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Old 02-17-2011, 03:53 PM #1
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Default Appealing w/dx change

I'm appealing an initial denial and the appeal will go next to the reconsideration stage.

My regular pain manager dx me w/RSD Upper extremity, RSD Lower extremity, Lumbosacral spondylosis, chronic pain syndrome and neuralgia. I initially filed for these conditions in addition to a few mental ones in July.

The pain manager moved away. My new pain manager (still under the same pain center) took an updated MRI and after seeing my back worsen over the last year dx me just w/Lumbosacral spondylosis, chronic pain syndrome and neuralgia - no RSD. I didn't have a chance to talk to her about it since the info was on my office visit receipt, after I saw her. My appeal is due before I see her.

Do I need to address the RSD in my appeal?
Thanks.

Last edited by Mycah; 02-17-2011 at 05:02 PM. Reason: typo
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Old 02-17-2011, 04:22 PM #2
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As I understand it, from my reading here, disability goes by how you are physically and /or mentally limited from working.
The labels or the diagnoses aren't the most important part.

You have to be able to show by the records, forms you fill out, and medical proof, that you cannot work, and why - from pain, limited use of body parts, medications, side effects of medications, mental/emotional etc.

You have to have much more from the drs than just the diagnoses.

There's a thread on getting started that may have some tips to help you out.
Maybe some things were overlooked when you first filed.
Don't start your claim unprepared!!!
http://neurotalk.psychcentral.com/thread143444.html
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Mycah (02-18-2011)
Old 02-17-2011, 11:47 PM #3
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Quote:
Originally Posted by Mycah View Post
I'm appealing an initial denial and the appeal will go next to the reconsideration stage.

My regular pain manager dx me w/RSD Upper extremity, RSD Lower extremity, Lumbosacral spondylosis, chronic pain syndrome and neuralgia. I initially filed for these conditions in addition to a few mental ones in July.

The pain manager moved away. My new pain manager (still under the same pain center) took an updated MRI and after seeing my back worsen over the last year dx me just w/Lumbosacral spondylosis, chronic pain syndrome and neuralgia - no RSD. I didn't have a chance to talk to her about it since the info was on my office visit receipt, after I saw her. My appeal is due before I see her.

Do I need to address the RSD in my appeal?
Thanks.
An appeal is to submit additional evidence or to visit something they missed. So yes, mention the RSD and how it effects your everyday life, what medications you are taking for it and how they effect you. The link below are impairments that the agency uses in making their determination. Example: according to (1.01 it states bla bla,) my condition fits all the required elements according to the ss disability rules.

http://www.ssa.gov/disability/profes...ltListings.htm
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Old 02-18-2011, 12:04 AM #4
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This might help too-

Evidentiary Requirements
http://www.ssa.gov/disability/profes...videntiary.htm
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Old 02-18-2011, 02:22 AM #5
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Mycah.....Did your new PM specifically say that you DO NOT have RSD ? Or did she just not include it in her write up ?

Some medical professionals use the term chronic pain syndrome to incorporate other distinct disease/syndromes like chronic myofascial pain, tension myositis syndrome, neuralgis, fibromyalgia, and RSD (and, of course, RSD's new official name is CRPS) All of those issues ARE chronic pain issues, so the CPS title still fits, although often CPS carries the connotation that psychological factors can CAUSE the CPS, rather than being the result of the stress of chronic pain, so I'm not a big fan of the term CPS.

Unless your PM said that the dx is RSD is not correct, I would DEFINITELY talk about/write about the RSD in your appeal. As others have already written, it's not just about having the dx of RSD (some people with RSD are able to continue to work......although I find that difficult to imagine, but everyone's pain and tolerance is different) it's about how the RSD affects you.....severe pain, side effects of the meds that you take for it, having to elevate extremeties, needing to lay down frequently, suffering confusion or 'brain fog' because of pain/meds/lack of sleep, being dependent on others to do errands, shop for your groceries, prepare meals, transportation, etc.

It sounds like your PM did not have a discussion with you that RSD is NOT part of your problem. It sounds more like an oversight in her documentation or her belief that CPS covered it all.

You could always call the PM to be sure if there is some doubt in your mind. You could ask for an updated report, but I wouldn't think that was necessary to make your case. You have the RSD documentation in your records. The focus of your most recent PM visit was the worsening MRI results and the docs notes reflect that.
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Old 02-18-2011, 10:36 PM #6
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Quote:
Originally Posted by finz View Post
Mycah.....Did your new PM specifically say that you DO NOT have RSD ? Or did she just not include it in her write up ?

Some medical professionals use the term chronic pain syndrome to incorporate other distinct disease/syndromes like chronic myofascial pain, tension myositis syndrome, neuralgis, fibromyalgia, and RSD (and, of course, RSD's new official name is CRPS) All of those issues ARE chronic pain issues, so the CPS title still fits, although often CPS carries the connotation that psychological factors can CAUSE the CPS, rather than being the result of the stress of chronic pain, so I'm not a big fan of the term CPS.

Unless your PM said that the dx is RSD is not correct, I would DEFINITELY talk about/write about the RSD in your appeal. As others have already written, it's not just about having the dx of RSD (some people with RSD are able to continue to work......although I find that difficult to imagine, but everyone's pain and tolerance is different) it's about how the RSD affects you.....severe pain, side effects of the meds that you take for it, having to elevate extremeties, needing to lay down frequently, suffering confusion or 'brain fog' because of pain/meds/lack of sleep, being dependent on others to do errands, shop for your groceries, prepare meals, transportation, etc.

It sounds like your PM did not have a discussion with you that RSD is NOT part of your problem. It sounds more like an oversight in her documentation or her belief that CPS covered it all.

You could always call the PM to be sure if there is some doubt in your mind. You could ask for an updated report, but I wouldn't think that was necessary to make your case. You have the RSD documentation in your records. The focus of your most recent PM visit was the worsening MRI results and the docs notes reflect that.
No, she didn't specifically say I didn't have RSD, in fact, she didn't mention it at all. I think it may have been a questionable dx in the first place but hey, I'm not a doctor. I don't have a flaming limb that can't be touched. I did have a wrist injury a few years ago that moved to my shoulder and when bitten last year on my foot (by my dog) I started having burning, sensitive skin, sweating. Sympathetic blocks did remedy these problems so maybe I'm in remission, who knows?

Hmmm, interesting about chronic pain syndrome and psychological factors. I've lost track of how many doctors have told me I'm nuts.

I will address the other issues in my 'novel'. I do know the Oxycontin and Percocet have really done a number on my ability to focus. Completing this appeal update is challenging so I appreciate your input.

Nancy
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