Don't start your claim unprepared!!!
 

I am starting this thread in hopes that it will somehow help someone avoid all the headaches and worries that others have suffered in this forum including myself. And believe me; this advice is in no way coming from a professional. Just from my experience and what I have learned from it. There are a lot of people in this forum that are a lot smarter than me. They know a lot more about this stuff than I do. When I decided to file for my SSDI; I did not research any at all. I went at it blindfolded you might say. I had not hired a lawyer to start with so I had no legal advice on an SSDI claim at all. I simply went to the SSA office and filed the paper work. I signed several forms giving the SSA permission to get my medical records thinking this was enough.
This positively will not get the job done.

1. If you have several medical problems as I do, you need to list in detail each and every one of them on the initial claim or the appeal form.

2. For each and every medical problem you list on the claim or appeal form, make sure you present copies of medical records to back up each problem including any x-rays. Your hospital or doctor can not refuse to give you copies of your records or x-rays. Don’t let them tell you they can’t. Present these records to SSA at the time of your claim or appeal. I didn’t do this. SSA does not accept word of mouth or the fact that something is written on the claim.

3. List all medications you take, the name of the drug, your prescribed dosage and any side effects the medication may cause. Some medication may cause side effects on you that they don’t normally cause on other people. Don't leave anything out.

4. This is very important; I think this is where I failed. On each and every question on the form, go deep into detail. Again, don't leave anything out. I figured that the records would provide the details so I answered most of the questions with the shortest answer possible. Wrong.

5. Be honest on your claim and don't tell a fib. I'm not saying that I lied on my application but I have read in another forum where someone got caught in a couple of lies and was denied. Their lawyer refused to represent them anymore in their appeal because they were being dishonest.

This initial application or the appeal is very long and takes a while to finish. Don't make the mistake I did. Whether you are filing for the first time or filing your appeal, take your time and answer each question with all the details you possibly can. Believe me; this will benefit you greatly in the long run. In my opinion and I could be wrong, but a lawyer is not necessary until when and if you are denied the first time. Then I would definitely get legal advice. I just believe that if you do the 5 things listed above, you will stand a lot better chance of winning your claim. And last but not least, SSA does not get in a hurry by any means. Don't expect an answer in a short time period. Some people get an answer in as little as 4 to 6 months, then again some people wait for as much as 5 to 7 years.

Great! Just want to add:

- make copies. They lost my file.
- I used some of their own language (SSDI Blue book), but not sounding uppity but informed.

My biggest tip is describing your 'average' day to them......not your best functioning day but don't overdramatize saying you can't do anything if sometimes you can.

Very good point. Always keep copies for your own records.

Thanks, rlj1959

This is true, I have read that the more you try to make them feel sorry for you, the less they feel sorry. I guess that they think you are exaggerating your situation.

Thanks, rlj1959

I don't want to sound harsh but, try not to whine. Like rlj states get advice, and gather knowledge, you don't have to necessarily use an attorney in the original complaint and the reconsideration the ssa.gov site has a question thread. (however, if you get to the ALJ hearing you may want to consider hiring an attorney.) The ss gov site will lead you to statutes and rules that gets the point across. In Fl. the SS statute that is used a lot is 404. Example according to 404.(additional numbers) it states that the description of disability is you can't walk, stand, sit and according to your statute this means I can't do any substantial gainful activity. This holds them down to their own meaning of a disability. Of course you have to back that up with doctors reports, mri, scans, copies of your medical bills ect. It can become difficult when you don't feel well to begin with, if you can read you can do this. My offer still stands, anyone needing help filling out forms I will be more than willing to give a hand.

Copies of your medical bills don't prove disability

This is true, they don't. But they do prove that you paid for a procedure or whatever to back up your claim. Think about it that way.

They do not care what med bills you have paid for. It has noting to do w/proving disability. More people than not do not pay their medical bills because of no insurance and/or economical reasons. Ever heard of FREE clinics and/or hospital charity cases? ;)

SS goes by medical reports and especially the doctors NOTES.
When you list all the prescriptions on the forms make sure you list every single side effect AND how the side effects affect your everyday life. Make sure you mention same to all of your treating physicians.

This is very important. When you chit-chat w/your doctor watch what you say. Doctors write everything down in their NOTES which SS reads w/a fine tooth comb.

What you state on the SS forms must match up to what are in the medical reports and the doctor's NOTES!


Hope this helps a little bit!

I totally agree with everything you are saying. But, if a person does have receipts, it does help to prove their claim. It may not have any bearing on the final decision. But it is documented proof that you have taken steps to prove your claim. And yes I have heard of free clinics and hospital charity. There again, this is documented proof for your claim even though it comes from a free source. A medical document is just that, a medical document. It dose not matter where it came from or if you paid for it or didn't pay for it.

excellant post Mz migraine. sometimes doctors dont accurately record what you told them. thats why its a good idea to review your medical records and correct any errors before a hearing or even before you file which you are entitled to do under HIPAA.

Copies of your medications do come into play when filing for disability, this is from the SS disability site. Example; you claim to have severe pain, what's going to be more convincing you're taking over the counter pain medication, or something prescribed by a pain medication doctor?

Evidence Relating to Symptoms

In developing evidence of the effects of symptoms, such as pain, shortness of breath, or fatigue, on a claimant's ability to function, SSA investigates all avenues presented that relate to the complaints. These include information provided by treating and other sources regarding:

* the claimant's daily activities;
* the location, duration, frequency, and intensity of the pain or other symptom;
* precipitating and aggravating factors;
* the type, dosage, effectiveness, and side effects of any medication;
* treatments, other than medications, for the relief of pain or other symptoms;
* any measures the claimant uses or has used to relieve pain or other symptoms; and
* other factors concerning the claimant's functional limitations due to pain or other symptoms.

The information above is from the link under evidentiary requirements.

http://www.socialsecurity.gov/disabi...videntiary.htm

Details n your claim
 

Dear RlJ1959,
Sounds like you fileld the 2006 version of the application. In the 2010 version of the application you don't have the same ooportunities to anser in detail, allthough there are ways around it. The 2010 version places the claimant at an extreme disadvantage. I've attached an article I wrote between the differences in the application versions.
2010 Application
In 2010 the Social Security Administration changed the application that had been in use since 2006. The focus and majority of the content of the 2010 application is on “Medical Treatment” which asks for Doctor’s contact information, “What medical conditions were treated or evaluated”, “What treatment did you receive?” and a limited list of potential tests and dates of tests.
The most dramatic change is that you are not given the opportunity to explain how the limitations of your disability affect your ability to work. In the 2006 version of the application you were given an opportunity to detail your illnesses, injuries and conditions and how these affected your ability to work. These vital questions have been eliminated in the new application.
In the 2010 version, Section 3 lists Medical Conditions which is an opportunity to list your illnesses, injuries and conditions and how they limit your ability to work. It’s possible to write extensive answers to this question in an attachment and expand your answer to include the limitations that interfere with your ability to work.
So, in Section 8, Medical Treatment, it’s critical to answer “What medical conditions were treated or evaluated with the illness, injury or condition and most importantly mention how it limits your ability to work. As an example you’re seeing doctor for severe back pain and muscles spasms that occur multiple times a day which limits your ability to sit in a chair for more than an hour, medication lessens the pain but doesn’t eliminate the pain. You could have answered the question with a simple “back pain and muscles spasms” but it does not give the caseworker any idea of the severity, duration or frequency of the problem. Severity, duration and frequency are the three characteristics you want to include in your answer. To answer the question in this manner requires doing an attachment since there is insufficient space on the application for long sentences.
When you answer what treatment did you receive for the above conditions you are ‘forbidden’ to list medications. Many have negative side effects that limit your mental or physical ability to work. Medications are listed in Section 7 of the new application and I highly recommend doing an attachment that answers the question; name of medication, name of doctor and reason for the medication but adding a fourth item, drug reactions. So in Section 7 you would write “See attachment 7” that lists the side effects.
Other than the above mention major changes, the organization of the application has changed. The 2010 application basically asks the same questions just in different places.

Comparison of the 2004 and 2010 Application
2006 Application
Section 1- Information About the Disabled Person
Section 2 –Your Illnesses, Injuries or Conditions and How They Affect You – Deleted
Section 3 – Work History
Section 4 – Doctors’ Information
Section 5 – Medications
Section 6 – Tests
Section 7 – Education and Training
Section 8 – Vocational Rehabilitation
Section 9 – Remarks


2010 Application
Section 1 – Information About Disabled Person
Section 2 – Contact who knows about your condition.
Section 3 - Medical Conditions
Section 4 – Work Activity
Section 5 - Education and Training
Section 6 – Job History
Section 7 – Medications
Section 8 - Medical Treatment
Section 9 – Other Medical Information
Section 10 – Vocational Rehabilitation
Section 11 – Remarks
It’s natural to resist change and those of you completing the new application won’t know the difference anyway. It’s just that you have to work harder to inform SSDI how your limitations affect your ability to work. My personal opinion is that the 2010 form is less friendly to the claimant and is solely based on the doctors you see and what they say in their office notes. If you have not mentioned limitations or they have not written them down then the caseworker has no idea of how your disability affects you. The only way around this is to incorporate your limitations in your answers.

Respectfully, Trudi

I never let them limit me in what I had to say on an application. I would always write on the form, in the small space provided. SEE ATTACHED. Then type up all the medical information both physical and mental along with statutes, rules, copies of doctors reports, mri's, medical bills, whatever it took to fulfill the meaning of substantial gainful activity, and residual functional capacity. I left no doubt that my client was disabled. I believe rlj didn't file his application until 2009.

I was surprised that I was accepted after the first denial, but my LTD company hired a firm to advocate for SSD for me. It doesn't hurt to let your physicians know that you are applying, so they can be ready to advocate if necessary.

That said, I think my doctor listing my prognosis as "poor" went a long way in my fairly quick acceptance. I have to admit, seeing "prognosis: poor" in my medical records shook me up a bit. I guess with all the body parts I have had removed, and all the interactions, side-effects and restrictions I have on my diet, my prognosis for improving is, in fact, rather poor! If you will never improve, medically, make sure your doctor documents that clearly in your records.

BTW, I was accepted for Crohn's, complicated by having had my entire colon removed, and a less than good result with my j-pouch (recurring complications.) I didn't even have to list my growing neurological complaints, which at the time were diagnosed as just peripheral neuropathy.

I'm glad to hear you had an attorney and physician who knew what they were doing. Like I told someone else, I don't like to say congratulations to someone who has lost body parts and will be ill the rest of their life, but I'm glad the stress and emotion of dealing with SS is over for now. With body parts missing I think your doctor using the term "poor" would be an appropriate word. SS loves cases like yours it's obvious you are disabled, you save time and a lot of aggravation and paper work, within the system. Take care and enjoy what you can out of life. I sometimes watch the show Mystery Diagnosis and it takes several doctors sometimes up to 10 yrs to figure out what's wrong with someone. When they don't know, they say it's in the person's head. Instead of just saying I don't know let me find someone else. I'm temporarily helping people with foreclosures, that's another mess. I needed a break from the stress and emotion of disability and I'm not even disabled. Take care.

Who paid for the procedure is not an issue SSA cares about.

Having had , say, an MRI proves NOTHING.

Having an MRI report that says xyz is wrong and the medical records that correlates your symtoms and physical limitations with an abnormal MRI finding is very helpful. All of that info is not on your bill.

************************************************** **

Most disabled people haven't actually lost body parts.

Being disabled doesn't mean you are ill.

SSDIHelp,

Do you know if there is an online link to the new form ?

(I'm about googled out)

This is a very good thread idea.

If it stays on topic with tips & suggestions on preparing for & starting a claim - I'd like to sticky it for future members.

Thanks Mz M !

I wanted to know what was on there if a new applicant asks questions. I completed an older form and that was years ago.

I underdstand they need all the background info, etc.....but I wish they asked the simple question........Why can't you do ANY job now ? I think that would cut through a lot of the bull and just get to the point quicker. Maybe then they could cut down on some of the backlog.

I think they could simplify the whole process. Ask that 1 question that the applicant fills out, then have the doctor(s) sign it with supporting evidence from their evaluations. Easy peasy.....and no waiting years for coverage.

A girl can dream......

That would be my suggestion for what people should write on that last blank page......a little essay on what prevents them from doing SGA and backing that up with why their symptoms are limiting and not just randomly listing symptoms.

This is a great thread!

I am a disability examiner, and if more people could read this thread it would make my work (and their claims, ultimately) so much less painless!

May I add my two cents, from the "other" side of the process?

Being detailed on the activities of daily living form is so, SO helpful to us. Be as detailed as possible. Please please PLEASE write as legibly as you can, in dark pen. Don't cram too much onto one little line - if you want to write more, you can write or type something out on more paper and enclose it with your form. In fact, I'd much rather you do that then try to read tiny cramped handwriting squeezed into one line.

I will be honest - I know the form is a pain to fill out, especially for those poor folks with carpal tunnel or tremors or those who have mental illness which impedes concentration. Please try your best. Have a friend or relative help. They can fill out the form for you if you can't write. Take breaks and just tackle a few questions a day if you need to. Call your examiner with questions if you have them. But please don't write just one word answers or leave whole pages blank. "What do you do from the time you get up until the time you go to bed?" "Nothing". That is what many people write. It might be true, but how does that help me or your claim? Do you have to stay on the couch because of pain? Do you try to read but lack concentration? Do you do chores sitting down (on the days you feel up to doing chores)? Be specific! TELL ME WHY YOU CAN'T WORK. Show me a day in your life. So many illnesses and impairments have multiple symptoms and limitations; which ones apply to you?

The work history form - you may receive a form which asks you to describe your past work. Be detailed. If you were a truck driver, for example, don't just write "truck driver" and leave it at that. Were you a long-haul driver? A delivery driver? What did you deliver? Did you have to load and unload the truck? Did you have to do any maintenance on the truck? How long did you do it for? We need details. Again, as above, if you need more paper, add it on. How I explain it to my claimants - "Pretend I am absolutely clueless and take me through your day at work as if I have no idea what your job title is". :)

Keep in touch with your examiner. Maybe call him or her once a week or two, to see how things are going and to see if there is any additional information he or she needs. Sometimes doctor's offices take a while to send us records, but if the claimant calls the records "mysteriously" show up within a day or so :) Be involved in your claim! One thing that can prolong a claim - not sending in the forms, not returning calls. If we call you, please call us back!

Keep us updated with phone number changes and address changes. Make sure we can get in touch with you if we have to.

One big, big thing that prolongs so many people's cases - make sure I know which doctors you are seeing. I do not know this unless you tell me. Don't just list the specialists you see - who is your family doctor? Have you ever been to the ER? Are you seeing someone new now that you weren't seeing when you first applied? Update me! I have no way of knowing unless you tell me. SO many people forget to list all the doctors they are seeing. I want to hear from your doctor! I'd rather not send you to an exam if I can help it. Your doctor knows you and knows your history! If your doctor wants to write me a letter to advocate for your disability, great! I want it!

I hope that some of these tips help you in your journeys. I wish you all the best of luck!

I filed in Dec 2009. All I know is the form seemed to have a hundred pages with a million questions. I don't really know what version it was.

One of the things I did that I did not see mentioned was I went back to all my doctors that I had seen in the 5 years before I filed. I updated each doc on what I have tried since seeing them, and any changes. I asked each type of doc if there is anything else I could do to decrease my pain, or increase my mobility. Since I have multiple diagnosis, this meant going to the physiatrist (movement doc), pain management doc, family doc, orthopedic surgeon, two neurologists (one specializes in injections like botox and so I also go to a "regular" neuro also), foot surgeon, orthotic maker (he makes my toe to knee plastic AFO braces), rheumatologist, physical therapist, medical massage therapist, asthma and allergy specialist, eye doctor.... etc. I told all the docs I was thinking of filing for disability. The ones that seemed to agree with that, I asked to write a letter for me describing my limitations. Even had a letter from my asthma doc stating the conditions I could not work in (dusty... etc). He actually may have been really helpful with his letter, as he has been treating me for 30 years and spoke of the decline he has seen in me in the last 10 years, how limited I was am in stamina etc. My eye doctor is also a surgeon, not just an optometrist... and he put in a letter how my medications affect my eyes, and the difficulty I have seeing to read, use a computer etc. ( I am very, very nearsighted)

I began to see a pain psychologist right after I stopped working in Dec. 2009, and continue to see her.

I got copies of all my records after seeing each doc.

During the months it took to do all of this, I kept a little notebook. I kept it with me. Every time I had problems doing something, either physically or mentally, I made a note in the book. If I had to adapt things, I made a note. Such as, I use a hook to reach a seat belt because I can't reach it due to my physical problems.

I also kept notes from 3 different days - a good day, a bad day, and a day away from home doing a few errands. I wrote down exactly what I did each day, from the moment I woke up. I included difficulties doing things, pain levels, sleep, medications, problems with personal hygene etc. I used these notes as examples of my average days.

I went in to the local social security and filled out the initial application for me. The woman saw me coming in, with braces on, using a service dog, and clearly saw the change in me during the nearly 3 hours it took for us to go thru all my info - how my concentration and comprehension went down when my pain levels went up. I think she helped me a lot by filling the initial application out much better than I would.

When I got my forms in the mail to fill out - a function report & symptom report... I called my case manager and told her it would take me a long time to do them. The symptom report took me about a month, and so did the function report. I ended up getting a dictation program for my Mac, and a microphone to be able to type all the answers to the questions. I am using that software now. I explained why it was taking so long to the manager - that I had trouble typing, seeing, and also my comprehension.

I think my function report was 35 typed pages, and my symptom report was over 20.

I didn't have to see any of their doctors.

Even though I had sent all my records in (with my notes attached to them for things like a doc writing down right arm instead of left arm), SS still sent for all the records from each doc anyway. Knowing this, I would still do it the same way, as it was important to know what each doctor had to say, and it helped me figure out what symptoms I've had how long etc.

I applied the last week of May 2010 and got approved first time, beginning of Sept. 2010, with recheck in 5-7 years. I am 52, high school education, worked in the same trade since I was 17.

I did not use a lawyer to file. I did talk to one for a few minutes on the phone. He told me he didn't think I had much of a chance because my main diagnosis was RSD, which is not one of the "automatic" diseases, and because I barely missed any work in the last couple years. I do know a person casually that lives halfway across the country from me, and is one of the people who works SS and decides if you get SSDI or not. She did give me a little advice, such as keeping track of what I did over a few days, and noting all the problems, pain, etc. in detail.

Once I decided to try for disability, I took on filing for it like a job. I tried to cover all the bases. It took me quite a while - almost 6 months. Some of that was time waiting to get in to see doctors because some were so booked up, it was months before I could get an appointment.

Still, I feel incredibly lucky to get it first time. It was kind of odd when it went through so fast, and with the 5-7 year re-evaluation. It really got me down for a couple months, because it was like a validation of the severity of my physical issues.

I think being as prepared and detailed as you can be really helps.

I wish YOU had been my examiner. I left messages for my examiner and was never called back. When he finally picked up his phone one day he told me that I should be getting a call within a couple of days to see an SSA doctor. No one called. I call back a week later to find out the status and left him a voice message (that he never returned). I wait ten days and end up speaking to his supervisor as he was gone for the day. She tells me that 'he really dropped the ball' and that she will have him expedite my case the next business day. Within two days I receive a letter and stupid me, I think it's a letter for a doctor's appointment, no, it's my denial letter!

Please do Jo*mar. I don't know how.

I have been reading through all these threads about SSI and there is one thing I can't figure out. When you first apply for SSDI with SSA, do they automatically sign you up for SSI or do you have to ask? Nobody at SSA ever mentioned SSI to me. I have read where if you get SSI and then SSDI, you have to pay back all or part of the SSI. That don't make donkey sense. I realize that SSI could help most folks including me during the SSDI nightmare but whats the use if you have to turn around and pay it back?

When you left your message did you also leave your claim number? Claim numbers are what identifies you to the claims examiner.
Your claim number is at the top right or middle of the initial application and all other paperwork that you receive from SSD.

I always kept in contact w/my claim examiner every 30 days during the 3 1/2 years it took me to reach an ALJ hearing. Each level I had different claim examiners.
At the ALJ hearing that is when I hired an attorney, so I stopped calling SSD. The reason is that when you are represented by an attorney, the claims examiner will not discuss your case PER YOUR ATTORNEY's INSTRUCTIONS.
If you want to speak w/your claims examiner while represented, you must instruct your attorney to allow this. Remember, the attorney works for YOU! Not the other way around. :wink:

I think, at least I was told when my wife applied for SSDI, when you apply for SSDI you also apply for SSI at the same time. My understanding is this is the procedure. My wife did not qualify for SSI because of too many assets etc. The payback part is SSI comes from the general fund not the SS fund, so that is why they're moneys to be paid back. I guess the logic is if you qualify for SSI, which I guess is similar to welfare because one does not have much in assets, you will when you receive SSDI.

No, I did not leave my claim number as he never requested that information during our conversations, just my name. I had only one claim examiner.

I am not represented by an attorney.

They never even mentioned it to me at all, whether I qualified or not. I still don't understand it. I was denied on my initial claim for SSDI but I have appealed. I hope they don't surprise me with SSI cause even though I could definitely use the money, I just don't understand it well enough to go along with it.

I can almost swear when you apply for SSDI you also apply for SSI at the same. SSDI takes work and patients to receive but SSI qualifications are pretty quick to receive or not (not qualified). SSI is federal aid SSDI is credit you earned and paid for. I would think it would be a federal issue not a State issue. If I were you I would call SS and ask them about SSI and check to see if you applied for SSI back when you did the paperwork for SSDI. As far as rejections for SSDI that shouldn't effect SSI or the other way around because they are on two different tracks.

They usually have you file for both ssdi and ssi when you first file. i wont say always because there are people here that are waiting to jump on anything you say and as im sure you have learned in life nothing is absolute. The reason to get the SSI money and then have to pay it back is because you may not qualify for ssdi after they check the non medical qualifications, but they is usually done very early. Also many people as you know are losing their homes, cant afford medicine etc so even if you have to pay back that money at least you have it if you are qualified for it.

I guess I didn't qualify so they didn't ask me. Don't get me wrong, I could definitely use the money. Just got another light bill with the "final disconnect notice" on it. I'm hoping I can talk them in to giving me the six or seven days left in this month until my VA check comes in. I think there is 31 days in January.

We didn't qualify for ssi because my husband receives a small stipend from his union and has a part time job. I not fed that on my app but they considered and rejected it. I got a call from my examiner but was having a serious head under the covers day. I don't remember a lot about my answers. Probably the reason I have to have an evaluation from the psychologist... I just hope I'm not required to walk a long distance to get to the exam room.

Thanks
Pat

What is a mental examine?y

I'm no expert, but I would think it would be a psychological evaluation.
I could be wrong.

Agreed, this is extremely important. That was something my claim reviewing doctor stressed to me in my exam. One of his key questions was like this; ' Forget about all the doctor opinions you have heard about your case so far. I don't care about those right now. How does your disability impact you in your every day life?'

Bipola, osteo arthritis AND DLA
 

I have osteo arthritis (OA) in my hips, knees, ankles, lower cack and cervical spine. I have been offered a full knee replacement but refused. I am in constant pain and on most days I walk very awkwardly. However, when I manic I can overcome the pain or should I say disregard it. Unfortunately I pay the price when I get down. Usually it warrants a week in the house with a very low mood and aching body.
Has anyone else experienced this which one could say it mimics "mind over matter"
:)