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canifindagooddr 07-09-2015 12:51 PM

Not yet. Thank you for providing it. I have it noted in my notebook to read it.


Quote:

Originally Posted by Hopeless (Post 1153848)
Did you read the link regarding PAIN that I listed for you? It goes into a lot of detail about how to deal with the subjectivity of pain.

Hopeless


LIT LOVE 07-09-2015 12:56 PM

Quote:

Originally Posted by canifindagooddr (Post 1153843)
You need to be prepared that this might be a very long process. You might need to consider moving in with family if you don't have another source of income.

^^^OK. Thank you for the tip. I cannot image how hard that would be on my girls AND me. My family is 2 to 3 hours away. But, I understand your point.

That is an unfortunate reality you may be forced with.

No, it does not appear your PN will qualify you with a Listed Impairment at this time. Becoming a klutz does not rise to the level of severity needed. The same thing with having body twitches a few times a day.

^^^Understood. But, the pain and weakness of my calves . . . hard to be nice and sweet and productive when one feels that their pain level is in a 6-8 range.

The standard is if you're capable of working at the Significant Gainful Activity level which is $1090 per month in 2015. If you can do that sitting at a desk, that's all SS will care about.


^^^I read an article from the NIH about small fiber neuropathy and the number one word is the article was PAIN. And I finally saw in print, what I have been dealing with for over two years now. "COLD PAIN".

I have RSD/CRPS so I understand something about pain.

Your current Neuro is increasing your meds to hopefully reduce your symptoms and give you the highest degree of function possible,

^^^My bro said the way he increased my GabaP was not correct. That it should have been gradually bumped up. Not a starting dose of 900mgs total for the day to 2,400 total for the day just six weeks later with no gradual build up. AND, this was with me calling in almost two months early than he had originally had me scheduled to come in. After the first visit, it was the 'see ya in three months' deal. After 3 weeks, the Gaba honeymoon was over and I was in to see him in six weeks rather than the 12 weeks that he had me down for.

You have a choice to find another doc.

^^^At the conclusion of yesterday's meeting, he had it in my charts to see him in SIX MONTHS! It is a two hour drive from my small town to see my shrink and my neuro. So, I try to 'double dip'. Stay the night with a friend. See one doc one day and see the other doc the other day. So, instead of six months like he put down on my chart - his nurse told the scheduler to put me down for a two month follow-up so we could do the double dip thing.

^^^Even my meeting yesterday - no change at all in meds. He tried to call my shrink while I was there with him. He could not speak with my shrink today. He said he would consult with my shrink and THEN they would change my meds. At least the AD I take. Makes since. But, all that really happened yesterday with the neuro was, "You got to have some talk therapy. We will try to help you find one in your area. AND, you STILL need to do LESS. Work for 15 minutes - rest for 30 minutes. Continue that pattern until bed-time.

If you're not seeing a mental health professional at least once a week, I highly doubt you'll be approved for BP disorder at the first stage. Why? Because SS will not consider the disorder severe enough to be disabling if you're not in active therapy.

^^^So, at this time - nothing in my meds have been changed.

that's not necessarily inconsistent with him thinking you may be capable of working.

^^^Understood. But there is that subjective area of PAIN. How is that handled?

SS will question how severe your pain is if you're not seeing a pain management doc or the equivalent.

The skin biopsy proves you have PN, not what your functional limitations are.

^^^Understood.

This might be a good time to request a referral for a Functional Capacity Evaluation. It will help provide your Neuro with objective test results regarding your abilities and limitations, as well as providing SS with the same.

^^^One has to walk at least a day in the shoes of the other to get an idea what the other's day is like. Is the above going to do that?

I underwent the testing I'm suggesting. They can determine your ability to function in an office setting over a day or even several days.

--And he is right, if he just guesses what he believes are your functional abilities, SS may or may not give it any weight. (Those forms your attorney asked your docs to fill out, and that were maybe even customized specifically for you, were probably a version of an RFC form.)

^^^Understood.

Did you give the Neuro a copy of the form that you had already filled in? If so, that was not a good idea IMO.

^^^I gave it to him as my brother suggested and I also told him he was free to throw it in the toss can if he so desired. I stated the reasons I gave them to him. Why do you think my bro's plan was a 'not a good idea'.

Just my opinion considering the circumstances.

BTW, it is possible SS will determine you are no longer capable of teaching PE due to your PN, and perhaps not teach any subject due to your BP disorder, but they might claim you are capable of a less stressful desk job.

^^^Which cannot be found . . . and if I sit for longer than an hour - my feet get naughty (painful). Remember neuro doc said MORE rest. That I do TOO MUCH. I said, 'all I do is pittle around my apt doing housework, paying bills, etc...

Less stressful desk jobs are certainly available, but you need to understand that you have to prove you're incapable of performing jobs as written in the D.O.T., not jobs in reality. You claim you can't sit for more than an hour without pain. You need to have medical documentation that you're not capable of sitting for more than hour.

In all my lengthy postings to you, the one thing I've forgotten to say is that qualifying for SSI/SSDI is a complex medical/legal evaluation.

^^^I understand.

One last thing, your brother can write a letter on your behalf, but unless he's a treating source, it will be the same as a letter from any other family member. His medical opinions might be 100% accurate, but they won't help you prove your SSDI claim, which needs medical documentation.

^^^Since I had him listed as a contact person, unbeknownst to me - they sent him a function report that is identical to mine . . .for him to fill out on me. He was not a 'happy camper' but he understands the importance of his filling it out in a timely manner and getting it back to SSA.[/QUOTE]

Those are 3rd party function reports typically sent to close family and/or friends. You need to keep in mind his opinion as a doc will not be of any help unless he's a treating source.

LIT LOVE 07-09-2015 12:59 PM

Quote:

Originally Posted by Hopeless (Post 1153840)
Now you have me a bit at a loss. Lit Love made NO mistake. She did mention that she was "capable" of one and that others would catch it IF one was to be made.

No one is perfect but when it comes to SSDI information, she is as close to that perfection as one can be and still be human.

The ONLY error I have seen in any post to this thread is my using your name and that has been corrected. I may have stated some things that were not applicable but Lit Love expounded and explained them for me.

Hopeless

I wish Janke still posted actively. I know enough to know how much I still need to learn, but thank you.

Hopeless 07-09-2015 02:49 PM

Quote:

Originally Posted by LIT LOVE (Post 1153869)
I wish Janke still posted actively. I know enough to know how much I still need to learn, but thank you.

Yes, it would be nice to have the added input from Janke. It would also help that you would not have to be the primary responder. Everyone needs a break now and then.

Enjoy your time away from NT for the next few days. Talk with you upon your return.

Hopeless

echoes long ago 07-09-2015 03:58 PM

cani your neurologist is very inconsistent which im sure you realize. he says you can work with pn but then tells you to rest more, work 15 minutes and rest 30 minutes. there are no jobs in the economy where that is possible.
Many people with PN are treated by neurologists or even GP's for pain since most people with pn are treated with antidepressants and anti seizure medicine for pain. Not many use opiates since they are of limited value in nerve pain and consequently dont wind up using a pain management clinic.

Hopeless 07-09-2015 04:09 PM

Pain
 
Quote:

Originally Posted by canifindagooddr (Post 1153863)
Not yet. Thank you for providing it. I have it noted in my notebook to read it.

It an applicant states PAIN is the debilitating factor preventing them from work, since it is subjective, a doctor must indicate that you have a condition that would reasonably cause that degree of pain.

It sounds as if the neuro does NOT think your objective skin biopsy results indicating SFN sufficient for your pain levels and will not support your pain levels. THAT is a problem.

It is not enough to have objective test results, you must also have support from a physician, that the pain levels you experience are reasonable for that condition.

I believe that everyone on NT that suffers with SFN will attest to the fact that their condition DOES indeed cause such severe pain. But if your physician does not support that, it is a problem. The ALJ is NOT a doctor, he is a judge.

Please read the link I provided regarding pain. I think you will find it very beneficial.

Hopeless 07-09-2015 04:18 PM

Echoes made me think about another point.

Echoes is right, many neuropathies are not treated with analgesics but with anti-seizure meds.

They will also look at your medications. If someone claims extreme pain but are not taking any type of medication for pain, that is a flag.

I can not tolerate oral pain meds. I have to use pain patches, otherwise, I get terrible nausea.

I made sure I stated that so there would be no questioning about why I was not taking any oral pain meds. My medication list was long but none were analgesic oral meds. I made sure my patches were listed.

Not everyone sees a pain mgt. doc, but if your claim is based upon PAIN due to a condition, having a pain mgt. doc would be a plus in my opinion.

I would probably have self amputated my leg had it not been for my pain mgt. doc.

canifindagooddr 07-09-2015 04:31 PM

Yes, I did. It was quite encouraging. I printed off several articles from that site. They teach these complicated topics in a style that works well with my mind. Thanks again! :)


Quote:

Originally Posted by Hopeless (Post 1153848)
Did you read the link regarding PAIN that I listed for you? It goes into a lot of detail about how to deal with the subjectivity of pain.

Hopeless


canifindagooddr 07-09-2015 04:40 PM

But, for neuropathies, the anti-seizure meds are what they use as a first line med for the controlling of neuropathic pain. So, I think I'll be OK with that. I have multi-health issues going on all the time. I have been under the care of shrinks for the last 8 years now. I have DX's for BP, OCB, GAD and ADD. It would appear that having worked 25 straight years of teaching elementary PE, plus my age (51) plus TONS of medical records on MANY conditions . . . Yeah. I feel a little better now. The KU doc is young and very inconsistent. I like him but . . .


Quote:

Originally Posted by Hopeless (Post 1153917)
Echoes made me think about another point.

Echoes is right, many neuropathies are not treated with analgesics but with anti-seizure meds.

They will also look at your medications. If someone claims extreme pain but are not taking any type of medication for pain, that is a flag.

I can not tolerate oral pain meds. I have to use pain patches, otherwise, I get terrible nausea.

I made sure I stated that so there would be no questioning about why I was not taking any oral pain meds. My medication list was long but none were analgesic oral meds. I made sure my patches were listed.

Not everyone sees a pain mgt. doc, but if your claim is based upon PAIN due to a condition, having a pain mgt. doc would be a plus in my opinion.

I would probably have self amputated my leg had it not been for my pain mgt. doc.


canifindagooddr 07-09-2015 05:00 PM

Quote:

Originally Posted by Hopeless (Post 1153915)
It an applicant states PAIN is the debilitating factor preventing them from work, since it is subjective, a doctor must indicate that you have a condition that would reasonably cause that degree of pain.

***I have multiple conditions that cause pain, and mental issues. And the mental issues feed into the pain/PN and a vicious cycle begins . . .

It sounds as if the neuro does NOT think your objective skin biopsy results indicating SFN sufficient for your pain levels and will not support your pain levels. THAT is a problem.

***As Echo pointed out - my KU doc is inconsistent. I understand it is a problem if he does not support me with PN and pain. But his big concern about my psyche might come in 'handy'. He was concerned enough when I visited him, that he talked to me about going to the ER . . . and getting my 'mind' checked out . . . additionally, he contacted a social worker who is suppose to be looking for a therapist for me here in my area. Finally, he said he is going to call my shrink . . . So, as far as my SSDI case goes, I can make my 'mind' be the 'cake', and PN and its pain making the cake worse -- is the 'frosting'. What do you think?

It is not enough to have objective test results, you must also have support from a physician, that the pain levels you experience are reasonable for that condition.

^^^I respectfully disagree. Two people can have the exact condition, yet one has been given the mental tools to deal with it well . . . and the other has not. Therefore, they experience their pain differently. The mind/body connection is real. There are plenty of stories about soldiers with SEVERE tissue damage . . . that felt no bad at all . . . .until months later, when the battle was over. And then still . . .some with severe tissue damage did not do well with pain . . . and others . . . with an injury of equal severity did.

I believe that everyone on NT that suffers with SFN will attest to the fact that their condition DOES indeed cause such severe pain. But if your physician does not support that, it is a problem. The ALJ is NOT a doctor, he is a judge.

^^^I agree with you 100%. I hope he 'falls out of bed, and bumps his head' and reflects back a bit and thinks/says, "Hey . . . what in the world was I doing telling that person that he could work and comparing to hundreds of my others patients. I need to think about this some more. Maybe I came to a wrong conclusion. I am young (38). I have never walked a day in his shoes. And . . .didn't they teach me in med school about people having different tolerances for pain...." I am very unfortunate and disappointed about his current position. Maybe, over time, he'll change it. If my case goes before a Judge, I will have plenty of articles about PN and SNF in particular . . . that show that its most common symptom is PAIN. Often times SEVERE pain. I already got one like that from the NIH.gov site.

Please read the link I provided regarding pain. I think you will find it very beneficial.

^^^Yes, I did. Thank you so much for providing that. I really appreciate it!

canifindagooddr 07-09-2015 05:02 PM

And what of his comment that 'many people with PN work'. What has been your experience with that? The few PN people I know, are all on disability. Thanks.


Quote:

Originally Posted by echoes long ago (Post 1153912)
cani your neurologist is very inconsistent which im sure you realize. he says you can work with pn but then tells you to rest more, work 15 minutes and rest 30 minutes. there are no jobs in the economy where that is possible.
Many people with PN are treated by neurologists or even GP's for pain since most people with pn are treated with antidepressants and anti seizure medicine for pain. Not many use opiates since they are of limited value in nerve pain and consequently dont wind up using a pain management clinic.


canifindagooddr 07-09-2015 05:08 PM

OH my . . . back to the find a 'good neurologist' game . . . I hope instead, over time, he changes his mind. I know, the chance of that are about as likely as me beating Michael Jordan in a game of one on one basketball. Like echo and I have pointed out -- work 15 minutes, rest 30 until bed . . . .his treatment plan . . . how can I hold down a job with a treatment plan such as his current one? My thoughts are . . . he gets me good enough to work full time . . . maybe that takes a whole year . . . then I get another year to do PT and what not to make sure everything is really ready to get back into the 'system'. I know . . . dreamer boy . . . I don't see shrinks for the fun of it. :confused:


Quote:

Originally Posted by LIT LOVE (Post 1153868)
^^^Since I had him listed as a contact person, unbeknownst to me - they sent him a function report that is identical to mine . . .for him to fill out on me. He was not a 'happy camper' but he understands the importance of his filling it out in a timely manner and getting it back to SSA.

Those are 3rd party function reports typically sent to close family and/or friends. You need to keep in mind his opinion as a doc will not be of any help unless he's a treating source.
[/QUOTE]

echoes long ago 07-09-2015 08:07 PM

there are many people with mild pn who do work and may have very few symptoms and as little as one area of the body affected. once you get to the moderate level, there are many more people not working and severe, it would be very difficult to hold down the most sedentary job. what is the cause of your PN, do you know? Depending on the cause and the treatment, PN may not progress, may progress slowly or may progress rapidly. there is no way of knowing. however after having it now 14 years, the success stories are few and far between. rest may lessen you pain but it wont cure you. the types of PN that may stay the same or improve include vitamin deficiencies, from chemo therapy, diabetes (sometimes), or nerve impingement. if you have had it more than two years the chances of you getting better are very very slim.

Hopeless 07-09-2015 08:55 PM

Devil's Advocate again
 
Quote:

Originally Posted by canifindagooddr (Post 1153923)
But, for neuropathies, the anti-seizure meds are what they use as a first line med for the controlling of neuropathic pain. So, I think I'll be OK with that. I have multi-health issues going on all the time. I have been under the care of shrinks for the last 8 years now. I have DX's for BP, OCB, GAD and ADD. It would appear that having worked 25 straight years of teaching elementary PE, plus my age (51) plus TONS of medical records on MANY conditions . . . Yeah. I feel a little better now. The KU doc is young and very inconsistent. I like him but . . .

Here I go again with the devil's advocate..... OK, if you have had the mental conditions for 8 years and were working during that time, then those conditions do not prevent you from being able to work.

From what I have read in your posts, it is actually the PAIN of SFN that has put you over the top and exacerbated the other conditions. So you are still stuck with all the issues that come with documenting the condition that has caused your pain and then exacerbated your other conditions.

If all I had was some paperwork in front of me as an employee of SSDI that documented your mental conditions during a time period while you were working full time and now pain without a doctor treating you for the condition that causes you the pain substantiating the reasonableness of it, I would not be inclined to approve you at the initial stage.

They may not deny you, but instead send you to their physicians for evaluation. Just a thought.

Hopeless 07-09-2015 08:59 PM

Medical records
 
Quote:

Originally Posted by canifindagooddr (Post 1153934)
OH my . . . back to the find a 'good neurologist' game . . . I hope instead, over time, he changes his mind. I know, the chance of that are about as likely as me beating Michael Jordan in a game of one on one basketball. Like echo and I have pointed out -- work 15 minutes, rest 30 until bed . . . .his treatment plan . . . how can I hold down a job with a treatment plan such as his current one? My thoughts are . . . he gets me good enough to work full time . . . maybe that takes a whole year . . . then I get another year to do PT and what not to make sure everything is really ready to get back into the 'system'. I know . . . dreamer boy . . . I don't see shrinks for the fun of it. :confused:

Those are 3rd party function reports typically sent to close family and/or friends. You need to keep in mind his opinion as a doc will not be of any help unless he's a treating source.

[/QUOTE]


Do you have a copy of the medical records of the neuro that talks out of both sides of his mouth? What did he WRITE in your chart? What he says to you does not matter if it is not written in your records. If he has charted that he feels you are not in pain, SS has a copy of that if you listed him as a treating physician. You and your attorney will need to address that.

LIT LOVE 07-09-2015 09:10 PM

Quote:

Originally Posted by canifindagooddr (Post 1153923)
But, for neuropathies, the anti-seizure meds are what they use as a first line med for the controlling of neuropathic pain. So, I think I'll be OK with that. I have multi-health issues going on all the time. I have been under the care of shrinks for the last 8 years now. I have DX's for BP, OCB, GAD and ADD. It would appear that having worked 25 straight years of teaching elementary PE, plus my age (51) plus TONS of medical records on MANY conditions . . . Yeah. I feel a little better now. The KU doc is young and very inconsistent. I like him but . . .

The last 8 years of treatment won't be a real factor. Why? Because you were able to work until 6 months ago. SS will look at med records going back 1 year from your AOD for the PN and 2 years for the BP disorder. If you're claiming your mental health is severe enough to prevent you from working, SS will expect you to be seeing a mental health professional frequently--I would say once a week is the norm.

BTW, very few pain mgmt docs are willing to prescribe narcotics anymore. Your neurologist might be providing adequate pain management, but if you're saying you are frequently hitting an 8 out of 10 on the pain scale, that doesn't seem adequate.

You might also consider seeing a pain psychologist.

canifindagooddr 07-09-2015 09:37 PM

The pain for the SFN is being treated with GabaP. Prior to that it was compression stockings, prescription creams, custom-made orthotics, etc. etc. Cause it unknown and it has been with me for over two years so according to echos . . . the chances of me getting better are very small . . .


Quote:

Originally Posted by Hopeless (Post 1153971)
Here I go again with the devil's advocate..... OK, if you have had the mental conditions for 8 years and were working during that time, then those conditions do not prevent you from being able to work.

From what I have read in your posts, it is actually the PAIN of SFN that has put you over the top and exacerbated the other conditions. So you are still stuck with all the issues that come with documenting the condition that has caused your pain and then exacerbated your other conditions.

If all I had was some paperwork in front of me as an employee of SSDI that documented your mental conditions during a time period while you were working full time and now pain without a doctor treating you for the condition that causes you the pain substantiating the reasonableness of it, I would not be inclined to approve you at the initial stage.

They may not deny you, but instead send you to their physicians for evaluation. Just a thought.


LIT LOVE 07-09-2015 09:37 PM

Quote:

Originally Posted by Hopeless (Post 1153897)
Yes, it would be nice to have the added input from Janke. It would also help that you would not have to be the primary responder. Everyone needs a break now and then.

Enjoy your time away from NT for the next few days. Talk with you upon your return.

Hopeless

Echoes, and Mz. Migraine help out as often as I do and are as knowledgeable. Janke was in a league of her own, no disrespect to anyone. I'm impressed with how much you've picked up, btw!

Hopeless 07-09-2015 10:23 PM

I sure did not mean to slight Echoes and Mz. Migraine. Earlier in the thread, Lit Love was the only one posting responses.

Thanks to you, too, Echoes.

Speaking of Mz. Migraine, is she around? Hello to you, if you read this post.

And Hi to you, too, Echoes.

LIT LOVE 07-09-2015 10:51 PM

Quote:

Originally Posted by Hopeless (Post 1153998)
I sure did not mean to slight Echoes and Mz. Migraine. Earlier in the thread, Lit Love was the only one posting responses.

Thanks to you, too, Echoes.

Speaking of Mz. Migraine, is she around? Hello to you, if you read this post.

And Hi to you, too, Echoes.

I didn't get the impression that you were slighting anyone at all, I just wanted to spread the love was all.

And of course I overlooked the Admins, who are the most generous with their time... Whoops!

Mz. Migraine is hopefully on vacation or doing something fun....

Sorry to get off track, you were posting about me the way I used to post about Janke and it reminded me how much I miss her presence here.


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