Any Advice
 

Hi all,

I don't venture onto this part of Neurotalk all that often, as I spend most of my time over on the RSD/CRPS sub-forum.

For those who do not know me, I had surgery last January to fuse both the subtalar and tibiotalar joints in my ankle after a 12+ year old injury ended up leaving me hobbling around with a cane with a high amount of swelling by the end of the day. Oh how I miss those days. Today, I spend most days in severe, constant pain from CRPS in not just my right ankle and foot, but now both legs, (entire right, and thigh to just below the knee on the left), both shoulders and into my left hand. I spend my day with my leg elevated to keep fair blood flow to my ankle, otherwise it turns purple and the pain gets worse. I do not know if the surgery caused the CRPS, if it was caused my a broken toe a few years back, or if it just happened over time with the high amount of trauma that I sustained years ago.

Thankfully, my husband, sister-in-laws and Mother-in-law all convinced me to file for SSDI and SSI as soon as surgery was recommended back in October of 2014. I did not qualify for SSI. I had too many assets, which has helped us get through financially for the last 16 months and is the only reason that we have made it along this long. Thursday, I finally received a call from my lawyer letting me know that my hearing in front of an ALJ has been scheduled for April 20th.

I am meeting with my lawyer on Thursday to review everything. I just want to ask everyone here if there is anything that I should know for either Thursday or come April. Any advice is very much appreciated.

Thank you

It sounds like you have it pretty much under control. Don't hesitate to ask questions of your attorney.

If you are up to it, you may want to review some of the "stickies" on the forum.

Did the attorney have you get anything from your docs, other than your medical records?

Wishing you the very best. Let us know how the meeting goes with your attorney.

Thanks Hopeless,

Although I am only a little nervous about my hearing, it's always nice to hear the experiences of others who have already been through the process. I just want to be as prepared as possible. I started reading through the stickies on this board last night, but figured that asking others wouldn't hurt.

The only thing that my lawyer has asked me to get from my docs is just to talk with them and make sure that they do not have any problems with submitting documents when asked. So far, I have not had any problems with that considering the medical problems that I have. They all just want to help me as much as they can.

PurpleFoot,

that sounds severe. I relate with you, my left ankle does not retain weight long due to a degradation of the soft tissue and muscles.(I have spent many years in bed and it's depressing to say the last vs being active and out in life) Not sure what the long view is but it seems to me a cane or wheelchair without the body's natural healing ability. Depending on the type of jobs you can do or what you did before and where you're at now you should get fairness in a judgment. Though remember how people are. I was in a chat room and they were knocking all disabled people in the same category. There seems to be a sort of hatred and blame toward disabled people as well. Regardless of the money they paid into the system for these very reasons. I hate when someone says entitlement(when what am I entitled to my own taxes?)

I would tell the truth, I would share my heart and soul. That's what I did... Some said no and other's said yes. I think when I finally met a Doctor who forced me to bare my soul cause I don't like to talk about my pain openly. I got the yes I needed. Unfortunately not the healing... Medical records and what they see and believe should give you a yes. I think! Laying in bed is no life and I pray you get better, though I don't know you. Believe me I know that type of pain. There are some good judges and good people out there in the System. There is hope and we all deserve help.

i had a hearing back in 2005, so thats 11 years ago now. try not to be too nervous, though i am sure that you will be somewhat nervous. you will be asked questions by the administrative law judge. Answer directly and to the point and try not to add things that are not being asked about, unless it is a general question such as what do you do during the day. be ready for that question. also they may ask you how you got to the hearing that day if you are claiming that you cannot get around well. Look the judge in the eye when you answer the questions. dont be afraid to ask the judge if you can stand for a while if you start to get uncomfortable sitting for too long. you may have to explain why your illness limits your ability to work. this would include the effects of unrelenting pain, the limits on your ability to sit, stand, walk, kneel, bend , climb, etc, being easily fatigued by pain, difficulty concentrating, the effects of your medications etc. whatever pertains to your particular situtation.

dont over dress or look too good make up wise. be truthful. for some people it is very hard to tell people actually how unwell they feel, how limited they are. it can be upsetting. dont let those kind of feelings prevent you from communicating why you cannot work.

Thank you both for your thoughts. From the sound of things, I should do fine come April. The truth is after all what I was planning to tell. I am sure that my lawyer will fill me in on some additional things that I should know when I see him later on in the week. I am still a little nervous, especially when I see that the ALJ that I have been appointed to only gave 16 favorable decisions out of 46 based on the report that is available through the SSA. It was from 2012, and does not say anything about the cases that he has heard, but makes me nervous none the less.

Thank you all again. I would still like to hear from anyone else who would like to share their experiences as well.

Ask your attorney if a Functional Capacity Evaluation would be beneficial. It would help document your inability to sit and stand for periods long enough to work even a sedentary job at the SGA level, which will in all likelihood be the most important thing you need to prove. Your doctor/s can then use the test results to fill out RFC forms if they haven't done so already.

I would suggest you start your research by reading this link for the 5 Step Sequential Evaluation Process: https://www.socialsecurity.gov/oidap...Evaluation.pdf

RSD/CRPS is not a Listed Impairment but there was a ruling regarding it, so it's important to read as well: https://www.socialsecurity.gov/OP_Ho...-02-di-01.html

Thank you Lit Love. That helps a lot. I think I read the ruling and even informed my lawyer some time back, but I will make sure I read it again, as well as read through the other link you posted.

I think I may have just had a functional capacity evaluation done today as part of my psychological evaluation for the SCS trial, but I am not entirely sure about that. I will ask both my lawyer, as well as the psychologist that I saw today to see if that was included in part of that evaluation today.

No, it was not a functional capacity evaluation today. I was originally supposed to have that done on January 10, 2015, at 7 am, but I had surgery the day before and was still in the hospital. They sent out a notice dated 12/23/2014, but were closed between Christmas and New Year. I finally reached somebody on the 5th of January to notify them that I had surgery scheduled for the day before and was still expected to be in the hospital. For some reason, it was never rescheduled. I will bring that up tomorrow with my lawyer.

Follow up on this
 

Dear Purple Foot,

I would recommend that you follow up on this since you still have time. This could make the difference in getting approval if the ALJ may be "on the fence".

I met with my lawyer yesterday to go over my case. I did ask about having a functional capacity evaluation done. His recommendation was to not have it done at this time. If there is a reason that we would need to contest the results there would not be enough time to do so and may hurt us if we go to an OT on a bad day or with little understanding of CRPS. I don't really understand why he would think we would need to contest it. I can not walk, stand more than 15 minutes and only assisted, lift more than light items conveniently placed, reach without loosing my balance, sit without having to find a way to elevate my foot above my heart every 15-20 minutes. I hate to go behind his back and have it done against his advise but I don't see how it would hurt. Would any of you recommend having it done anyway or should I stick with his advice?

He did give me a form to have my PM, PCP or Ortho fill out that he thought would be more useful called the RSD/CRPS Medical Source Statement. My PCP will not fill out forms, I have only seen my current PM once so my Ortho is going to help fill it out come the end of March. It was the earliest he could get me in. Is that too late? Am I breaking my contract with my current PM if I take it to my previous PM, who I only left when he asked me to find another PM when he ran out of treatment plans?

HELP:confused:

It's a tough call if you should go against your attorney's advice. I'd generally say no, but I personally think he's wrong in this case. Maybe try and explain that you don't have good days. (The law changed recently and attorneys must submit all medical documents now, where as in the past they would pick and choose what supported the case...)

The FCE can take place over a few or even several days if needed. I had to break up mine over several days. It's also a good way for the therapist to document how long it takes you to return to baseline pain levels.

I have RSD as well and my FCE validated how quickly my dominant hand begins the cycle of swelling and pain from any fine motor skills--like typing, writing, grasping paper, etc. My physical therapist used water displacement to measure the swelling that occurred after doing various office tasks. It resulted in my being given a RFC rating with only two potential jobs prior to my hearing. I received a bench decision with the ALJ deciding that my RFC rating was less than Sedentary.

a primary care physician who wont fill out forms is less than useless to someone with a disability who is trying to get SSDI and who will need forms filled out periodically even if you get a favorable decision at your hearing. when you get a chance find someone else to be your PCP who does fill out forms.

i dont know what your contract says, but i dont see why it would be violated by having a form filled out by your former PM based on observations and information gathered while you were his/her patient.

Usually you're only in violation of a pain contract for seeking narcotics from another doctor.

ahh! Thank you Lit Love. I was not sure about that, but was going to ask my new PM on Tuesday about that.

Hi Purple Foot,

I believe a Medical Source Statement covers a lot of the same information that would be on a residual function capacity.

Is the Medical Source Statement designed by your attorney or is it a standard format?

If it is tailored to YOUR condition(s), that will be helpful, instead of a Medical Source Statement that is too generalized to properly depict your limitations.

I am a little concerned that an Ortho would be the only one you can get to complete the Medical Source Statement. Would he be aware of all your limitations? Can he speak about areas outside of his specialty that affect you?

I would definitely get the Medical Source Statement completed. Have the physician give it to YOU, and if you think it beneficial, pass it along to your attorney. If it does NOT support your case, then keep it to yourself. I say this based upon the post that your attorney MUST submit all documentation he has received regarding your medical condition.

That may not be good advice, but that is what I would probably do. There is a catch there, too. If the physician completing the form (Medical Source Statement) keeps a copy of it in your file, (which he probably will), then it may be obtained by SSDI without your submission to your attorney. On your application, you have agreed that SSDI may contact your physicians and obtain your medical records.

Talk with the physician about the medical source statement before he actually completes it, to be sure he is on board and supportive, so you don't have something written in your file that may harm your case.

The statement that was given to me does not look like one that was created by my attorney. Looking at it, it has a copyright on the bottom from someone outside of my lawyers office for patients going for SSDI. It is intended for patients with CRPS/RSD so it is based on my limitations.

The reason I figured my orthopedic surgeon would be the best doctor to fill it out is... He is the one who originally thought it might be CRPS and recommended I see a PM. The pain management doctor that I first saw, and treated me for the first few months and who gave the original CRPS diagnosis is a colleague of his that works in his office, so he has records of the diagnostic criteria that I met and still meet. He has full records of my progress and continuing treatment even those away from his office. He is the only one that has stayed with me from day one. He is trying to help me as much as he medically can so he is keeping a close eye on how I am progressing or I should say, not progressing.

If it was not for everything listed above, I would have made an appointment with my previous pain management doctor to have him fill out the form. I just felt my orthopedic surgeon was a better choice.

Hi Purple Foot,

From your post, it sounds like your ortho is IDEAL for completing the medical source statement. I am so glad to hear that he is supportive and willing to help you.

Also glad to hear that your medical source statement is tailored to YOUR medical condition.

I have seen many of the medical source statement forms for various conditions and I think this will be of great help in your claim.

ONE word of caution. These forms are sometimes ambiguous in their wording. One area on mine was understood by both my physician and myself to mean one thing and I discovered that it was NOT what either of us thought. We had to answer that area differently once we discovered the ambiguity.

If I can remember to do so, I will look it up and pass along the way SSDI looks at that question versus the way it "reads".

You may want to go over the questions one by one with your attorney BEFORE you have your ortho complete it so that your doc does not make the same mistake we had to fix.

Most of the statement form is straight forward but there are a few spots that can be misleading in the way it is worded.

If I don't get back to you, PLEASE send me a PM to remind me. I want to help but I forget to do things if I don't write it down and put it on my "to do" list.

Just a word of warning, you aren't allowed to pick and choose which medical documentation you provide SS with. You must submit everything, not just what looks favorable. The new rule was passed within the last year.