My docors wrote me letters for ssdi

Discussion in 'Fibromyalgia Main Forum' started by cafe52, Oct 18, 2005.

  1. cafe52

    cafe52 New Member

    Hello everyone.

    Well both my GP and my rhuemy wrote letters for me to send in with my paper work asking that they consider me.

    But heres the thing after reading them over a couple of times they aeem to be very non spacific and almost ,aking me look like a Hypocondryact so I thought I would let you guys read them and get some feed back, Well I can't find the one my GP wrote I have a copy of it but can't seem to find it for the life of me but here is what my Rhuemy wrote
    please note he aske to see my GP's letter so he could get an idea of what to write seeings as he has never done it before.


    I am writing this letter to request you to consider Teri House's for disability. Teri House has been my patient since sept 7 2004. She has an extensive past medical problem list. Her current complaints include fatigue, mulitble joint pains, stiff in the hands and neck. She also has abnormal liver funtion test. and fatty inflitration of the liver, which also makes ussage of the NSAID's somewhat more hazardous. She has truly attempted to continue to work but found it impossible to work due to her current problems. I would recommend disability for her in view of the above facts.
  2. JenniferAnn539

    JenniferAnn539 New Member

    That doesn't sound aggressive enough.

    You might want to make a list of the things that you are no longer capable of doing and have that incorporated into the paper work.

    You might want to be evaluated by a doctor who is a specialist and has dealt with disability claims before.

    Good luck.
  3. jaltair

    jaltair New Member

    The doctors need to put in diagnoses/conditions such as FMS / CFS / Severe Debilitating Arthritis, etc.

    There is a "blue book" that Social Security uses to determine eligibility, and the book contains lists of diseases by diagnosis and clearly defines what is considered to make someone disabled.

    The "blue book" for Social Security can be googled by putting in, "blue book Social Security." Conditions are listed For Adults and Children.

    I'd recommend going there and printing off sections that could pertain to your specific disability and then provide that to your doctor. It's hard to believe that he hasn't dealth with disability before.
    * * * * * *

    I'm adding some of the language that is from the Blue Book that may help define what doctors need to do to help patients obtain Social Security Disability. This is a lengthy post, please forgive, but important:

    Disability Evaluation Under Social Security
    (Blue Book- January 2005)

    Part II - Evidentiary Requirements

    Medical Evidence
    Under both the title II and title XVI programs, medical evidence is the cornerstone for the determination of disability.

    Each person who files a disability claim is responsible for providing medical evidence showing that he or she has an impairment(s) and severity of the impairment(s). However, the Social Security Administration (SSA) will help claimants get medical reports from their own medical sources when the claimants give SSA permission to do so. This medical evidence generally comes from sources who have treated or evaluated the claimant for his or her impairment(s).

    Acceptable Medical Sources

    Documentation of the existence of a claimant's impairment must come from medical professionals defined by SSA regulations as "acceptable medical sources." Once the existence of an impairment is established, all the medical and non-medical evidence is considered in assessing impairment severity.

    "Acceptable medical sources" are:

    licensed physicians (medical or osteopathic doctors);

    licensed or certified psychologists;

    licensed optometrists (measurement of visual acuity and visual fields);

    licensed podiatrists (for purposes of establishing impairments of the foot, or foot and ankle only, depending on the State in which the podiatrist practices);

    and qualified speech-language pathologists (for purposes of establishing speech or language impairments only).

    Social Security also requests copies of medical evidence from hospitals, clinics, or other health facilities where a claimant has been treated. All medical reports received are considered during the disability determination process.

    Medical Evidence from Treating Sources

    Currently, many disability claims are decided on the basis of medical evidence from treating sources. SSA regulations place special emphasis on evidence from treating sources because they are likely to be the medical professionals most able to provide a detailed longitudinal picture of the claimant's impairments and may bring a unique perspective to the medical evidence that cannot be obtained from the medical findings alone or from reports of individual examinations or brief hospitalizations. Therefore, timely, accurate, and adequate medical reports from treating sources accelerate the processing of the claim because they can greatly reduce or eliminate the need for additional medical evidence to complete the claim.

    Other Evidence

    Information from other sources may also help show the extent to which a person's impairment(s) affects his or her ability to function. Other sources include public and private social welfare agencies, non-medical sources such as teachers, day care providers, social workers and employers, and other practitioners such as naturopaths, chiropractors, and audiologists.

    Medical Reports

    Physicians, psychologists, and other health professionals are frequently asked by SSA to submit reports about an individual's impairment. Therefore, it is important to know what evidence SSA needs. Medical reports should include:

    medical history;
    clinical findings (such as the results of physical or mental status examinations);
    laboratory findings (such as blood pressure, x-rays);
    diagnosis;
    treatment prescribed with response and prognosis;
    a statement providing an opinion about what the claimant can still do despite his or her impairment(s), based on the medical source's findings on the above factors. This statement should describe, but is not limited to, the individual's ability to perform work-related activities, such as sitting, standing, walking, lifting, carrying, handling objects, hearing, speaking, and traveling. In cases involving mental impairments, it should describe the individual's ability to understand, to carry out and remember instructions, and to respond appropriately to supervision, coworkers, and work pressures in a work setting. For a child, the statement should describe his or her functional limitations in learning, motor functioning, performing self-care activities, communicating, socializing, and completing tasks (and, if a child is a newborn or young infant from birth to age 1, responsiveness to stimuli).
    Back to Top

    Consultative Examinations

    If the evidence provided by the claimant's own medical sources is inadequate to determine if he or she is disabled, additional medical information may be sought by recontacting the treating source for additional information or clarification, or by arranging for a CE. The treating source is the preferred source for a CE if he or she is qualified, equipped, and willing to perform the examination for the authorized fee. Even if only a supplemental test is required, the treating source is ordinarily the preferred source for this service. However, SSA’s rules provide for using an independent source (other than the treating source) for a CE or diagnostic study if:

    the treating source prefers not to perform the examination;
    the treating source does not have the equipment to provide the specific data needed;


    there are conflicts or inconsistencies in the file that cannot be resolved by going back to the treating source;
    the claimant prefers another source and has good reason for doing so; or prior experience indicates that the treating source may not be a productive source.

    Consultative Examination Report Content

    A complete CE is one which involves all the elements of a standard examination in the applicable medical specialty. A complete consultative examination report should include the following elements:

    the claimant's major or chief complaint(s);


    a detailed description, within the area of specialty of the examination, of the history of the major complaint(s);


    a description, and disposition, of pertinent "positive" and "negative" detailed findings based on the history, examination, and laboratory tests related to the major complaint(s), and any other abnormalities or lack thereof reported or found during examination or laboratory testing;


    results of laboratory and other tests (e.g., X-rays) performed according to the requirements stated in the Listing of Impairments;


    the diagnosis and prognosis for the claimant's impairment(s);


    a statement about what the claimant can still do despite his or her impairment(s), unless the claim is based on statutory blindness. This statement should describe the opinion of the consultant about the claimant's ability, despite his or her impairment(s), to do work related activities such as sitting, standing, walking, lifting, carrying, handling objects, hearing, speaking, and traveling; and, in cases of mental impairment(s), the opinion of the consultant about the individual's ability to understand, to carry out and remember instructions, and to respond appropriately to supervision, coworkers, and work pressures in a work setting. For a child, the statement should describe the child's functional limitations in learning, motor functioning, performing self-care activities, communicating, socializing, and completing tasks (and, if the child is a newborn or young infant from birth to age 1, responsiveness to stimuli); and


    the consultant will consider, and provide some explanation or comment on, the claimant's major complaint(s) and any other abnormalities found during the history and examination or reported from the laboratory tests. The history, examination, evaluation of laboratory test results, and the conclusions will represent the information provided by the consultant who signs the report.

    Evidence Relating to Symptoms

    In developing evidence of the effects of symptoms, such as pain, shortness of breath, or fatigue, on a claimant's ability to function, SSA investigates all avenues presented that relate to the complaints. These include information provided by treating and other sources regarding:

    the claimant's daily activities;

    the location, duration, frequency, and intensity of the pain or other symptom;

    precipitating and aggravating factors;

    the type, dosage, effectiveness, and side effects of any medication;

    treatments, other than medications, for the relief of pain or other symptoms;

    any measures the claimant uses or has used to relieve pain or other symptoms; and

    other factors concerning the claimant's functional limitations due to pain or other symptoms.


    In assessing the claimant's pain or other symptoms, the decisionmaker(s) must give full consideration to all of the above-mentioned factors. It is important that medical sources address these factors in the reports they provide.

    * * * * * * * * * *

    The Role of the Health Professional

    Health professionals play a vital role in the disability determination process and participate in the process in a variety of ways:

    As treating sources or other medical sources who provide medical evidence on behalf of their patients;


    As CE sources to perform, for a fee, examinations and/or tests that are needed;


    As full-time or part-time medical or psychological consultants reviewing claims in a DDS, in one of SSA's regional offices, or in SSA central office; or


    As medical experts who testify at administrative law judge hearings.
    Treating Sources

    A treating source is a claimant's own physician, psychologist, or other acceptable medical source who has provided the claimant with medical treatment or evaluation and has or has had an ongoing treatment relationship with the claimant. The treating source is usually the best source of medical evidence about the nature and severity of an individual's impairment(s).

    If an additional examination or testing is needed, SSA usually considers a treating source to be the preferred source for performing the examination or test for his or her own patient.

    The treating source is neither asked nor expected to make a decision whether the claimant is disabled. However, a treating source will usually be asked to provide a statement about the claimant's ability, despite his or her impairments, to do work- related physical or mental activities.

    Consultative Examiners for the DDS

    In the absence of sufficient medical evidence from a claimant's own medical sources, SSA, through the State DDS, may request an additional examination(s). These CEs are performed by physicians (medical or osteopathic physicians), psychologists or, in certain circumstances, other health professionals. All CE sources must be currently licensed in the State and have the training and experience to perform the type of examination or test SSA requests.

    Fees for CEs are set by each State and may vary from State to State. Each State agency is responsible for comprehensive oversight management of its CE program.

    Medical professionals who perform CEs must have a good understanding of SSA's disability programs and their evidentiary requirements. In addition, these medical professionals are made fully aware of their responsibilities and obligations regarding confidentiality and:

    CE scheduling intervals;

    CE report content;

    Elements of a complete CE;

    When a complete CE is not required; and

    Signature requirements.

    Go to Part II - Evidentiary Requirements, for more information about CEs.

    Program Medical Professionals

    Physicians of virtually all specialties and psychologists at the State, regional, or national levels review claims for disability benefits. The review work is performed in the State DDSs or SSA’s regional office or headquarters. It is strictly a paper review in which the program physician or psychologist usually has no contact with the claimant.

    Medical Experts

    Because there is no direct involvement of medical professionals in the disability decisions made by administrative law judges in the Office of Hearings and Appeals, administrative law judges sometimes request expert testimony on complex medical issues. Each Hearing Office maintains a roster of medical experts who are called to testify as expert witnesses at hearings. The experts are paid a fee for their services.

    Confidentiality of Records

    Two separate laws, the Freedom of Information Act and the Privacy Act, have special significance for Federal agencies. Under the Freedom of Information Act, Federal agencies are required to provide the public with access to their files and records. This means the public has the right, with certain exceptions, to examine records pertaining to the functions, procedures, final opinions, and policy of these Federal agencies.

    The Privacy Act permits an individual or his or her authorized representative to examine records pertaining to him or her in a Federal agency. For disability applicants, this means that an individual may request to see the medical or other evidence used to evaluate his or her application for disability benefits under the Social Security or the SSI programs. (This evidence, however, is not available to the general public.)

    SSA screens all requests to see medical evidence in a claim file to determine if release of the evidence directly to the individual might have an adverse effect on that individual. If so, the report will be released only to an authorized representative designated by the individual.
    [This Message was Edited on 10/18/2005]
  4. winsomme

    winsomme New Member

    you need to go to a CFS or a Lyme literate Doc.

    they will know how to write a strong letter clearly defining your illness and say that because of it you are impaired and need disability.

    if you let me know where you are i can maybe let you know of some DRs

    i mentioned Lyme because chronic lyme is a clinical diagnosis based on symptoms - which are almost identical to CFS. and many CFS people who go to Lyme specialists, LLMD, test positive for Lyme.

    and lyme DRs are very good at getting disability.

    if you want an LLMD near you, go to www.lymenet.com and check out the flash discussions section.

    there is one called "seeking a doctor"

    thanks
    bill
  5. petesdragon

    petesdragon New Member

    My doctor simply wrote in his notes "this patient cannot work". Got me nowhere. The judge simply said your doctor says you cannot work but does not say why you cannot work.

    I think the two things that saved me were that one doctor wrote I was dizzy a lot and my shrink said I was too clinically depressed to continue in my job and my SSI legal eagle was able to find a copy of a letter in my file that I had been offered a new contract for another year at a higher salary. This apparently told them I was not just applying for SSI because of an argument with the boss.

    You need to document with your doctor what you can no longer do and why you can no longer do it and prove it is not because of an argument with your boss.
  6. cafe52

    cafe52 New Member

    My GP did put that I had fibro but as a secodary thing she threw in my cervical cancer I had years and years ago and some of the problems I have now.

    She reffered me to this Rheumatologist, I think he is new

    He says one thing she says another I'm not sure he thinks I have fibro but he has diagnosed me with anything else,

    Just keeps ordering test that come back negative or not bad enough for them to care about.

    petesdragon: I live in Northern Claifornia about 200 miles away from Sacremento. I have checked the doctor refferal here and there are none close to me and alot of the docs now wount take new patients and some won't take private pay which is what I am. I think I am stuck with the ones I have I have been seeing my GP for about 26 years now.
  7. cafe52

    cafe52 New Member

    And another thing lol I contacted the Allsup people that say they have a high sucess rate at getting people there disability I talked to them but was not ready to hire them yet.

    They called me regularly to see if I was ready if I had heard anything yet, so when I finally did call them back to say yes I am ready.

    I asked them what would happen if my Doctors were not on board completly with this they told me then they could not help me and that was that.