Social Security Disability

[MellowOne]

My mother injured her back a year ago and can't work. She has applied for SS Disability twice, denied both times. Now she will appeal. Is this the usual process? Is it true you have to go to court to get disability checks?

[CelticWinter]

1. From everyone that I know who has had to

go on disability they usually end up having to go to court to get it. It's terrible when you work all your life and end up hurt that you have to fight for what you paid into.
Blessings
~~Celtic

[Imagevision]

47. Definitly get a team like " Disability Advocates of America" to represent

you, costs you nothing unless you win... I was denied my first time and after using this group I was approved for SSDI 8 months after I applied the second time.

I re-applied the day I was denied the first time resubmitted the exact same information and no court, SSDI simply sent a letter stating that I was approved 8 months later and gave me a substantial back-payment check from the first time I apied. But I used Disability Of America as my representative should the case need to go to court.

Give it a whirl > http://www.disability-advocate.com/

[dysfunctional press]

63. i didn't have to go to court to get mine...

but it IS a very good idea to get a lawyer that specializes in disability cases.

[better tomorrow]

79. me neither....

mine resulted from a traumatic brain injury when a 10 year old student pushed me into a steel doorjam when she tried to kick another student.....I sued the school board, too, and won....the girl didn't even get detention.

Good luck.

[eleny]

2. Yes, she may have to go to court

Don't guve up. I worked for social services and saw too many people go through this. Don't give up since when she wins her case, she'll get paid from the date of the most recent application.

[MellowOne]

4. thanks for the encouragement

It's awful like you said, you work then can't get the money you put into SS. She can't work, her back is twisted and they say she isn't disabled!

[Besq]

39. Medical bills reimbursment

Get copies of all your medical treatment and drugs that you purchased. Go to the places you got the treatments/drugs and request them to contact the state for reimbursement. When they receive it, they will give it to you.
Caution: Wal-Mart will give you a run-around. I suspect they send in the application, receive the cash and tell you it timed out. They will say SS is slow until the time runs out, then you're out of luck. I think in this instance, they get the money and keep it so be aware.
But do this, you are entitled to the reimbursement.

[schmuls]

43. disability approval

My boyfriend was denied at first too. He had to appeal, which included letters from two people attesting to his disability. He was finally approved after two years, which we were told is the generally waiting time. Do not give up; they have people on staff whoses sole purpose is to deny applications. Keep pushing for it. They want people to get disgusted and give up. Best wishes to your mother.

[Historic NY]

62. Bush's SSI reform................

ain't that the truth. They do have private companies involved in screening process. They get paid for ever denial that is made. I've got to go to a Disability Dr. on 1/2/07 they denied me twice already for disability, once at a hearing. The hearing officer thought because I had a masters degree I should go back to work in that field. I told him it would be pretty hard finding a job given that I can't stand for long, can't sit for long, I have constant back pain. I could take all the pain killers and act like a zombie. I've worked in public service for 31 yrs and my degree is in public administration. I recently was awarded a performance of duty disability pension by the state. The state says I'm disabled but the Fed's think I should go back to work..interesting concept. I hope this time the award it, my lawyer was blown away by the comment the hearing judge made after denying me. I got hurt 2yrs ago the 4th and life has been hell between Dr's therapy, lawyers, more therapy, it an ever ending circle. I been fighting Workman's Comp and my Employers WC Insurance ever since. I could never go back to my original job and in the course of treatment they found an Triple A aneurysm, that is constantly monitored. Its crazy, they won't pay but they took part of a civil suit I won, go figure.

[Katidid]

65. do you know how much time SS gives you to collect and

submit drug and medical treatment costs for reimbursement?

Thanks - I hope you can help me with an answer.
:hi:

[bodacious]

78. agree n/t

[hyphenate]

3. I'm in the middle of an appeal as well

I hired Binder and Binder to help get my benefits for me. There are lots of websites that will give you info. It's a fact that about 75% of applications are denied on the first round. Persistance supposedly pays off. I applied almost a year ago, with still no result. And I get more in pain and exhaustion every day. It does suck--it's MY money that I'm applying for--I shouldn't have to fight for it like this.

[blueknight]

6. call the american bar association

and ask them to refer a lawyer who works in your area that specializes in ss claims. seems everyone i know that hired a lawyer got their ss

[MellowOne]

7. Is it best to get an attorney?

She was just going to appeal but if that will help, I'll tell her.

[oneold1-4u]

45. Everything counts

For me it was loss of strength and dexterity of right arm/hand due to carpal tunnel syn.,stayed working, over 50% loss of hearing in both ears,kept working, left knee surgery,back to work, and final was back surgery for lumbar arthritic deposits and disc degeneration of L3/L4. The medical records were over a 15 year period and had to all be collected and presented first to SS and then to a lawyer after the refusals, along with recommendations from both primary and ortho for leaving the work force (any reasonable income). Within 3 weeks of acquiring a lawyer to represent me, I had my claim accepted back to the first day the Doctor took me off the job. The lawyer received 25% of my back benefit claim but it was a bargain.
All of my medical was also paid back through all the doctors, tests, and back surgery and therapy. You do have to eat the first 6 months of your claim even if you are paralyzed! The only option for all the non-employable months is your state welfare and food stamps. You can't live on that without some support from family, friends, or other form of charity.
Do seek an attorney who handles SS claims and follow through with all of his instructions to get records of every physical injury and impairment that you have ever had. Have your sight and hearing
checked, get blood test for diabetes, and make sure that your lawyer has all records. His presentation to SS can often be enough to avoid any hearing.

[Imagevision]

48. Skip the Attorney, get Disability of America, they have a track record

They fight for you , cost you nothing unless you win, not doing spam for them but without them don't think I would have made it on the second go round. good luck
http://www.disability-advocate.com/

[Maine Mary]

51. I'm not aware of anyone who gets $ (unless you win)

But most lawyers DO want a percentage of the backpay. In my State a lawyer cannot take more then 25% backpay.

I'm sure the folks you speak of are good Imagevision, but I'm just saying D of A might not be the only good deal. I also agree with another poster... get someone to represent you- either a lawyer D of A. It's much too hard to do it on your own.

Good Luck to you and your mother.

[Imagevision]

52. quicker if you use a representative to lay out groundwork if you don't win

they get nothing. google disability of america

[happyslug]

70. The Social Security Administration restricts Lawyer's fees to 25%

Thus the 25% is NATIONAL in Scope.

[JL810]

83. Disability Advocates -

I am sure disability advocates are a well trained, professional group of representatives. But, because they are "nationwide" I wonder if they have the experience and knowledge from day to day representation at the Local ODAR offices that a rep in the state/area would have, simply by virtue of working w/that office and the particular ALJ's (and experts) over a period of time.

[bodacious]

75. good luck

win your case.

[knowbody0]

5. standard

get a lawyer.

[blueknight]

8. what area is your mom from?

[MellowOne]

9. North Carolina

She lives near Asheville.

[blueknight]

10. pm me

i may be able to give you some info

[DemBones DemBones]

11. Not everyone has to go to court and some are

approved the first time but many have to appeal. She should have an attorney for her appeal -- she wouldn't have to pay the attorney unless she's awarded the disability claim.

[zann725]

24. The general 'rule of thumb' IS they only approve first time round IF

you're hospitalized, or have been hospitalized recently.

Another rule of thumb: Take someone WITH you to ALL doctor exams they send you to. Their doctors are PAID to exclude you from elibility, and if you ask to see their report...you will be appalled at how they lie about what you said or did or felt during the exam. So take someone with you as a witness. OR take a tape recorder, and put it out in full view, and insist on taping the meeting. Say you're not feeling well, and want a record of what went on. Do it, or you may end up waiting another year, through another round of appeals.

Good luck!

[alfredo]

27. I got it first time, but I had advice from my union. That helped

a lot. I let them know right off that I knew the game of the "company doctors." My family doctor did that through one contract period and was totally disgusted with the game.

I got several doctors supporting my claim, kept everything, took notes, and treated all the doctors and case workers with respect. I had the two top neurosurgeons in the region diagnose me. I helped that they were notorious rivals but came to the same conclusion.

This was during the unfortunate Worker's Comp part of my three year struggle. The Post Office decided to retire me. To do this I HAD to apply for SS disability. Not only did I take info relevant to my injury, I took info on all other illnesses and injuries. (severe migraines, Crohn's disease, and PTSD).

A couple months later SSI accepted me. I was totally blown away. A few weeks later my Postal Disability was approved.

It seems like I had an easy time, but I just told the good parts and not the work that went into my good fortune.

Get second and third opinions, get documentation, get educated. Most of all, keep your cool, and don't ever give up.

[DemBones DemBones]

34. That may have been true in your case but it's not true in all cases.

It's possible to be approved the first time without having being hospitalized recently.

It's also possible to be approved the first time after being sent to SSA doctors for examination; they don't exclude all applicants.

Pay careful attention to filling out all the paperwork correctly and be sure all medical records are submitted. Incomplete applications are said to be a major reason for being denied benefits.

[greccogirl]

59. That is very true.

I got mine the first time, I had a transplant with complications. I could've gotten it three years earlier I found out but like a fool I kept on working. Also I got it for a friend of a friend and had to take her to one of the "disability docs" (office in a strip mall, a chiropractor's office!!) and she had a brain tumor, can you believe that? She was also completely deaf and had already had one brain surgery. She was approved after that, even the sorry excuse of a doctor they hired couldn't look me in the eye when they were examining her.

Good luck!

p.s. I also had the "help" of the disability agency paid for by my LTD insurance company. They are for anything that reduces their pay to you. That's right, if you have LTD, they will force you to file for SS and if you get it, they will take it to reduce your pay from them. So be forewarned out there guys, you don't get insurance payments AND SS, they don't want you to be too far from the poverty line................

[bodacious]

76. thank God

your transplant worked.

[DemBones DemBones]

35. That may have been true in your case but it's not true in all cases.

It's possible to be approved the first time without having been hospitalized recently.

It's also possible to be approved the first time after being sent to SSA doctors for examination; they don't exclude all applicants.

Pay careful attention to filling out all the paperwork correctly and be sure all medical records are submitted. Incomplete applications are said to be a major reason for being denied benefits. You want to give them everything they need and more besides!

[YellowdogIam]

85. First time approval

It is NOT true that you get approval first time only if you are or have been hospitalized
Every case is different, ask 100 people you will get 100 different answers..
I was approved first time with little or no difficulty and no attorney.It just depends on your disability and your doctors cooperation and supporting reports

[lgardengate]

12. i was accepted on the first try but...

i have both heart and lung disease and was on oxygen. My cousin is almost that bad and she was denied.She is appealing.

[Lady Sonelle]

13. First appeals are almost always refused...

It's SOP.
1. You have the right to unlimited appeals! Use that right. Keep after them. Do NOT take "no" for an answer.
2. find a good attorney if you have to. Look for a firm like Binder & Binder or that doctor who was on AAR (anyone else know who I'm talking about?) but be aware that you will have to share some of the award with them...
3. Get your Congressman into the fray! Go to your local SEnator or congressman's office and get a letter form them! This opens a LOT of doors!
4. Document EVERYTHING told you by the SSA! Get names, dates, info. WHO told you WHAT, WHEN.

And don't be surprised to have a lot of it contradicted later!

One very good way to press your caqse is to find ONE person in the SSA who seems to know what is going on and *staple* yourself to him.her!! Well, not literally but the convo should go like thius:

"Hello, is Mrs. Kevorkyanne in?"
"What is this in reference to?"
"My mother's SSI claim (insert details)"
"Oh, Mr. Cheatam is handling that."
"No, I want to speak with Mrs. Kevorkyanne!"
"She is not available"
"We will be over in half an hour and we wish to speak with her."
"But Mr. Cheatam is the one..."
"I'm sorry, but Mrs. Kevorkyanne is handling our case and we will speak with her, only."

What happens is, you become that person's headache! They know the inner workings of the office and they will move HEAVEN and EARTH to get *you* OFF their desk! If it turns out Mr Chreatam *is* higher up, then transfer your limpet-cling tactic to HIM! Every question every call, every day, every letter, every visit every eVERYTHING goes to that one individual! Be polite, be kind, be regfretful, but be a BROKEN RECORD!

"I want to speak with Mr Cheatam."
"Sorry he is away from the office."
"When will he return?"
"We don't know."
(Horse shit! They know! If they tell you they don't... he's IN!!)
"I would like to speak with Mr Cheatam."
"I just told you, he is away..."
"I would like to speak to Mr Cheatam."
"We don't know..."
"I would like to speak with Mr. Cheatam."

And so on. Wear them down, but BE polite, be gentle, never show fatigue, just be a broken record.

Also, learn how to "walk papers through". When a paper needs a signature in your local office, GO there and HAND them the papers in person. If Mr. Cheatam has to sign, then tell them you will WAIT for him to come out so you can have him sign them in your presence!

Again, do everything with a soft sweet gentle voice, be nice to them because they are usually treated very rudely... but be like water... no matter where they grab, you slip away and regroup. Eventually they WILL give in!

Been there, done that, still getting the checks!

Lady Sonelle

[YellowdogIam]

86. First time applications are often approved

It just dedends on the individual.. don't listen to rumors

[Imagevision]

14. You should always use a lawyer for second appeal -->

I did and was approved the second time with little effort on my part but having a lawyer proved to be the solution.

Filed second time ion January...was approved in August and they gave me a lump sum from the date of my first filing 20 months.

[happyslug]

15. In my experience

First, you let me tell you how the system works. First you make an application. That Application is sent to your State's Bureau of Disability Determination (BDD). The BDD than reviews your case based on your Doctor's records (which they have to obtain) based on the "POMS" issued to them by the Social Security Administration (SSA). If you do not meet the "POMS" you are denied and must appeal for a Hearing in Front of an Administrative Law Judge (ALJ) (There use to be middle step know as a "Request for Reconsideration" but it was phased out about 2000 for it generally restated the decison of the first denial).

At the ALJ hearing is the best place to get a favorable decision (At the ALJ Hearing you should have a lawyer, I swear the ALJs ask more questions and go into more details of your case of you have a Lawyer even if all the lawyer does is sit there).

If you are denied by the ALJ you can still file another appeal to the Appeal Council in Falls Church Virgina and if that fails to your Local District Federal Court, than to your Circuit Court of Appeals and than technically to the Supreme Court of the US. The problem with Appeals above the ALJ level is that they will NOT re-litigate your case, all they will do is review the decision of the ALJ and if the decision is supported by "Substantial Evidence" than the appellant court must uphold the decision of the ALJ.

Now if you are denied you can always make a new application based on new evidence (for example a new report from your Doctor). Thus you can apply over and over again.

Now the biggest problem with most people applying for Social Security Disability is rarely if you have a disability or not, but does the disability prevent your from working "In jobs that exists in substantial numbers in the National Economy". Note, you may be so disabled that you can NOT do your past work, but if they are jobs you can do (of a full time nature) with your disability you are NOT disabled for Social Security Disability.

I mention this for I have clients come into my office all the time who tell me they can do work, but want to apply for Disability. I have to tell them if they can work they are NOT disabled under the rules for Social Security Disability.

Now, SSA has taken into consideration the Aging process, thus the test for Disability for a person over age 50 is NOT the same as someone below age 50. Thus age is a important factor in any Disability claim (as is education). Below is a form letter I give to my client which goes through the Five step Sequential process SSA does on every application. The test is actually a little more complex than this but this is as simple as I can make it:

DISABILITY DECISION TREE USED BY SSA TO DETERMINE DISABILITY:

The following is the systematic method used by SSA to determine whether someone is disabled or not. It is included with this form for your information on HOW SSA will determine if you are disabled or not. It consist o FIVE (5) Steps:

1. Is claimant engaged in substantial gainful activity (SGA)? (20 CFR § 404.1571 et seq).
SGA is defined as earning more than $700 per month.
If you are earning, $700 or more per month you are NOT
disabled.If you are earning less than $700 the Claimant
Proceeds to Step Two (2).
.
2. DOES CLAIMANT HAVE A SEVERE IMPAIRMENT? (A DEMISE TEST).{(20 CFR § 1520(b)}. This test is designed to eliminate anyone who is not suffering from any impairment. "Demise" is Latin for minor or insignificant. If you are suffering from any impairment that affects your day to day activities you survive Step Two.

3. Does claimant have an impairment that meets a listing? {20 CFR § 404.1520(d)}.
IF YES, Than the claimant is disabled;
IF NO, Than you go to Step 3.
The listing of impairments are listed in Appendix 1 to the Social Security Regulations. If you met the requirements of any listing or combination of listings you are disabled. If you do not met the requirements of any listing or combinations of listing you proceed to Step Four (4)

4. Is claimant able to perform past relevant work. {20 CFR § 1520 (e)}
If YES, Claimant is NOT Disabled.
If NO, go to Step Five (5).

5. a. Does Claimant have a exertional impairment?
If no go to Step 5c, If yes than go to Step 5b
b. Is claimant disabled under the "Tables". SSA refers to Appendix 2 of the SSA regulations as the "Tables". The "Tables" are decisional trees to help ALJs decide whether someone is disabled or not. If you are "disabled" under the "Tables" you are disabled, if not go to step 5c.

THE TABLES (Simplified):
HIGH SCHOOL EDUCATION OR MORE
AGE TO BE DISABLED
55-65 YOU MUST BE INCAPABLE OF DOING "MEDIUM WORK".
50-55 YOU MUST BE INCAPABLE OF DOING "LIGHT WORK".
BELOW 50 YOU MUST BE INCAPABLE OF DOING "SEDENTARY WORK".
***************************************************************
LESS THAN HIGH SCHOOL EDUCATION BUT MORE THAN 7 YEARS OF
SCHOOLING.- "LIMITED EDUCATION".
Same as for High School or More Grid.
***************************************************************
LESS THAN 7 YEARS OF SCHOOLING.-"MARGINAL EDUCATION"
Same Test as for High School or More Grid.
***************************************************************
ILLITERATE - TO BE DISABLED - Same as for High School or More Grid.
EXCEPT: The test for "SEDENTARY WORK" starts at age 45.


c. Does claimant have a significant non-exertional impairment? If either yes or no go to Step 5d.

d. Can the claimant perform other work as it is perform in the national economy. {20 CFR § 404.1520 (f)}
If yes, Claimant is NOT disabled.
If no, Claimant is disabled. 



VOCATIONAL GUIDELINES - NOTES
20 CFR § 404 and 416 of Appendix 2

NOTE #1: The regulations are always Changing this is meant as a guidelines of the regulations NOT the regulations themselves.

Note # 2: The exertional limitations stated in the “Simplified Tables” ONLY APPLIES TO CLAIMANTS WHO SURVIVE TO PARAGRAPH 5d on the Sequential Evaluation Process (page 17). Step 5 is after the ALJ has made a finding of not meeting a listing (Step 3), a finding of in-ability to return to past relevant work (Step 4) and a finding that the claimant is suffering from an severe impairment (Step 2).

Note #3: Age, education, exertional limitations and past work experience are the main factors considered by SSA when SSA determines whether a claimant is capable or not capable of performing work as it is performed in the national economy.

Note # 4: WARNING: If a claimant has a skilled or semi-skilled experience and those skills are transferable to other jobs that exist in the national economy, such a claimant can never be disabled.

Note #5: These Vocational Guidelines is a vocational determination, not a medical determination, but it is a vocational determination based on the testimony of the limitation of the claimant and the medical records. Generally a Vocational Expert (VE) will attend the SSA hearing and will testify to the following:
1. Whether the past relevant work of the claimant is skilled or semi-skilled;
2. Whether the skills are transferable; and
3. What other jobs can a person with the disabilities of the claimant perform.

Note #6: The biggest factors (besides disability) in determining if a claimant is disabled are education and age. The “Simplified Guidelines” attached hereto is a Simplified BREAKDOWN OF THE "TABLES" SET FORTH IN APPENDIX 2 OF THE SSR REGULATIONS.

Note #7: For Simplicity the “Simplified Guidelines” Attached Hereto Assume No Previous Work History and Non-transferable Work Skills. Furthermore All of the “Simplified Guidelines” Assumes "Unskilled" Work Training.

[onecitizen]

16. Thanx for this post.........

very helpful. As someone who has been thru it and works with people who go through it, I've learned some things about it: someone mentioned hand carry reports to them. Good idea. Just make sure you get a receipt from WHOEVER takes it from. Send anything by "Certified" mail. That too gives a record of your correspondence. They have a nasty habit of "misplacing" things.

When you go before the Judge, be honest. Don't try to make up things. They know when you are doing that. In my area, the Judges will almost always ask if you drove there. So best to get someone to go with you at the time of the hearing. If you use a device to help you ambulate, make sure you take it that day. After asking me my name and addy, the next thing Judge asked me was: HOW MUCH DO YOU WEIGH????????? First thought I had was LIE! But I swallowed hard and told him the gawd awful truth. I think it was a trick question. I was very swollen from 3 months of 1000mg of IV steroids every day. I looked like a monster.

The people at my local office were idiots. Don't trust them. Check out everything. They told me that when filling out my forms to ONLY out down current health problems. Not to go back and tell what my HX was. BIG mistake. Judge told me that was what stopped me from getting denied the first two times. I had had MS since I was 21 and had always worked after having episodes with it. He was impressed that I tried. They wanna see that you have made the effort to stay in the workforce. Going before the Judge was the BEST thing for me cause he got to see me and question me. Which he did for 2 hours. And you get to tell him YOUR side of the story too. He granted me my case right then and there.

It is so stressful. By all means, get an attorney! It took a load off me. They stepped in and handled everything accept the actual hearing. You'll be in a room with Judge, YOUR attorney, and possibly an occupational therapist or the like. My Attorney only spoke once, the OT never opened her mouth, then me and the Judge did it all. My Attorney told me I was great.hehehe :-). Don't know how cause I was scared.

Anyway, if I can think of anything else I'll add it. Good luck! Get the Attorney!!

[MellowOne]

17. I appreciate your input

What types of questions did the judge ask other than those you stated. You said it lasted two hours!

Why is it so necessary to have the attorney?

[MellowOne]

18. I printed the above for my mom

She said she can't work full-time to support herself because when she sits, it pinches the nerve in her back causing numbness in her legs and swelling in her lower back which her doctor listed as an permanent impairment. She's 55 and her doctor said she was "light duty." Her disabilty was denied because they said she could work as a receptionist which she did in the past. but she says there is no way she could sit all day to do the work and support herself. She has some college but no other skills. Her chiropractor says her spine is twisted and her back is like someone who has been in a tragic accident. She does not have an arch in her back and needs support in her back to sit up without pain.

Her medical doctors only look at her disk problem and not the total spine.

Any suggestions?

[happyslug]

20. At the hearing she has to say she can NOT sit/stand in one location.

I will be using the Terms from my Paper "Step 1, Step 2, Step 3, Step 4 and Step 5". If you have any question read my paper I posted last week.

Your mother sounds like she will win at Step Five (5) if she survives Step Four (4). Step Four being "Can you return to past relevant work" that she did in the last 15 years? Step Five is "Are they jobs of a MEDIUM nature she can do". Medium work requires her to lift up to 50 pounds occasionally and/or 25 pounds frequently (A common Medium job is a cashier in a Super Market). She can NOT do this with a bad back and given what you told me I do not see ANY doctor saying she can do more than Light or Sedentary Work.

As I said given that her Doctor has says she is limited to "Light Work" I do not see the ALJ (Administrative Law Judge) ruling she can do more than "Light Work". Thus given her age and education she will win at Step Five of the Sequential Evaluation process PROVIDED SHE SURVIVES STEP FOUR.

Remember it is a SEQUENTIAL evaluation process. Step 1, than Step 2, than Step 3, than Step 4, than Step 5. If she loses at Step 1, 2 or 4 she is out of luck, she never gets to Step 5 (You can win at Step 3 if you meet a "Listing" but you can not lose at Step 3, thus I ignore it for the previous sentence, you can only lose at Step 1 and 2, but your Mother passes Step 1, she is EARING less than $800 a month, and she passes Step 2 in that her back affects her day to day living activities and as such is a "Severe" problem as that term is used in Step 2). Step 3 is not relevant in that there is no listing for a bad back except if it is do to Arthritis and than only the lower back.

Thus the issue in your mother's case looks like a Step 4 question. She survives Step 1 and 2 and does not meet a listing for Step 3 that leaves her at Step 4 which is "CAN SHE RETURN TO PAST RELEVANT WORK". Finding the job, getting to the job or even being hire ARE NOT FACTORS IN SS EVALUATION, just the ability to DO that past job.

Step Four cases are hard, you have to show that she can NOT do a job she did in the past. One way is she has to show that she MUST get away from the Job Area 5-10 minutes every hour. If she has to walk away, or lay down or do something OTHER THAN Siting or standing, the Vocational Expert (VE) will testify that such a person can not do any work and especially her past relevant work.

You must remember to do work she has to be able to sit or stand at the receptionist desk for 8 hours a day. Now that will not be constant, she will be able to leave the area for a mid day and after noon break and a lunch break, but she still has to be on task at least 55 minutes of every hour. On task being on or around the receptionist desk (and answering phones and dealing with customers, receptionist is also a high Stress job).

In your mother's case this type of case ALWAYS goes to a hearing for the ALJ wants to hear from the Vocational Expert (VE) as to what are the requirements of the claimant's past relevant work. Receptionist is a Sedentary high stress job (You are dealing with the Public) with a sit/stand option (She can sit or stand depending on her situation).

Now in my experience Your Mother should win her case (Provided the Doctor has provided SS with copies of his office notes and those notes clearly shows the problems with her spine AND the doctor wrote something to the effect her spine will affect her ability to sit or stand in one location for any length of time). If the Doctor has provided that information and your mother says something like she has to walk around or lay down very hour or so for 5-10 minutes (Or what ever is how long she can go) I foresee the ALJ ruling she can not do her past work as a receptionist (Survives Step 4) nor any MEDIUM jobs and as such disabled at Step 5 of the Sequential Evaluation Process.

One last note, to be eligible for SS disability your disability must have lasted a year OR EXPECTED TO LAST A YEAR. I do not think this was a problem in your mother's case but I do not have access to her records so to be safe I am mentioning that problem. One year I had TWO people come to my office who had been in body casts, one who came to me AFTER he was out but only in the cast for 11 months (He lost his claim for SS Disability for his disability did not last a Year). The Second came to me also after he was out of his body cast to have me help him continue his SS disability. The Second had also been in the cast 11 months but while he was in the Cast his DOCTOR HAD TOLD SS THAT THE CLAIMANT WOULD BE IN THE CAST FOR OVER A YEAR. Since the Claimant had a Doctor's note the Second Claimant received SS disability for a year. The Second Claimant was cut off Disability once he was out of the body cast (and no longer disabled) but he had had Disability payments for almost a year while he was in the cast as opposed the the First Claimant who received nothing (For his doctors never told SSA that the person would be in the Cast for over a year). Notice the issue was NOT if someone was disabled for a year or more BUT WHETHER THEIR DOCTOR REPORTED THEY WOULD BE DISABLED FOR A YEAR OR MORE. I point this out for it may be a problem given your mother's back pain is only in the last year or so. I do NOT think it is the problem, I think the problem is a Step Four problem but I believe you should be warned about this possibility also.

[greccogirl]

60. One of the worse problems I have left over from my

transplant is circulation. I've had cellulitis 6 times, hospitalized for it five times (on top of everything else).

Whenever I get gruff from anyone about my disability I take a digital picture of my legs, knees and ankles and fax it to them. I usually don't hear another word.

[cadmium]

61. Good Info--Also get a copy of this SSA publication

"Disability Evaluation Under Social Security" January 2005

I don't know if there is a newer edition. This doesn't guarantee anything but at least you will know what they know re: exact guidelines. It is the guidelines in outline form and is an SSA publication

www.socialsecurity.gov

Social Security Administration
Office of Disability Programs
SSA Publication No. 64-039
ICN 468600
January 2005

[oneold1-4u]

46. This was great!

But the average person trying to understand everything alone to go to a hearing isn't a very good plan. They (SS) knows that about half of all claimants will not fight being told they are not eligible and many even die during the months it can take through denials and hearings.

[frankly_fedup2]

19. I was denied once, then I went to court and the judge approved . . .

my disability.

My lawyer said the only thing I had going against me was my age (which at the time was 43). I am now 45 and continue to get my monthly check and an offer for Medicare (my husband has great insurance so I did not need to pay an extra $60 almost a month for Medicare).

Also, I could not believe that we have to pay Federal and State taxes out of our disability checks. That just blows my mind.

[Megahurtz]

38. I agree

paying Federal and State taxes out of disability pay is bullshit.

[JAK1941]

21. "Social Security Disability"

I've heard the same story from others, but I guess I was just "lucky." I qualified in 1980 but didn't have enough work credits. By the time they reopened my file in 1998 it was three inches thick, I had more reasons to apply, and I was approved.

Just tell her not to give up, to keep trying. The system works, but sometimes the wheels grind ever so slowly. Also, sometimes it is how the questions are answered on the forms. She may need to obtain legal advice, but usually attorneys work on a percentage basis, (of the amount obtained), and sometimes, (although rarely), they work for free.

My prayers for your mother, by the way, as I have degenerative disc disease of the entire spine and have undergone four lumbar spine surgeries, (lamaenectomies), since 1978. It's no fun!

Oh, by the way, when they reopened my file I also had history of carpal tunnel and cubital tunnel surgeries on both arms and wrists and advice from the latest surgeon that, if I had any more trouble, I was not to work. While waiting to consult a surgeon prior to my last back surgery, I developed additional trouble with my hands.

[eShirl]

22. My husband got his disability on the second try, with no lawyer.

They turned him down the first time even though he had proof he was permanently legally blind. Then they approved his second try for it, not long after he was also diagnosed with end-stage renal disease (impending permanent total kidney failure). At that time they awarded him one year's worth of back-payments, which they said was the maximum.

(I don't remember now if he reapplied or appealed, it was several years ago.)

[bodacious]

77. lucky guy

no lawyer. Wow.

[zann725]

23. Yeah, she needs to get an attorney who specializes in SSDI.

They do it on a "contingency"...so if she doesn't prevail, they won't charge her. "Binder & Binder" is a large national SS firm, and if she has good medical documentation, they'll take it.

An honest judge's clerk will discourage a Claimant from even going through with a Hearing UNLESS the Claimant has an attorney. Because due to the "pressure" for the Judge to dismiss as many claims as possible...it's much easier to do so when a Claimant appears alone. Plus the attorney knows just how to arrange a Claimant's "Meds"...and also can easier get from your doctors EXACTLY the documentation you need to win your claim. One of the most important forms I saw was a "Limitations" questionnaire, which gets each doctor to answer IN DETAIL how you would be limited from performing your old job and/or ALL work at this point.

Good luck to your Mom. If she waits too long to get an attorney, the final phase of the appeal is NOT heard before a judge...but ONLY the paperwork is reviewed by a panel (WITHOUT the Claimant present).

And even once her claim is approved, it can take up to another 6 months to begin receiving benefits. Very long and gruelling!

Wish her luck. Tell her to get an attorney NOW. And do NOT give up.

[motherbell]

25. When she does

I know this is hard, but before she goes to court, make sure she sees a mental health specialist. I have seen all kinds of disabilities get denied, but if you add that you are depressed, it helps.

Just not being able to get out of bed is not enough. You have to be too depressed to get out of bed too. Works every time.

[hollowdweller]

26. I'm a disability examiner for SS. A back problem has to be bad to qualify

What do you want to know? How bad is her back? What is her diagnosis?

Basically for a back problem you have to have a herniated disc, gait disturbance, positive straight leg raising test, muscle wasting, loss of reflexes and motor strength, and sensory deficits. I have a friend with a herniated disc who is a doctor, but he still works. I have bulging discs and as long as I keep the weight off and walk a lot I'm OK.

Let me know what her situation is I might be able to give you some pointers.

[MellowOne]

29. She just found new problems

She has a herniated disc at L-5 but she recently went to a chiropactor because of neck pain. Upon examination, he found her spine is twisted, her neck almost to the point of dislocation, subluxation at L-5 with sensitivity and swelling and several other subluxations in her spine. Her hips are rotated forward and up and legs are uneven. He said her back was wrenched in her struggle but no one bothered to check for that. They only looked at her disk problem. She can't sit longer than about half an hour before her back swells and she has numbness in her left leg.

She would greatly appreciated any pointers.

[hollowdweller]

30. MellowOne, she needs to get her doctor (not chiropractor) to write a

letter on her condition and submit it with her claim or appeal. With a herniated disc what the listings call for are pain and limitation of motion, sensory loss in the leg usually along the pattern of the nerve the disc is pushing against, reflex loss on that side and muscle atrophy. She should have the doctor check all these things and put them in his letter. He should do bilateral measurements of her thighs and put them in there to cover the atropy part of it. He should give forward bending in degrees and also perform a straight leg raising test.

It is hard to get allowed on a back condition the regs are so tough, but a lot of times people are needlessly denied because their doctors fail to mention stuff like the above so to the person reviewing the claim it appears they do not meet the criteria.

From what you say your mom didn't meet the criteria or at least there wasn't enough detail to show she met. However if she is over 55 and unable to return to her past work she would be a medical vocational allowance, this means that given her age education and work experience she is so limited that at her age she cannot do her past work and that there is not any work in her vocation that she could transfer to. At that age transferabiltiy outside her vocational area is not an issue.

So what she needs to do is to find some way to document that she lacks the ability to perform the full range of sedentary work. If she can do this the reviewer can limit her to setting with frequent breaks and that would knock her down to less than sedentary work and she would be a med voc allowance. Another angle is if she is having cervical spine problems and you can document she has weakness or fatigue in her hands that would also limit her ability to perform a full range of sedentary work and would likely result in a med voc allowance.

This is the problem with doing skilled work. Or even light work. 20 years ago I did scores of med voc allowances cause there were a lot of people doing heavy work and they could not return to their past work and were the proper age and education. Now we have so much light and sedentary work ,cashiers, telemarketers, security guards that people have to be a lot worse to be a med voc allowance.

If she gets turned down on the first two levels THEN get a lawyer. The judges that do the hearings in theory are supposed to follow the same regulations as we are, but in practice they basically can allow almost anybody and they don't have the rigorous review of their decisions that we at the lower levels do. In some years judges allow 75 to 90 percent of the people denied at lower levels. But it also depends on the judge. Some are tough, some are super lenient.

Hope that helps.

[riverwalker]

89. then why is my ex collecting

and rides horses all day, goes on long pack trips, having the time of his life.

[idon44]

28. I am on SS Disability

due to back problems-I've had two back surgeries. The best move I ever made was to go to a doctor that specialized in insurance assessments. He knew how to fill out the paperwork,apparently, because I really didn't have a problem getting SS. I did have to have an examination by the SS Doctors, but i still got approved with my first application.

[hollowdweller]

31. You are right on idon44!

Getting the proper documentation is key to getting it the first time around. If people get on ss website and familiarize themselves with the criteria then get their doctors to do a thorough note then their chances are good.

My major hassle doing the claims is that the information that SS wants has a lot of functional information. Like bending gait, muscle strength etc. But most doctors may do that on their initial evaluation but then later on may just scribble brief indecipherable notes from then on. Then we have to get an exam. A lot of people percieve this as SS sending them to one of "their" doctors so they will be denied, but the truth is I've allowed more people on exams from our doctors because they do an exam like the doctor you mentioned, geared to what we're looking for.

[Sugarbleus]

33. Same thing here. I was amazed I wasn't denied on first try...

I have multiple conditions. With doctors reports on file and in hand, I simply filled out the initial intake document and gave them every single detail of every single waking moment of my life. Not just how much I can or cannot lift but what life is like at home..in the morning, in the evening, at the grocery, in the car... etc etc...

I was surprised when they said okay. I did have an SS attorney's number in my rolodex...for just in case.

As baby boomers age, Arthritis and other things start to crop up. I imagine the SSDI is swamped with applications. Go online to the Social Security Website. Look through it to see just who and what is covered then, just keep trying.

Good luck to all. :hi:

[otohara]

41. With My Application I Sent My Dr's. Report

and was approved 3 weeks later. I think it's key to send your doctor's report along w/ app., it show's right away you have someone on your side.

[teakee]

32. Denied twice here, went to court.

Sold my soul....no, but you will be very, very poor and robbed of all dignity and pride.

I was crying before I even got in the court room, but I have fibro and depression is just one of the side effects. One of the worst days of my life.

Thank goodness, the judge's wife had fibro because before she developed it, my lawyer said he rejected most cases. (I had back problems too.)

Do not let your case close or you will lose benefits and have to start over. Good luck. The SSA runs behind and usually (the lawyer told me this) will tell you anything to turn you down, because they are so back-logged.

I think the lawyers and SSA have something going on--the fee worked at to $5300, the max the lawyer could charge. Go figure. :(

[happynewyear]

36. denied twice also

It was looking like round three and I went blind and couldn't even get out of bed. Luckily, I had a lawyer lined up when I initially filed and was prepared to be denied. I'd suggest others do the same.

I was far to sick to go to a doctor and travel. I got a hold of the lawyer and he contacted Social Security and told them the severity of my situation and the second denial was promptly overturned.

So, for those that do not believe a lawyer is necessary, I say it is very necessary, especially if you become far to sick to even fill out a form properly and/or can barely move or get out of bed due to paralysis and blindness.

It took me a total of 16 months to get SSDI. It was a very difficult time in my life and very frightening as well. Luckily, some members of my family were still living.

My lawyer got about $2,000 out of my case and sent me part of that money back being he was able to get my case through without having to file any papers or go to court.

I was shocked to say the least and I remember I sent him a note saying, "Alas, an honest man! Thank you Sir!" I meant every word of it too. :D Not all lawyers are crooks, at least IMO.

DTC

[Corgigal]

37. husband was denied once

and that is with being struck by a car driven by a guy who tried to kill him because he was a deputy sheriff. The whole thing was on tape and the guy got 25 years to life BUT my husband was only 30 at the time. He did however get hit in the front and then hit again in the back. His spinal cord was jarred and he now as autonomic imbalance(dysfunction). Remember that term. You won't get that from a regular "doc" but you need to see a neurosurgeon. Does she have problems with her Blood pressure? Does any part of her "automatic" bodily functions not work the way it did before she injured her back? Did she hurt her back from trauma?

After a few years dicking around they finally award disability to him and got full back pay. We did get an attorney but he didn't have to go to court. Our lawyers secretary just talked to the judge and got awarded. NO LIE. It was just because of his age. He also got money from the Federal govt being injured in the line of duty but that took 3 years but again he got it without an attorney.

Don't give up. She will get it if she doesn't give up.

[Arwennick]

40. I guess I was lucky

When I first filed, SSA sent the interviewer to take my Application while I was paralyzed in the Hospital.I had only 2% mobility at the time in my lower extremities.I was 45 at the time.I have been reviewed once since then in 2004.At that time I was at 50% mobility rate,but because of my age(52) and my previous job description(High rise Const.) they choose to keep me on SSD subject to reviews with my doctors.Keep a record of every Doctor and hospital visit for future reviews as this is a deciding factor in the review process.

Note:I wish I could work because $3500.00 a month is a hell of a lot better then $1300.00.

Also when you do get your SSD make sure you sign up for Plan"B" because it pays doctor visits and medicine and ambulance rides.I screwed up and didn't get it and now they won't let me saying it was a one time offer.

[DanCa]

42. I was denied twice also

you might want to get a disability lawyer. There are services out there that arent that expensive or are for free. Tell you mom to feel better.

[apollo56]

44. Its a problem that I thought I would have but didn't!

When I first applied, I was told that would be the normal process and after the second appeal then you get a lawyer. The problems is - SS does not pay the lawyer but you will be back paid to the time of the claim and the lawyer will take his fee from that in most states! I was shocked when I was approved on the first go around which does not happen often but I was sick and had a hospital bed in my home. The process is so long and SS does not pay for the first six months and you have to wait for two years from the time you are paid to get medicare. I filed on Sept 5 and was approved on Dec 29th and my first check was March 1 of the following year. Medicare took effect took two years from the March 1 date. Also, you will be reviewed every so often - they make it so hard to be sick! Good Luck!

[AirmensMom]

49. I got mine on the first try, without a hearing.

My doctor told me to expect to have to fight for it. He was really surprised when I got it. He deals with them all the time and I guess he's gotten pretty good at filling out whatever they ask him for. I've been reviewed 3 times so far and I'm still getting benefits. It's a little hard on the nerves when a review comes up. So far, they haven't sent me to their doctors.

[Humor_In_Cuneiform]

50. I had some help from someone I knew who got hers the first time,

and I also got mine the first time.

We shared the same disabilities, so it helped a lot to hook up with folks who have the same disability and have gotten through it.

It did for me anyhow.

[AbbyR]

53. We are fighting this whole mess, too

My husband is, literally, dying, and needs to get disability. He is denied because he is still working, but can't stop going to work because he will have nothing coming in and no insurance. I can't put him on mine, we can't afford it. It's a mess and no one, apparently, can do a thing about it. You have to be out of work for five months, with no income, before you qualify.

[AGKISTRODON]

54. My doctor helped me

When I got out of the hospital, I got a checkup at the county clinic. They sent my records to SS, but it still took 7 months to get a check.
Have you talked to a lawyer who specializes in SS claims? I also suggest your local health clinic, there are ways to get help. Don't put this off, go for it! Make them tired of looking at you!
There are a whole bunch of folks here who care, we are pulling for you!

[AGKISTRODON]

55. Jaysussfookinfrog!

This thread is much too typical, y'all show up with a problem, a whole bunch of folks try to help you, but, you are done gone away, just like a fart on a hot skillet!
I wish you well, wherever the hell you have run off to, wherever that is!

[sarcasmo]

84. My wife is in the same boat as your husband. I think they make it so difficult they hope you either...

Give up or die trying. We are in our first go around and just sent out a 25 question pamphlet we each had to fill one out, it is a nightmare. Michigan is out of work for 12 months.

[MaryBear]

56. The important thing is to document

her problems with activities of daily living -- dressing -- cooking -- cleaning house -- driving -- sitting -- walking -- the basics -- and having state disability first helps. Watch what the doc writes -- look it over before it goes to SS -- they don't like to write as a rule and under report or minimize. Read the questions and maximize symptoms, within the truth, in every respect asked.

[kittykitty]

57. Absolutely! I got it on my first try, and here's why. . . . . .

I was an Itinerant Teacher going from school to school. It got too hard to rush around, climb stairs, carry supplies. (I have MS and have had for over 30 years). Someone said, "why aren't you on disability?" It had never occurred to me that I could do this.

I went to my local Social Security office where I was interviewed. I made sure to wear my ankle/foot orthosis, and use my Lofstran crutches. (I didn't always use these things) I was given a form to fill out having to do with the Activities of Daily living, how my life had changed because of my disability, etc. There wasn't much room on these forms for everything I wanted to describe. I typed out the answers on separate sheets of paper. I GAVE MINUTE DETAILS AD NAUSEM!

I don't know what my doctor wrote, but a few months later I received a letter saying I was granted disability, and a surprise--a check for the time between the time I stopped working and the time my disability was granted.

Later, a member of my MS Group was turned down for SSDI. She went to a lawyer for help. I gave her a copy of my answers to the questions. Her lawyer was very interested in them, and kept them. She used my answers as a model, and her claim was granted.

And so I agree with MaryBear.

[cutlassmama]

71. Yes. A lot of it weighs on your answers, but your doctor also has to agree

that you are in fact disabled.

[Irishonly]

58. I was

denied, then I appealed and was denied again. I took advice from a neuropathy support group and retained a lawyer for my hearing. By the time my hearing came around, it had been a very long three years. Going through the social security process was terribly dehumanizing for me. I had been a teacher for years and social security agreed that I could no longer teach but I may be able to work for a couple hours a day doing no lifting or nothing that required snap decisions or that would require too much use of my hands.

I had been prepared for a hearing that would last close to an hour. My lawyer prepped me and asked me hard questions. The day of the hearing my husband got me and my wheelchair in the car and I prayed the whole way. After I was sworn in, the judge read my doctor's letter and asked me one or two questions. He apologized that the system had put me through so much strife. I was done in fifteen minutes and part of the time was waiting for him to fill out the forms. I received my back check about sixty days after the hearing.

There are advocates you can talk to. Most disability groups can tell you if there is one in your area. For me, the right decision was to have an attorney and I am not sorry at all I retained one. I only wish I had done it before. Other people I have met have flown through the process and had no problems.

Good luck.

[cutlassmama]

64. I had to. Good luck

[otohara]

66. Have Her Doctor Write A Letter

stating based on her disability, she is no longer able to work for the rest of her life. Resubmit the application -

My doctor wrote more than that of course. She had results of muscle strength in arms, legs and my history. She closed the letter with the "she can no longer work" statement and I was approved right away.

[SlingBlade]

67. Sounds like she is in the same place as me.

I was also denied twice and my attorney has asked for a hearing before a judge.

It’s a load of B.S, I never thought it would be so difficult.
Have you heard anything new yet ?

[allisonthegreat]

68. Everyone usually gets turned down at least once

But every case is different. I know for me I had to appeal. Tell your mother don't give up it is just a bureaucratic process that gets better when you finally get in the system. Good luck!

[zanne]

69. I didn't have to but my husband needed a lawyer.

He had had three back surgeries and couldn't stand, walk or sit for more than an hour. Some smartass the the SS Bureau said; "Well, can't you get a job where you could do something lying down"? God's truth.

[williesgirl]

72. Took me 2-1/2 years to get approved, finally by a judge. Sorry this has to be the case.

[UALRBSofL]

73. Mellowone, The rule of thumb

After you have been denied 2 times, hire an attorney as soon as possible. In my case I was turned down 2 times, hired an attorney, went through the process and had full approval. The administrative judge approved me and I didn't go to court. When I got my letter, one of the doctors hired by social security didn't recommend me, but, I had such a strong case from my neurologist that the AJ rejected that doctors opinion and accepted my neurologists opinion. Good luck with your mother.

[mdinusa]

74. I have heard this happens a lot

[ildemo]

80. It's easy if ...

... you've been involuntarily committed. That's what happened to me. I was in the hospital for five nights.

Consequently I was approved almost immediately. No exam, no nothing.

Of course, involuntary commitment is not the most pleasant experience.

Now what I am on disability, can anyone tell me if it would be safe to work a menial part-time job for some extra cash? Like at the corner gas station?

Or will it red-flag me?

I really need a little extra money to cover the bills, but I don't want to get cut off, especially since I have only been on SSDI for a month.

[otohara]

81. Submit Application w/ A Letter from Her MD

saying she can't work for the rest of her life. Of course he needs to put some specifics in the letter as to why, but in the end - she can't work. Send with application.

[JL810]

82. Mother's Age & Past Work May Make A Difference

If your mom is 50+ depending on what kind of work she has done in the past she may only have to show she cannot perform "light work." (Walk, Stand most of the Day). For someone with a back impairment light work is simply out of the question.


To "prove" her back impairment she should have some findings on an x-rays, mri, and/or physical examination that you can point to that supports the fact that she has such an impairment. Get an opinion from her treating doctor about what she can and can't do. SS law recognizes that pain varies from person to person so that a person with what may seem "minimal" findings may experience excruciating pain. The point is that once she shows she has some "objective medical findings" they are required to assess the intensity, persistence, and duration of her pain (which is a credibility determination for the most part).

Just because she was denied initially and at recon doesn't mean she doesn't have a good case. You should see if she is eligible for free representation from your state's legal services. Your states legal services may have a unit that assists elderly with a variety of legal issues. Some Legal Services also have lawyers and paralegals who represent clients at SS hearings. (They typically have to meet income/asset requirements). As far as I know, most of them do not charge a fee for representation and they typically have quite a bit of experience with SS disability cases.


If your mom has past work that was sedentary or skilled or she has recent training, education, the case is more "complicated."

But someone who is 50+ with NO past work, and no recent training/education --with a back impairment that is documented by the medical records, WITH a statement from her treating physician, would be a decent and somewhat straightforward case.

[AmericaForgotus]

87. Disability

Unfortunately, this is the case.I am hanging in there fighting social security, again. Could you Please Sign My Petition! Reform Social Security Disability SSDI and SSI Determination Processes ?- http://tinyurl.change.org/zXUto Thanks! I won at the hearing level 2006, but got cut off soon after that due to husband making too much $ for SSI/Medicaid. Now hubby left, have to reapply all over again in April! Just got first denial notice... Here we go, reconsideration, again. Not so sure I'll make it for hearing again this time. It is ridiculous. You must First become a supporter of Poverty in American, then click on sign my petition button.

[marcicj]

88. I would be happy to help

I too went through applying for disability benefits and spent some of the money I made building a site with information to help those that apply for disability. Please feel free to contact me if I can help in any way.
Marci