Applying for "Social Security Disability Benefits" (SSDI)

STOP!

Spinning Your Wheels With SSDI Applications

A recent SSDI case in New York State favored the victim of ARD when it was granted to her based on her incapacitations caused by the symptoms of adhesions among other physical causes.

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Apply for Disability Benefits

Adult (Age 18 or Over)

http://www.ssa.gov/applyfordisability/adult.htm

"Incapacitated" & "Disabled"

The things you will need to be aware of when applying for

SSDI when suffering symptoms of "Adhesion Related Disorder."

Incapacitated: debilitated, laid up, out of action, harmed

Misconception: mistaken belief, false impression

Hindered: delayed, stuck, stalled

Substantiation: Confirm, proof, corroboration, validation

Symptoms: warning signs, indication of

Impacted: impaired, placed upon or in

Disabled: rendered inoperative, immobilized, put out of action

Misconception

The first misconception people have about applying for SSDI is that they have to "prove" that they have a medical condition that is hindering them from being able to function in their daily lives. Why is this a misconception, you might ask? Let me explain:

A person can be stricken by any number of physical conditions that impacts their lives to the point that they cannot function well enough to perform basic daily activities.

Be it a disease, disorder, congenital defects or injury, physical, psychological or emotional, short term or chronic, if that person cannot function well enough to perform basic daily activities, they are rendered "incapacitated" by their physical condition/s.

As long as you have substantiation of your medical intervention validating that you are currently receiving medical care for something that, understandably, can render one incapacitated by the symptoms of the medical condition the person has been impacted with, or validation that one has a "limitation" that impacts their life in ways that they cannot perform basic daily activities, this is will support your claims of being rendered "incapacitated"

The Social Security SSDI application will request you to list all your medical care- providers so that they can secure your medical records. Make sure you list ALL the medical care-providers you have utilized over the period you were being treated by them. Include all Dr.'s, Hospitals, Physical Therapists, Chiropractors, Psychologists and Pain Management Clinics & Emergency Room visits. The information received from your medical care-providers will offer the validation you will need verifying that you indeed have been treated for a medical condition.

Medical Care Providers

Here is where your first hitch in getting approved for SSDI benefits may come in! Approval will depend on whether the medical condition/s being treated by the specific medical care-providers validate that your condition/s, in and of it-self is such that it can render a person incapacitated. What is recorded in your medical files about your specific symptoms and condition will depend upon the amount of knowledge your medical care provider has about that condition. The medical care-provider's knowledge and theories on a given medical condition differ greatly from one provider to another and depending on what they believe to be the issues in your case, it will be reflected in your file when secured by the office of the Social Security Dept.

It is for this reason that each victim afflicted with "Adhesion Related Disorder" take as much information about "ARD" as possible! YOU must "validate" to your medical care-provider, NOT the Social Security Dept., that your symptoms could indeed be the result of "adhesions" based on your past surgical history and YOU must validate that adhesions can and do in fact have to potential to create the symptoms your presenting to them with!

Pain is subjective and cannot be diagnosed, and "adhesions" cannot be diagnosed without an invasive diagnostic procedure, so it IS up to each victim of ARD to either educate your attending medical care-providers and if they are not receptive to that, go find one that will be willing to learn how they may be serve YOUR needs!

Remember this: The medical care-provider is NOT paying you to come to them for their care, "YOU" are paying them to care for you!! If they are NOT effective in this manner, find one who will be!

In my opinion, "All" victims of ARD have experienced one or more of the following scenarios when seeking medical intervention for their symptoms.

• The medical care- provider was really ignorant to the reality of ARD and the symptoms it impacts on those afflicted with it.
• The medical care-provider simply "chooses" not to accept that "adhesions" in and of themselves, could indeed cause the symptoms the patient presented to them with.
• The medical care-provider simply "pretends" that they don't believe "adhesions" cause pain, or any other symptom for that matter, so that they do not have to make any attempts to treat those symptoms, hoping the patient will just, "go away!"
• The medical care-provider will "deny" that "adhesions" cause symptoms, as claimed by the patient, and they will make the "assumption" that the patient would be best served by being evaluated by a psychiatrist, and once that patient is referred out, they close their door to them, not offering anymore medical services. It just might be to your advantage to secure a therapist more then for a few visits, as to be chronically ill, you deserve that attention and support…and file!
• The medical care-provider claims that the symptoms the patient presents with, is "creating" them due to a dysfunction in their personal life and not due to any medical condition and treat accordingly, possibly with placebo treatments and medications.
• The medical care-provider knows " exactly" what adhesions are, and the symptoms they cause and that they will not make money on the ARD patient, but will be consumed by the patient and not be able to make them well, so he orders LOTS of diagnostic tests that return with "negative" findings so he refers them to another medical care-provider. And that medical care-provider knows the same thing about the ARD patient as the referring provider, so after all his diagnostic tests are completed and return with negative findings, he too refers the ARD patient to yet another medical care-provider, who in turns makes his money off them and then finally refers them to a surgeon who is most willing to perform a "diagnostic" procedure in which he finds, " adhesions", which he lyses, and then he tells the patient one of two things: Nothing "abnormal" was found or that he in fact encountered "adhesions" which he lysed and that the patient should not experience anymore symptoms as he "cured" them! And that is exactly the way things will be reflected in your file when your file when it is secured by the Social Security Dept
  

It is very important that YOU, the patient, secure your medical records and have them in YOUR possession. This gives you the opportunity to know what each respective medical care-providers perception of your presenting symptoms were, what he thought caused the symptoms as well as how he treated them and why he chose the intervention that he did render to you.

If you have changed medical care-providers, that doesn't mean that your medical records followed you! By "assuming" that your current medical care-provider has up to date history on you, may not be so. Even though you place it on a "new patient" questionnaire, that does not give the Social Security Dept. enough information on the medical care rendered you by prior physicians so that they can base an informed determination on your SSDI claim.

It is most necessary and responsible for you to secure your operative reports and all associated PRE- surgical diagnostic reports, POST surgical reports, pathology reports and any other medical interventions rendered you surrounding your surgeries.

You will be able to make copies of these reports and attach them to the SSDI application for validation of your claims of being incapacitated by your medical condition. By you, the patient, doing this, it shows that you are responsible and educated to your condition, as well as respectful to the application process and persons receiving this application. You will also be perceived as being aware of the application process, which cannot hurt at all.

Your Reason for Applying for SSDI:

When applying for "Social Security Benefits," you must be totally familiar with the reasons a person will be approved for disability benefits. Those reasons will be based solely on the patient's inability to secure gainful employment due to being incapacitated due to a medical condition. As long as the person applying for the disability benefit can in fact validate that a medical condition exists by showing cause in the medical files that will be secured by the Social Security Dept. It is not necessary or productive for the person applying for the disability to try to "convince" the Dept. of Social Security that they in fact have a medical condition, of your medical files do not indicate that effectively, there is nothing you will be able to do about that as you cannot personally over-ride the information in your medical files as they are presented!

The only way that you will be approved for Social Security Benefits is to be classified as, " disabled." This means that the medical condition you presented with to your medical care-providers was hopefully represented in your medical files factually and correctly, and reflected a condition that in fact can render a person incapacitated and unable to perform daily tasks. Because the person cannot perform daily tasks, they are not employable thus cannot secure a job (gainful employment) because they are "unemployable" due to a disability caused by a medical condition. As long as the medical condition could in fact render a person incapacitated enough to become "disabled" it matters not what type of condition it is. With ARD, it is difficult to prove it exists let alone being responsible for incapacitating someone. Chronic pain IS acceptable as a medical condition severe enough to cause on to become incapacitated to a point they are disabled and cannot secure gainful employment.

You are applying for Social Security Benefits because your think that you have been incapacitated by chronic pain and rendered disabled to the point that you cannot secure a job due to not being able to function at ordinary everyday tasks, let alone tasks required for employment outside your home.

How do you show that you are incapacitated

It is imperative that your medical records show that you have complained about "not being able to perform" your daily tasks without assistance or that you have had to give up doing certain tasks altogether due to your pain and suffering being to great for you to perform them.

The reasons behind your inability to perform certain tasks might come from:

• The pain levels you experience either chronic or intermittent
• How your body reacts to medications your taking, such as the inability to drive yourself to and from places, medications causing other symptoms such as drowsiness, nausea, diarrhea, excessive thirst,
• Due to pain you cannot sit for over two-three minutes without needing to sit again or recline,
• Due to pain, not being able to bend, be it to tie a shoelace or pick up an item
• Due to symptoms you exhibit, such as Gastroesophogeal Reflux Disease (GERD) you need to hydrate yourself frequently, thus you carry water or some other beverage at all times, you spontaneously regurgitate due to GERD, and must have access to medications for it as prescribed.
• Due to your pain levels, you must have access to your pain medications at all times, and depending on the side affects of the medications, you must have access to bathroom facilities at all times.
• Due to your medical needs you must be available to seek medical attention at scheduled times, some being frequent, but at times spontaneously if a bowel obstruction is suspected.
• Due to your pain and other presenting symptoms, some compounded by the side affects of medications, you cannot perform your own household duty's, but have others perform them for you; such as: grocery shopping, cleaning house, doing laundry, cooking, etc.
• Due to your symptoms, you cannot bath yourself without assistance, get in and out of bed, or a chair without assistance, need assistance with scaling stairs, use a wheelchair when out of the house, etc..

What you are showing here is that you are incapacitate at these levels in your daily life and even if you could present for an interview for employment, you would not be hired as your seen as a liability and not an asset to any employer. Due to your medical condition, you cannot perform tasks that allow you to be employed, thus you lose your ability to secure "gainful" employment. You will need letters from persons who, in fact, assist you in these tasks, as that will validate your claims of not being able to do them on your own.

• They should list the type of service or task that they help you with
• They should list the amount of time, hours and/or number of days that they help you with a given task
• They should list reason why you cannot perform the task they are doing for you or assisting you with
• They should also state what they observe in your behavior with any given symptom: I witness this person vomiting frequently, holding her abdomen when she stand or sits, uses heating pad when I see her, cannot walk unassisted,
• State any observations such as the patient not leaving the house very often, decreased socialization,
• Behaviors such as crying, sleepiness ness, anxiety, lack of appetite or eating,
• Anything that they would notice was not within a "normal' activity compared to a person who is healthy and active.

Once you have proven that you are incapacitated in ways that inhibit you from securing gainful employment, you will be classified as being, " disabled."

Classified "Disabled" by the Dept. of Social Security

Once you are classified as "disabled" by the Dept. of Social Security, your claim will be processed as to the degree of disability you posses and your benefits will be determined by the degree of disability you are found to have.

Once SSDI is secured please ask about SSI benefits for your minor children!

MOST applicants for Social Security Disability Benefits are denied the first time around, and only about 20% of all claimants will be approved for Social Security Disability Income (SSDI)

The most important thing for the claimant to do it have all the paper work in order, provide defined answers, cover every basis such as supporting letters from friend who assist you in any way, friends that can offer support to what will be found in your medical records. It will be up to each victim of ARD to do everything in their power to make sure your medical care-providers record facts about your symptoms, if you feel that you are not being understood, respected or believed, get another medical care provider or get an advocate who can help you impress upon your provider the reality of what your suffering with…and ARD will be up to you to prove if your to get your symptoms recognized, but only at the medical level.

You will NOT secure a disability claim through the Dept. of Social Security based on adhesions and surgeries alone, but based on your symptoms of chronic pain, and the inability to secure employment…it is up to you to prove beyond a reasonable doubt that you are indeed disabled by a medical condition!

By you doing this, you are less likely to be perceived as just a patient "looking" to secure disability benefits without knowing why you are entitled to them! By being responsible for your own medical intervention, your perceived as being honest and aware of what your claim is based on and that you are aware that what you are experiencing in your life is within the guidelines for being approved of receiving Supplemental Security Income (SSI)

The things you will need to be aware of when applying for "Social Security Disability" when suffering symptoms of

"Adhesion Related Disorder."

Persons who suffer symptoms of "Adhesion Related Disorder"

Must be aware that there is no medical code recognizing ARD as a medical disorder. ARD cannot be used in the form of a diagnosis, or as an "end means" of symptoms suffered as a result of them. Explanation of "end means: "End means" is the same as "cause of "symptom/symptoms.

Diabetes is an "end means" for the symptoms of poor circulation to extremities, blindness, excessive thirst, frequent urinations, etc. Diabetes can be listed as the end means of these symptoms and can be used as a "diagnosis" by the attending medical professional because Diabetes has a code recognized by the FDA.

It remains a curiosity to me - and a bit of a sore spot - that the incidence of adhesion formation as the direct result of certain surgical procedures has been recognized within the medical arena for many decades and the increasing number of those surgeries has also been recognized within the medical arena for many decades, yet no ICD code exists to recognize them as an end means of our symptoms nor for adhesions to be used as a diagnoses by attending medical professionals.

However, there IS an ICD code that can be used by surgeons when writing a pre-operative and post-operative procedure they perform called an, "adhesiolysis." There also exists an ICD-9CM code that allows the use of an "adhesion Barrier" in the procedures called "adhesiolysis." Surgeons can use that ICD-9CM code to collect from insurance companies for performing the adhesiolysis and for using adhesion barriers, but, there is no code stating that adhesions exist as a diagnosis in and of themselves!

The FDA is responsible to assign the medical codes used within the USA medical system. Without a diagnostic code, a person cannot secure SSI benefits based on disabilities caused by the symptoms of adhesions, as there is no code recognizing adhesions as exiisting let alone being the end means or cause of our symptoms.

A SSI disability is NOT based solely on the person's medical condition (s) but rather it is based on the person's inability to secure and perform gainful employment!

Though the illness,/injury is the cause of the persons inability to perform certain or most job tasks, and that illness,/injury must be proven by current and consistent medical intervention (substantiated and verifiable by the person who is applying for the SSI,) the decision whether the person is denied or approved for the SSI will be based on whether the patient applying for Supplemental Security Income (SSI) can perform work skills or not!

This is the bottom line of whether you will or will not be approved for SSI benefits.

Once again: The physical/medical problem causing the person to be incapacitated is NOT what must be focused on when applying for Supplemental Security Income (SSI), but rather, the person applying must show what physical tasks or limitations the physical/medical problem has

impacted their lives with causing them to not be able to perform job tasks thus limiting their ability to secure gainful employment to support themselves while they are disabled.

Social Security Disability offices

Social Security Disability offices are located in each state of the United States serving every community in each state. "Supplemental Security Income (SSI)" is a federal program, thus it does not differ from state to state by rather each state is under the "umbrella" of the same rules and regulations of the Social Security Administration, a division of the United States Dept. of Health and Human Services in Washington, D.C.

The surest way to file a Social Security disability claim is to go to the nearest Social Security office in person and wait to see someone to file the claim in person.

You may have to wait in turn to see an agent, so if you are not well enough to wait, a person may contact the nearest Social Security office by telephone and arrange for a telephone interview to file the claim. Call that office and ask what the procedure is to file for SSI when you cannot make it to the office in person. You may be asked to make an appointment even though you cannot go to the office in person, this is simply procedure, once you do that, and the application can be sent to you via mail. You can then cancel the appointment once the application arrives. This does not in any way impede your ability to secure SSI.

Supplemental Security Income (SSI)

1. What is the definition of disability used by Social Security?

The best, surest way to file a Social Security disability claim is to go to the nearest Social Security office in person and wait (often for a few hours) to see someone to file the claim in person. In the alternative, a person may contact Social Security by telephone and arrange for a telephone interview to file the claim.

Supplemental Security Income (SSI)

1.) Disability Facts: Frequently Asked Questions

http://www.allsupinc.com/FAQs/FAQs.htm

2.) Social Security On line Answers To Your Questions

http://ssa-custhelp.ssa.gov/cgi-bin/ssa.cfg/php/enduser/std_alp.php

3.) Providing Medical Evidence To The Social Security Administration For Individuals With Chronic Fatigue Syndrome: A Guide For Health Professionals
http://www.ssa.gov/disability/professionals/cfs-pub063.htm

4.) Winning Your Disability Case in Three Words: Frequency, Severity and Duration

http://chronicfatigue.about.com/library/weekly/aa062101a.htm?once=true&

5.) How Do I Prove I Am Disabled? What Kinds of Benefits Are There? What Are the Steps in Applying for Disability Benefits? Are There Any Restrictions After Benefits Are Approved? How Long Do Benefit Payments Last? What About Having A Lawyer On a Social Security Case? Social Security Law, Practice and Disability Links

http://freedomlaw.com/SSDI.html

6.) Social Security Disability: Frequently Asked Questions

http://www.nosscr.org/faqind.html

7.) Filing for Disability

http://www2.rpa.net/~lrandall/disabled.html

8.) Filing for Disability Benefits

http://www2.rpa.net/~lrandall/filing.html

9.) Social Security Online Disability Programs

http://www.ssa.gov/disability/

10.) Social Security Administration provides public information materials about the Social Security and supplemental security income (SSI) programs

http://www.healthfinder.gov/orgs/HR0067.htm

11.) You May Be Able To Get SSI
http://www.ssa.gov/pubs/11069.html

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In a disability case, almost any symptom or limitation can be disabling; but to determine whether they preclude work, the relevant questions are how frequent, how severe, and how long do they last?

A critical point I make to people who contact me every day is that their disability case is won or lost based on symptoms/limitations and not on their diagnosis! Clearly, under federal law, a disability claimant has to have a legitimately diagnosed physical and/or psychological disorder to even allege disability, but this is only the beginning of the analysis.

Disability cases are almost always won or lost based on the quality (documentation) of your medical records and the subsequent opinions rendered by your treating physicians regarding your ability to sustain full-time employment. The documentation of symptoms and limitations in your medical records is critical, as it provides tremendous credibility to and an understanding of why your doctors have concluded you are unable to work.

Once a diagnosis is established, the disability inquiry immediately shifts to why you are unable to work due to the symptoms and limitations that result from the diagnosis. I tell my clients that of the total time spent in a disability hearing before a federal judge, 5% is spent on the diagnosis and 95% is spent determining the frequency, severity and duration of symptoms and limitations, and whether they prevent all work. Ignoring this fact places the success of your claim in great peril…don't ever forget this!

A common problem disability claimants frequently make is having "tunnel vision" and focusing solely on their diagnosis, as if the fact that they have been diagnosed with a disorder automatically confirms they are disabled and entitled to benefits. This is especially true of people suffering from chronic pain and fatigue disorders such as fibromyalgia and chronic fatigue syndrome. I believe this is true because these folks have almost universally been sent on an "odyssey" by the medical community, simply to obtain a diagnosis. Never forget that obtaining a physical and/or psychological diagnosis is the very beginning, and not the end of your disability case.

Thus, the question becomes, "How do I document the frequency, severity and duration of my symptoms and limitations?"

Tip #1: What should I be documenting?

Simply put, whatever it is that prevents you from working. For example, let's use chronic pain and fatigue. It is critical that you distinguish why the pain and fatigue is different from what an average person may experience. If I say "I am in pain and fatigued," that does not tell you much. Why? From time to time we all experience some degree of pain and/or fatigue. But if you tell your doctor, "I am unable to function as I experience severe daily pain and exhausting fatigue lasting most of the day without relief," or "I am unable to function 2 days per week due to migraine headaches that last all day even with medication," now you've given the doctor and the judge an idea of why your symptoms are so debilitating.

Tip #2: Obtain a Copy of your Medical Records from your Treating Physicians

After you have followed Tip #1, the next question becomes, "Did the doctor write down what I just told him/her?"

I am often surprised at how many people applying for disability benefits have never seen their medical records. Obtaining a copy of your current treating physician's records is important because it will give you an idea of whether your symptoms and limitations are being recorded. You may be surprised to find that your complaints do not appear in the records or if they do, the doctor's notes are totally illegible! Illegible handwriting is a real problem, because the judges who decide your claim are just like you and I--they don't (and generally won't) try too hard to decipher what the notes say.

If you are not satisfied with the documentation, address the issue tactfully with your doctor and explain the importance of documentation to your disability case. If they are receptive, I suggest you give them a copy of this article for reference.

Tip #3: Keep A Short Diary of Your Symptoms and Limitations before your next Visit to the Doctor

Whether you know it or not, your daily life tells a compelling story about your inability to work. But how do you remember the frequency, severity and duration of your symptoms especially if you can't spell your name at times!

I advise clients to keep a short and simple diary one week before their visit with their doctor. For simplicity sake, the entries should be short and not detailed (otherwise you will not do it). On a day when you were unable to get out of bed due to pain or fatigue, document it. Or document when you slept for only three hours the night before and then took a couple of naps the next day. Or document the migraine headache that lasted for two days in spite of medication. Then, on your next doctor visit, when he/she asks "How are you doing?" you will have a laundry list of symptoms and limitations rather than giving them a blank stare!

Of course, winning your disability case is more complicated than this article can address; however, following these tips will significantly increase your odds of winning. Best of luck in your pursuit of disability benefits and remember never to quit!

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Scott E. Davis is a social security and long-term disability insurance attorney in Phoenix, Arizona. Although Mr. Davis has experience representing clients with a broad spectrum of physical and/or psychological disorders, the majority of their disability practice is devoted to representing individuals with FM and/or CFIDS. They do represent clients throughout the United States. In most cases, a fee is charged only if their client obtains benefits. Mr. Davis invites your questions and inquiries regarding representation via email (harris.davis@azbar.org) or telephone at (602) 482-4300.

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YOU ARE THAT SICK AND YOU DESERVE THIS!

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