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CraigR

Disability Question

35 posts in this topic

I am considering going out on Social Security disability, but I need to find out the likelihood of being accepted. If I am not accepted, it would be a terrible financial blow, especially regarding ultimate Medicare coverage.

 

I am 54, have slow-onset (limited, CREST) scleroderma with secondary Sjogrens syndrome and pulmonary hypertension. Also have a history of lymphoma (in remission past 6 years). I have peripheral neuropathy in my feet from chemotherapy/sclero. Have had complete right hip replacement due to avascular necrosis, and have recently had diagnoses of lumbago, sciatica and osteoporosis. I also take blood thinners for a history of blood clots in my legs.

 

Presently I work 20 hours/week as a financial analyst, but I want to go out on complete disability, perhaps in a month.

 

Any ideas of what my chances would be of getting SS disability? I am also planning on making an appointment with the local Social Security office to see what they recommend.

 

Thank you!

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Hi Craig,

 

It sounds to me like your chances would be outstanding. But of course I'm not a disability expert. However, I would recommend you contact a disability lawyer, who specializes in Social Security Disability, before meeting with the social security office. They might have some good tips for you.

 

Search for the previous disability threads on Sclero Forums. Also, talk to the lawyer because you may not need to quit entirely. Maybe just reduce your hours to 15 per week, and still be eligible! So don't go cold turkey on work until you get a legal opinion, first.


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.

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Hi Craig,

 

I was told that obtaining disablilty is usually a lengthy process, so get started on it sooner than later.

 

I dont know if it differs by what state you live in, but in my state there is a 3 - 5 month waiting period after you apply until you get decision, either accepted or denied.

 

Good luck

 

Kathy


Diffuse Scleroderma Diagnosed March 2009

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Craig,

 

You have been given great advice. Get started now if you want disability. I applied in November of 2005. I was turned down the first time. I appealed it and a medical examiner for the state examined me and I got it. I was approved in April of 2006 for state disability and June 2006 for social security disability. I was very lucky because I didn't need a lawyer. I get state disability too because I was a teacher. At the time I applied for disability I hadn't been diagnosed with scleroderma yet. I had fibromyalgia, Sjogren's, Raynaud's, GERD, and watermelon stomach. I also had had a botched hand surgery on my right hand and couldn't use it very well. I don't think you should have any trouble getting it. If you have a doctor that knows how to write it up it really helps.

 

Best of luck to you. If you have any other questions feel free to PM me. I too have CREST.

 

Nan

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Hi Craig,

 

I feel with the complexity of your health conditions, you'd have a really good chance in getting it. I have some information you might be interested in that may help you in the process. If you want, send me a private message with your email address and I'll send it to you.


Warm and gentle hugs,

 

Pamela

ISN Support Specialist

International Scleroderma Network (ISN)

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Craig,

 

Would the dr(s) who diagnosed you...be a possible advocate for you?

 

My rheumatologist took on that responsibility, doing an excellent job, I might add, providing all of the pertinent information, regarding my case.

As a result, I provided all of the necessary paperwork required of me thereafter and everything was taken care of.

 

In the meantime, how are things going, in this regard?

Please do, keep us posted?

My best to you.


Special Hugs,

 

Susie Kraft

ISN Support Specialist

ISN Chat Host

International Scleroderma Network (ISN)

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CraigR,

 

Best wishes to you in whaever your decision.


I may have Scleroderma, but Scleroderma doesn't have me!

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I have CREST, and applied for social security disabilty in November 2004, and was approved the first time, with approval coming in April 05. My main medical problems are Esophagael reflux, with a history of throat ulcers, difficult swallowing, slow motility, raynauds with a history of digital ulcers and as a result half my right index finger was amputated, & awful fatigue, and still with only a small amount of problems as compared to others I was still approved the first time. Good Luck! Patty

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Thanks to all for your input.

 

I had my interview on August 20, and things seemed to go well. I did my homework, so I had everything that could possibly need at that point.

 

My Rheumatologist is a very good spokesperson for me, so that will help. Also, we have a local area sclero support group , and they have been giving me good advice. I am confident that it should be approved, sooner or later. As with you folks, the experiences of the support group people have varied. Some seem to think that they almost always turn down claims the first time, but later they have success. So on with the process...

 

With the initiation of the process, I went into a terrible depression, and have gotten help. Looking back, I probably should have done this a few years ago, but staying at work let me sort of deny the problems. Also, since the disease varies so much from day to day, it's easy to feel, on good days, that there isn't much of a problem....then along comes a bad day when I can hardly get out of bed...

 

Craig

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Craig,

It sounds like things are going well. I think it's good that you are addressing your depression. Denial is so much easier sometimes. :)

Nan

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Craig,

 

I to was told by many people that most people get denied the first time, so I anticipated that was going to happen to me, & was totally surprised when approved the first time. I think what helped me besides my Dr.s input was my filling out of the questionaire they send you after the initial phone interview. The questionaire asks questions about how you presently function on a daily basis, from things like showering, getting dressed, to preparing meals etc.. I filled out the questionaire relating to each of these questions to how I would function on the bad days(those days that you dont even hardly have enough energy to get out of bed), then I added 11 handwritten pages of how life is on a day to day basis & trying to maintain working fulltime. Again I wish you luck!

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Craig,

 

I just noticed your inquiry about medicare also. You become qualified for medicare exactly 2 years from the approval date of disabilty. While waiting for that 2 years to pass some people qualify for full medicaid, but if not for full mecicaid due to income level, I was told all people on disabilty qualify for medicaid but it would be based on what they call a spin down, meaning medicaid would kick in after you put out a certain amount of money on medical care each month, & that spin down amount would depend on how much you make. Patty

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I got word from Social Security - and I was denied.

 

So I guess now is the time to get a lawyer.

 

I was surprised at how their summary of my medical condition seemed to trivialize things: e.g. - "occasional fatigue" ("constant" would be more correct). I guess if you can get out of bed you are denied.

 

There also appears to be an error: They state that I said I could "stand and walk up to 6 hours in a normal 8 hour work day" That was for a different job, that I haven't done for 8 years.

 

Craig

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Craig, the error and discrepancy (fatigue) would seem like good grounds for appeal. I've heard almost everyone is turned down the first time they apply. Good luck!


Jeannie McClelland

(Retired) ISN Director of Support Services

(Retired) ISN Sclero Forums Manager

(Retired) ISN Blog Manager

(Retired) ISN Assistant News Guide

(Retired) ISN Artist

International Scleroderma Network

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Wow I am so surprised you were denied. In November of 2008 Scleroderma was listed as a disease that is to be fast-tracked for approval under the compassionate allowance. This means that due to your having the disease it is almost always approved if your medical documentation is good in showing that you suffer from everything that sclero does to you. I was lucky in that I applied in October, had my telephone interview in November, approved in December, and received my first check in January. Mine was fast-tracked for approval under the compassionate allowance. The social security rep that did my telephone interview was a huge help and went over my application thoroughly and made necessary changes. I guess I was lucky that where I doctor at did a very good job in the medical records in what I have and the problems that I have. You need to talk to your doctor and get him to help you in getting this disability. If he were to write a letter indicating everything medically and to really document what you have; how it affects you; what you're not able to do; and what you will probably continue to have in the future and what you are up against.........I think would be a huge help.

 

With regard to Medicare they are right. I didn't have to do a thing and it's 2 years this January and I already received my Medicare card. Now I will find a supplement that will pick up the 20% that Medicare doesn't pay and a prescription plan to cover my meds. These 2 policies will still be a huge savings to us monthly and I am so grateful that I got disability and now Medicare. I honestly don't know how I could go to work..........I couldn't. I have such terrible fatigue that it seems when the clock strikes Noon my day is done and my body has had it. I can't fight the yawns and the eyes go shut and my body has had it. Granted it may due to the terrible muscle pain that I deal with that by then my body says enough is enough but how in the world does a person hold down a job with this disease?!

 

I wish you good luck and if you get the medical documentation done to the degree that it needs to be to show you can't work you should be able to get it. It would be so nice if you could do this without an attorney as this usually ends up being easy money for them and they take a portion of your settlement that you get as your disability approval will go back to the day you first applied so if this takes a long time that can add up to quite a bit and the attorneys love this.

 

Again, good luck and keep at it.

 

Warm hugs,

Peggy

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Craig,

I am so sorry. Get going asap on your appeal. I was told by my cousin who is a lawyer to not get a lawyer until you have been denied 2 or 3 times.

Hang in there,

Nan

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There are three levels of appeal in a Social Security claim- a reconsideration, where the case is returned to the same agency that made the original decision but to a different employee. Then there is a hearing in from of an Administrative Law Judge, who is an attorney and is held face to face. The last is an Appeals Council review.

Disability determinations are made from criteria listed in the DISM- a manual that lists all medical conditions and the thing that are needed to approve the claim. Sometimes people miss mentioning some key phrase that is needed and a lot of time, doctors only copy their medical records and send them in and those medical records do not have complete information- this should be listed in the denial letter.

There have even been cases of the wrong records being in file. Or the agency not waiting till all records are in file.

 

If you can provide extra information that includes the items the lletter said was not proven, maybe a letter from your doctor covering this, it may be enough for a reconsideration. Make sure all records are in file.

Usually lawyers will charge on a contingency basis- no money unless approved. Law judges certainly do like to listen to lawyers.

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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

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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!

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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.

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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

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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.

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