Help! Please tell me your experiences re: Disability.

Discussion in 'Fibromyalgia Main Forum' started by orachel, Sep 10, 2005.

  1. orachel

    orachel New Member

    I need help (or at least to know I'm not the only one!) dealing with these yahoos! I've been sick since mid June (diagnosed a month ago with FM), and my symptoms are severe and medication resistant. I have been unable to work, and often times have difficulty doing minor amount of walking due to hip/knee pain (not to mention insane fatigue!). I've been working with UNUM Provident (my employers short term dis provider) since mid june to try to get my ST Dis benefits....constant nightmare. They still haven't started paying and money situation is getting rough. My husband's job just barely covers bills, and that doesn't include my medical bills, which are starting to arrive now.

    Here's my concern, and I'd like any help/assurance you can give (THANKS IN ADVANCE!). I don't want to be negative, or assume the worst, but it would be physically impossible for me to work any job, even part time sitting job, like I am now. I'd like to believe that I will improve dramatically, as soon as possible, but I also need to be realistic and proactive with this. My docs are saying good results are 30-40% improvement....that in no way would allow me to go back to work full time.

    So, what have your experiences been in getting ST Disability from employer's ins provider? Any experience in getting LT Disability from the same? My ST benefits only last 13 weeks total, and long term can begin in week 26 (there's a nice big gap in there where no money is payable...nice, huh?). And finally (gulp!), it scares me to even ask this because I can't imagine that I'll be this way forever, but anyone have any experience with Social Security Disability? I'm just terrified that none of these will pay, regardless of what my docs provide. They're giving me the bigtime run around, and I'm starting to sweat and panic financially. Please tell me anything you know re this issue. As if we needed one more thing to worry about when our bodies throw FM at us! Oh, by the way, I'm only 30, so does that affect the SSI thing at all?

    Thanks all!
  2. Francey54

    Francey54 New Member

    Dear Rachel:

    I do not have any experience with ST Disability or LT Disability. I went straight to Social Security Disability.

    I worked for 33 years of my life was an active outgoing and hard workng person. I was diagnosed with FM and CFS 5 years ago when I noticed I was having so much pain, fatigue, migraines, insomnia, etc. etc.

    I tried to continue working for 2 more years after the diagnosis but finally had to quit in 2002 because it become totally impossible and I knew I was going to lose my job. I was constantly late and absent because of all the FM and CFS symptoms.

    After a three year battle with SSD, I was finally awarded full benefits with retro pay going back to 2002. You have to have alot of medical backup such as lab work, x-rays, sonograms, CT scans, MRI's and if depressed a good Pyschiatrist who will write up a good report about you. This is the only way you can win any type of disability claim. If the facts are there you will win.

    I hope you will be able to continue to work. It is gratifyng to be productive. Some people with FM and or CFS can continue to work with meds and others can't. Everyone is different.

    Hope this helped.

    God bless and good luck.


    [This Message was Edited on 09/10/2005]
  3. kac1960

    kac1960 New Member

    I can relate, I was diagnosed with fm, osteoarthritis,IBS, scoliosis, degen disc and buldging disc in April 2004, just got my st and lt dis from Prudential, they said nothing was physically wrong but my mental state is why thewy gave it to me, and of course in our policy they only have to opay benefits for 24 months if it is due to mental state. Their way of not paying long. Was night mare I even had to get lawyer. the ins companies are all the same they do not want to pay.
    As far as ssd Ive been turned down 2 times have a lawyer now just waiting for a hearing.
    I really feel sorry for you this last year for me was sso stressful financially, I really think it added to my deteriorating health, if it werent for family helping me and my partner I would of lost my house, I hope things go better for you.
    Just dont give up that is what the ins providers want you to do.
    Good Luck.........Kathy
  4. orachel

    orachel New Member

    Thanks both for posts. I'm unable to work now...have only been ill for 3-4 mos, and have tried to go back to work 3 times with disastrous results, and that's before my symptoms got nearly as bad as they are now. So, I'm afraid that unless I have major improvement with my symptoms (or a miracle!) i'm not going to be able to work full time, and that scares me to death.
    Plus, as for st and lt provider won't pay on the basis of anything mental at all, so can't even explore that option. I'm reasonably depressed at this whole life has ground to a halt in last few mos! But regardless, they don't cover anything unless its physical. Oh well...guess I'll just wait and hope for the best, but thanks so much those of you who answered!
  5. catgal

    catgal New Member

    Hi Rachel~~I saw on TV recently a law firm listing several insurance companies that people have had difficulty getting their short and/or long term disability from employers who use "those" listed insurance companies, and UNUM was one of "those" listed. The law firm {which I can't remember right now} said that if you were having difficulty getting any of those specifically listed insurance companies to pay off to call them, and they would handle your case. The next time I see this Law Firm AD on TV, I will write down the info for you and post it to "Rachel". But this Law Firm listed about 6 or 7 of these particular insurance companies that repeatedly denied coverage. And UNUM was one of them I remember because it had such strange initials.

    I am 56, was born with severe asthma/allergies & IBS. At age 12, I was diagnosed with FM/CFS (but they didn't call it that back then) However, althrough my life I was continually rediagnosed with FM/CFS even though it went through a series of name changes. And all my life, I ached, hurt, had swollen joints, fibrofog, all the other things that go with FM/CFS, and always felt so exhausted even though I tried to live a normal life including working my way through college, graduate school, and working as a psychotherapist for many, many years. The FM/CFS was my constant companion. After losing my only pregnancy at 4 months along and at the age of 29, I had to have a radical hysterectomy. And the FM/CFS became worse and unrelentless. In my early 30's, I developed osteoarthritis, psoriatic arthritis, and rheumatoid arthritis. Through all the years I continued to do the work I loved as a therapist even though I was in alot of pain, discomfort, and fatigue. I ached so badly that I made the mistake of thinking everything that hurt was due to the FM & various arthritises. Until one morning 5 years ago when no matter how hard I tried--I could not get out of bed. My back/neck/and shoulder area hurt so badly that I felt paralized. A friend took me to the hospital, and after alot of tests and MRI's--I was sent to 4 different orthopedist/back specialists who said I had extremely advanced and progressive degenerative disc disease to the point that I was declared "inoperable". My doctors & various specialists all said I needed to quit work and file for disability, but I refused and continued to work. It was a living nightmare, but the last two years I worked took a terrible toll on my delapidated body and caused me long term damage. For the last 12 years, I worked as a therapist for a Native American Tribal program, and they did not offer any kind of insurance. In early 2004, the last year that I continued to work, I had 3 strokes that severely handicapped me, and May was the last month I worked. The program I worked for gave me a medical termination in July/2004.

    I reluctantly applied for SSI, but was denied because I had a small CD that I couldn't touch until August/2005. And even though I had no money, no means of support, no husband, and even denied food stamps--The Social Security Administration (SSA) still said according to their policies the CD was still a resource. And because of the CD, I was denied all other assistance programs.

    Out of desperation, I finally applied for disability (SSDI)
    in October/2004 filling out all the paperwork and sending them all my medical files, etc. I did all this by myself. In November/2004, I was called by a very nice & kind SSA interviewer, and I was so sick that day with my asthma/allergies that I could barely talk, and I was in a great deal of pain from my back, arthritises, FM, and completely exhausted from CFS and all the pain, stress, and financial worries. She interviewed me for 4 1/2 hours. I was so congested and wheezing that she offered several times to finish up the next day, but I wanted to get it over with. As she asked me questions, and I answered--I noted that she would take what I said, rephrase it in the terminology that SSA wanted to hear. It was all still the truth, but she just put it the way SSA wants it to be.

    I never heard another word from SSA until January/2005. And then for the next 5 months--they sent me for 6 tests/exams by one of their chosen specialists a month. I had mental health exam by a psychologist; then a memory test; next an eye exam; a vision field exam, and the last one was to be examined by an orthopedist.

    In June/2005, I received my Disability Award Letter for 100% disability and later that month my retro monies from December/2004 to April/2005. They had decided in Dec./04 that I was disabled, however you have to have not been able to work for 5 consecutive months before they will begin to even consider you as "possibly disabled"--so they started those "unable to work" months in June/2004 since May,2004 was the last month I had worked. They determined I WAS disabled in December/2004. The tests/exams they sent me on starting in January/2005 was to determine the PERCENTAGE of disability since they can declare you anywhere from 10% to 100% disabled.

    On the tests/exams, they focused on the effects of the strokes such as how the strokes had damaged my eye sight, wiped out my memory (can't remember anything unless I write it down) and other consequences of the strokes; my depression, and the severity of my back problems. Since I was born with severe asthma/allergies--those were already extremely well documented. They did not even look at the
    FM/CFS. However, the orthopedist who did their examination on me along with wanting his own new x-rays & stuff, did note my FM.

    Sorry this turned out to be so long, but I hope it helped in some way. The main thing is to have plenty of documentation on every ailment you have. Answer questions truthfully, but based on your worst days. And be persistent, persistent, persistent. And above all, remember the 3 major terms: FREQUENCY, SEVERITY, & DURATION.

    Best of luck to you. And if I can be of any help--just post to catgal. Blessings, Carol....

  6. Nspiker

    Nspiker New Member

    I have had both SS disability and MetLife LTD benefits. Recently my LTD benefits were denied but I am appealing the decision. The best advice I can give you is you have to be your own best lawyer. You need a doctor that will support you disability on an ongoing basis with facts, medical information, blood work and letters documenting your illness. Keep copies of all medical info yourself including doctors notes, blood tests etc. Consult an attorney if you need to...and then be willing to wait for the denials, which will come guaranteed. You are the best defender of your illness. I'd be glad to help you in any way I can - E-Mail me if you need any specific help at You have to play the waiting game and it may take months or even years.
    Good Luck to you, Nancy

  7. rigby

    rigby New Member

    My company had Unum they paid two weeks of STD then no more this was in Nov. 2002 I kept getting sicker but they continues to denied my claims I finally got a lawyer just last month I got my 10 weeks they needed to pay me before my LTD should of started now I have to file for LTD. On the 12 week I had just got out of the hospital. I got SSI before I even got a lawyer. They still refused to paid after I got SSI. It's hard to find a lawyer to get STD but I finally find one. Don't give up it took me almost 3 years but they paid and they paid my lawyer fee.
  8. orachel

    orachel New Member

    Thank you all so much! Yesterday was my first day on these boards, and I basically showed up here out of desperation and lonliness and a desire to find ANYONE who wouldn't be irritated or pitying about what I'm going thru physically and emotionally. You guys have really been an amazing source of information (especially specifics about UNUM controversy! I had no idea they were under scrutiny...will have to get that info right away!)and support.
    All of you have such amazing stories, and have all been thru so much for so long. Being diagnosed with FM (and Bursitis...those are the only things I've been diagnosed with so far, plus some semi minor back issues) for only a few months, I'm sure all this worry I have about LT Benefits is premature, as I know you have to have a doc say you're unable to work ANY job for at least a year, and I'm still dealing with my doc on a monthly basis for work releases (like he thinks I'm suddenly going to feel better overnight...does that ever happen for anyone with FM? Just suddenly Ok again?). But I've had such an issue fighting with UNUM (and even the docs..have to be super insistant to get them to send the right info to UNUM) for ST benefits, that I just want to be prepared for the possible fight ahead. The scariest and most frustrating thing for me is that I am so young, and newly married, and suddenly all of the things my husband and I planned for our future are called into question....I may never be strong enough to have a baby and care for him/her full time, for instance. Its all just terrifying. Then add in all the financial stress and trying to explain how I feel to my husband (who is amazing, but I can tell on some level he just does not want to believe whats going on with me...he's still in the stage where he won't tell anyone whats happening to the pain and fatigue will just go away and I'll be able to hop up and pick up our life like it was just 5 or 6 months ago...)and friends and family who don't understand or who act like i'm just malingering in some way.
    Anyway, I'm just rambling (as I'm lately taken to doing...think it has something to do with not being able to keep thoughts together...that's freaking me out too!), but I wanted to say thank you to all of you. Reading your stories which are a bit scary in their severity, you guys just seem like you've been through sooo much for sooo many years, but YOU'RE STILL HERE! And that's really what I needed to see, I think. That its possible to find some level of happiness and contentedness even with all the pain and frustration with fatigue and limitations. And its clear that even though your lives may be different than what you might have imagined, you're all still hanging in there. And that is pretty darn amazing. So, now I'm crying and going to go hug my husband, and try to remind myself that even though this FM nonsense realllly sucks, I might be able to make some kind of a worthwhile life for me and my husband, even with these limitations. So, thanks again. And I'm not planning to let UNUM get away with jerking me around. You're all right...if I need a lawyer, I'll get one, but I am entitled to these benefits (short term at least!) and I'm not going to let them "stall" me into giving up what they owe me! Grrrr...Ok. Now I feel empowered. lol...
  9. ImDigNiT

    ImDigNiT New Member

    To me just to hear the word Unum puts me in a flair!

    I went on STD last Nov. and had no problems. Then when I filed for LTD they played alot of games and I was turned down.

    I have hired an attorney, who by the way, took my case right away as soon as they heard Unum. They are vultures and I they have a major class action suit against them right now!

    My advice is to go ahead and file for social security and find an attorney pronto. The attorney will not charge you unless they win to case. In fact, my attorney is sending to me to their own Drs.

    Whatever you do don't give up. I know first hand how difficult it is financially as by husbands salary barely pays our bills and it is a real struggle. But as I said earlier don't give up, and it may take some time but the benefits you will receive later will far outway the struggles you are going through right now.

    Please let me know if there is anyway I can help.

    Peaceful mind and body.

  10. JLH

    JLH New Member

    First of all, Rachel, welcome to our board/support group! I hope you stick around and continue to join in!! (I read your bio -- and see where you are from. My niece just moved to your city recently to start a job teaching English at the University of Toledo!)

    I don't have any experience with private insurance companies re short- and long-term disability, but I have heard that trying to get disability from these companies is awful!!!!

    I do have experience with SSDI, though. I retired after working 30 years. I had to take early retirement at age 48 due to a multitude of health problems (see my bio). One year after being retired, I applied for SSDI and was awarded disability status on my first try!! I was just extremely lucky!!

    However, you hear more stories about NOT being awarded SSDI than being awarded on the first attempt! The average wait on getting it is about 2 years. People get denied the first couple times, then have to go before a judge, etc. It is a very time consuming, stressful process for most people. Another thing that I have heard is that it is harder to get it if you are under age 50.

    The best bet on getting SSDI is to have a doctor who is on your side and has adequate records that document your medical condition(s) that indicate that they are debilitating enough not to be able to work.

    Good luck in your process,
  11. JLH

    JLH New Member


    If you have to go the route and apply for SSDI, the following info may be of interest to you. It is a long read, but maybe you can print it off and read it later at your convenience.

    Here it is ......

    I posted the following info on 11/09/04:


    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****



    Additional Info for Applying for SSDI from another old post 08/03/05 09:16 PM

    The following additional info is from another old post - not mine, but from Lisa:



    Hi all.

    I came across this website that offers tips on how to better ones chances of winning SS Disability. Also at the end is a list of FAQs - for answers you'll need to check out the website.

    Hope it helps.


    Social Security Disability cases based on Fibromyalgia alone are generally difficult to win, and are always easier to win if other impairments are involved.

    But having said that, it should be be noted that the outlook for such cases is starting to improve because more information is coming to light about the nature and causes of this illness.

    Regardless, however, of whether a claimant is applying for disability based solely on Fibromyalgia, or alleges several impairments, a case involving Fibromyalgia can be strengthened by understanding how Social Security Disability Examiners consider medical evidence. This was covered to some extent in the article preceding this one, but on this page the tips will be more specific.

    Tip 1 regarding Social Security Disability Fibromyalgia Cases

    If you allege Fibromyalgia when you apply for disability, make sure you have a diagnosis of this in your medical records. It's happened more than once that a doctor has mentioned to a patient that they "might have fibromyalgia" without actually diagnosing this condition in their medical chart.

    Tip 2 regarding Social Security Disability Fibromyalgia Cases

    If your primary doctor (i.e. family doctor or internist) diagnoses you with Fibromyalgia, try your very best to be referred to a specialist, such as an orthopedist or a rheumatologist (or a pain or chronic fatigue specialist), who can give you the same diagnosis. As we said earlier on the previous page, because so many doctors hand out the fibromyalgia label when they can't otherwise diagnose a patient's complaints, the value of this diagnosis is somewhat diluted. It can be significantly strengthened, however, and taken more seriously, if the same conclusion is reached by a physician who specializes in bone or tissue disorders, or disorders that involve complaints of pain and fatigue.

    Tip 3 regarding Social Security Disability Fibromyalgia Cases

    Although it may be impossible to do, try to avoid being diagnosed with Fibromyalgia by a mental health professional. Why? Because the simple truth is this: in the same way that family doctors mislabel their patients and overuse the Fibromyalgia diagnosis, so do psychiatrists. This is a regular occurrence, in fact, for patients who are being treated for depression.

    It should not be surprising to anyone, of course, that a person who experiences continuous pain and/or fatigue might also have to deal with depression as a result. Nevertheless, a Fibromyalgia diagnosis by a mental health practioner is usually interpreted by a Disability Examiner to mean this: that the disability claimant's symptoms and complaints are psychosomatic in nature. In other words, all in their head.

    Therefore, again, for the fibromyalgia sufferer who is trying to win disability benefits, it is always sound advice to seek a supporting diagnosis from a specialist.

    However, this becomes doubly more important for the claimant who is also receiving mental health treatment.

    Tip 4 regarding Social Security Disability Fibromyalgia Cases

    Find out what's in your medical records. The importance of this cannot be stressed enough. All Social Security Disability cases are decided chiefly on the basis of a claimant's records. This is true at the intial application level, reconsideration level, and at the Administrative Law Judge hearing level where a claimant is generally represented by an attorney, or non-attorney disabilty representative.

    Applying for disability without knowing what your records state about your condition is unwise, to say the least. And many claimants have been surprised to find that the doctor who claimed to support their case did not indicate the same level of support in his or her treatment notes.

    By getting copies of your medical records before you apply, you can get a rough idea of how your case looks and decide if you need to switch to a different physician, one who is more capable concerning your treatment and more willing to support your disability case.

    Quick Links to Questions & Answers on

    For Social Security Disability, when is a person considered disabled?
    When should I apply for Social Security Disability
    How do I apply for Disability benefits through Social Security?
    After I apply, how is my Social Security Disability case decided?
    What kind of medical evidence is used to evaluate my Social Security case?
    How long will it take to get a decision on my Disability claim?
    If my Social Security Disability case is denied, what do I do?
    How do I appeal a Social Security denial for disability?
    How long does a Social Security appeal usually take?
    Will I have to file more than one claim for Disability?
    How do I survive financially while waiting on my case?
    Is there anyone who can assist me financially while I wait on my Disability appeal?
    Can I work and earn money while waiting on my Social Security case?
    Do I need a representative for my Social Security Disability case?
    How can a representative help me on my Disability case?
    How much does a disability representative charge for a Social Security case?
    What can I do on my own to help my Social Security Disability case?
    What is SSI and how is it different from Social Security Disability?
    If my Social Security case is won, what exactly do I get?
    How will I know if I have won my claim for Disability benefits?
    If I win my Disability case, how long will it take to get the money?
    If I am eligible for a back payment, will I get it all at one time?
    If my Disability case is won, how long will I receive disability benefits?
    If a judge denies my Social Securitycase, what do I do?
    How to - improve your chances for Social Security Disability
    How to - get updates on a Social Security claim for disability
    How to - get doctors to assist on your Social Security claim
    How to - react if your Social Security Disability case is denied
    How to - request the first appeal for a Social Security claim for Disability
    How to - plan ahead financially for a Disability claim with social security
    How to - update creditors regarding a Disability case
    How to - file a request for a Social Security Disability hearing
    How to - get updates on a Social Security Disability case
    How to - get a Social Security hearing scheduled faster
    How to - present before a judge at a Disability hearing

  12. obrnlc

    obrnlc New Member

    hi rachel, and welcome to the board! we can provide you with lots of dirty little details regarding the scumbag company in question--BOTTOMLINE--Don't trust them EVER!! Record your conversations at all times, because they do and will take what you say and twist/turn it into something else, or just outright lie, cheat, etc!! I had a "spy" sent out to my neighbors saying that he (a sweet young man) needed to find me to tell me his poor grandma had died, went to 2 different neighbors with this tale of woe, and then said--"by the way, how is Laurie? is she working? does she get out much?...etc." I got LTD benefits for a few months, then cut off because i told one of the caseworkers when they called to see how i was that i wipe my dogs' feet when they come into the house! That was actually written on the termination letter! I did appeal and got back my benefits, but now i am at the 24 month mark and they are desparate to drop me again. And watch what you say on here and who you talk to, they do monitor things like this board, oh they are slimy lowlife snakes! They will arrange for you to get SSDI through one of their lawyers (genex company) so they can get all of your backpay and reduce the amount they have to pay you, just in case they can't get rid of you. For every insur. company--keep multiple copies of ALL MEDICAL RECORDS, in cluding physical therapy, etc because when they want info, they put a time limit on it and will make your life miserable (more so than usual) if you don't make their deadline. so good luck, and be careful, none of them are your "friend", even though they will try to be, just be honest and don't offer too much info. unless asked. sorry to be such a cynic, but i have been dealing with 4 of these companies for over 2 years now, and it does wear one down! (unum-LTD, CUNA--mortgage dis. insur, PRUDENTIAL-life insur. waiver of premium, and PROVIDENT--life insur. thru employer) Good luck, and welcome again to the boards--Laurie
  13. wiseeagle

    wiseeagle New Member

    I feel for you very much!! Look your compay has paid in for this service and you need to push for it. Get you dr. to fill out all the forms they need. (this is STD and LTD). THe major key is your dr.'s documentation on that you can not work in any MEANINGFUL JOB! THen get a lawyer that only specializes in Social Security Disability. They don't get paid until you win the case. The thing with SS disability is deny your claim three times and then go before a judge that actually will look and review your case. Most times if your dr.'s fills out these forms correctly with the help of a lawyer you will win your case without a problem!! then the judge decides what the percentage the lawyer will get. It also goes back to the date
    that is documented that you could not longer work.

    Be very careful with the STD and LTD companies they do hire investigators to gather info. on you and YES they talk to your neighbors and anyone they can get a hold of. They would rather spend their money on these investigators trying to prove you are NOT disabled instead of paying out compensation to you.

    They will never leave you alone!! I've been on SS disablity and LDT for 13yrs. Now my long term disability is harrassing me and trying their best to terminate my claim.
    You see the company I worked for was an HMO and I was a RN
    nurse coorindator and got Legionnaires disease from my office but could prove it because @ that time NY law was 3 people had to be ill for the board of health to investigate it. After many years the HMO(HIP) went out of business and they have totally tore down that bldg. (it was a sick bldg)
    But the statue of limitation is long since over and I can't sue!! Hartford is my LDT company and wants to remove me in the worse way. They recently send me pages upon pages of release forms for me to sign allowing them all medical and dental info., If I don't sign they will remove me. NOT much of a choice. They also have the main superivor look at my case with a fine tooth comb, I know that they probably plan on sending an investigator soon, to get any kind of negative feedback that they can!!

    SS disability only sends me a form about every 5 yrs!! see the difference.

    I plan to talk to a lawyer regarding Hartford's continous
    harrassment. I don't believe they should be able to go this to people.

    Hope this info. helped.

    Love and Light,

  14. natrlvr2

    natrlvr2 New Member

    I have alot more wrong with me than lil' ole fibromyalgia(and that gives me severe pain 24/7)and I had to fight hard for 6 YEARS before I won my claim with Social Security.Then I had another battle for another year.
    During this battle,my husband and I had to file bankruptcy,I needed to see a shrink(the battle almost put you over the edge),and then my now ex,filed for divorce.And was trying to take my son from me.(he did not want to pay child support,that is all)
    Social Security lied to me over and over.They lost my file over and over.The judge never actually read my file,just kept denying and saying I had no proof,when I did.The thing is,I had a lawyer too and he could nto beleive all the stuff I was going through.It was not fun and it still isn't.Now I live on a fixed income that is not enough to survive on.(pay bills and buy groceries)