Applying for Social Security Disability (SSI/SSDI)

[KitCat]

I believe that social security looks at severity of condition. If cognitive issues are found to be "severe" by ssa that could be a great help. If they are moderate, then they will look at everything in combination.

please excuse my memory here, did you get a physical rfc from your doc as well?

 

[Clerner]

@KitCat yes, I got the specialist fibro dr to fill out rfc. It was for pain, fatigue, dizziness, muscle spasms, and cognitive impairments.

I still can move just fine and did all the things my ce dr asked me to do, but I have terrible throbbing pain so it's just hard to prove.

I am expecting a denial, but will go to a lawyer.

 

[KitCat]

great. did your rfc form have functioning information - like ability to walk, lift, stand, stoop, etc?

 

[Clerner]

Yes, walk short distances with frequent stops, not standing for more than 1-2 hrs, not lifting more than 5lbs, trouble bending to floor ( sometimes I get dizzy, but was able to do it at ce exam.
I hope your right, and they take that info into account vs. just moving/lifting body parts at exam.

 

[KitCat]

great! the official social security policy is that they are supposed to give more weight to your treating physician.

if the person who filled out the form is a doc you were seeing regularly, then they are supposed to treat that as more important. If they are a doc you had only seen a few times, then they are supposed to treat that as equal to the CE.

of course social security does not always follow their own policies, but that is how it is supposed to work and how it usually works.

I am very glad you got that rfc. well done.

 

[KitCat]

I have added another step. I am trying to update this a little every day. Suggestions/corrections welcome...


Ten Steps To Winning a Social Security Claim for Chronic Fatigue Syndrome
(SSI & SSDI)

Step One: Make sure you have the right kind of doctor

• Social Security is very particular about what kind of doctor they would like you to see.
• Here's how to figure out if your doctor is the right kind of doctor.
• A CFS specialist is great! But not required. Many areas do not have CFS specialists. Some online articles state that you must have a CFS specialist, but this is not the Social Security policy.
• Important: Social security would like you to see your doctor "frequently" and "ongoingly."

Step Two: Make sure your doctor supports your application

• Here's a list I put together of Best ways to talk to your doc about your disability ap
• Here's some ideas for What to do if your doc is not totally supportive
• It helps if you can figure out Why your doctor might not be supportive
• If your doctor still does not support your claim, please consider changing doctors. Finding a supportive doctor can make a huge difference. It is very difficult to win a CFS claim if you do not have your doctor's support.

Step Three: Start having great doctor visits that create great records

• Here's How to have great visits that create great records that win your claim
• This is super important! Please try to do these things if you can.
• If anyone reading here is already on disability, please read this too. Basically, do these things forever.

Step Four: Document Signs & Symptoms

• Social Security has a special ruling about Chronic Fatigue Syndrome. Unfortunately, it is super confusing.
• I have put together this simpler list of Medical Signs & Symptoms from the ruling.
• Social Security would like your signs and symptoms to be documented by a doctor over a period of 6 months.
• If at all possible, it is wonderful if you can review this list with your doctor and talk about how to document this in your medical records.
• Please keep in mind: Never, ever assume that your doctor will know anything about Social Security policies if you do not show them. They don't teach this stuff in med school!

Step Five: Get a great RFC Form

• Physical RFC
• Mental RFC (optional)
• The ideal RFC is signed by your treating physician (regular visits for 3+ months)
• The ideal Physical RFC is signed by an MD
• The ideal Mental RFC is signed by a psychiatrist or licensed psychologist
• Before asking your doctor, it's helpful if you put together info on your limitations
• Try to set up a special appointment just for this form. Request an extended appointment if possible.
• Please don't skip steps one, two and three. It can be really helpful if you can establish a good relationship with the right kind of doctor before asking them to fill out an RFC.
• Here's some ideas for What to do if your doc doesn't like paperwork
• Don't forget to submit your completed form to Social Security. How to Submit.

Step Six: Clinical Evidence and Tests

Coming soon!!! Suggestions and input are welcome and needed! Please don't get sucked in by the lure of step six. Every step is equally important here. Tests are just one piece of the puzzle.


Step Seven: Collect & Check Your Records

• If some of your medical records get lost or go missing, they will not tell you, they will just deny you. Sad but true.
• Many people who have lawyers and still wind up with missing records.
• How to find out what records are missing
• How to review your disability file
• Handy-dandy guide to submitting records

FAQ

Are these steps the same for SSI and SSDI?
Are these steps the same for Long Term Disability (through my employer)?
Where can I learn more about the Social Security ruling on CFS?
Why did someone at Social Security tell me I won’t get on for CFS?
Why are you calling it CFS? Are you in the dark ages?

 

[KitCat]

gosh, I seem to have lost the ability to edit my posts in this thread, but I can still edit my posts in other threads. Does anyone know if there is something I should be doing differently?

 

[KitCat]

I have updated a bunch and started putting everything in a blog post.

How does this look? Can people see the images?

Corrections/suggestions welcome!

TEN STEPS TO WINNING A SOCIAL SECURITY CLAIM FOR CHRONIC FATIGUE SYNDROME

http://forums.phoenixrising.me/inde...m-for-chronic-fatigue-syndrome-ssi-ssdi.1978/



.

 

[CFS_for_19_years]

gosh, I seem to have lost the ability to edit my posts in this thread, but I can still edit my posts in other threads. Does anyone know if there is something I should be doing differently?

I believe you can only edit your posts for 7 days. It didn't used to be like that.

The 7-day cut-off came about because several newcomers came onto the forum and said they had cured themselves of ME/CFS with bla bla bla and then when anyone asked them what their original symptoms were (did they really have ME/CFS?) they would go back and edit their first post to include things like PEM, OI, etc. I saw this and the moderators saw it happen several times with newcomers who were trying to sell a product or program or what-have-you.

By the way, it's still OK for a newcomer to come to the forum and say they've been cured of ME/CFS with bla bla bla, but they won't be able to go back and edit their first posts to include the "right" symptoms.

 

[KitCat]

oh, very interesting history!

Thank you.

 

[KitCat]

I am still working on and adding to this list. I just put together this little overview. Corrections/suggestions welcome.

++++++++++++++


What To Expect While Traveling Down the Disability Road

The disability process has several different stages. People can be approved at any stage. The process takes most people about two years. However, I have met people who were approved after one month, and I have met people who were approved after five years. These are the stages of most applications:

• Initial applications - This decision gets made based on paperwork submitted by you and your doctor. It takes about 5 months, but can be faster or slower. Roughly 33% are approved.
• Reconsideration - This stage exists in some states, but not all. It takes about 2 months but can be faster or slower. It is a review of your last application. Roughly 7% are approved.
• Hearing Appeals - This decision gets made based on paperwork from you plus paperwork from your doctor plus paperwork from your lawyer (if you have one) plus a hearing with a judge. It generally takes 1 - 2 years. Check the wait time in your area. Roughly 65% are approved.
• Appeals Council and Federal Court - Most people don't persist to this stage. It is a bit complex, so I will save this for another day. For now, let's just hope you get approved at one of the earlier stages.

Disability is the wild west of government bureaucracy and anything can happen. However, there is good news. You can dramatically change the odds in your favor. If you are able to follow any of the ten steps on this page you can greatly improve your chances of being approved early on.

 

[Clerner]

please excuse my memory here, did you get a physical rfc from your doc as well?

Well, I just got the letter that I was denied for disability. I am disappointed but not surprised. I had a lot of medical evidence/testing and my specialist dr. Filled out the rfc also. Not sure if I should appeal or not? I'm too tired to fight.

 

[Clerner]

@KitCat They listed all the medical reports they used and my rheumatologist report was NOT listed! I had called weeks ago and specifically asked them to wait until they received the report to make a decision. Of course, they apparently did not. I think having info from a rheumatologist would be important.

 

[KitCat]

I am very sorry to hear this.

Please don't give up hope. Most people are denied at this stage, and if you continue to appeal your chances are much better if you get to hearing with a judge.

Did they write you and tell you that you can put in a "request for reconsideration"? This is not available in all states, but I think that it is in Florida.

This means you will have another chance to submit your rheumatologist report I would strongly recommend you get a copy of the report and send it in at the same time as your reconsideration request, plus check and send in any other documents that were missing.

Are you certain they received both your rfc forms and both these forms actually made it into your file? Things often get lost there.

The reconsideration decision is very quick, so if you want to send them any more materials, it's best to do it at the same time as you return the form. There is no time after to follow up with more stuff.

Please don't lose hope. This is totally normal, many people think of the initial application as just step one.

 

[Clerner]

Ok, I will try to stay positive but it is hard.

Yes, I can do a " reconsideration".

I personally sent my rheumatologist report to them weeks ago.

It just lists my doctors report but does not specifically say the rfc. I personally sent the rfc with the stack of lab tests.

Should I get a lawyer to do/file the reconsideration?

Thanks for the words of support.

 

[KitCat]

I know it is hard. This is a very difficult process. I am glad you still have some part of you that wants to continue. Many many people who are very very ill get turned down at this stage - it means nothing about you or your condition.

You are doing a great job of learning more and taking good steps on your case. that is very positive. In my experience, the people who really make an effort like you are do get approved in the end.

Many people find that having a lawyer is very helpful for a hearing appeal (that comes after reconsideration).

I have not really heard stories of lawyers doing very much to help reconsiderations, but you can try. Just because I have not heard of it, doesn't mean it doesn't happen

Whatever you do, just make sure to make the reconsideration deadline - must be in their hands within 60 days.

You can request a copy of your case file on CD, that will show you exactly what records are in your file and may also give you more information on how they made their decision.

If they did not use your rheumatologist report, then you can mention this on your request for reconsideration. It gives you a place to write the reason for your request and you can write that an important document was left off the list of medical evidence and then send it to them again along with the rfc forms if they are not already there.

Are you currently working at all? Do you currently see a doctor?

 

[Clerner]

Ok, thanks for the info.
I am not currently working and have not worked since June 2, 2015.

My last dr visit was rheumatologist on May 19th. But, she stated she does not know how to treat cfs and it's chronic viruses/infections. She just continued the antibiotics and gave orders for some lab tests to make sure antibiotics werent causing problems.

I only have the rfc filled out by specialist dr ( only saw 2x) but he wrote the book "The new fibromyalgia remedy". I guess I still can go to my GP who took good notes of my symptoms for quite some time over a year, always stating ebv, fatigue, depression, dizzy, memory problems etc. I have not asked him to do an rfc, but he may be willing. Just scared he may not want to do it.
I guess I can just ask him to look back at all his notes and just state all the problems I have reported. Remind him he is not making a disability decision, just stating all that has been reported and how that would affect my ability to work.
Again, pain and fatigue are not "provable".

 

[CFS_for_19_years]

@Clerner, please don't give up the fight for benefits! In the long run, some of your stress will be relieved once you start receiving benefits, but I know it sucks at the moment!

I don't know if things have changed much in the last 20 years, but when I applied for Social Security, very few people got in on the first try or on reconsideration. You have your best chance with an appeal, which is the point where I believe you definitely should get a lawyer on board to help you. Do follow through with requesting a reconsideration though, because you never know if someone may reverse the decision.

 

[Clerner]

Thanks! My husband is really spurring me on to keep fighting (even tho I'm too tired).
I guess I have nothing to lose. I will do the reconsideration request. I will keep you posted.

 

[KitCat]

Ok, thanks for the info.
I am not currently working and have not worked since June 2, 2015.

My last dr visit was rheumatologist on May 19th. But, she stated she does not know how to treat cfs and it's chronic viruses/infections. She just continued the antibiotics and gave orders for some lab tests to make sure antibiotics werent causing problems.

I only have the rfc filled out by specialist dr ( only saw 2x) but he wrote the book "The new fibromyalgia remedy". I guess I still can go to my GP who took good notes of my symptoms for quite some time over a year, always stating ebv, fatigue, depression, dizzy, memory problems etc. I have not asked him to do an rfc, but he may be willing. Just scared he may not want to do it.
I guess I can just ask him to look back at all his notes and just state all the problems I have reported. Remind him he is not making a disability decision, just stating all that has been reported and how that would affect my ability to work.
Again, pain and fatigue are not "provable".

Absolutely GREAT idea.

Yes, Social Security will give much more weight to your treating physician. A doctor you saw twice won't count very much.

Before you ask your doc for an RFC it is a really good idea to find out if they support your application. Have you talked to your doctor and told them you are applying for disability? What did they say?