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| Scales of Justice |
SSDI and Their Expert Witness
Make sure you doctor is documenting what you say in your medical
record. Don't assume anything.
What the SSA wants to see is how illness affects your ability to
function and with objective measurable criteria.
- What is your cognitive-neuro score? This is a grueling all day tests
that measures your cognitive deficit and is administered by a credentialed
forensic specialist psychologist.
- How does altered sleep interfere with your ability to copy with
everyday things?
- How long does it take you to prepare for work?
- What is your life like at work?
- Is your work willing to make accommodations?
- Have you had to make adjustments to your work schedule in order to cope
with the pain and fatigue?
- What is your work record like, are you unable to make it many days, and
if so, why?
Excerpt from Integrative Therapies for Fibromyalgia, Chronic Fatigue
Syndrome and Myofascial Pain. Read more
here.
The ALJ may request expert testimony from medical and vocational
experts. These “experts” may or may not have firsthand knowledge of [FM, CFID, myofascial
pain, systemic Lupus, RSD/CRPS, Lyme’s disease, GWS, or other invisible illness.] In my experience, finding a doctor who is
aware of these conditions was difficult, so you can well imagine the knowledge
base of the ALJ’s “expert witness.” The laws protect the claimant to some
extent in that the ALJ must give more weight to the opinion of the claimant’s
treating doctor than to the opinion resulting from a one-time medical exam
requested by SSA or their team. However, the judge’s expert witnesses have more
impact on the ALJ’s decision when the claimant’s physician has not adequately
addressed and documented key issues in the claimant’s medical record. This is
why it is so important to make sure your medical records reflect the continuing
disabling effect of chronic pain.
WINNING A SSDI APPEAL
Getting Turned Down—What Next?
Book excerpt from “Approaching the System Systematically”
Your denial letter will most likely suggest you do some specific type
of simple, sedentary work. The SSA gets their suggestions from the Dictionary
of Occupational Titles and their suggestion may have little or no relevance to
your claim. If you disagree with the decision, you can request a review, called
an “appeal.” There are certain guidelines for filing the appeal, so be sure to
verify information with the Social Security Administration.
Here is a link you might find helpful. http://www.ssa.gov/pubs/EN-05-10041.pdf
IF YOU ARE IN APPEAL, you need a good attorney. I hear over and over
again from people who lose at this stage, they are not happy with their legal
representation. Your attorney needs to understand what your illness is, the repercussions,
other issues, and how they all come together to affect your ability to
function. Educate them.
How do you make it through a day? How many hours to you have to care
for the unpredictability of it all. Day by day, moment by moment we are held
hostage by our symptoms.
Explain this in a daily diary; buy a calendar at the $1 store and
document symptoms, treatments, medications, and whether or not they work. Photo
it and get it into your medical record and give a copy to your attorney. Let
them see, make them see, what it is to walk a day in your shoes.
Even though you may have a SSA qualified illness, your application for
SSDI benefits can turned down. They based their decision not on your diagnosis
but on your ability to function, or more sadly, the lack of documentation.
If you have brainfog, get that neurocognitive exam.
My doctors saw me holding on to work by my fingernails. I did not go
down easily. I cut my hours, changed gears, until I had to face the grim
reality. The majority of us have stumbled down this road, quite literally. The
SSA does take stock in what your personal doctors have to say. Make sure they
say it.
If you lose at this level, don't give up! Remember, get your
documentation in order, and consider hiring another attorney if yours is
unfamiliar with our illnesses. Most work on commission and their fee is capped.
There is an entire section in the book devoted to SSA filing, documentation, what to expect, etc. The book has many
documentation tools throughout to help you explain your condition and needs,
painting a picture for your physician to help in his assessment. Using the
forms will also get the information in your medical record. Make sure you physician
puts the help sheets in your record where it belongs. It will help him/her save
time and validate to the powers that be, why the treatments and medications are
given, etc., and explain what it is like to be in your body.
When defeat comes, accept it as a signal that your plans are not sound,
rebuild those plans,
and set sail once more toward your coveted goal."
--Napoleon Hill
Final Tips:
- Always be truthful
- Document everything, even your conversations with SSA (you won't remember, but they will)
- Explain what it is like on your worst day (I recommend having someone help you fill out the paper work during these periods, as most likely you will not be able to. It is human to dismiss how bad things are on a bad day when you are having a good one. This is what your life is like, explain it in no uncertain terms, it is difficult for those who do not experience our pain and fatigue to know what it is like).
Other links you might find helpful:
From my website - When pain and disability is life limiting. The Seven
Rules, here.
Social Security Application
http://www.socialsecurity.gov/applyfordisability/
SSA Listing of Impairments (Blue Book)
SSA Listing of Impairments Part A
SSA Listing of Impairments Part B (Childhood)
Fibromyalgia Residual Function Questionnaire
http://www.docstoc.com/docs/16448838/Fibromyalgia-Residual-Functional-Capacity-Questionnaire-_without
You can find the book at all major retailers. There is a synopsis on the book and links for purchase. though it was written with specific patients in mind, 80% of the material can apply to anyone living with invisible illness. In healing and hope, Celeste
All answers and
blogs are based on the author's opinions and writing and are not meant to
replace medical advice.
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