Eleven ways to assure the success of a disability claim

[JalapenoLuv]

Really good info.

http://www.lowandcanata.com/CM/Articles/Eleven-Ways.pdf

 

[minkeygirl]

You piece is informative on a general level and to me it assumes that disability companies will play by the rules and treat you fairly. They don't and that article doesn't tell you how to 'play the game' that you must when dealing with disability insurance. Getting approved is one thing. Staying approved is an altogether separate thing.

That article (it was too much for me to read all of it) talks about a psych component to health issues. Psych issues usually have a 2 year cap (some limit) on receiving benefits. So you don't even want that mentioned.

Linda Nee's Blog has been tremendously helpful. She who worked for a disability company and knows what they will try to do to deny you in the first place and how to 'beat them at their own game' (my words) to keep getting disability.

This particular article was hugely helpful to me when it came to talking on the phone (which I now refuse to d0) with a claims adjuster. Her blog has tons of fanatic information.

http://lindanee.wordpress.com/2012/02/23/what-happens-when-insureds-speak-directly-to-insurers/

 

[ahimsa]

@JalapenoLuv , I skimmed that article you posted and what I read looked pretty good. And it did give some warning about how the deck can be stacked against people filing LTD (long term disability) claims, e.g. this quote from the first page:

Aided by a federal law known as ERISA, (Employee Retirement Income Security Act of 1974), they have been given procedural advantages and have means at their disposal to intimidate and oppress even the most well-informed “claimants.”

@minkeygirl, that blog is also a good resource! Thanks.

It's so hard for anyone who has become too sick to work to file all the paperwork for any type of LTD claim. But it's even worse for patients who have brain fog.

 

[JalapenoLuv]

@JalapenoLuv
It's so hard for anyone who has become too sick to work to file all the paperwork for any type of LTD claim. But it's even worse for patients who have brain fog.

That's why you hire a lawyer for SSA.

 

[minkeygirl]

Staying on is the key an no lawyer will take it on contingency so sources like Linda Nee are vital.

@JalapenoLuv saying hire a lawyer like it's the same as breathing is not feasible or affordable for some. It's easy for me, as fogged as I am, to just plow through the paperwork on my own then to try to explain it to someone else who will charge me for every minute we're on the phone.

 

[JalapenoLuv]

Lawyers always take SSA cases on contingency. The Disability Key and Nolo sites have good info on getting a case ready.

 

[ahimsa]

That's why you hire a lawyer for SSA.

I know it is different for everyone but, in my case, filing for disability with Social Security was fairly easy. I was approved on my very first try. I did not have a lawyer. It was about 8 months between when I first filed the paperwork and when the money was deposited in my account.

My difficulty was with my ERISA LTD claim. I've never heard of a patient winning an ERISA LTD claim without a lawyer. They may exist out there somewhere but I'll bet they are pretty rare.

 

[JalapenoLuv]

I know it is different for everyone but, in my case, filing for disability with Social Security was fairly easy. I was approved on my very first try. I did not have a lawyer. It was about 8 months between when I first filed the paperwork and when the money was deposited in my account.

My difficulty was with my ERISA LTD claim. I've never heard of a patient winning an ERISA LTD claim without a lawyer. They may exist out there somewhere but I'll bet they are pretty rare.

Really, they approved you for CFS without a lawyer? What was your supporting evidence? Were your doctor's notes detailed? Did you have function and pain diaries?

 

[ahimsa]

Really, they approved you for CFS without a lawyer? What was your supporting evidence? Were your doctor's notes detailed? Did you have function and pain diaries?

It was a long time ago but here's a summary as I remember it.

I stopped working in Sept 2000 and filed later that year (Dec, I think?). My primary medical evidence was an abnormal Tilt Table Test. My cardiologist and my primary care physician wrote letters. I also had letters from my former boss and one co-worker. And a letter from my husband (and some SSA form he had to fill out).

I can't remember a lot of the other details. I did not have any diaries.

I think one factor which helped me was that I had been sick since 1990. I had gone on and off medical leave (covered by my short term disability insurance, part of my employee benefits, but I paid the premiums) for the past 10 years.

So, I think my work history made it pretty obvious to Social Security that I did not just become sick and immediately file for long term disability. I had been trying to stay at work for all that time. But after my endometriosis surgery in 2000 I just never recovered enough to get back to work even part time.

Also, my salary as a software engineer was so much higher than the pittance that SSDI pays. Aside from the fact that I loved my job, and I hated the idea of having to file for long term disability, it would not make any sense from a purely financial point of view. Why would anyone file for SSDI when making that much money? If someone was only interested in the money angle then it would be much easier to slack off at work and coast along instead of pretending to be sick and trying to file for SSDI.

Finally, my application was filed shortly after the Tilt Table Test was recognized by SSA one of the tests that supports a CFS diagnosis. See http://www.ssa.gov/OP_Home/rulings/di/01/SSR99-02-di-01.html for a copy of the document adopted in 1999 (this has now been replaced by a newer version at http://www.ssa.gov/OP_Home/rulings/di/01/SSR2014-01-di-01.html ).

To be honest, I don't really know exactly why I got approved when so many other claims get turned down. Some combination of medical evidence, doctors' letters, personal details, timing, luck -- who knows?

I know I'm not the only one who has gotten SSDI without a lawyer. I've seen posts by other folks who have done it (on this forum and other forums). I do know that it's not all that common but it's definitely not impossible.

 

[JalapenoLuv]

The thing I hate about the tests SSA recognizes is that they all aren't covered by insurance, just like lawyer's fees. If the system was fair they wouldn't withhold the first few months and would pay the lawyer if you win.

I'm glad you sailed through it. As a 44 year old man the judge did everything he could to ignore my claim. It took four years but eventually I forced it through.

 

[geraldt52]

...To be honest, I don't really know exactly why I got approved when so many other claims get turned down. Some combination of medical evidence, doctors' letters, personal details, timing, luck -- who knows?

Mostly, it is pure luck, usually early on. Once an Administrative Law Judge makes a negative finding it is all up hill from there.

My case was not unlike nearly everything you describe in yours, ahimsa. My lawyer said it was as straightforward a case as any she had seen, and she's handled many hundreds. The actual facts and record never changed from day one. In the end it took seven years and a trip to Federal Court before I finally got my first check. At every level Social Security representatives failed to follow their own rules, completely ignored facts in the record if they didn't support their preconceived notions, and out and out made things up and inserted them into the record to continue denying my claim. In the end a Federal Judge threw out everything they did.

Because there is no cap on attorney fees after you exhaust all appeals and end up in Federal Court, it ended up costing me about $35K in my past due benefits. How much did it cost anyone at Social Security? Not a damn dime. Who was held accountable? No one.

 

[minkeygirl]

Just read this. Interesting on why claims are processed the 4th quarter of the year. Go down to the bottom.

http://lindanee.wordpress.com

 

[minkeygirl]

Here's a better piece on LTD and CFS.

http://lindanee.wordpress.com/category/chronic-fatigue-syndrome/

 

[AaroninOregon]

I have a question for those of you who have filed for disability...

I've reached the "Remarks" portion of the application and here's what the application states:

"Please provide any additional information or remarks you want to send with this application:
If you estimated any dates, places, or amounts, please explain. For example, if you estimated a date of marriage, please explain. There is a limit of 750 characters (about 15 lines)."


I'm wondering if this is where I am supposed to list my illness, symptoms, etc. ?

Thanks,
Aaron

EDIT: Never mind, I figured it out...stupid brain.