Reflex Sympathetic Dystrophy (RSD and CRPS) Reflex Sympathetic Dystrophy (Complex Regional Pain Syndromes Type I) and Causalgia (Complex Regional Pain Syndromes Type II)(RSD and CRPS)

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Old 02-06-2015, 09:11 PM #1
Always_Believe Always_Believe is offline
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Originally Posted by Littlepaw View Post
Glad to hear you got in with a PCP. I hope the gabapentin, amitriptyline combo brings you some relief. I find nortriptyline helpful. My neuro prefers it, saying it has fewer side effects. If the amitriptyline makes you feel bad you could always try a different TCA. At least now you might get some good sleep and we know that helps everything.

Keep hanging in there,
Littlepaw
Thank you! Anything is worth a try at this point!!
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Old 02-06-2015, 09:51 PM #2
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Just to be clear SS doesn't ever request a FCE, but when you have a diagnosis that most ALJs will have very little experience with, evidence of specific functional limitations can be a major asset--at least that was my experience.

Some doctors will fill out RFC forms without a FCE, but it certainly helps with your documentation.

http://www.disabilitysecrets.com/rfc...statement.html

In regards to your AOD, you certainly don't need to change it to reflect receiving a diagnosis. I'm not sure how familiar you are with the Grid Rules, if at all? Basically there are three ways to be approved. 1)Meet an Impaired Listing 2)The 5 step process 3)Via the Grid Rules. It can be much easier qualifying for the Grid Rules at 50 (and easier still at 55) than going through the 5 step process (which is how you were just denied.)

So long as you can prove your skills are not transferable, you no longer have the burden to prove you can't perform SGA at any job, so long as your AOD reflects your 50th bday (or possibly 6 months before your 50th bday at an ALJs discretion.)
http://www.disabilitysecrets.com/top...grid-rules-age

In my personal opinion, an ALJ is going to want to see extensive medical documentation AFTER you've been diagnosed. (By the time you appeal and hopefully receive a remand to the ALJ, you'll have time to do just that.)

You might have to decide if the fight for extra backpay is worth further delaying approval. I'm just trying to give you fair warning now.

What your doctor said to you in person will not necessarily match what is in his or her notes, as I'm sure you know. With your background you're in a much better position to self advocate than most patients.

Good luck.

Last edited by LIT LOVE; 02-06-2015 at 09:59 PM. Reason: clarification
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Old 02-06-2015, 10:55 PM #3
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Well I'm still over a year away from 50, so that part is out. My primary goal is/was/has been/forever will be to get back to work. I began bawling like a baby at the doctors office today simply because all I want is my life back!
I guess I assume that when functional ability is discussed it's actually put into your records. I'm finding that is not the case. Any suggestions on how to ensure it is included??
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Old 02-07-2015, 12:17 AM #4
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Originally Posted by Always_Believe View Post
Well I'm still over a year away from 50, so that part is out. My primary goal is/was/has been/forever will be to get back to work. I began bawling like a baby at the doctors office today simply because all I want is my life back!
I guess I assume that when functional ability is discussed it's actually put into your records. I'm finding that is not the case. Any suggestions on how to ensure it is included??
You telling the doctor what you are no longer capable of and him noting it is vastly inferior to going through a FCE.

When I went through a FCE it helped prove that when I perform fine motor skills with my dominant hand it starts the cycle of pain and swelling within just a few minutes. My physical therapist used water displacement to measure my swelling after certain intervals. What should have taken a few hours in one day to complete had to be spread out over several days because I begin to flare with any activity. When my range of motion and grip strength was tested only once, they were within normal ranges, albeit substantially lower than before I developed RSD/CRPS. When those tests were repeated at both short intervals and longer intervals, my function dropped off substantially. This backed up what I had self reported and what a family member had written in her questionnaire for SS.

You want to get as much medical evidence added into your record up until you file your appeal. Even if the AC does not review the new evidence, it's apparently a loophole that it will be included in your record if you have to pursue your claim to federal court.

By the time you receive a decision from the Appeals Council and receive a new ALJ hearing, you'll very likely be past your 50th bday. (Assuming you receive a remand, of course.) You won't be far enough past it to accrue very much backpay if you decide to amend the AOD though, and so your attorney might not encourage it--just something to keep in mind. You really need to be prepared that even in a best case scenario, and you do receive a Fully Favorable Decision, it could be a year or even two before you receive any benefits. The Appeals Council very rarely issues a Fully Favorable decision.

Returning to some type of work should of course be your goal. Whether or not that is realistic, is another matter. If you utilize the services of a Vocational Rehab Counselor, he or she might be able to help determine if that's a possibility--they will send you out for testing if needed. In some scenarios there might even be help with living expenses while training. You'd also potentially have access to jobs that would attempt to accommodate your special needs.

Depression is absolutely a component of RSD/CRPS. And not only are you trying to deal with a devastating diagnosis, you also moved recently and have the financial complications of being disabled and not working. These are individually incredibly stressful. Combined together it can be overwhelming. I highly recommend seeing a pain psych doc, even if only temporarily.

Last edited by LIT LOVE; 02-07-2015 at 12:33 AM.
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Old 02-07-2015, 11:56 AM #5
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Quote:
Originally Posted by LIT LOVE View Post
You telling the doctor what you are no longer capable of and him noting it is vastly inferior to going through a FCE.

When I went through a FCE it helped prove that when I perform fine motor skills with my dominant hand it starts the cycle of pain and swelling within just a few minutes. My physical therapist used water displacement to measure my swelling after certain intervals. What should have taken a few hours in one day to complete had to be spread out over several days because I begin to flare with any activity. When my range of motion and grip strength was tested only once, they were within normal ranges, albeit substantially lower than before I developed RSD/CRPS. When those tests were repeated at both short intervals and longer intervals, my function dropped off substantially. This backed up what I had self reported and what a family member had written in her questionnaire for SS.

You want to get as much medical evidence added into your record up until you file your appeal. Even if the AC does not review the new evidence, it's apparently a loophole that it will be included in your record if you have to pursue your claim to federal court.

By the time you receive a decision from the Appeals Council and receive a new ALJ hearing, you'll very likely be past your 50th bday. (Assuming you receive a remand, of course.) You won't be far enough past it to accrue very much backpay if you decide to amend the AOD though, and so your attorney might not encourage it--just something to keep in mind. You really need to be prepared that even in a best case scenario, and you do receive a Fully Favorable Decision, it could be a year or even two before you receive any benefits. The Appeals Council very rarely issues a Fully Favorable decision.

Returning to some type of work should of course be your goal. Whether or not that is realistic, is another matter. If you utilize the services of a Vocational Rehab Counselor, he or she might be able to help determine if that's a possibility--they will send you out for testing if needed. In some scenarios there might even be help with living expenses while training. You'd also potentially have access to jobs that would attempt to accommodate your special needs.

Depression is absolutely a component of RSD/CRPS. And not only are you trying to deal with a devastating diagnosis, you also moved recently and have the financial complications of being disabled and not working. These are individually incredibly stressful. Combined together it can be overwhelming. I highly recommend seeing a pain psych doc, even if only temporarily.
This whole SSDI confuses the crud outta me! I think with my initial app, they determined my MDI was not severe enough to prevent SGA. I believe that is in part to MD documented (undocumented) severity levels as well as omission of function (good, bad or indifferent). My PT records were not requested or reviewed. THOSE would have shown/documented my function (or lack thereof) as well as my intermittent swelling/inflammation/pain. At any rate, I am working on compiling every document I can to submit with my initial reconsideration/appeal.

I am working on obtaining a pain management referral. One of my close friends sees PM psych, so I might see about getting a referral to the doc she sees to coordinate the depression aspect. I'm certain I will include that added diagnosis as well as the RSD diagnosis on reconsideration request.

My biggest confusion comes in with regard to Function Report and FCE. While I was sent a work history report to fill out, I was not sent a Functional Report. I'm not sure if I should just print one out, fill it out & send it in with my reconsideration or wait for them to send me one. As for the FCE, I imagine none was requested because of the aforementioned conclusion on severity of MDI. Perhaps I should request another EMG/NCS as well. Ugh.
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Old 02-07-2015, 12:52 PM #6
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Quote:
Originally Posted by Always_Believe View Post
This whole SSDI confuses the crud outta me! I think with my initial app, they determined my MDI was not severe enough to prevent SGA. I believe that is in part to MD documented (undocumented) severity levels as well as omission of function (good, bad or indifferent). My PT records were not requested or reviewed. THOSE would have shown/documented my function (or lack thereof) as well as my intermittent swelling/inflammation/pain. At any rate, I am working on compiling every document I can to submit with my initial reconsideration/appeal.

I am working on obtaining a pain management referral. One of my close friends sees PM psych, so I might see about getting a referral to the doc she sees to coordinate the depression aspect. I'm certain I will include that added diagnosis as well as the RSD diagnosis on reconsideration request.

My biggest confusion comes in with regard to Function Report and FCE. While I was sent a work history report to fill out, I was not sent a Functional Report. I'm not sure if I should just print one out, fill it out & send it in with my reconsideration or wait for them to send me one. As for the FCE, I imagine none was requested because of the aforementioned conclusion on severity of MDI. Perhaps I should request another EMG/NCS as well. Ugh.
SS will not ever request you undergo a FCE. They will also not request your docs fill out RFC forms. (RFC forms WERE part of the application in the past.) You can submit this information nevertheless. I don't remember SS having a "function report". They do request information about your "Activities of Daily Living" though. http://www.disabilitysecrets.com/res...ily-living.htm

I was confused, btw! I thought your denial letter was after an ALJ hearing. Sorry about that. Some of my earlier posts don't apply now! The Grid Rules will likely come into play if you end up at an ALJ hearing.

It was unlikely for you to be approved at the first stage because you don't meet an Impairment Listing. In theory, the adjudicator can rule in your favor if your impairment/s "equal" a listing.

Have you read the Blue Book? If not, THIS SHOULD BE THE PLACE YOU START: http://www.ssa.gov/disability/profes...ltListings.htm
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Old 02-07-2015, 02:01 PM #7
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Quote:
Originally Posted by LIT LOVE View Post
SS will not ever request you undergo a FCE. They will also not request your docs fill out RFC forms. (RFC forms WERE part of the application in the past.) You can submit this information nevertheless. I don't remember SS having a "function report". They do request information about your "Activities of Daily Living" though. http://www.disabilitysecrets.com/res...ily-living.htm

I was confused, btw! I thought your denial letter was after an ALJ hearing. Sorry about that. Some of my earlier posts don't apply now! The Grid Rules will likely come into play if you end up at an ALJ hearing.

It was unlikely for you to be approved at the first stage because you don't meet an Impairment Listing. In theory, the adjudicator can rule in your favor if your impairment/s "equal" a listing.

Have you read the Blue Book? If not, THIS SHOULD BE THE PLACE YOU START: http://www.ssa.gov/disability/profes...ltListings.htm
Okay, what is an RFC? And how do I go about that? How do I get my doc to fill out an FCE? Is that form available online to download?

From my understanding of my denial letter (from initial app), I do meet one of the impairment diagnoses. Just was not evaluated to prevent me from SGA (most likely due to not enough information regarding my functional limits). I never got anything specific to ADL's, only what was on the initial app. And now I have 2 more diagnoses to add.

As for the Function Report, I found it online when looking into the reconsideration/appeal procedure. I downloaded it and have been working on filling it out/re-filling it out/going over every little thing I can/cannot do. I think I read where ssa used to send it out regularly with work history report. Perhaps they still do but did not feel it warranted in my case due to the omission of functional capacity in the documents they received.
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