SSI CATCH 22

Discussion in 'Fibromyalgia Main Forum' started by hbic, Sep 25, 2002.

  1. hbic

    hbic New Member

    Heres the story. My Rhuematologist will not help me with SSI because he will not testify that I am completely unable to work. He will, however, submit that while I am capable of working (to a certain physical extent,ie: lift no more than 10 pounds, sit/stand for long periods..) he doubts that I will be able to do this consistently and to keep to a regular work schedule. Because he said that, my Employment Case Worker at Welfare gave me a work Exemption, but she doesnt know how long shell be able to do that because, in the end, thats not up to her, its up to the Medical Unit at Social Services. But she can, at the very least, give me the exemption while we wait for the determination to come down from there. Until the Med Unit at Social Services makes their determination, I have to live on the Saftey Net program. If they decide to give me an exemption, theyll put me back on TANF, but if they say I can work, then I have to work at least 30 hours a week and will get only partial assitance under Safety Net. In New York State, TANF(Temporary Assitance to Needy Familis) is just like regular old welfare as we all know it. You get very little money, just enough to live on, MAYBE. Safety Net is the program for people who either have no children, or have reached their 60 month TANF limit. Safety Net is differnt from TANF in the sense that you get enough cash assitance to purchase household needs like TP, Shampoo, and an allotment towards a phone bill. However, your gas, electric and rent are paid by voucher directly to the payee, and you, as the Safety Net recipient, have to pay Social Services back all that money that was paid out on your behalf or sent to you in cash. You pay this back after you have left the welfare system. The amount you pay is in monthly payments of 10% of the total monies paid to you or for you while on Safety Net. If you havent left the welfare system and are still on Safety Net 1 year after having been placed on the program, you pay Social Services back by recoupment. They take 10% of your total case budget out of your monthly "cash to recipient" payment. The one you get to buy the things you need at home. Basically, if you were poor before, your so poor now that you cant even afford the OR on the end, and your just PO.
    Anyways, the Rhuemy says he has had several patients with Fibro or CFS that he has said, "NO, He/She cannot work" so that they can get SSI or SSD, but found that when their dream job came along, and their medical records were requested, his declaration of NO, they cannot work, cost them that job. He says, if he states that YES, this person can work, but with limitations, whether mild or or extreme, that person is covered under the Americans with Disabilities Act, which provides for certain employment obligations and modifications to keep that person earning a living, without fear of losing their job because they needed more than the employer wanted to provide, like time off. I appreciate his theory because I am hoping to get an Investigator position with New York State. And they do want my medical records, and if it says, NO I cannot work, they will not, legally, cannot hire me. They may still decide not to hire me based on the limitations that he has set, but they certainly wont if he says NO. And if they do hire me anyways, despite the limitations, they cant fire me Under the ADA laws. My Rhuemy is aware that with SSD and SSI, you can work (to a certain extent) and still recieve disability benefits, but it would be on me, have nothing to do with the doctor and his recommendations, and it would be basically AMA, Against Medical Advice.
    So, I call up my insurance provider to get the names of the other Rhuemies that participate with my insurance, which is Buffalo Community Health Plus Med. I call up these 4 doctors, yes, thats right, grand total of 4. The first, no longer works at that office, no idea where to find him. The next, Participates in Buffalo Community Health but not Buffalo Community Health Plus Med, because they do not accept Medicaid. The next "doesnt believe in SSI" and the last one, Doesnt know enough about Fibromyalgia to help me. So, Im stuck with this ONE Doctor, who understands that I need SSI, but wont help with SSI because he doesnt want to be the cause of my missing out on something. So, Now what? I called a Disability Attorney and spoke with a Paralegal, I believe, who said, If my doctor is not willing to cooperate with the application process, and I cannot find one who will, there is nothing I can do. Im hoping this paralegal is wrong and that you may know something she didnt. I realize that this whole messege may be a little difficult to follow, so Ill be happy to clarify anything for anyone. But, if anyone knows anything about what I can do about this situation, please let me know. Winter is coming, and I have no money to buy my kids their winter coats.
  2. hbic

    hbic New Member

    Heres the story. My Rhuematologist will not help me with SSI because he will not testify that I am completely unable to work. He will, however, submit that while I am capable of working (to a certain physical extent,ie: lift no more than 10 pounds, sit/stand for long periods..) he doubts that I will be able to do this consistently and to keep to a regular work schedule. Because he said that, my Employment Case Worker at Welfare gave me a work Exemption, but she doesnt know how long shell be able to do that because, in the end, thats not up to her, its up to the Medical Unit at Social Services. But she can, at the very least, give me the exemption while we wait for the determination to come down from there. Until the Med Unit at Social Services makes their determination, I have to live on the Saftey Net program. If they decide to give me an exemption, theyll put me back on TANF, but if they say I can work, then I have to work at least 30 hours a week and will get only partial assitance under Safety Net. In New York State, TANF(Temporary Assitance to Needy Familis) is just like regular old welfare as we all know it. You get very little money, just enough to live on, MAYBE. Safety Net is the program for people who either have no children, or have reached their 60 month TANF limit. Safety Net is differnt from TANF in the sense that you get enough cash assitance to purchase household needs like TP, Shampoo, and an allotment towards a phone bill. However, your gas, electric and rent are paid by voucher directly to the payee, and you, as the Safety Net recipient, have to pay Social Services back all that money that was paid out on your behalf or sent to you in cash. You pay this back after you have left the welfare system. The amount you pay is in monthly payments of 10% of the total monies paid to you or for you while on Safety Net. If you havent left the welfare system and are still on Safety Net 1 year after having been placed on the program, you pay Social Services back by recoupment. They take 10% of your total case budget out of your monthly "cash to recipient" payment. The one you get to buy the things you need at home. Basically, if you were poor before, your so poor now that you cant even afford the OR on the end, and your just PO.
    Anyways, the Rhuemy says he has had several patients with Fibro or CFS that he has said, "NO, He/She cannot work" so that they can get SSI or SSD, but found that when their dream job came along, and their medical records were requested, his declaration of NO, they cannot work, cost them that job. He says, if he states that YES, this person can work, but with limitations, whether mild or or extreme, that person is covered under the Americans with Disabilities Act, which provides for certain employment obligations and modifications to keep that person earning a living, without fear of losing their job because they needed more than the employer wanted to provide, like time off. I appreciate his theory because I am hoping to get an Investigator position with New York State. And they do want my medical records, and if it says, NO I cannot work, they will not, legally, cannot hire me. They may still decide not to hire me based on the limitations that he has set, but they certainly wont if he says NO. And if they do hire me anyways, despite the limitations, they cant fire me Under the ADA laws. My Rhuemy is aware that with SSD and SSI, you can work (to a certain extent) and still recieve disability benefits, but it would be on me, have nothing to do with the doctor and his recommendations, and it would be basically AMA, Against Medical Advice.
    So, I call up my insurance provider to get the names of the other Rhuemies that participate with my insurance, which is Buffalo Community Health Plus Med. I call up these 4 doctors, yes, thats right, grand total of 4. The first, no longer works at that office, no idea where to find him. The next, Participates in Buffalo Community Health but not Buffalo Community Health Plus Med, because they do not accept Medicaid. The next "doesnt believe in SSI" and the last one, Doesnt know enough about Fibromyalgia to help me. So, Im stuck with this ONE Doctor, who understands that I need SSI, but wont help with SSI because he doesnt want to be the cause of my missing out on something. So, Now what? I called a Disability Attorney and spoke with a Paralegal, I believe, who said, If my doctor is not willing to cooperate with the application process, and I cannot find one who will, there is nothing I can do. Im hoping this paralegal is wrong and that you may know something she didnt. I realize that this whole messege may be a little difficult to follow, so Ill be happy to clarify anything for anyone. But, if anyone knows anything about what I can do about this situation, please let me know. Winter is coming, and I have no money to buy my kids their winter coats.
  3. JaciBart

    JaciBart Member

    I cannot believe this! I cannot also help but start being a believer in "conspiracy therorie" regarding Drs & ins companies.

    Jaci
  4. allhart

    allhart New Member

    im going threw much of the same thing ,the more youb need help the less chsnce you have of getting it,
    hugs
    kara
  5. momkrone

    momkrone New Member

    I can relate to your cause. My husband was hurt on the job two years ago so I was making the living. My doctor told me that my spine was collasping and I could no longer work. So then they tell me that I cannot work where I would have to stand or sit for long periods and I cannot work shift work and I cannot work where it takes remembering two or more things at a time ,( since you see sometimes I end up with milk in the microwave instead of fridge) and I will be not be able to work where I cannot take breaks at least once an hour. So now what kind of job can I get ( I was a prison guard) for the state of Texas. He says that he cannot tell anybody that I'm completely disable since I can walk into his office, so what are people in this shape suppose to do? Along with fibromyalgia and chronic fatigue, I have osteoporosis in my spine of a 65 year old and in my hips of a 75 year old and many other myalgias so what does a person do when they cannot work because of the problems , but they cannot get of SS because a doctor says since you plan for and save energy to go to the doctor and walk in you are not disabled, he says you cannot work but you are not disabled.I do understand and would love to find someone with some advise. Sorry for complaining but I am at wits end we are fixing to lose our home , car and everything else and I just don't know what to do . Thanks for listening . Momkrone
  6. SaraD

    SaraD New Member

    Hi, well I wanted to say hi, I am 29 (or will be next week) and a mother of 4, thank god though I am married and my husband has a good job, I pray for you and all those single moms out there, I don't know how you do it, BRAVO!!!
    Well, I started the SS process last may 2001 and had my hearing on August 2nd 2002 and waiting to here, I worked at an insurance company for 9 years and they gave me ltd until they decided, not to anymore, that if I can care for my 4 kids that I can work. I did work 40 hours, then 30 and then 20 over a 5 years span till I couldn't barely function and then was diagnosed by a rhuemy of the fibro. Anyway, doctors didn't want anything do to with any legal things, so I just went on my own, with a lawyer and just had all my medical records and am hoping that will be enough. let me know if you want any more info etc...
    Sarad
  7. hbic

    hbic New Member

    that my doctor cannot refuse to fill out the paper work for my ssi application. She has Chronich Fatigue and has SSI. Unfortunately, if he fills them out, Im afraid that what he says will cause SS to determine that I am not in need and deny me every time I apply and appeal.