Neuopsyc Eval
 

Good afternoon,

New here. I posted in the new folks thread but it didn't post.

Recently diagnosed (March '14) with mult-TBI's/concussions and MVA '08 which I received a subarachnoid hemorrhage (frontal lobe) and fractured C6 & C7. My first head injury happened at 4 years old. I raced off road vehicles and dirt bikes for years and have been involved in 2 major MVA's. Was also told that abuse from childhood tosses in PTSD. I was always aware of coping and issues that arise from childhood abuse, had therapy, etc. Toss in the TBI ballgame and it seems a lot more questions about myself are starting to be answered. My neurologist said that they go hand in hand. I am grateful for the diagnosis. Blessing to know and also a curse it seems. It has helped me understand some things but also opened new issues to figure out.

My neurologist last month said it would take years to rehab. It was validating that I am not just a crazy person, actual problem with my brain. He referred me for a neuropsyc eval that is to happen at the end of this month.

I cannot stand tests, never have. I am very nervous and encouraged to have this testing done though to see what is.

Anxiety, brain fog, blurred vision, balance issues, leg numbness, tinnitus, headaches always, light and sound sensitivity, angered easily (mainly frustrated), problems with job retention (about a year and I move on, however, been unemployed 6 years now) and some more I cannot remember.

Thank you for reading.

goldenwillow,

Welcome to NeuroTalk.

I am surprised you have not applied for SSDI. It sounds like you would qualify.

An NPA would be good. Try not to think of it as test. It is not quantifying you as a person. It is quantifying your injury and how it has effected you. There is a not a need to feel like you need to pass the test.

Think of it as a form of medical lab work/ x-rays, etc. that just uses your performance on a variety of tasks to look inside your brain.

Thank you Mark. I appreciate the kind words in regards to the testing. I am mostly affraid of what the results will say. Labeled on paper. Guess it is what it is. I have learned not to share my tbi diagnosis wtih others (in real life) very much. Feel that I am viewed differently.
I have not applied for disability yet because I thought I had to have all my "ducks*in *a row", test results and such. Am I wrong on that?

You should apply for SSDI as soon as it starts effecting your ability to work. The application process often includes SS Administration requesting testing. Your delay in applying has drastically reduced the monthly benefit amount you will receive. They average your income over the past years to come to a benefit amount. The years you have not worked will reduce that amount.

So, get the application started. You can start it online at https://secure.ssa.gov/iClaim/dib

I had no idea.
I have been a stay at home mama the past 5 years. The MVA where I had the hemmorage and broke my neck happened a month before we conceived. I returned to work part time last November, worked for 5 months due to my co workers being hostile and cruel with my mistakes, I quit. My boss at the time was knowledgable of tbi and that is where this journey started.
Thank you for the insight.
I suppose that I am going to have to see their doctors (ssdi) as well? Or, in your knowledge, will they possibly accept the documentation I have thus far?

Start the application process and see what they ask for. They may send you to a occupational psychologist or other professional to asses you ability to work. The first application is handled by a state agency usually called Disability Determination Services. The first issue is whether you have accumulated enough work credits to qualify for SSDI. You can view your Social Security account status online.

Did you plan to return to work after your baby ?

I did eventually plan to work. I started the application. I saved and stopped filling it out when I got to the symptoms portion. Filled out what I know I have problems with. Got tired at that point.

There are two different categories of symptoms to focus on. Cognitive and memory symptoms/dysfunctions is one. Pace and persistence is the other. Pace and persistence means you can't maintain a satisfactory pace (speed) doing the work activity and persistence means you can not last an entire continuous work period. Many of us can struggle through on the cognitive/memory issues with work-arounds. The mental fatigue that requires frequent breaks is often a bigger problem. Employers do not want workers who need constant breaks.

The SSDI Blue Book has a list of symptoms. Here is a link to the Mental Disorders section
http://www.ssa.gov/disability/profes...dult.htm#12_02
This includes both mental illness and neurological injury caused disabilities. Don't get freaked out by the term Mental Disorders.
There is also a section on Neurological Disorders at
http://www.ssa.gov/disability/profes...ical-Adult.htm
But, it refers over to Mental Disorders for non-Epilepsy issues.

There is a description of the evidence needed, lab work, psychological testing, doctor's diagnosis, etc.

Just working through the application can give you a good idea of your pace and persistence issues.

I hope this helps.

My best to you.

Thank you for the information. I have read the tbi section awhile ago. I feel like
it would be a benefit to have help completing this application with someone whom knows the right things to write. Is that a lawyer whom specializes in this? I do not want to make mistakes with this.

What kind of medical records do you have that discuss your disabilities ? Do you have any employment records that discuss your difficulties trying to return to work ?

There are attorneys who specialize in SSDI. Some are national law firms and others are local. Their fees are limited by SSDI regulations.

If you want to discuss any of this in a PM (Private Message), that would be fine. Right click my screen name and click on the PM link.

As I said, The TBI section alone is not complete for our needs. You need to use the Mental Disorders section.

Thank you again for your information. I read through the mental side and find a lot that fits me.
The only medical records I have at this point are what diagnosis' I have from my ARNP, Neurologist and a pain Dr. whom each state, tbi, anxiety, depression, tinnitus, and a couple others. My neuropsyc eval is on the 30th this month and I think if I have more info (diagnosis) the better? As far as the work records, no I have nothing, however, my last employer, whom is an acquaintance, said when I left she felt I was "high functioning" but the detail aspects were failing. I think she would write a letter for me as a past employer. I do not think that any of my other employers would be so kind to do so.
I appreciate the PM offer and may do so when I have better questions (informed) to ask, do not want to waste your time :)
All of this is very overwhelming to say the least.

Had my neuropsyc eval last Thursday. Battery of tests roughly 5 hours long. I found I was exhausted around the lunch break, 2 1/2 hours in. The rest of the testing day was pretty tough. 1 month for out for my results.

It can be pretty tough to listen to your report. I hope your results are good. Just in case, you might want to take a friend or family member along for support. And, of course, we're all here for you. Many of us have been down that road and have some insight into how you're feeling.

My neuropsych report was devastating - but it was the best thing I ever did. It led to my getting cognitive and occupational therapies that addressed my identified deficits and advanced my recovery.

Thank you. I found myself very emotional through most of the testing process. I realized that I am very dependant on taking notes, using my fingers to count and how much I have depended on my husband for recollection of facts.
I am looking forward to my results. I wish they would not take so long to get to me, however, I am finding some relief in all this while I am waiting. Pieces of the puzzle.

I am awaiting my report which I was told would take a month, now 2 weeks out. The past 2 weeks have been very difficult. I just want to know what my neuropsychologist found and hope to move forward. It feels overwhelming but I have felt that way most my life so what's another 2 weeks has been my mantra :)

I am also finding that I have been secretly suffering with my impairments since I was very young. It is somewhat validating having my diagnosis' . Known about PTSD for years but the TBI, new diagnosis since March. Not sure which injury in my life brought that on. My mother and I wrote a list of all my head injuries and loss of conciousness and it was quite long. However, the last MVA in September '08 sealed the deal apparently. Not one person in the ER at that time spoke about TBI (according to my husband and my paperwork). I had fractured C6, C7 and had 2 LARGE open wounds frontal and occipital that required many staples to close. Also a subarachnoid hemorrage as well.

I was blessed with pregnancy a month later (had made the decision to have a baby a few months prior to our accident) and into another unknown chapter of life. I had no idea that my pre existing anxieties were 10 fold due to my TBI, thought it was my prior PTSD and the new ones you naturally get as a new parent. Now that my child is going to school, I have some time to myself and now can breathe a bit. But with that, I see my impairments much clearer, sort of speak, and find I am saddened and relieved with all this information, and more is to come.

I guess I needed to vent, thank you. The support group in my area, meets once a month at 7pm to 9pm at night, weirdly, and I am toast at that time of day, usually
trying to bed the family down to sleep.

I hear you on the difficulties of being a TBI mom.

With a young family, between kid activities and bedtime rituals, my area's evening support group meeting just won't work for me. TBI is isolating. Being a TBI mom, well... As women, we are socialized to care for others and ignore our own needs - no matter how pressing. The number 1 rule of motherhood is MOMS CAN'T GET SICK.

As moms, it's really hard for us to get the rest and quiet so important to TBI recovery. On the plus side, the desire to do better for our children provides powerful motivation to keep striving to improve. Frankly, I was so badly injured, if I didn't have a family that needed me, I think I would have just given up.

While it's not the case for me, perhaps there are other young moms in your support group. If so, maybe they'd be interested in pushing for a different meeting time and/or forming a smaller subgroup that was more accommodating for those on the mommy track.

I had some PTSD after my mva. Are you being treated for this? In addition to traditional talk/desensitizing therapies, some interesting work is being done with medications and memory. I think there is reason for optimism on this front.

Thank you Hockey. I sincerely appreciate your kind words. I am not one to post on online forums, however, in need of support. Thank you also for the advice on seeing about other moms in my local group. I do feel the same as you that my family is what I am living for.

I suggest you schedule a light day of activities so you can be rested enough to attend the support group. Many of us have to do just that in order to have a late day or evening activity.

Good advice Mark. Driving at night bother my eyes typically but I have not rested prior to an evening outing. I typically avoid them.

If you're having trouble with your night vision, speak to your optometrist. There are lens treatments that can help with that.

Yes, rest is so important - but so hard for a mom with young kids. Do you have friends and/or relatives that could give you some respite time?

Don't try to be "super mom," either. If you need to pop in a cartoon DVD, so you can get 30 minutes of quiet, it will not damage your children's future. What's important is to have a mom who is as healthy as possible.

Good idea to see the eye dr. I had not thought of that. My son associates night time with being at home so really, that is what we do :)

We do not have much in the ways of support for care for our son. I can count on 1 hand how many times my son has been with friends of ours or a babysitter. Usually we hang out with those friends as well. Working on that and school has been a good step. Our extended family does not live locally but when they visit we do take time to take a hike on our own.
We live rurally due to my dislike of living in town, prefer the country. I have been looking for a young adult close to us whom would be a good fit for my son. He does watch dvds but I typically get things done, however, understanding the importance to rest much more these days and we as a family are learning to adjust to this new knowledge of my TBI.

I opened my account for ssdi last month. Got overwhelmed with the application and stopped. Received a letter from them stating they will deny my claim if I do not complete by the 25th of this month. I made it through the printed application a couple days ago and completed my written letter of my ability to function this morning.

I went into my local ss office last Friday to talk about my neuropsyc report not being available until the 30th and what a horrible experience. I took a # and sat down until I was called. Every other person waiting was called over a microphone and was listed on the tv screen. My # was called by his voice and I realised that on his 2nd call. I said I just had a question about the 25th date due to my report not getting to me yet and he immediately started talking about what they needed from me, completed app and the release... just sign that. We are here to help, can we help.... I have pulled up your app and see you, are a working person... hummm... you have worked... kept talking and talking about the process and again how he was there to help me but he wouldn't let me speak. So when he was done I asked about the date and explained my report was to come after that.... he went into that I have had plenty of time to complete. I started to get overwhelmed, heart racing and began to tear up a, little and said, I wasn't being disrespectful, I thought I had more time to complete. He told me to compose myself and that he received a message from someone in the back that there was problem with our supposid conversation, he was doing all the talking, and if I wanted help with the application there was someone to help, said that over and over until I agreed to the help. Sat down at window 6... go to window 6, again, go to window 6 and she'll meet you there. So I went to window 6, metal shutter rolls up and was given a pen. She asked if I wanted her to file online for me because I was writing too slow. I asked if she would be able to print out the app she typed when we we done and said no. I decided to continue writing it out on my own and was told again I was taking too much time. It was not busy in the office, 5 or so people waiting so I clearly was not in the way. I told her thank you and that I was not comfortable and would complete at home, then I left.

My gosh. I felt bullied. All I wanted to ask was if I was right on having more time to complete. That is it.

I have all my Dr.'s reports except the final from my neuropsyc eval. I emailed my neuropsuchologist Monday requesting I hope to receive it by the 25th deadline. Would like to submit all together, however, if I do not receive in time, will submit all I have by the 25th and walk the rest in when in hand.

Amazing.

I'm sorry you have had this kind of a journey. Stinky deal!

I have had two neuro psych done. THey often schedule two days for people to do it so that they can take the breaks they need in order to complete it. It will give a good window on how much is related to PTSD...and how much is related to brain function. It doesn't...however, explain balance things...or convergence insufficiency.

So...good for you to have one done... use it as a tool...no matter what the outcome of it is. Do you best to be open about the results so that you can get the best care possible!

Cheers!
Kat

Oh, I feel so bad for you. SS is supposed to treat you better. It appears they do not understand or have people with neurological issues very often. You should be able to call them on the phone if you have questions. Maybe that would be better than the commotion of the SS office. You can always have a SSDI attorney handle the application for you. Their fees are limited by SS regulations.

My best to you.

Thank you for the support Mark. I felt like a whiner after posting that ssi post, which I usually do not feel that I am one.
I sat at the beach today and closed my eyes for a while, felt good. I am ready for the next step of this journey. Moving forward, never straight.

Also, I am grateful I didn't have 2 days of testing KateRN. Glad I got to knock it out in 1 day!

Goldenwillow, I just noticed that you are from the PNW. Me too! Whereabouts are you? I'm in WA. I haven't contacted my local group but plan to soon. This online forum thing and support group stuff is very strange to me too as I am not usually someone who asks for help, lets others in easily and I don't like being vulnerable. I am learning to adjust so many things in my life as I'm sure everyone with a TBI discovers.

Google "brain injury Washington" and you will find a number of web sites with information about support groups and other services in Washington state.

I turned in my application yesterday. It feels good to have that part of the process behind me. I turned it in, in person. I asked if there was any type of confirmation that I did so and the woman signed a # slip (the one you get when you check in ) and said her "John Hancock is all you need because my name is known around here". Alrighty. I had everything except my neuropsychological evaluation report which I am still eagerly awaiting. Supposed to receive by months end, which seems cannot come soon enough. The SSI woman said to just bring it in when received.

Waiting.

Do any of you see a psychologist? Maybe this is too forward of a question?

I am finding while waiting for my results and understanding the intensity of my injuries I am very saddened and angry. Any particular specialty to look for? I assume there are TBI specialists, off to look in to after posting.

Sorry if someone has suggested this already. I am learning the severities of my accident and how the ER Dr.'s did not explain the possible seriousness of this 6 years ago.

There were many writings of our accident where I fractured C6, C7 and had a subarachnoid hemorrage and now... learning about he TBI diagnosis. Apparently, the glass that broke between my head and the roof of my rig stopped the hemorrage, saving my life.

goldenwillow,

Have you asked the NeuroPsych who did your NP Assessment ? If he does not offer counseling, he may have some good referrals.

I do see a psychologist. I don't know that it is helping....but I do go. If anything it he helps me realize that I am not "looney" as so many people have said. It really is about support.

I have the same bouts of anger, sadness...and often times not certain of what about.

I would suggest a psychologist who deals with TBI/PCS

Since you did work recently, it might make your SSDI approval a bit more difficult.

It might qualify as a "Unsuccessful Work Attempt". This link will explain: http://www.disabilitysecrets.com/res...rk-attempt.htm

Most attorneys will not represent you until you've accumulated some potential back pay (if you listed your Alleged Onset Date going back a few years, you might have 7 or 8 months potentially already...) but a non-attorney SSDI rep might be willing to work with you right away. Allsup generally has a good reputation, but you might want to see if you can find someone locally--often former SS employees make good representatives.

http://www.allsup.com/

I disagree with LIT LOVE almost 100% other than the Unsuccessful Work Attempt. MTBI based SSDI can be a long slow process, even with an attorney so by the time the ALJ hears the case, plenty of back pay has accumulated. It took well over a year to get the hearing. Almost three years to the day from first application to approval. The maximum SSDI attorney fee is usually based on only 18 to 24 months of disability. My attorney earned her maximum fee from only 16 months of back pay. Because we were well past her maximum fee based on back pay, she did not fight for a higher benefit that I deserved. Getting me a better benefit would not have earned her a penny more. I got stiffed for thousands more in back pay and $150 a month more in permanent benefit.

Many attorneys, but certainly not all, will not even interview clients in person until they've been denied Reconsideration (or the equivalent) and are ultimately going to be headed for an ALJ hearing.

Many people prefer having someone that will be very hands on from the beginning of the process--sometimes you can find an attorney willing to that, but more often--not. My suggestion was that with the right representation she might be able to be approved earlier and avoid the long wait of an ALJ hearing.

Another good option is to research on one's own, using the info found at free sites like SSDfacts.com (several good sites are also listed here on NT in the stickies in the SS Disability forum) but it is better to do so prior to starting the process, not after. Decisions like a person's Alleged Onset Date can greatly effect their monthly benefit amount, their maximum back pay, and if there is recent employment, chance of denial. And that's just one example of an incredibly important decision that has to be made at the time of application.

--BTW, I had an attorney that recommended a Closed Period Award, so that he got his full fee and I was left fighting on my own for a Fully Favorable Decision. I was ultimately successful, and got all my back pay and my maximum monthly benefit, but there are MUCH easier and FASTER ways to achieve what I accomplished.

Thank you both for your experienced words.

I read the link and I did have breaks in between reurning to work at different positions/job functions, trying to find something that I could do with no avail.

I decided to go ahead with my application after my husband and I read all we could find. I figured that honestly, it is what it is and will take it as it comes. I completed the application the best I could with all the documents I have since this head injury/hemorrage has been documented. I did write about my problems throughout my working career and all the head injuries and abuse I sustained as a young person.

I honestly do not have a date when all this began for me. I listed my date as the date of my most recent accident (where I seemed to have suffered the most with documentation). I have had TBI issues for years (now understanding) and doing my best to just move forward.

I also figured it was in my best interest to atleast try to apply on my own. If denied, then move forward with what they throw at me. My documentation is pretty straight forward thus far (waiting for neuropsyc eval to support) and I am hopeful this will work out. I am realistic that it could potentially be a struggle but I cannot dwell on the what if's right now. I am already having a difficult time with the what is.

Sorry, I was talking in generalities in my second post, and didn't mean to upset you.

You are early enough in the process to hire a rep if you wish to and have them really effect your outcome at a potentially minimal charge. It's totally fine to try and do it without representation as well!

Having a neuropsych eval done now is an excellent idea, IMO.

It might be a bit premature, but you might seriously consider having your doc/s fill out RFC forms now as well. Your docs/s might be willing to fill them out for free or at a small charge.
http://www.disabilitysecrets.com/rfc...statement.html http://www.disabilitysecrets.com/res...ental-residual

You absolutely have a legitimate claim that your latest job was a Unsuccessful Work Attempt. Your former boss might be willing to write something on your behalf explaining that you were given special accommodations, etc. (This could have happened without your even being aware of it.)

There are 3 ways you can be approved for SSDI: 1)Meet a Listed Impairment 2)Qualify by the Grid Rules 3)Qualify by the 5 Step Process. The fastest way is to meet a Listed Impairment. The Grid Rules only apply for workers age 50 and above. The 5 Step Process is more complicated, so it can take longer.

These links explain qualifying for a Listed Impairment with a TBI.
http://www.disabilitysecrets.com/soc...in-injury.html
http://www.nolo.com/legal-encycloped...in-injury.html

The disabilitysecrets.com/nolo.com websites are an excellent resource, btw. They're provided by NOLO Press which sells a book on the SSDI process and law reference books in general. Everything you need should be on the website, but a hardcopy can be invaluable as well.

Good Luck! If you ever need help, please stop by the SS Disability forum or even pm me and I'll be happy to help if I'm able.

LIT LOVE,

If you would read the thread starting at http://neurotalk.psychcentral.com/thread210551.html, you see that we were helping her along the process. Head injuries are quite different than other disabilities. The applicant can be 100% functional from every observable standard until they try to process the tasks of a full time job. The disabling issues are most commonly related to pace and persistence. They may be able to complete all of the job tasks at a high level for a short period of time but they often can not maintain the pace needed or be at that high functioning level every day. Sometimes, behavioral issues can interfere with employability. Sometimes, it is an inability to tolerate the work environment.

Nolo Presses publications are just paraphrased repeats of the SSDI Blue Book. I find the Blue Book easier to read.

The SSDI process can be difficult due to the cognitive struggles we usually have. Having an experienced SSDI attorney to help is valuable.

I read the entire thread before my first post. I have researched TBI in the past while helping someone with their application, so I'm familiar with many of the issues--and the reason why I recognized a claim that her job was an Unsuccessful Work Attempt was appropriate.

I'm confused by what you're even upset about? That I suggested a non-attorney rep might be helpful this early in the process? Is your opinion that the OP should hire an attorney, but should be how far along into the process before she tries? Another option is to find an attorney provided for free by an Advocacy Group--often available in large cities for these types of claims.

You have an easier time reading the Blue Book. Many people, even those without cognitive issues, struggle with the Blue Book. Most of the authors on NOLO are experienced SSDI attorneys and they impart their experiences as well. I'm not sure why more than one option is a problem.

I have no concern about your 'Unsuccessful Work Attempt' comment. I may have not used those terms but I had commented that since had she tried to return to work and failed, that she should try applying for SSDI. I try to avoid too much 'in the know' jargon or abbreviations, at least early in the communication..

I had pointed her to the specific parts of the Blue Book with comments. Nolo uses generalities that make it hard to understand the specifics needed in an Application.

You said " Is your opinion that the OP should hire an attorney, but should be how far along into the process before she tries?" What is an OP ? It usually means Opposing Party but Opposing Party does not apply in SSDI issues. They are not supposed to be adversarial.

My point was that she already had enough time since injury/disability that an attorney could expect a maximum fee. She has a number of challenges that an attorney can help with beyond the disabling issues. Five years since injury and leaving the workforce to be a stay at home mom needs quality explanation. Those are legal issues to be addressed. I did not recommend an attorney at first because she needed to start the process and get the first denial.

I did point her to searching for an advocacy group. I know there is one online for her area but I have lost my bookmark. Their web pages often have attorneys and other advocates listed. I finally found it. http://www.headinjury.com/

Residual Functional Capacity forms are very difficult with an mTBI where the Applicant is fully ambulatory. The best is a good Neuro Psych Assessment. Often, the State Disability Determination Office will arrange for an abbreviated Neuro Psych Assessment or even an Occupation Psychological Assessment at no charge to the Applicant. This is usually requested at the Re-Application process.

Regarding getting an advocate to work for free through an advocacy agency, Nolo says "Even disability advocates who work for legal aid agencies almost always charge 25% of disability backpay for their services. "

I am not upset. I just thought you were making the process too complex with the way you were explaining things and your thought that attorneys would not take the case until they knew that they could get a full fee. Both attorneys and non-attorneys get the same fees.

btw, May I ask what your disability is?

My best to you.

I had no intention to derail the OP's (original poster) thread and so my apologies to goldenwillow.