SSDI denied again.
 

My wife Suzy, who has RSD, was denied SSDI again. Not only was she denied a claim but denied her day to present her case in front of a judge with her attorney present for the first time sinse 2006 when she first applied. In the letter, the judge refused to hear her case, Why? The judge refered us to read the "Order of Dismissal" in which it states:

"The record shows that the claimant has engaged in significant work since his alleged disability onset date. It apppears that the monthly earnings may be sufficient to commence and perhaps conclude a trial work period. Moreover, it appears that the trial work period may have commenced within 12 months of his alleged disability on date, which is impermissible.

The case is remanded to the district office to obtain documention of the monthly wages and hours worked since disability onset date."

I am sure of two things, one--my wife is a female and two- she has not worked sinse 2006, at all ever, I don't think she hasn't, I know for a fact she hasn't. A matter of fact I wish she could work and she would too!!!
One thing I'm not quite understanding about the Order of Dismissal is where it states:

"It apppears that the monthly earnings may be sufficient to commence and perhaps conclude a trial work period. Moreover, it appears that the trial work period may have commenced within 12 months of his alleged disability on date, which is impermissible."

This sounds to me a person who may have had SSDI and was working under the table of sorts, or some manner, because of the wording of "trial work period". Or maybe its a WC case? Or could it be someone who has SSDI is working partime trial basis?

In eitherway clearly SS has denied my wife her day infront of a judge with her lawyer because they've mixed her up with someone else. Monday morning I'll contact her lawyer. If anyone can shed some light or experience on this mess I would surely appreciate it.

jim

It does sound like the paper work was messed up when the judge was reading it....:confused:

Hopefully it is a simple fix to get this mistake set right.

Thanks Jo*mar. My fear is even if it's their mistake and they rectify it, it may take another year to get the hearing. :mad:

Hi Jim,
This is beyond inexcusable..
Can you contact your local congressman/woman to help you unravel this terrible bureaucratic mistake, which is keeping you and your wife's lives on hold!
Don't give up
Hope4thebest :hug:

Yes, I'm contacting her lawyer first and for the 3rd time Congressman Connally. If this moves along slowly then I'm going to submit all my wifes medical records and SSDI files to local reporters here in Washington and if that fails I may submit to foreign reporters to show others in the world how the US federal government treats their very sick citizens after paying insurance for 30 years. We no longer have insurance because of the way our system rids those who are sick and unemployed. Even though I'm employed the employer can no longer offer coverage. Medicare is what my wife needs for coverage and to prove to furture doctors that she is disabled with RSD not some drug seeking slug. Sorry about the rant hope4thebest. :o

I got denied 3 times via mail... and when i was first filing i think i was still trying to work part time... they never used that as a reason for denying me. it was always because i was so young (20 when i started applying) and because i wasn't blind... once i got to the trial stage, it didn't take very long at all to get the hearing, i initially went in by myself... but the judge said i should get a lawyer.. and reset the case for 6 months later. my lawyer thought i'd have issues winning because of my age as well, but as soon as the judge asked me how my life was pre rsd and then post rsd... i pretty much started balling after the first sentence. I had also written like a 5 page statement describing what kind of a person i was pre and then post and how my life changed and stuff... but as soon as i was able to spit out enough words the judge said off the record that there was no way i was losing. and even still... i've been working part time for the last year since i started getting my ketamine infusions and the trial work period is only i believe 6-9 months... granted you have to show that you make enough to support yourself, which i don't, so they still haven't taken away my ssd. my ssi payments they have, but that wasn't even $200 a month.. i don't make enough for them to decrease the ssd monthly checks. and even if they were to eliminate them due to making too much money, i'd still be able to get the medicare/medical. and if there came a time in which i needed to stop working again i'd be able to get the monthly checks started back up again because with rsd its perminant disability... so they don't ever take it away and make you start all over again. good luck tho. i know its a hard thing to deal with... but at least once its won you get back pay from the time you initailly filed, and its such a great feeling of triumph once they see things your way. i'll keep my fingers crossed for u!

Thanks msdrea83! I'll will say age does play a role, the younger the tougher. My wife is close to 52, college educated and a professional and worked nearly 30 years. In her case there was no lawsuits, WC etc...it was a fall and a broken wrist that started her nightmare. SS screwed up soon after she applied in 06. She called SS 3 months after she applied only to be told they've made no decision as yet. About 3 weeks later I told Suzy to call again only to be told they made a decision 3 months ago and that she was denied. This put a halt to an appeal because you only have 60 days to appeal in which she missed that window. We appealed that and won because they never sent us a letter of refusal from the beginning. So, to see another screw up even worse than the one way back is unforgivable and extremely incompetent to say the least. My thinking leans toward a unwritten policy of depriving Americans. It seems to be on purpose. But what amazes me is the stop they put on her altogether in seeing this judge, and by this judge who never met Suzy ever.

Jim,
I am sooo sorry to hear this...why do we pay into SS and then get denied for what we have worked for our whole lives? I am in my first round and I have 2 appts next week, so I am very unfamiliar with the whole process, but thanks for the update....the more I read about everyone's experience, I am expecting my SSDI in about 5 years.:grouphug:

Dear Jim,

I understand what you are talking about in regards to the "working before the onset". I was approved not for SSDI but for regular SS Benefits which comes with medicare and benefits for my minor children and back benefits for my 18 and older chilren up until they became 18, just to clarify what I actually got approved for. When they mentions "working before the onset" SS gave my attorney a complete list of the part time work I had done prior to my approval and to make a long story short, I did work a litlle to much on year and it was not hours it was the dollars they are looking at. So, in order to settle I had to give up about 3 years of back benefits. I got 4 years instead of seven, but to me it was worth it. I had waited long enought and suffered financially because of this whole mess and just wanted it over so I gave up 4 years of earnings. I was told that if Iwent in front of a judge I could possibly lose because of the slight overage and I mean it was really a small amount of money I went over for a short, short peroid of time . So, I settled.

I hope this helped.....

Gabbycakes

Just one other possibility, Identity Theft. There is a chance someone worked under her SS# without her knowing. While the odds are it's just a mistake, remember you don't want to be confrontational with the ALJ's office. Bees, honey, vinegar, whatnot... :)

Record backlogs in SSDI claims reported
 

FYI....

Our newspaper this morning reported that there is a record backlog in SSDI claims nationwide - in some states it exceeds 2 years. The backlogs are partly attributed to the increase in unemployment. Apparently disabled individuals who have worked in the past and are finding it difficult to find work now are instead filing for SSDI, increasing the number of filers.

So sorry for your troubles Jim. I hope things get resolved soon for you and Suzy. XOXOX Sandy

i read the story too...

http://news.yahoo.com/s/ap/20100510/...bility_backlog

make sure they(last job) did not cash in her sick pay, vacation, 401k loans etc.. as income that would look like she worked.



i was told that you cant work part time or even volunteer for free because this would prove that you can work a little. they can take your disability away or not approve it.

i have a bad headache somaybe this isnt making much sense, hopefully you understand what i am trying to say.

good luck,

You can work PT...
 

I worked PT almost the whole time I was waiting for my decision. You can make up to $980 per month before they start to deduct from your monthly benefits. A matter of fact when I first applied and got denied the first time in the deniel letter from the SS Office they stated I should try and work PT, which I did exactly what they said. When I got an attorney to do the appeal and then got a "Fully Favorable" decision he felt it worked to my benefit that I at least tried and continue to work PT on the books. I get my s.s. check every month without any deductions...Please check with your attorney or you local SS Office before you change anything if you are fighting a deniel.
You do have to be very carefull when yo do work PT not to go over that $980 per month. My previous post on this subject explains what happened to me.

Good Luck to all,

Gabbycakes

Good Luck to all.

Thanks everyone for their response! It appears ALASKA MIKE maybe on to something and my dates got mixed up. When my wife applied for SSDI she hadn't worked or received any moneys for 8 months. She listed her onset date, her last day she appeared at work but not before her employer payed her 6 months short term disability pay in which she was terminated afterward, 8 months later she applied for SSDI. I thought it was earlier but it wasn't. The confusion is the short term disability pay. SS needs us to show that it was in fact short term disability pay not hours worked. This I'm working on now and having success so far. :) And I will admit I was very confused for a couple of days.

Maybe when she gets Medicare, she can get that sex change operation :p

The thought of SS getting the sex wrong has gotten under my skin a bit. Her lawyer said not to worry about it of course. All said and done Suzy applied for SSDI several months after she received her last paycheck from short term disability and listed her end date at work when she could no longer work, this was the question the folks asked her at SS when she applied not whether she drew short term disability. I will say Suzy worked a full 4 years with RSD until she couldn't do it any longer. My fear now is SS is going to find any excuse to reject her claim on a technicality if need be and we will never stop appealing.

Hi,
 

Nothing surprises me about SS. I went through so much crap to get mine years ago. My papers ended up in another state, they didn't know they had sent me or a Physc. evaluation. I finally got a State Rep that got mine.

Mike is also right on watching what you do while trying to get it or even after. My neighbor got a letter a few months back that she was being taken off of hers at 54. She had to go back to her lawyer to fight them again. If anyone deserves her disability she does. I do about 2 hours of volenteer work at the vets home now and even that worries me to do. Makes you wonder if they think you will die and get off of it faster by sitting on your *** doing absolutely nothing but looking out of a window at home.

There doesn't seem to be much organization in the system. You hardly ever hear of any case that runs smoothly in fighting for it.

Ada

Ada, I'm already planning my next approach on top of an appeal if Suzy gets rejected again. I have written twice to my representative. They said they performed a "congressional inguiry" on her case but I've never seen any proof of that of one form or the other. The process sure wasn't sped up. Ada, may I ask what exactly did you do to motivate your rep?

thanks jim

Hi Jim,
 

I would write to more then one if you think the one isn't going to do it. I wrote to one we had here. His name was Ben Nighthorse Cambell. The man had mine within a week. What I did was sit down and hand write him a letter. I wanted to make it personal and I sent him a stack of my medical records. I wanted him to personally see what I was dealing with and it worked.

I think to it does depend on the State Official you get. When Gov. Romer was in office, he helped me with several issues but we now have a Gov. that has no common sense. He's already said he wouldn't run again. He knows he won't get in. I have written to him about things and he changed his email that went straight from mine and now people have to go into a website to write to him. It's his way of not hearing from the people. Make it harder.

If you think this one isn't going to do anything, write to another one. I felt like if I sent my medical file it would prove to him what I had been through.

Ada

How do you make someone understand RSD? I have it and don't understand it. I am in the appeals process of SSDI. I have been through a Psych-eval (which IMO with RSD is a gimmme that you are depressed), I have an attorney but still no answers.

Wht do I say to my representative that is going to make them go to battle for me?

I am so sorry for you and your wife are going through :hug:

Thanks Ada. I now remember you posting this before and I found it very interesting to gather all your records and send them to the representative. I do remember Ben Nighthorse Cambell. He looked to be American Indian, wore nice western style cloths, grey hair pulled back into a pony tail...neat guy.:D

Hi,
 

He was very caring. He was Indian. He was a very caring man. Gov. Romer was the same. I ask him to help me with a couple of things that didn't pertain to me but someone else and he did. He helped me get my Methadone at a time when I was fighting every month for the insurance to pay for it. 40. a month and they fought me.

I got my medical records from the Drs. as I saw them back then so all I had to do was run off copies of them. It was about 2 inches thick. I honestly don't know if he read them or just thought OMG, give it to her and be done with it. LOL Now I have a army trunk full and I quit collecting them. I can't lift the trunk and it won't hold anymore. I said, that's enough.
You just have to find that one that cares. Gigglebabe {Deb} that was on here for a long time got hers through the help of one too.

Ada

Does anyone know if there is anything in the Americans with disabilities Act that could be helpful in this fight?

A good question. When I find time I may dig into it. :)

Jim,

I am also going to look into and maybe together we can come up with something! It is just a shame that our disease is off the charts on the McGill Pain scale yet so many don't take it seriously!

I think not.......SSDI's whole point is they are saying she is not disabled. ADA is about discrimination against someone because of their disability

Dear Jim -

Sorry to be so late in opening this thread. It does indeed sound like a nightmare.

Has your lawyer told you that it will take another year to get a hearing? I have to think there's a proceedure for a motion for a rehearing based upon err if filed within 30 days or so of the judge's order. Please check it out.

Mike

Mike, my wife's lawyer told me we have 30 days to straighten it out. All week I've been in contact with my wife's former employer, a very very large defense contractor. What we need to prove is whether pay she received 8 months before she filed for SSDI was short term disability, not hours worked. Her W-2 does not state it was STD but "retirement" instead. We've given the employer her SS#, her company ID number but instead they want her pin number which Suzy has forgotten after 4 years. They are mailing us the pin number just in case we're fakes. We'll use this pin number to aquire accurate records. However, yesterday they did mail a copy of the original letter of benefit sent to Suzy stating she will receive 6 months of short term disability at her full salary dated Jan. 2007. I faxed it to the lawyer hoping that may be enough proof. One other comment told to me from the lawyer who said SS felt that so called short term pay sounded way too much to be STD. Depending how long you've worked for this outfit they will and did pay Suzy full pay for 6 months then she was terminated.

I do have a question. My wife said she does recall, when filling out the application for SSDI, that a question was posed to her wether she was receiving or had received disability pay in which she stated yes. Does any one recall if that is one of the questions asked in the interview or application process, because it sounds like it should be asked in order to avoid this mess which only cropped up now, not at any previous rejections.

I was receiving WC when I applied for SSDI, so I still had income coming in too. I don't specifically remember having to document that, but I must have because I know SSDI knows about my WC because they lowered my backpay, my SSDI amount, and my kids' SSDI amounts to offset the difference (because with all of the above, I would be over the cap of 80% of pre disablity income on my SSDI amount.)

So, Sorry you and your wife are having these problems...
 

Hi Jim,

I posted on this thread before and truly feel so bad that you and your wife are going through all this BS....I don't want to repeat but I was just approved withing the last 3 months, it took almost three years and did not have to go in front of a judge either. I had a attorney just as you do. When a problem or situation came up his office took care of it since he is the one who will get his payment direct from SS. The only thing I had to do was read the papers agree and sign. I don't understand why you have to do all this work. Outside of providing him with the proper papers he needs he should be fighting for your wife.....If don't mnd me asking what state do you live in? In our state, short term disability is through the state in almost 90% of the cases only some companies have private short term disability. The disability is taken right out of your paycheck from the day you begin to work....

In my experience with attorney's some are very, very good and some I wonder how they even passed the bar exam....Maybe leaning on your attorney might just get some speeder results....

Truly I wish you guys the best!!!

Gabbycakes

Gabbycakes, Her short term was paid by the employer at full wage by her company. The lawyer Suzy has is supposed to be one of the best in Northern VA. The issue maybe two fold with me doing some of the leg work. I am my wife's advocate and do many stressful things for her and the other is we are dealing with a private company not a government agency. Having the exployee and or spouse gather personal data from the private sector may be easier and quicker. I do like this lawyer except I did get taken aback when she seemed to agree with SS that this so called "short term disability pay" seemed high.

Hi Jim,

It must be a bear of a task to try and get through the red tape of an employer who employees 350,000 people. When I was able to work full time I was a business/software consultant and had a to deal with many difficult problems for clients with insurance companies, goverments agencies etc. That was some time ago. I know things are so different today. I do work PT. I have one very small business I consult for and even though it is small the problems are the same. What I try and do when I have to deal with something that I know is going to be insane, thats the only word I could thnk of, I attack it like they are going to attack me...It sounds like you have covered all your bases I wish I had some advise. The only thing I can think of is when I was going through the same process my case manager at the SS Office was really a great help. Again, I did not have a lot of issues it just took almost 3 years. I also live in a very small rural area so when you walk into the office, most days, there's only 5 people sitting there.

It is very kind of you to help you wife in this way. I have friends who suffer with other type of issues and the husbands are just mean... I am also lucky my husband has supported me from the beginning. I am not going to say it's wasn't stressfull at times but we made it.

Again, good luck and keep us all posted.

Got great news today. Our lawyer talked to the judge and the judge, after reviewing my wife's old files from her employer, realizes that her pay was short term disability pay, not onsite pay! So, apparently the hearing date will be rescheduled. :):)

Woo Hoo !

That's great news JK !

Congratulations
 

Jim, congrats What great news, I know you Two have been fighting for too long, it's about time they finally listened to you, it shows that we just have to keep fighting until we at least get somewhere, I think that some Dr.s think they are god and their word is etched in stone, they are so wrong! I'm really happy for you, you got it across to them. Good luck on your next challenge.
Your friend Wendy

Jim -

That's great news, with a reset hearing you guys should be feeling the wind at your backs. Congrats!

Mike

Jim and Suzie~

This is such good news...you both deserve a break....congratulations!!!!

Hugz... Kathy

I'm so very sorry, but here's a little more to know
 

Welcome to the gates of hell known as SSI. Here you are 4 years into the process and still getting the run around. Well I'm sorry to say, you're far from done with it and one of the areas is regarding Medicare.

Even after you finally do get your SSI through, I think you'll find that your local state Medicaid program will be your only medical insurance solution for no less than the first 2 years. Only after being on disability for 2 years does a person qualify for Medicare and then you'll have the $110 payment for Part B coverage plus if you don't buy a supplement during the brief 7 month window (3 months before Medicare kicks in, the month Medicare kicks in and 3 months after it kicks in) you have no guarantee of ever being able to get any kind of Medicare supplemental from then on which you're going to need badly since Medicare is usually 80/20, meaning you'll still owe 20% of the bill. Actually after January the 1st, because of Medicare dropping down the amount they're paying the doctors, the supplement also kicks down meaning most patients now owe an additional 3rd bill for the difference the first two insurance plans didn't pay. In other words, once you're on Medicare you can plan on paying $110 for Part B, plus a supplement for around $150 plus Medicare Part D that costs around $35 a month with a $310 deductible (averaged out together that means most are now paying around $65 a month for Part D drug plan coverage). There's a lot of people who now have both Medicaid and Medicare together. If you want more info, contact either SHIP (a nationwide Medicare help organization that's simply wonderful) or me and I'll help you through this part of your challenges at hand.

The average person is paying around $300 just for their insurance and there's still things that Medicare won't pay for which you'll be left financially on the hook for. The fact that Medicare won't kick in till after you've been on full disability for 2 years is the other thing that hurts most people the most.

On a positive note, even without SSI, you might be able to qualify for Medicaid right now.

As far as why you were denied one more time, I'd like to think it's just another slight accident on their part, but I've become to cynical in my old age. The reason you've had so many roadblocks is not because your wife isn't disabled, it's because of there being so many people who've abused the system to death and now they've run out of money plain and simple.

I'm so sorry that you couldn't apply for SSD instead of SSI because it would have made a world of difference in both the amount your wife will eventually get plus there are so many restrictions regarding assets and total monthly income for those who are on SSI.

Best of luck. Contact me if you need more info on the insurance side of your problems. Bob.

Hi Jim.

I am sorry you are having such a rough time with your case. I just wanted to throw in my two cents here. You are doing the right thing by staying involved with your case, and not just expecting the lawyer to take care of it. In my experience (I won an 8 year fight for workers comp / disability) the more you know about your case the better. Some people can’t handle the stress and so they stay out of it. But if you can handle the stress, then it can only help you to be your own advocate, and your wife is very lucky to have you involved. Even the best lawyers (I had a good one) can make mistakes, be overworked, have conflicting priorities due to other cases, or just plain forget things. Staying involved and being a squeaky wheel is the best way to ensure the best results from the lawyer. Also, at least in my case (although I would imagine this is rare), by assisting the lawyer enough to make their job easier, they accepted a lower fee when the case was done. Best of luck with your case, and God Bless You.

Bernclay- :holysheep: