Definitely confusing!! I am still trying to figure this all out! I guess my thought was with the "The medical evidence in file shows that your condition does cause some restrictions..." statement on my denial letter, I have a MDI that just per documentation does not meet the severity SSA is looking for.

The diagnosis on my initial app did not include RSD/CRPS, only patella fracture, meniscus tear & peroneal nerve damage. I will be adding the depression and RSD to my reconsideration request.

But if I amend AOD to when I turn 50, first of all: I don't even turn 50 for another year and a half; secondly: how is that even possible???


So my doctor's office has access to the RFC forms? Or do I download/print them and take them to the doctor? If I download/print them, are they found on the SSA site?
I can certainly make an appointment with my TN ortho for a follow-up/re-check visit if that helps the longevity of care. Sadly, I could no longer afford $2300/mo for COBRA or travel 500+ miles for continued care. I, too, hate the lapse in care.

It was knee surgery and considering I subsequently underwent surgery (performed by a different ortho) for that same diagnosis (given by the ortho that erroneously documented I 'refused'), does that factor at all? Would that be something I can discuss with ALJ? I actually told the first ortho I would "do whatever it takes to get my life back", a sentence I continue to repeat today. I would much rather be doing what I have loved and wanted to do since I was 5 years old than have my daughter on stand-by when I shower & help me get my pants on.

Currently, there has been no surgical recommendation for my nerve damage. PT has been recommended/ordered and performed. I actually purchased a recumbent bike to work on my quad strength at home, but without a current MRI to determine if there is new injury or not, I am reluctant to potentially cause more damage.

Finally getting a PCP and an ortho referral, I am hopeful I will be able to obtain updated records within the 60 day time frame for reconsideration. Failing that (since you are so knowledgeable & helpful ), would I submit a new application with AOD reflecting the peroneal nerve damage diagnosis (4/2014) or the RSD diagnosis (2/2015) (which would definitely take more time to determine 12 months or more) or both/all?

My apologies for such a lengthy post and the ongoing continued questions. And many many thanks for your assistance!

No problem!

I am feeling so alone on so many fronts here and I appreciate your help so much! I almost feel like understanding the SSDI stuff is going to require way more work than my care (we have already come up with some solutions, but I am terribly worried my daughter-who has been my biggest help-will run off with her boyfriend who is of the mindset that I "can do stuff when I want to.

"This confuses me a bit but what I believe you are saying is the lapse in seeing an MD is my downfall. So the fact that I could not afford an MD until such time as I did see one (and received the diagnosis at that visit) will not really come into play with my appeal...???"

It's MOST LIKELY your downfall for a fast approval IMO. There are certain illnesses where this is not the case--pretty much those that qualify as Impairment Listings found in the Blue Book, and this is why it can get confusing. You have a different set of requirements. Assuming your biggest current health issue is RSD/CRPS, you're newly diagnosed with no history of how you'll respond to meds or treatment. If you do a good job of documenting your case between now and your ALJ hearing, it's totally conceivable that you could receive a Fully Favorable decision and receive backpay to your Alleged Onset Date.

If you are still on crutches and can not walk without them, that MIGHT be a game changer for a faster approval.

"With a new app after I turn 50, would I have the same AOD as it relates to my original app?"

No. You have to have an AOD on your 50th bday or later (or 6 months prior IF an ALJ allows it). So if you stick with your current application, and current AOD, the standard for approval will not decrease. (An ALJ doesn't actually need your permission to change your AOD btw, but then it becomes a Partially Favorable Decision. So, most often the applicant agrees to the change, a Fully Favorable decision is made, and you are unable to appeal the older AOD.)

"Found the RFC forms (). Still confused about the FCE. Whom do I request that from? Is there a form I missed for that?"

You ask your doc if he or she feels a Functional Capacity Evaluation would be appropriate. If you undergo a FCE, the doc or pt will generate a report showing the results.

It is an incredibly difficult process. I don't mind contributing if I can help. If you choose to hire representation you still need to be involved, but to a lesser degree. Some attorneys are very good and you might want to check out local non attorney reps as well. Some attorneys will only look at your file half an hour before walking into an ALJ hearing--way too late to help you in many cases. Allsup has non attorney reps and they have a good rep for being hands on, which I think might make your life easier.

I received a Partially Favorable Decision for a closed period award where I had attorney representation, and then won a Fully Favorable Decision pro se several years ago. It's a good idea to have a rep in most cases...

Your daughter is probably just as likely to kick her bf out. How would he react if she has to face a devastating illness at some point? (I'm not sure I'd bring this up to her, but you get the point.) It is intrusive to be dependent financially and physically on anyone...

Be active about your treatment--both physical and mental. Go to a pain psych doc to help learn some strategies in coping with a permanent disability. Get food stamps if you're able (or food banks) and research any other financial programs you might qualify for. Do things to help around the house when you're feeling at your best. If it means getting up for 5 minute intervals to make dinner to help out, or fold laundry in bed, or make cookies as a surprise--great. You might want to check to see if there are any local housing options you might qualify for--even with long wait lists, it might be a good idea long term.

Own my home outright (property taxes are h3ll though), currently receiving food stamps and medicaid. As for doing stuff...this is where I am struggling the most. If I do anything longer than 15 minutes or multiple 15 minute sessions, I am in INCREDIBLE pain and about useless for 1-2 days following a day with that kind of physical activity due to the general pain, the burning and loss of function (I have no idea what my lower leg is doing or how to control it). To be fair, I did do a lot more when I had narcotics on board (or in a bottle to take at the end of the day) but of course, my PCP does 'not do narcotics' and refused a PM referral until it can be determined if the gabapentin/amitriptyline combo works...which by my math is not for another month. Maybe ortho will accommodate that end (if an ortho can even write a referral for PM)...or I will simply insist. Period.

You shouldn't be prescribed pain meds for a month to determine a baseline. I get it's tough.

If all you can manage is 5 minutes ata time, once an hour or every four hours, so be it.

I got the impression you were living in your daughter's home? Is your home sitting empty? You might consider renting it out if that's the case.

The month makes too much sense now..thank you.

I did quite a bit yesterday and have only been able to give 15-20 minutes total today. (Been 'holding it' for over an hour at this point because I don't want to move)

My daughter & her BF live in my house with me. My daughter has already helped considerably financially and so long as they are helping get the home suitable for me (was a foreclosure & needed some 'work' in addition to unpacking all the stuff from the move & repairing all the broken furniture-I'm never moving again), I am not charging them anything. Of course, neither one has gotten a job since we moved (my daughter because she thinks she needs to be here at all times for me, even if the assistance she offers is slim; her BF because he is doing the construction/handiwork stuff-he has his RN, however he voluntarily surrendered his license due to HIPAA issue).

Ugh! I am so sorry you are going through so much. Remember, you are one tough cookie. A thought on finances, not everyone would want to do this but in some situations it can be a big help...many counties have a program for people who cannot afford to pay their property tax due to disability. You have to do the requisite paperwork of course because on this program homeowners don't pay the tax so a lien is put on the home but does not get called in until the home is sold. Messes things up for passing the house on but as I said this does help some people in some situations. I have known of people doing when medical expenses overtook what they could pull off on limited income. God knows property taxes can eat a monthly budget. I don't know that you have to have approval on SSDI to get this. In our county you did not. Not every disabled person has it as we know. I hope things improve for you soon!

Sending Healing Love,
Littlepaw

Thanks Littlepaw. I have looked into my county's property tax assistance program. I do need some documentation of disability-either a disable person ID or SSDI and it's a very paltry amount. I think for mine, it's ~$250...my taxes are 3500/6 months...meh

Wow! That stinks. I would not have thought the program here was so much more generous than elsewhere. Austin likes collecting its dollars as much as anyone and taxes are regularly jacked up on account of the coolness factor affecting real estate. I guess the program there is not a lien program? I think the county here just figures they'll get it eventually...

hugs, Littlepaw