Lerner's Office Won't Fill Out Disability Paperwork.

[Tired of being sick]

@Ema

Very sorry to hear this..

I feel your pain Ema..

You are not alone

I am going through similar BS , My lawyer is still filing appeal after appeal being denied time after time to win disability for the first time..

I have had a Lawyer from the get go for the fact I could never handle the over whelming stress from the never ending red tape paperwork loops on top of my illness..

I have had absolutely no income since 2011..

I am on food stamps and medicaid (thank god for that)
Single men without children do not qualify for cash assistance.

If it weren't for my loving father, I would most definitely be homeless and most likely six foot under..

 

[Dreambirdie]

If your own doctor refuses to support you on paper, then you are just left to the mercies of the doctors that SSD hires to do their exams.

This time around the burden is on them to prove that I am recovered and not the other way around. But it still sucks.

I think you should consider some of the advice here before making plans to go see Lerner in person. There may be some things that you can still do or the SSD people can do for you to get him to fill out those (damn) forms. I would let the information sit and stew a bit, and then let your instincts be your guide.

If it was me I would also consider dropping Lerner as my doctor in the future. I wouldn't want to have a doctor that I had to beg to do the right thing. His attitude sucks... But that's a whole other story for future consideration.

 

[JalapenoLuv]

You say that you are trying to keep disability so the requirements are probably less strict than getting the initial claim. I think you just have to prove that you have the same conditions that you had when you are approved rather than having to have known the MD for six months or more. This is an assumption by me however, I belong to the Legal Shield plan and would ask for a phone call to a disability attorney to answer that question. Maybe you can just find a local MD who would review your records and examine you locally to prove your diseases haven't changed and tell this MD to shove it. MDs are all about avoiding litigating these days. I bet that's the reason.

 

[JalapenoLuv]

@Ema

Very sorry to hear this..

I feel your pain Ema..

You are not alone

I am going through similar BS , My lawyer is still filing appeal after appeal being denied time after time to win disability for the first time..

I have had a Lawyer from the get go for the fact I could never handle the over whelming stress from the never ending red tape paperwork loops on top of my illness..

I have had absolutely no income since 2011..

I am on food stamps and medicaid (thank god for that)
Single men without children do not qualify for cash assistance.

If it weren't for my loving father, I would most definitely be homeless and most likely six foot under..

You should look into testing to validate your condition and strengthen your case. If you've had pain longer than six months get an exam by a neuropsychologist to see if they can diagnose you with somatoform condition (automatic win b/c on list of impairments). State programs often are sliding scale. I had one done free and it won my appeal on the first try after an ALJ rejected it.

After that there is a two day exercise test to prove CFS. I'd get that if you can't get a good response from the neuropsych test.

SSA is hoping you die/give up before they pay out.

 

[Kati]

The last thing you want to do when you want a dr to be on your side for disability is to name his name publicly, even to members only. Just saying. It's not going to sit well with him if any of his patients send out the comment to him.

 

[Alea Ishikawa]

If you've had pain longer than six months get an exam by a neuropsychologist to see if they can diagnose you with somatoform condition (automatic win b/c on list of impairments) . . .

After that there is a two day exercise test to prove CFS. I'd get that if you can't get a good response from the neuropsych test.

I would strongly caution against this. Somatoform disorder is classified as a mental disorder. In contrast, ME/CFS is classified as a "nervous system" or "neuromuscular" disease by the WHO and NIH, respectively. To accept one diagnosis when you have another is misrepresenting both diseases and could cause further problems down the road.

It would make more sense to strengthen the ME/CFS case than attempt an alternate and potentially false diagnosis. Ema is trying to maintain disability. Someone might notice if her doctor did not sign the forms and she moved from one disease category to another via another doctor. She might be suspected of malingering.

It's better to just keep on the up and up.



@Ema - Thankfully, the SSA recognizes different tests and studies for a CFS MDI. See Section II-C.

I would ask for copies of all your medical paperwork from Lerner's office. There could be something in there that helps strengthen the case. I would definitely try having your hub give a call, maybe talk to someone different, and mention the timeline in question is for 2013 not 2014. There might have been a misunderstanding. Skype might also be an option.

I would personally go down to his office as a last resort.

I'm sorry you have to go through this.

 

[JalapenoLuv]

Actually Alea couldn't be more wrong. Once you're disabled you have legal protection against discrimination and your health records are protected by Hippa. If you're filing for disability the odds are against you ever working again. Only a few percent ever do. I think this is because CFS is a progressive neurological disease that attacks nerves. Moreover, it is easier to get disability for mental disorders rather than physical because they are on the list of chronic impairments.

This forces biased judges to approve the claim. Judges are biased if you are young and educated. So ignoring chronic pain and the possibility of lab testing that will prove a condition that will win your case is very risky.

Another great thing is that the monitoring period for mental disorders is longer once you're approved, something like eight years vs two years. So you'll have less hassle getting reapproved.

 

[PNR2008]

This is horrible. Do you have paperwork showing you saw him in 2013? Prescriptions filled out with his name? Anything showing you visited him and he treated you? Any diagnosis or prognosis? Gas you spent going to MI, eateries, lodging. Most things are on credit cards, also his fees. Proving you went to see him, was sick enough to be treated by him and that he is now uncooperative is on him not you.

Of course, it's always better to have his cooperation but that ship may have sailed. This person may need a lawyer or male figure convincing him to act and if he acts badly hopefully you have something on paper that you were sick enough to be treated by him.

 

[JalapenoLuv]

This is horrible. Do you have paperwork showing you saw him in 2013? Prescriptions filled out with his name? Anything showing you visited him and he treated you? Any diagnosis or prognosis? Gas you spent going to MI, eateries, lodging. Most things are on credit cards, also his fees. Proving you went to see him, was sick enough to be treated by him and that he is now uncooperative is on him not you.

Of course, it's always better to have his cooperation but that ship may have sailed. This person may need a lawyer or male figure convincing him to act and if he acts badly hopefully you have something on paper that you were sick enough to be treated by him.

The fact that I tried seven anti-depressants was listed in the medical records from a psychologist at a University clinic. He ignored it and instead framed me as being noncompliant for not taking anti-depressants when I really couldn't tolerate them due to side effects. Like I said, they are biased and just want to starve you out. You need every advantage you can get to survive it.

"Independent medical exams are among the most disputed components of New York’s troubled workers’ compensation system. "
http://www.nytimes.com/2009/04/01/nyregion/01comp.html?pagewanted=all&_r=0

and

Data show disability benefits can depend on judge (USA Today, 2011)

I was initially peeved at having to be diagnosed with a mental disorder instead of the CFS which is the real underlying complaint. But the lawyer said, considering how many people are permanently rejected you have to be happy no matter why you're approved. Believe me, the judge was grumbling when he signed that approval letter that he rejected at the first hearing.

If they approve you for being a duck, don't complain, just quack happily and take the money.

 

[golden]

And what about the Children?

The future generations which will be incorrectly treated and abused if all M.E. patients start concocting non-existent mental health issues?

Abhorrent.

 

[JalapenoLuv]

Don't blame the patients. Anybody with an unrecognized disease that causes chronic pain gets this label. It's probably so the insurance companies can cut off claims at two years as a mental exclusion.

 

[Ema]

UPDATE -

I spoke to the office manager (who is very nice) and she looked at the paperwork, said that it is only a request for chart records and that they would send those out without a visit required. She apologized for the mistake and upset and all is well.

To be fair, I should say that it is apparently not Dr Lerner's fault at all in this case but the fault of the receptionist that called me on Tuesday who did not understand the difference between a chart request and a functional capacity exam.

To be fair to myself though, it's been a pretty tough ride with Dr Lerner and while I have respect for him and what he has given to the field of CFS, I'm frustrated by my experience as a whole.

Whew. Maybe I can get some sleep now. Thanks to all for the support. I really appreciate it.

 

[Dreambirdie]

@Ema I'm glad it worked out. What a relief. Though I still think you should consider finding another doctor who is easier to deal with.

 

[Ema]

@Ema I'm glad it worked out. What a relief. Though I still think you should consider finding another doctor who is easier to deal with.

I still have my main doctor here locally so no worries there. She was supportive of me seeing Lerner even and has now taken over prescribing the antivirals so I can stay on them for the necessary length of time without having to travel to MI for the monthly monitoring. It's a very open and collaborative relationship which is a welcome change.

 

[Alea Ishikawa]

I was initially peeved at having to be diagnosed with a mental disorder instead of the CFS which is the real underlying complaint . . .
If they approve you for being a duck, don't complain, just quack happily and take the money.

Somatoform disorder is a different classification from ME/CFS.

Actually Alea couldn't be more wrong. She is hypersensitive about mental issue diagnoses. Once you're disabled you have legal protection against discrimination and your health records are protected by Hippa . . . I think this is because CFS is a progressive neurological disease that attacks nerves. Moreover, it is easier to get disability for mental disorders rather than physical because they are on the list of chronic impairments . . .
Another great thing is that the monitoring period for mental disorders is longer once you're approved, something like eight years vs two years. So you'll have less hassle getting reapproved.

See the following:

• Mental disorders are noted for being more difficult to claim and come with significant social stigma.

• Any recognized disability receives protection under U.S. law, including CFS. Protected Health Information (PHI) is already protected under HIPAA ("violent tendencies" are not protected).

• CFS is not automatically progressive. Patients also experience relapsing/remitting CFS.

• CFS is a chronic impairment (MDI) under SSA. As with somatoform disorder, there is still a burden to prove the illness prevents gainful activity. The frequency of disability reviews is determined by the classification of ability to improve. Most mental disorder cases are 3-year - so claiming a mental disorder does not automatically grant 8-year reviews. A review can also happen more frequently for other reasons.

• By definition, a diagnosis of CFS is given only when psychiatric causes are ruled out. If somatoform disorder is listed as a cause of fatigue which prevents you from working, that could disqualify a CFS claim.

 

[JalapenoLuv]

Somatoform disorder is a different classification from ME/CFS.

See the following:

• Mental disorders are noted for being more difficult to claim and come with significant social stigma.

Only if they aren't on the list of recognized impairments. I said this before, will you please read my answers. I feel like you have your opinion and you ignore everything contrary to it. The lawyer is talking about mental problems that are not on the list.

• CFS is a chronic impairment (MDI) under SSA. As with somatoform disorder, there is still a burden to prove the illness prevents gainful activity. The frequency of disability reviews is determined by the classification of ability to improve. Most mental disorder cases are 3-year - so claiming a mental disorder does not automatically grant 8-year reviews. A review can also happen more frequently for other reasons.

You do not have to meet the burden of proving somatoform disorder because it is on the list. Please do not make me say this again.

• By definition, a diagnosis of CFS is given only when psychiatric causes are ruled out. If somatoform disorder is listed as a cause of fatigue which prevents you from working, that could disqualify a CFS claim.

It wouldn't matter. SSA goes on the strength of the evidence. So regardless of what you are trying to claim, you can claim more than one thing, the strongest one wins. This stuff about disqualifying a CFS claim is nonsense. You seem to have no knowledge of how SSA really works, just quotations from online sources. Have you actually gone through the process?

 

[Gingergrrl]

@Ema, I'm glad that this all worked out for you but sorry you had to go through all the stress! Best wishes moving forward.

 

[Alea Ishikawa]

Only if they aren't on the list of recognized impairments. I said this before, will you please read my answers. I feel like you have your opinion and you ignore everything contrary to it. The lawyer is talking about mental problems that are not on the list . . .
You do not have to meet the burden of proving somatoform disorder because it is on the list. Please do not make me say this again.

Federal law/SSA regulations are not an opinion. Depression, bipolar, schizophrenia, etc. listed by Laurence are all part of SSA MDIs under Mental Disorders - the same place as somatoform disorders. See the categories for affective disorders, anxiety-related, schizophrenic, etc. All mental disorders still need to be proven as preventing gainful activity for a disability claim. See here.

Also see here (emphasis mine):

The evaluation of disability on the basis of mental disorders requires documentation of a medically determinable impairment(s), consideration of the degree of limitation such impairment(s) may impose on the individual's ability to work, and consideration of whether these limitations have lasted or are expected to last for a continuous period of at least 12 months.

CFS is evaluated similarly. See here (emphasis mine):

We adjudicate claims involving CFS using the sequential evaluation process, just as we do for any impairment. Once we find that an MDI(s) exists (see section II), we must establish the severity of the impairment(s). We determine the severity of a person's impairment(s) based on the totality of medical signs, symptoms, and laboratory findings, and the effects of the impairment(s), including any related symptoms, on the person's ability to function.

It wouldn't matter. SSA goes on the strength of the evidence. So regardless of what you are trying to claim, you can claim more than one thing, the strongest one wins. This stuff about disqualifying a CFS claim is nonsense.

I did not say a somatoform disorder claim automatically disqualifies a CFS claim. Rather, I said it "could." Somatoform disorder is classified as a mental disorder that is medically unexplained. ME/CFS is classified as a nervous system or neuromuscular disorder. Is it possible to have both? Perhaps if the symptoms for one disease are not claimed for the other - but when you claim the same symptoms are caused by both diseases, or claim both diseases, how does that look to an observer? Your symptoms from ME/CFS cannot be claimed for somatization, unless you were to engage in willful misrepresentation, which I do not advocate.

Also see here (emphasis mine):

When there is evidence of the potential presence of another disorder that may adequately explain the person's symptoms, it may be necessary to pursue additional medical or other development.

Claiming somatoform disorder could realistically put a CFS claim under scrutiny and thus in jeopardy.

Addressing your statement: "you can claim more than one thing, the strongest one wins." By this logic, stronger evidence for one case eliminates the other case. So, if subjective evaluation of somatoform disorder is stronger, then a somatization claim can disqualify a CFS claim.

You seem to have no knowledge of how SSA really works, just quotations from online sources. Have you actually gone through the process?

I am somewhat familiar with disability claims. I have a father on disability for stroke damage after a two-year process. Also, a person does not need to actually be the subject of a disability claim to understand SSA regulations.


If you have concrete evidence of your claims, feel free to share.

 

[barbc56]

You do not have to meet the burden of proving somatoform disorder because it is on the list. Please do not make me say this again

It doesn't make sense that certain conditions get a free pass. The system is designed so all sides are presented, at least in theory.

What list?

Barb

 

[JalapenoLuv]

Depression, bipolar, schizophrenia, etc. listed by the lawyer are all part of SSA MDIs under Mental Disorders - the same place as somatoform disorders. See the categories for affective disorders, anxiety-related, schizophrenic, etc. All mental disorders still need to be proven as preventing gainful activity for a disability claim. See here.

Alea, just because you know someone who filed for disability is not the same thing as going through the process. You think there is the same burden whether a condition is on the list or not. That is completely wrong. From your tone and repeated posts it is clear you think SSA follows everything they write verbatim when instead they have their customary way of doing things and the guidelines are mostly a public face used to try to look good then they are excessively and inappropriately dismissing people trying to claim conditions that are not on the list of impairments. Again, the point of the list is that the impairment listed is commonly accepted as being so severe that someone doesn't have to work.

Depression is not on the list as an accepted disorder. It is a component of the larger affective disorder.

In order to be in the list someone has to show the mandatory components. This is not the same thing as proving that a disease that is not on the list is impairing enough to prevent someone from working. You are confusing the two. My previous comments were correct.

Social Security’s Blue Book is a list of impairments that qualify for disability when the requirements for an impairment detailed in the listing are met; in other words, the impairment listings specify when Social Security will find a medical condition to be disabling. If your medical evidence meets the requirements of an impairment listing, you will automatically be found disabled; Social Security will not need look at how your impairments limit your activities (unless specific functional limitations are requirements of the impairment listing).
(Multiple Disabilities: Social Security Must Consider Combined Effects.