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Disability Question


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#21 CraigR

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Posted 14 October 2009 - 07:12 AM

I had an interesting discussion with my rheumatologist concerning disability eligibility. It was encouraging when she told me that she had never known a patient more deserving of benefits!

When I originally submitted the information, I did a detailed summary of my medical history, but this was not made use of, as they went about "filling in the fields on the computer screen", which excluded an extensive explanation (including the entire cancer history).

Needless to say, I will use the summary in the appeals process, with great detail of all symptoms (I had assumed that the mention of a serious disease made the effects/symptoms obvious, but apparently not. Also, I have a tendency to play down medical symptoms, as I find such things tiresome when there isn't anything that can be done). Guess I will have to work on becoming a bit more of a drama queen!

Craig

#22 smac0719

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Posted 14 October 2009 - 01:34 PM

CraigR,

Best wishes to you with your appeal. My thoughts will be with you during this next phase of the process.
I may have Scleroderma, but Scleroderma doesn't have me!

#23 enjoytheride

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Posted 15 October 2009 - 05:01 PM

Since there are symptoms that have to be sort of "checked-off" to be awarded benefits at the first level of appeal, making sure that a good history is in file is not being a drama queen but makes sure that you have the best shot of getting those "magic" words in the file. Especially if your doctor can say them too.

#24 CraigR

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Posted 04 November 2009 - 06:36 AM

I met with a lawyer - who started by pulling at his hair over how absurd the denial was.

He pulled out the actual law code and said that I more than qualified for scleroderma, but also met the qualifications for Sjogren's syndrome. So that is the first appeal level.

Craig

#25 Shelley Ensz

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Posted 04 November 2009 - 07:59 AM

Hi Craig,

I'm delighted to hear that you have a lawyer. They will be of immense help in getting your application appropriately processed. The system is just very slow and cumbersome. So hang in there. We are all rooting for you!
Warm Hugs,

Shelley Ensz
Founder and President
International Scleroderma Network (ISN)
Hotline and Donations: 1-800-564-7099

The most important thing in the world to know about scleroderma is sclero.org.

#26 Sherion

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Posted 04 November 2009 - 02:35 PM

Good for you Craig! Sounds like you have a lawyer that's on the ball and knows what he's doing!!

Sherion

#27 Sweet

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Posted 04 November 2009 - 05:57 PM

Hi Craig,
I'm so glad you met with a lawyer. I like the way this is sounding so far! Keep at it, don't give up.
Warm and gentle hugs,

Pamela
ISN Support Specialist
International Scleroderma Network (ISN)

#28 LisaBulman

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Posted 05 November 2009 - 02:42 AM

Hi Craig,
Hopefully your appeal will go quickly and smoothly!! I had to appeal twice, then get a lawyer and was waiting for a court date when the paperwork came from the judge who automatically approved me.

Fingers crossed for you!! Keep us posted.

Hugs,
Lisa
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#29 barefut

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Posted 05 November 2009 - 07:51 PM

You Go Craig!!! :emoticons-yes:

#30 JustME

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Posted 06 November 2009 - 03:13 PM

I think you have a good chance but if you don't want to go through the hearings process the best way is to have a lawyer apply for you. They will get 25% of your back pay with a maximum of $6300. It is worth it. I was approved after 2 years and after the hearing.

#31 Patty1

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Posted 11 November 2009 - 07:45 AM

Hi Craig,

We are in the same boat, so to speak. I applied in February. After reading almost all of the threads here on Disability, I didn't mess around. I went straight to an Attorney that specializes in Disability. To me it is worth it. Especially after reading all of the horror stories, and then the paperwork they ask you to fill out. I am on my "Reconsideration" after being turned down the first time. My attorney told me to expect this, and then to expect to be turned down on the Reconsideration. He said, at least in this state (Massachusetts) they almost always turn you down, all the way through. Then you get to see the Judge. This state "contracts" out to another state agency...Disability Determination Services, who review all of the medical records submitted, plus your questionnaire. When they turned me down this first time, they told me.."While you have had issues with Scleroderma, you can still lift 10 pds, and sometimes 20 pds, AND stand on my feet most of the day" they go on to say, that they realize that my condition prevents me from doing my past job, but does not prevent me from working.........groan.

I WORKED FROM HOME!! With wonderful supervisors who understood that I needed to rest quite frequently, was to fatigued to work some days..and forgave my hospitalizations. I had the best job possible for anyone with this disease. Due to my severe Raynaud's, I go out very little in the fall, winter and early spring. It is too painful being in the cold. I can't comprehend trying a daily commute in cool/cold weather. I don't think I would have any feet or fingers left.

I also have other issues, like most of us, spinal issues, neck and back with one surgery down, and it looks like another one coming. Then throw in the assortment of scleroderma related issues, reflux, esophageal spasms, motility, etc, arthritis, yada, yada, yada. How they figure we could hold down a full time job without getting fired is beyond me. So I am going to sit tight and wait to see the judge, if what my attorney tells me plays out exactly as he mapped out. Who knows, maybe I will be really surprised and be approved on the "Reconsideration"!

Best of Luck to you, and keep us posted on how your process is going.

Stay Warm,

Patty

#32 Honey

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Posted 19 November 2009 - 06:24 AM

Hello, friends.

I have systemic sclerosis (diffused scleroderma) diagnosed in January, 2009. I applied for disability in May-June this year, and was approved in August. I started receiving benefits in September. I am wondering about MEDICAID application, since 2 years is a long time to wait for medicare. Should I contact my local office and ask them how to apply?

Warm regards,
HONEY

#33 Peggy

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Posted 19 November 2009 - 12:30 PM

With regard to medicaid go to your local social services office and get the application and fill it out. If you don't qualify for that there are other health plans available for you so make sure to ask them what all is available to you until you get on medicare in 2 years. In our state there is a health plan available to people who don't qualify for medicaid that is more reasonable and this allows people to at least have some type of coverage. Then once you are on medicare in 2 years and have a supplement to pick up the other 20% medicare doesn't cover and a drug plan for the prescriptions you will be all set.

That's the decision I just had to make. I go on medicare in January, it's already been 2 years that I've been on disability. Well I needed to figure out if I should stay on my husband's medical plan or switch to Medicare part B and a supplement. Well I sat down with an insurance agent that I work with and she compared all the costs with medicare, including the part B premium of $110; the cost of the supplement to medicare (which for me would have been $199); the cost of the medicare part D (for me was $38); and then all the costs of the co-pays for all my drugs. I woulld have hit the donut hole on Medicare Part D in July! I would then pay full price for all my meds the rest of the year. So after crunching the numbers it's cheaper to stay on my hubby's health plan.

The one nice thing to know is if you decide not to Medicare part B and a Med D plan if your current plan is considered what they call a Medicare plan you aren't penalized if down the road a couple of years you change your mind and want to go on Medicare Part B and Medicare Part D. That was a huge part of the decision. Because if you are a regular person that is going on medicare if you don't do Medicare Part D right away you are penalized 10% for every year after, meaning if down the road 5 years you will pay 50% more for your plan. That makes the decision pretty easy to make sure to do the Med D right away and not miss that opportunity. Well it's different for us that are on disability.

I hope I haven't made this too confusing. If you have any questions make sure to call social security and they are very helpful in all this. The guy I got was on the phone with me for almost a half hour explaining it all to me.

Warm hugs,
Peggy

#34 Honey

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Posted 20 November 2009 - 05:05 AM

My local SS office, too, is very patient and kind to deal with. It is my concern that staying with our current health plan might be less expensive, especially since my husband's employer pays almost half of the cost. Things will change when my husband retires in a few years.

I will call my SS office for information. Thank you so much, Peggy, for your reply.

Warm regards,
HONEY

#35 Peggy

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Posted 22 November 2009 - 02:36 PM

That was the most crucial thing to hear from the person I spoke with at Social Security was that if I decided not to go on Medicare Part B and take a supplement and a Medicare Part D for the prescriptions now would I be penalized if I needed to take it later. To find out that as long as my current plan was a "recognized medicare plan" now then if my husband were to quit his employment or something changed that I couldn't have that insurance any longer I could then go on Medicare Part B and the others and not pay the penalties. That was so good to hear being staying where I am at is in fact cheaper than switching to the Medicare plans.

I hope this helps someone else dealing with this.

Warm hugs,
Peggy