Help (Arizona) need new attorney SSDI hearing

geraldt52

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@Howard, I don't want to seem to be giving you medical or legal advice, because I'm not qualified in either regard. But just in the way of observations, in the hopes that they might be helpful...

It is going to be difficult to get an SSDI approval without the help of a current doctor with at least some current tests and that doctor's verification of your "signs and symptoms". Judges routinely ignore letters of support from family and friends, but cannot legally ignore letters from treating physicians. It's a Catch 22 that finding a doctor who'll be cooperative with a CFS disability claim can be expensive and exhausting, which is beyond so many people with CFS. Unfortunately, Social Security couldn't give a shit.

If a lawyer has already accepted you on a no-win-no-fee basis, as it appears, then appeals will have no out of pocket expenses as far as the lawyer is concerned. Of course there will be medical expenses, as you'll need to keep your medical records current.

It may be especially wise given your circumstances to start a new claim, maybe with a new lawyer, and have that lawyer assist you from the get-go with what will be needed from a medical standpoint. If the lawyer has handled CFS cases, the lawyer may even be able to help you connect with a doctor who is cooperative with CFS cases.

You can still appeal your existing claim, and you can still add evidence to your existing claim, so any new medical tests, signs, and symptoms can, and should, be added to both claims.

I know how difficult and depressing the situation you find yourself in is. Maybe take a few days or weeks to gather yourself before continuing...
 

nyanko_the_sane

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Just some thoughts for those thinking of starting the process.

The main issue I see is trying to entice an advocate to help you from the start. In my experience they tend to jump in late in the cycle with ME cases. They may not even want to help you with the appeals process. But as the potential for payout gets bigger and they think you have a case, that is when they will jump in.

In recent years even letters from ME doctors don't pull a whole lot of weight in the appeal process. For instance I had an advocate evaluate the letter Stanford sends to patients in support of their disability. He didn't think the letter carried enough weight to sway a judge in my favor.

Evidence is the key to a strong case. Any abnormal labs and scans, detailed notes from doctors and therapists will add weight to your case. Keep a diary of your daily symptoms and activities. Try to coax your doctor into making an ME centric RFC report for you.

It is a tough long process for many of us who try to get disability on a ME diagnosis. For some it is easier to get disability for the diagnosis of depression and not ME at all.
 

StarChild56

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I'm so sorry. It should not be this hard.

I second what @geraldt52 noted - I know in my case (although not for CFS, but I was very young and had back and pain problems which are very difficult to win moreso for young people) - I saw my doctor every month to every 3 months. My doctor noted - and I told him every time - how I was impaired, what all my symptoms were and how they interfered with me being able to even perform the ADLs (activities of daily living). I had really strong documentation about my medical issues and how my symptoms made it so that I can't work (any job). My lawyer instilled in my head that I must complain (which I did not like to do) - I must talk about all my problems at my appointments. That also speak about your worst times (which were the most frequent) rather than the few times when you do a little better for a short time. Your doctor must record this information.

Because I had such good, consistent medical records (even though my MRI did not show horrific problems) - when my ALJ read my medical file 6 days prior to the hearing, he called my lawyer and gave me an immediate favorable ruling. He mentioned specifically the form letter my lawyer asked my MD to fill out that listed things such as - I can stand no more than 15 minutes at one time and no more than 1 hour max per day / similar for sitting, things about concentration and being able to listen to and follow instructions. The judge also included medical problems in my record that we had not even put onto the application, for instance my asthma, as another factor. So again, the more medical documentation of any and all health problems, the better.

On another note - the process and decision making for SSI and SSDI are exactly the same except that to qualify for SSDI you have to have "earned" enough work credits. SSI is for those who have not worked enough to qualify for SSDI. SSI is around $800 a month last I was aware but SSDI is based upon what you've earned over you entire work history.
There are asset limits for those on SSI and you also get Medicaid with SSI. With SSDI you will get Medicare 2 years after your date determined as your disability date.

I hope you pursue this and get your victory sooner than later.
 
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Second star to the right ...
Just opened the mail & my appeal was rejected.
Oh, shite, @Howard !!! That's just effing heartbreaking. And equal parts just effing boneheadedly unfathomable. Apparently to qualify for SSDI you have to already have been killed by whatever you're dealing with, in which case they approve you and then immediately disapprove you for 'deadness'

@geraldt52 and @nyanko_the_sane both have provided valuable, solid input, as has @StarChild56 , along with almost step-by-step instructions on how you need to conduct and direct medical appointments for maximum utility and effect.

Have you talked to your atty yet? I think that might be your next 'first step - stage 2' .... she might have some decent input as well, and you could run some of the excellent thoughts proposed here by @geraldt52 and @nyanko_the_sane by her and get some more feedback, after you've had a chance to rest up and recuperate from this nasty hard gut-punch from a guy who makes a very nice living sitting in a comfortable room and judging people, then goes to the gym, catches a movie, and has a hearty dinner. F>ck 'im.

Whatever, this is NOT the end, or the final word.

Perhaps there is nothing wrong with me, physically...
Oh, total horsehite and you know it. Please don't let the judgment of a guy who's never seen you or lived thru a day with you sway what you KNOW to be true.
@Howard , can you appeal? What does the letter say about that?
Did you file for SSDI or SSI? IF you lost for SSDI isn't there a chance you could get SSI? That is what ended up happening for a friend of mine.
That was my first thought. The second was "Why didn't his atty review the materials to be submitted and let Howard know that they might need more substantiation?", but then, my opinion of attys is right down there with my opinion of Drs.

I agree with @Shoshana. I don't think you can apply for SSI if you own so much as a birdfeeder. And your spouse's income is taken into account.
You should file an appeal immediately. There are a couple more levels of appeal within Soc Sec, and then you can appeal to a Federal Court.
Gerald seems to really, really know his stuff.
I despise everything and everyone associated with SSDI.
Oh God, hear hear and double that.
I believe that a spouse's income, and assets, make someone ineligible for SSI.
Those factors are irrelevant to SSDI.
If someone uses up all of their income and significant assets, then they can apply for SSI, is what I believe.
As far as I know, you're totally right.
For some it is easier to get disability for the diagnosis of depression and not ME at all.
That may be worth considering, @Howard, and discussing with your atty, as well as the advisability of both contesting and appealing this judgment, while opening a different claim for immobilizing depression. Can your therapist recommend someone who's expert in SSDI depression claims, especially since his opinions were discarded by the court and a more seasoned SSDI therapist might do better? I can't begin to figure out how you posit this to him without hurting his feelings or pissing him off, but you'd prbably know.

Again Howard, chin up. This is NOT the end of this, and when you finally get there, you'll win.
 
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This is going to sound crazy. I have a neighbor who got divorced on paper, and never had any trouble in the marriage, nor did they separate at all. They did this just so he could get Medicare.

I am not suggesting this, it is probably illegal.. but I am saying that this is horrible and I have seen people do very strange things to get medical care in this country.
 

Tammy

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Opinion of nurse practitioner not taken into consideration, lacking formal evidence (despite recent active EBV greater than 600)
That right there should have been enough to get disability. Evidence of EBV titers greater than 600 is how I got my disability. I would point this out to your lawyer. So sorry you are having to deal with all of this Howard. Sending hugs.
 

Howard

knowing NOTHING - - the final destination
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That right there should have been enough to get disability. Evidence of EBV titers greater than 600 is how I got my disability. I would point this out to your lawyer. So sorry you are having to deal with all of this Howard. Sending hugs.
Sorry, I meant to respond to this earlier. But yes, I feel the EBV should have been considered. Although it appears as though 640 is the magic number, and I'm only at 600.

Perhaps another round of blood work would be prudent.
 

Howard

knowing NOTHING - - the final destination
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This is going to sound crazy. I have a neighbor who got divorced ...
The divorce option has been put on the table several times at $600 out of pocket, but there's no guarantee I could get medical coverage afterwards.

Right now my medical insurance costs just shy of $500 per month just for me... which is significant in a one-income household. Not sure we fit under this classification, but the Working Poor might be an apt term.

One office visit costs between 300 and $400 total for transportation and the office deductible, plus the wages my wife loses from work on one of these days, which can be up to $100. So the total cost for one office visit is roughly a week's take home pay.

I know we're not unique, and everyone else has these difficulties, but I just don't know how to make the numbers work. We already cleaned out our life's savings trying to get me diagnosed in the first place, back in the 2010-15 timeframe.

I'm not complaining, that's just today's reality. And I never once expected this reality to take shape the way it has.

Either way, we've got some options and a few choices to make. And sometimes choices get made for us. It's possible none of this matters tomorrow.

Thanks everybody,
H