 'Fibromyalgia Main Forum' started by BLUEROSE7, Jun 24, 2005.

  1. BLUEROSE7

    BLUEROSE7 New Member

    Maybe helpful/interesting info for those of us going through the disability process.

    **Be SURE to look through out the whole post, Important info spread through out the whole post!

    If you suffer from depression, anxiety, panic attacks, OCD etc... along with FMS/CFS like myself the information below maybe helpful in your disability case. (long read)

    I have been doing alot of research on things to do and not to do for Disability and if any are interested I will continue to add info. to this post.

    **I Will Continue to add info here to this post..You may want to scroll down and look at each heading if you are looking for something inperticular!!!

    UPDATE: I won SSDI at the Reconsideration stage!! Alot of the info through out this post helped in winning my case! I wish all you Luck in your fight for Disability and Never GIVE UP!!
    ***********************************************************


    By Martha A. Churchill

    Some individuals with mental illness are not aware of their own behaviors and symptoms. The person realizes he or she cannot work, but does not understand exactly why. This makes it difficult for someone with a mental illness to obtain benefits.

    It's hard for you to prove you are disabled when you don't even realize what your behaviors are, and how you affect others.

    That’s why it is so important for friends, family, and former employers to write letters and reports about you. They notice the things you do or say that don’t fit in at the employment scene. Statements from the people who know you best are important to your Social Security claim. Observations from your family can carry a lot of weight and make a big difference for the success of your claim.

    Your doctor is a key person when you are trying to prove your disability to the Social Security Administration. A doctor’s report carries more weight if your doctor knows you well, and has been treating you for a long time.

    A psychiatrist or psychologist is the best type of doctor to write a report about your disability. A family practitioner is okay, but a specialist is better. Your psychologist, social worker, or psychiatrist should be helping you with your Social Security claim by writing a suitable letter explaining your symptoms and behaviors, in detail.

    Anyone who is around you frequently, and knows you well, can write a report or come to your hearing and explain what problems you have interacting with other people.

    For example, maybe you isolate yourself for hours at a time when you feel stressed, but you don’t realize you do this. Your friends or family might notice this. Information of this type is extremely helpful when you are trying to prove that you are disabled due to mental illness.

    Some people think that if they have a diagnosis such as "depression" or "schizophrenia," the Social Security Administration will automatically grant benefits.

    That is not true. You can’t get benefits just because you have a label like "schizophrenia." First, you have to prove that your illness is severe enough to stop you from working.

    There is a "Catch 22" here. Because of your illness, you have trouble realizing what the problems are that you have in the workplace, and you don’t know how to explain it.

    But if you are too good at writing reports and expressing yourself, the Social Security judge will think that you are capable of getting a job. So, you need other people to talk or write about your difficulties. It isn’t pleasant to hear these things about yourself, but it has to be done if you want to receive Social Security benefits or SSI.

    As a general rule, for people with psychiatric disabilities, having an attorney or other representative is a must.

    There are four main areas of functioning that are considered by the Social Security judge in deciding whether your illness is severe enough to prevent you from working: (a) daily living, (b) social functioning, (c) concentration, and (d) decompensation. (see chart.)

    If you have bipolar disorder, major depression, phobias, agoraphobia, Tourette Syndrome, obsessions, compulsions, or panic attacks, you must prove that you have problems in at least two of the four areas of functioning.

    If you have somatoform disorder or a personality disorder, Social Security requires you to have serious problems in three of the four areas.

    THE FOUR AREAS OF FUNCTIONING

    (a)
    Daily living skills
    Activities of daily living include cooking, cleaning, and laundry. It includes getting dressed, brushing your teeth, going to the grocery store, and paying your rent on time.

    If you need reminders to do those kinds of tasks, or just don’t do them, you have "marked restriction of activities of daily living." That is important in proving that your mental illness prevents you from working.

    (b)
    Social functioning
    Social functioning means knowing how to say the right thing, and when. Evictions, firings, fear of strangers, and social isolation are important signs that you can’t work.

    Are you unable to start up a conversation? Do you make rude remarks-- or "clam up" and don’t speak to others? Can you get along okay with family, neighbors, and the landlord? Can you get things done with a group of people? How do you act with people in authority? Those social skills are necessary to work, no matter what the job.


    (c) Concentration, persistence, or pace
    If you can’t complete tasks in a timely manner, that shows you have a deficiency in your "pace." Lots of people start a project and don’t finish it, especially with a hobby. But if you start important projects and never finish them, because your mind wanders, then you have a significant deficiency in concentration and you can’t work.


    (d) Episodes of deterioration or decompensation
    Decompensation means that you withdraw from the situation when you feel stress, or perhaps you "blow up" all of a sudden when things aren’t going right.

    Do you go into a tailspin sometimes, and lose your cool? Does this happen even when you are trying to be on your best behavior? Any exacerbation of your signs and symptoms is an "episode" that keeps you from working. Having episodes like that, repeatedly, is a sure sign that you can’t function at work.

    To prove that you are disabled, the social security office needs to know all about your behavior as it relates to the four areas of functioning.

    Your Doctor has to write a letter or report that explains whatever problems you are having in these areas. The Doctor has to give specific examples, and go into detail. Show your Doctor this chart about Four Areas of Functioning. Make sure he or she has a written report that discusses your problems in a way that will be understood at the social security office.

    *** I myself also feel the four areas of functioning (listed above) applys to FMS/CFS because most of use are not able to do those things due to severe pain and chronic fatigue****

    ***********************************************************
    ****What you will find through out this post!

    1.) Four Areas Of Functioning (above)
    2.) Winning disability with help from your co-workers, family memebers, and friends.
    3.) How to talk to your Physician about supporting your case.
    4.) Contacting Your Senator & Rep about your SSD claim.
    5.) How your Daily Activties affect your SSD case.
    6.) Dire need letter for SSD or SSI.
    7.) Things I did and feel that helped in winning my disability at the reconsideration stage. (6 months)
    8.) All about Disability -Introduction to Disability & SS.
    9.) If a ALJ denies you...what to do next.
    10.) Preparing for your SSD Hearing
    11.) Social Security Appeals Process
    12.) All you need to know about the hearing process-if you have a upcoming SSD hearing.

    [This Message was Edited on 03/14/2006]
  2. BLUEROSE7

    BLUEROSE7 New Member

    Winning Your Disability Case with the Help of Co-Workers, Family Members and Friends

    by Scott E. Davis, Disability Attorney

    09-21-2001 In a social security disability claim, the credibility of the client is often the determining factor of whether the claim is approved or denied. For cases involving chronic pain or fatigue, such as fibromyalgia or
    chronic fatigue syndrome, the credibility of the client is usually crucial to success.

    The reason for this of course is due to the fact that those diagnoses involve subjective symptoms and limitations that usually cannot be objectively quantified by medical or laboratory tests.

    Thus, SSA and judges will listen to the client’s story about why they are unable to work due to the frequency, severity and duration of their symptoms; but they will also look for corroborating evidence from other
    sources such as doctors or individuals who know the client.

    As you may know, my practice is exclusively disability law and I specialize in chronic pain and fatigue cases representing clients throughout the United States. Over the past several years I have been very successful in winning disability cases before SSA and judges throughout the United States.

    While winning hundreds of cases and losing only a small percentage of them, I have
    learned a great deal about how to win chronic pain and fatigue disability cases as well as the importance of a client’s credibility.

    A tool I have used extensively for the past several years is to obtain affidavits or statements from a client’s former co-worker (or preferably a supervisor), family member or long-time friends.

    What is an affidavit? It is simply a notarized document that essentially is a narrative letter regarding a person’s observations of problems the client has functioning on a daily basis due the symptoms and limitations, with a conclusion that they are unable to work in any occupation as a result.

    In my opinion, it is essential that SSA and a judge have corroborating evidence from those who know a
    client the best and the affidavit performs that function.

    Because I view a client’s credibility as paramount to the case, I want to protect it, develop it and support it from as many different independent sources as possible. The quality of the affidavits or statements and from
    whom they are from matters more than having a large volume of them by people who do not know the client well.

    I know thoughtful affidavits have a big impact on SSA and judges because I have seen countless judges from all over
    the country reference them as a reason why they approved my client’s claim.

    I have also talked with judges after a hearing and they have told me the affidavits provided persuasive support of my client’s allegations regarding their limitations.

    It must be noted that it is unlikely an affidavit alone will win a disability case; but along with other corroborating medical records and doctor’s opinions it can be a powerful tool. Use this article as a foundation for developing this important part of your claim.

    Tip #1 The Affidavit should be Brief

    To avoid lulling weary SSA personnel or a judge to sleep, I believe the affidavit should be no more than two (2) pages in length. Please remember your file will contain several hundreds of pages of records…you want the
    affidavit to be read and be factored into your claim.

    Tip #2 The Affidavit should be on regular paper and be Notarized

    The document itself can be on any regular paper (preferably 8 ½ x 11 inches), preferably typewritten and should be titled “Affidavit.” However,any paper will do and a handwritten one is better than nothing.

    It should be notarized because this will confirm that the person who purported to draft the affidavit actually signed it before a notary public. The notary stamp and signature should go at the end of the text and after your signature(remember not to sign it until you are before the notary!).

    Having the affidavit notarized eliminates any question with regard to authenticity of the document (i.e. you are not trying to pull one over on SSA or a judge!). If it is not possible to obtain a notary then simply submit a handwritten statement.

    Tip #3 The Content of the Affidavit is Critical

    The contents of the affidavit determine whether it is a piece of evidence that will be persuasive in the case. The affidavit should always conclude with a sentence that the client is unable to engage in any occupation and
    due to what reasons.

    The contents should be organized by paragraph, numbered and should discuss the following in a separate paragraph or less: the background of the person making the affidavit (i.e. occupational status and title, address); how long
    they have known the client, how they met (family, work, friends), and how often they have in person or telephone contact; discuss what the client’s activity/work (work ethic) level was like before they became unable to work.

    The bulk of the affidavit and several paragraphs should be devoted to discussing the physical or psychological changes that the client exhibited at the time they last worked

    (i.e. observations of chronic pain and fatigue,
    spending days in bed, dramatic changes in appearance, lack of stamina,absences from work, being unreliable); discuss the physical limitations they have (the ability to sit, stand, walk, or do anything for only short periods
    of time); a medical treatment/medications/therapy they have tried without success; discuss how limited the are in activities of daily living.

    The last two (2) paragraphs must conclude with a statement that due to the above discussed reasons the client is not able to work in any occupation and that you are willing to discuss your affidavit with the judge if necessary.

    Tip #4 How Many Affidavits should you Obtain?

    With regard to quantity, less is better, the nature of the relationship with the client and content of the affidavit are the issues. I like to obtain as many as we can from former co-workers or supervisors. Then I like to obtain
    one from a spouse or long-time significant other, family members and then finally long-time friends. Generally, the complete story of the client can be told with three (3) or at most four (4) affidavits from those people who
    know them the best.

    Best of luck in your pursuit of disability benefits and remember never to quit!

    Scott E. Davis is a social security and long-term disability insurance attorney in Phoenix, Arizona. Mr. Davis represents clients throughout the United States. Although Mr. Davis has experience representing clients with a broad spectrum of physical and/or psychological disorders, the majority of his practice is devoted to representing individuals with chronic pain and
    chronic fatigue disorders. In almost every case, a fee is charged only if his client obtains benefits.

    ** I personally have not obtained a lawyer as of yet, but this info above was very helpful to me and I hope it will be to others!!
  3. darude

    darude New Member

    They are reviewing my appeal now with the new info. When i went to get letter from doc she said she wanted me to go to OT first. I was so mad I know I can't do it and with all the appointments I have in coming weeks it's gonna be ridiculous. Anyway I'm hoping they will approve this time.
  4. BLUEROSE7

    BLUEROSE7 New Member

    I so hope and pray you are approved this time too.

    Keep me in your prayers as well, also hoping & praying im approved this go round.

    Im so sorry your doc wants you to go for OT...I cant believe it and your doc knows your in the middle of disability and your conditions.

    Well you know I would go for the first visit and if you can not do it...then I would just let them know right away you cant. Then it can be turned into disability that you did go and try, but was just not able to!!

    Lots of Prayers & Hugs
    Bluerose
  5. Carollie

    Carollie New Member

    to you both. Thanks so much.
    Carole
  6. Pinkgirl

    Pinkgirl New Member

    after I was hospitalized for severe anxiety, BPD and depression and began having problems keeping a job. After a while I did find a combo of meds and a job I really loved, but the meds quit working,I was dx'ed with FM, and I fell apart.

    When I reapplied I actually filed mental illness as the reason, and FM/CFS as aggrivating conditions. I figured that since it was so hard to get SSI/SSDI for FM I would go the other route. I haven't had much success though.

    I'm going to print your posts out and go over them w/ my psych. on Monday!
    Thank you very very much for posting all of your hard work, I really appreciate it!
    Hugs,
    Love
  7. hagardreams

    hagardreams New Member

    I am sure I will get turned down. But hopefully if I can remember what is written on this page, I can do better in the future. Thanks, Julie
  8. BLUEROSE7

    BLUEROSE7 New Member

    Pinkgirl so sorry your having to go through this as well.

    Please dont give up though, keep fighting for whats yours anyway.

    I have not obtained a lawyer as of yet, but I have talked with right many and all have told me I have more of a chance of winning my case based the depression, anxiety etc...

    Any helpful info I find, im happy to share...I know how hard it is!!!!!!

    Keep fighting!!!

    Lots og hugs & Prayer
    Bluerose
  9. sydneysider

    sydneysider Member

    This is very timely advice for me.
  10. lovethesun

    lovethesun New Member

    I am saving all the info I can get.I appreciate your hard work.Linda
  11. BLUEROSE7

    BLUEROSE7 New Member

    How To Talk with your Physician about Supporting your Disability Claim

    by Scott E. Davis, Disability Attorney 04-17-2001

    Well, it happened again this week. What am I referring to? The all too familiar story of a treating physician who does not support a patient’s claim for disability benefits.

    This usually comes as a complete shock to the patient who thought the physician was in their corner. (In this article I use physician interchangeably to mean medical physicians, psychiatrists, psychologists or podiatrists).

    I am aware of this problem because I often talk with treating physicians about a client’s disability claim. The client has told me they are certain the physician supports their claim. I am always surprised when the physician
    does not support the claim or does not “want to be involved in the claim.” To be sure, the physician’s response of “not wanting to be involved” is the same as not supporting your claim.

    In this article I will discuss why is it critical to have the support of your treating physicians and hopefully how to obtain it.

    Tip #1 The Support of a Treating Physician is Often Critical to Claim Approval

    In a social security disability (SSA) claim, federal law gives the greatest weight to the opinions of treating physicians. If SSA has your physician’s opinion that you are unable to work, you should have a strong case.

    If you do not have your physician’s support, or they are “silent” on the issue of your disability, your claim will likely be compromised. This is not to say cannot win your case, but the mountain you must climb will be steeper without a physician’s support.

    The fact that SSA gives the greatest weight to your treating physician’s opinion is critical because one of SSA’s physicians (who may have only reviewed your records) will usually conclude that you are able to work. If
    confronted with differing opinions, federal law requires SSA or a judge to give greater weight to your physician’s opinion because they know your medical condition best. Thus, if your physician has told SSA you are unable
    to work, SSA should use that opinion and approve your claim.

    If your physician does not want to be involved in your disability case, or will not complete a form, this is the same as not supporting your claim.

    Why? Because you can bet SSA has an opinion in your file from its own physician that you can work. Without your physician’s opinion, SSA will use its own physician’s opinion (even if they have never seen you!) to deny your claim. Thus, if your physician has told you he/she does not support your claim, or does complete disability forms, you have a real problem that needs to be addressed as soon as possible.

    Tip #2 When to Talk with Your Physician About Supporting Your Disability
    Claim

    Remember the old adage, “Keep it Simple Stupid!” Let this adage guide your conversation with your physician. First, you should talk with them about supporting your claim only after you have been evaluated by them 3 or 4 times, or after you feel they know your condition well.

    Never talk with a physician about your claim after the first or even second visit. Why? Your first priority in the relationship should be for treatment that allows you to return to work. The physician will be very reluctant to
    support your disability claim if they believe you are motivated by disability benefits rather than getting better. The physician will be more willing to support your claim after they have treated you for a period of time without meaningful results.

    Tip #3 How to Talk with Your Physician About Supporting Your Disability Claim

    With all due respect to the medical community, many physicians do not know how SSA defines disability. The problem is most physicians think they know who is and is not disabled.

    I know this to be true because I have personally spoken with hundreds of physicians whose definition of disability was completely different than SSA’s. In almost every case, the physician’s definition of disability is much stricter and harder to meet than SSA’s definition!

    Invariably, the treating physician concludes the patient is not disabled using their definition and will not support the case. However, after I explain SSA’s definition, the physician agrees the patient is disabled and unable to work! The key to obtaining your physician’s support is how you frame SSA’s definition of disability.

    Tip# 4 Discussing SSA’s Definition of Disability with your Physician

    To obtain the support of your physician, I believe the following is an effective approach. First, never tell your physician you are “disabled” or have a “permanent disability.”

    Why? Because those expressions are terms of
    art our society uses but are totally irrelevant to a social security disability claim. Remember, your physician will usually save those labels for only their most seriously ill patients. You probably don’t “look” like
    one of those patients.

    Instead, ask the following questions. First, tell them you have filed a claim for disability benefits because you are “unable to sustain full time work.” Ask your physician if they also believe you are “unable to sustain
    full time work at the present time.” Notice that I did not use the words “disabled” or “permanent” in either question.

    If your physician agrees with you then ask for their support for the next 18 to 24 months. Why such a short time? For one, this will get you past SSA’s requirement that you be unable to work (or you are expected to be unable to work) for at least 12 months.

    Second, most physicians believe disability is a “permanent” condition and once your claim is approved, you will never return to work. Countless physicians have told me they don’t want to be put in the position of saying
    a patient is permanently disabled. You would not want to be put in that position either. So…don’t put them in that position.

    However, almost all physicians will agree that a patient is unable to work for a period of time. Your physician will feel more comfortable supporting your disability claim when they know it is for a limited period of time and
    that you want to return to work after a period of recuperation If after 18 to 24 months you are not able to return to work, then address the issue again with your physician. If your physician does support your claim, ask
    them to please write into the medical record that you are unable to work and to document the reasons why.

    Conclusion

    If you approach your physician in the manner discussed in this article I can assure you that you will have more success. I know this to be true because I use it every day when I talk with a physician about supporting a client’s
    disability claim.
  12. BLUEROSE7

    BLUEROSE7 New Member

    Contacting Your Senator or Representative About Your Social Security Disability Claim

    By R. M. Bottger

    When you apply for Social Security or Supplemental Security Income disability benefits, you want to do everything you can to help your case. One of the things that you can do is contact your United States senator or representative about your disability claim.

    Once you contact your congressperson, he or she will contact the Social Security Administration about your case. An inquiry from your congressperson will not change the ultimate decision in your Social Security and/or Supplemental Security Income disability case from a denial to an allowance.

    If you meet the Social Security Administration's requirements for Social Security disability benefits, then you will be found disabled. If you don’t meet their requirements, then you will not be found disabled.

    However, contacting your congressperson can still benefit you when you apply for Social Security disability benefits. When I was a disability determination specialist in Oklahoma, cases were placed in a backlog to await assignment to a disability determination specialist when they first came into the office. Sometimes cases stayed in the backlog for weeks awaiting assignment to a disability determination specialist.

    However, cases that had a congressional inquiry were immediately assigned to a disability determination specialist. Once a case with a congressional inquiry was assigned to a disability determination specialist, updates were frequently sent to the congressperson to tell him or her what was currently being done on the case.

    These updates helped to make sure that the case was looked at frequently and not just setting in somebody’s office without anything being done to it. Although contacting your congressperson can’t guarantee that your Social Security and/or Supplemental Security Income disability case will be an allowance, it can help your case be done a little faster.



  13. BLUEROSE7

    BLUEROSE7 New Member

    Bumped in case someone missed this info...it may be of help!!!
  14. obrnlc

    obrnlc New Member

    great info, thanks alot!
  15. darude

    darude New Member

    How is your case going? They are holding mine over until they get more info. I would rather that than they deny again and then have to go in front of a judge. Should have all info by next week so see how goes. what have you sent in for your appeal so far?
  16. BLUEROSE7

    BLUEROSE7 New Member

    I agree with you, I would rather have my case held over for more info. then denied right off and having to go before a ALJ.

    This could be a good sign for you that there are even willing to hold your case for more info. I feel like in most cases after so much time they would go ahead and deny you and let you bring more info. before a ALJ....so I think this may be a great sign and I pray you get it this time.

    I have not heard anything as of yet on my appeal!!

    What I sent with My appeal(reconsideration)!

    1. A letter from myself explaining what all I was sending with my appeal, in this letter I also explained again how my medical conditions have not only effected me phycially, mentally but also financally(sp). ***My husband typed this letter for me and I signed it as well as him!

    2. A letter from my husband on my behalf.

    3. A letter from my mother on my behalf.

    4. A letter from my sister on my behalf.

    5. 3-sets (3-specailist)of past medical records that SSD did not bother to get in my intial claim.

    6. A letter from my Main treating physcian stating all my medical conditions, how they have affected me and that I was unable to maintain/do any type of employment. That in his medical opinion I was Disababled and he supported my claim etc...

    7. The Phychologist I have now been seeing for a month, has also sent in a letter on my behalf. I had to go see him again yesterday and he said he was going to even check into my claim for me today. I need to get a copy of his letter....I have a copy of all the other letters and things sent in.

    ** I also had told SSD that there would be more info and records...which I gave them the dates of all my new appointments, but I think I will get the records myself of all the new doctors I have seen since turning in my appeal.

    Im praying for all of us!! What Have you turned in Darude with your appeal so far?????????

    Hugs
    Bluerose
  17. tcpolchies

    tcpolchies New Member

    Just curious. I was awarded SSDI based on partial approval. I dont know what exactly that means but I have noticed my medical and psychological status to have worsend since I filed in 2000. I would like to claim full disability. I know I cant function out there abd sometimes barely take care of myself at home.

    Any advice?

    T~
  18. BLUEROSE7

    BLUEROSE7 New Member

    Im not sure what is involed in going from partial Disability to Full Disability!

    This will be bumped so maybe someone can answer and I will try to find some info on it...

    You know im sure you could call your local social security office and they could tell you what you need to do.

    Hugs
    Bluerose
  19. darude

    darude New Member

    I have all new info as you know. I gave them Rhuemy report, MRIS showing brain tumour and lesions, 2nd MRI report, blood tests, letter from husband and daughter. Advocate letter also has fms/cfs. I know have something on chest xray and will be giving them that plus all appointments in coming months. Appointments so far are sleep study, neurlogist, surgeon, endo, another spine MRI. My doctor let me down tho said need to go to OT and they will say disabled! Seeing her next week and gonna demand a letter as this is ridiculous. Also wrote them letter myself with all the info in typed by hubby of course. When she first phoned from disability she said she was gonna make a decision in a few days. Now wants to wait for further info to support claim. Also have emg,eeg tests in July.
    [This Message was Edited on 06/30/2005]
  20. cindymindy

    cindymindy New Member