Disability Evaluation Under Social Security

Discussion in 'Social Security' started by rainvet, Jul 17, 2005.

  1. rainvet

    rainvet New Member

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    Medical/Professional Relations

    Disability Evaluation Under Social Security
    (Blue Book- January 2005)

    Listing of Impairments - Adult Listings (Part A)

    VA and Social Security Administration Create New On-line Link to ...

    "Veterans who have already applied for benefits from Social Security ... information to VA, and in some cases, can have their claims processed the same day. ..

    govinfo.library.unt.edu/npr/library/news/vetssa.html - 7k -

    http://www.ssa.gov/disability/professionals/bluebook/AdultListings.htm

    http://www.ssa.gov/

    http://ssa-custhelp.ssa.gov/cgi-bin...=&p_page=1&p_pv=&p_prods=&p_cv=1.105&p_hidden
    _prods=&cat_lvl1=1&cat_lvl2=0&p_hidden_prods=&p_search_text=&p
    _new_search=1&search_type=answers.search
    _nl&go=Go

    http://ssa-custhelp.ssa.gov/cgi-bin...=&p_li=&p_new_search=1&p_srch=1&p_sort_by=&p_
    gridsort=&p_row_cnt=43&p_prods=&p_cats=&p_pv=&p_cv=1.105&p_search_
    text=&p_nav=foot&p_page_head=1&p_page_foot=1

    http://ssa-custhelp.ssa.gov/cgi-bin...a=&p_li=&p_new_search=1&p_srch=1&p_sort_by=&p
    _gridsort=&p_row_cnt=43&p_prods=&p_cats=&p_pv=&p_cv=1.105&p_search_
    text=&p_nav=head&p_page_head=1&p_page_foot=1

    http://www.socialsecurity.gov/disability/professionals/bluebook/

    http://www.ssa.gov/disability/professionals/bluebook/general-info.htm

    Medical/Professional Relations

    Listing of Impairments - Adult Listings (Part A)
    The following sections are applicable to individuals age 18 and over to children under age 18 where criteria are appropriate.

    This electronic version contains the Skin Disorders listings that became effective July 9, 2004 changes to Neurological as a result of adding Amyotrophic Lateral Sclerosis (ALS), and the new Malignant Neoplastic Diseases listings and related listings changes, effective December 15, 2004.

    http://www.ssa.gov/disability/profe...sionals/bluebook/11.00-Neurological-Adult.htm

    www.ssa.gov/disability/professionals/bluebook/AdultListings.htm 1.00
    Musculoskeletal System

    2.00
    Special Senses and
    Speech
    3.00
    Respiratory System

    4.00
    Cardiovascular System

    5.00
    Digestive System

    6.00
    Genito-Urinary System

    7.00
    Hematological Disorders
    Changes Effective
    December 15, 2004

    8.00
    Skin Disorders
    Effective July 9, 2004

    9.00
    Endocrine System

    10.00
    Multiple Body Systems

    11.00
    Neurological
    Changes Effective
    December 15, 2004

    12.00
    Mental Disorders

    New!
    13.00
    Malignant Neoplastic Diseases
    Effective December 15, 2004

    14.00
    Immune System

    http://www.ssa.gov/disability/professionals/bluebook/11.00-Neurological-Adult.htm

    http://www.ssa.gov/disability/professionals/bluebook/12.00-MentalDisorders-Adult.htm

    http://www.ssa.gov/disability/professionals/bluebook/4.00-Cardiovascular-Adult.htm

    http://www.ssa.gov/disability/professionals/bluebook/5.00-Digestive-Adult.htm

    http://www.ssa.gov/disability/professionals/bluebook/6.00-Genito-Urinary-Adult.htm

    http://www.ssa.gov/disability/professionals/bluebook/7.00-HemicandLymphatic-Adult.htm

    http://www.ssa.gov/disability/professionals/bluebook/8.00-Skin-Adult.htm

    http://www.ssa.gov/disability/professionals/bluebook/9.00-Endocrine-Adult.htm

    http://www.ssa.gov/disability/professionals/bluebook/10.00-MultipleBody-Adult.htm

    http://www.ssa.gov/disability/professionals/bluebook/11.00-Neurological-Adult.htm

    http://www.ssa.gov/disability/professionals/bluebook/12.00-MentalDisorders-Adult.htm

    http://www.ssa.gov/disability/professionals/bluebook/13.00-NeoplasticDiseases-Malignant-Adult.htm

    http://www.ssa.gov/disability/professionals/bluebook/14.00-Immune-Adult.htm
  2. rainvet

    rainvet New Member

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    Links to Social Security Disability Ratings

    How to Qualify for Social Security Benefits

    A. Military and Social Security Benefits

    The earnings of people who serve in the military services on active duty or on active duty for training have been covered under Social Security since 1957. Inactive duty service in the armed forces reserves (such as weekend drills) has been covered by Social Security since 1988. However, people who served in the military before 1957 did not pay into Social Security directly, but their records are credited with special earnings for Social Security purposes that count toward any benefits that might be payable. Additional earnings credits are given to military personnel depending on when they served. This fact sheet explains how and when these special earnings are credited and provides other general information military personnel need to know about the benefits available from Social Security.

    1. Paying Social Security And Medicare Taxes

    While you're in the military service (from 1957 on), you pay Social Security taxes the same way civilian employees do. Those taxes are deducted from your pay and an equal amount is paid by the U.S. government as your employer. In 1999, the tax rate is 7.65 percent up to a maximum of $72,600. If you earn more than that, you continue to pay the Medicare portion of the tax, 1.45 percent, on the rest of your earnings.

    2. Social Security "Credits"

    You earn Social Security credits when you work in a job covered by Social Security. Before any benefits can be paid on your record, you must have credit for a certain amount of work covered by Social Security. In 1999, you earn four credits (the maximum) if your annual earnings are $2,960 or more. (You earn one credit for each $740.) The amount needed for each credit will increase in future years to reflect increases in average wages. The number of credits you need to qualify for Social Security depends on your age and the type of benefit you might be eligible for. Nobody needs more than 40 credits (10 years of work or military service) to be eligible for Social Security. In some situations, you can qualify with less than 40 credits.

    3. Earnings Added To Military Records For Social Security Purposes

    The "credits" mentioned in the previous section determine if you are eligible for Social Security. The amount you get from Social Security depends on your earnings averaged over much of your working lifetime. Generally, the higher your earnings, the higher your Social Security benefit.
    Under certain circumstances, special earnings can be credited to your military pay record for Social Security purposes. These extra earnings may help you qualify for Social Security or increase the amount of your Social Security benefit. The extra earnings credits are granted for periods of active duty or active duty for training. (No additional earnings are granted for inactive duty training, and Social Security cannot add extra earnings credits to your earnings record until you file for Social Security benefits.)
    Here's when the additional earnings are granted:

    a. Service In 1978 And Later

    For every $300 in active duty basic pay, you are credited with an additional $100 in earnings up to a maximum of $1,200 a year. If you enlisted after September 7, 1980, and didn't complete at least 24 months of active duty or your full tour, you may not be able to receive the additional earnings. Check with Social Security for details.

    b. Service In 1957 Through 1977

    You are credited with $300 in additional earnings for each calendar quarter in which you received active duty basic pay.

    c. Service In 1940 Through 1956

    If you were in the military during this period, including attendance at a service academy, you did not pay Social Security taxes. However, your Social Security record may be credited with $160 a month in earnings for military service from September 16, 1940, through December 31, 1956, under the following circumstances:

    - you were honorably discharged after 90 or more days of service; or
    - you were released because of a disability or injury received in the line of duty; or
    - you are still on active duty; or
    - you are applying for survivors benefits and the veteran died while on active duty.

    You cannot receive these special earnings credits if you're already receiving a federal benefit based on the same years of service. But there is one exception to this rule: if you were on active duty after 1956, you can still get the special earnings for 1951 through 1956, even if you're receiving a military retirement based on service during that period.

    4. Applying For Social Security Benefits

    There are many kinds of benefits available from Social Security besides those for retirement and disability. Members of your family and your dependents can receive survivors benefits if you should die. There's also Medicare coverage and Supplemental Security Income (SSI) payments. For more information about these benefits, ask Social Security for a copy of the booklet, Understanding The Benefits (Publication No. 05-10024).

    When you apply for Social Security benefits, you'll be asked for proof of your military service (DD Form 214), or information regarding your reserves or National Guard service.

    5. If You Get Both Social Security And Military Retirement

    You can get both Social Security benefits and military retirement. Generally, there is no offset of Social Security benefits because of your military retirement. You'll get your full Social Security benefit based on your earnings. However, your Social Security benefit may be reduced if you also receive a government pension based on a job in which you didn't pay Social Security taxes. Ask Social Security for a copy of the fact sheet, A Pension From Work Not Covered By Social Security (Publication No. 05-10045).

    Social Security survivors benefits may affect benefits payable under the optional Department of Defense Survivors Benefit Plan. Check with the Department of Defense or your military retirement advisor for more information.

    6. SSI For Children

    SSI pays monthly benefits to people with low incomes and limited assets who are 65 or older or blind or disabled. If you have a child who gets SSI, those payments may continue if you''re stationed outside the United States (including Puerto Rico and U.S. territories and possessions) while in military service and the child lives with you. Your child must have received SSI the month before you reported for duty.

    7. A Word About Medicare

    If you have health care protection from the Department of Veterans Affairs (VA) or under the CHAMPUS or CHAMPVA program, your health benefits may change or end when you become eligible for Medicare. You should contact the VA, the Department of Defense or a military health benefits advisor for more information.

    8. For More Information

    You can get recorded information about Social Security coverage 24 hours a day by calling Social Security's toll-free number, 1-800-772-1213. You can speak to a service representative between the hours of 7 a.m. and 7 p.m. on business days. Our lines are busiest early in the week and early in the month, so, if your business can wait, it's best to call at other times. Whenever you call, have your Social Security number handy.

    People who are deaf or hard of hearing may call our toll-free "TTY" number, 1-800-325-0778, between 7 a.m. and 7 p.m. on business days.

    You also can reach us on the Internet. Type www.ssa.gov to access Social Security information.
    The Social Security Administration treats all calls confidentially--whether they're made to our toll-free numbers or to one of our local offices. We also want to ensure that you receive accurate and courteous service. That's why we have a second Social Security representative monitor some incoming and outgoing telephone calls.

    B. Oganizations to Find Legal Representation for Social Security Claims

    NOSSCR: National Organization of Social Security Claimants’ Representatives - www.nosscr.org/
    Established in 1979, the National Organization of Social Security Claimants' Representatives is an association of over 3,300 attorneys and paralegals who represent Social Security and Supplemental Security Income claimants. Our members are committed to providing high quality representation for claimants, to maintaining a system of full and fair adjudication for every claimant, and to advocating for beneficial change in the disability determination and adjudication process. To reach NOSSCR: (800) 431-2804, or e-mail: [email protected].

    C. General Information

    To qualify for benefits, you must first have worked in jobs covered by Social Security. Then you must have a medical condition that meets Social Security's definition of disability. In general, we pay monthly cash benefits to people who are unable to work for a year or more because of a disability. www.socialsecurity.gov

    Benefits usually continue until you are able to work again on a regular basis. There are also a number of special rules, called "work incentives," that provide continued benefits and health care coverage to help you make the transition back to work.

    If you are receiving Social Security disability benefits when you reach age 65, your disability benefits automatically convert to retirement benefits, but the amount remains the same.
    Let's look at the requirements more closely:

    In addition to meeting our definition of disability, you must have worked long enough--and recently enough--under Social Security to qualify for disability benefits.

    Social Security work credits are based on your total yearly wages or self-employment income. You can earn up to four credits each year. The amount needed for a credit changes from year to year. In 2003, for example, you earn one credit for each $890 of wages or self-employment income. When you've earned $3,560, you've earned your four credits for the year.

    The number of work credits you need to qualify for disability benefits depends on your age when you become disabled. Generally, you need 40 credits, 20 of which were earned in the last 10 years ending with the year you become disabled. However, younger workers may qualify with fewer credits.

    IMPORTANT: Remember that whatever your age is, you must have earned the required number of work credits within a certain period ending with the time you become disabled. Your Social Security Statement shows whether you meet the work requirement at the time it was prepared. If you stop working under Social Security after the date of the Statement, you may not continue to meet the disability work requirement in the future.

    The definition of disability under Social Security is different than other programs. Social Security pays only for total disability. No benefits are payable for partial disability or for short-term disability.
    Disability under Social Security is based on your inability to work. We consider you disabled under Social Security rules if you cannot do work that you did before and we decide that you cannot adjust to other work because of your medical condition(s). Your disability must also last or be expected to last for at least one year or to result in death.

    This is a strict definition of disability. Social Security program rules assume that working families have access to other resources to provide support during periods of short-term disabilities, including workers' compensation, insurance, savings and investments.

    To decide whether you are disabled, we use a step-by-step process involving five questions.
    They are:

    1. Are you working?

    If you are working in 2002 and your earnings average more than $780 a month, you generally cannot be considered disabled. If you are working in 2003 and your earnings average more than $800 a month, you generally cannot be considered disabled. If you are not working, go to Step 2.

    2. Is your condition "severe"?

    Your condition must interfere with basic work-related activities for your claim to be considered. If it does not, SSA will find that you are not disabled. If your condition does interfere with basic work-related activities, go to Step 3.

    Is your condition found in the list of disabling conditions?
    For each of the major body systems, SSA maintains a list of medical conditions that are so severe they automatically mean that you are disabled. If your condition is not on the list, SSA has to decide if it is of equal severity to a medical condition that is on the list. If it is, SSA will find that you are disabled. If it is not, then go to Step 4.

    3. Can you do the work you did previously?

    If your condition is severe but not at the same or equal level of severity as a medical condition on the list, then SSA must determine if it interferes with your ability to do the work you did previously. If it does not, your claim will be denied. If it does, proceed to Step 5.

    4. Can you do any other type of work?

    If you cannot do the work you did in the past, SSA see’s if you are able to adjust to other work. SSA considers your medical conditions and your age, education, past work experience and any transferable skills you may have. If you cannot adjust to other work, your claim will be approved. If you can adjust to other work, your claim will be denied.

    Most people who receive disability benefits are workers who qualify on their own records and meet the work and disability requirements we have just described. However, SSA wants to point out some situations you may not know about:

    If something happens to you, benefits may be payable to your widow or widower with a disability if the following conditions are met:

    -He or she is between ages 50 and 60.
    -The widow or widower meets the definition of disability for adults.
    -The disability started before your death or within seven years after your death.

    NOTE: If your widow or widower caring for your children receives Social Security benefits, he or she is eligible if disability starts before those payments end or within seven years after they end.

    You should apply at any Social Security office as soon as you become disabled. You may file by phone, mail or by visiting the nearest office. You can find out the name and address of the closest Social Security office here. If you want to apply by phone call our toll-free number, 1-800-772-1213, and we will set up a time for your local Social Security office to contact you.

    If your application is approved, your first Social Security benefit will be paid for the sixth full month after the date we find that your disability began.

    For example, if your disability began on June 15, 2002, your first benefit would be paid for the month of December 2002, the sixth full month of disability. Social Security benefits are paid in the month following the month for which they're due. This means that the benefit due for December would be paid to you in January 2003, and so on.

    In most cases, you will continue to receive benefits as long as you are disabled. However, there are certain circumstances that may change your continuing eligibility for disability benefits. For example, your health may improve to the point where you are no longer disabled. Or, like many people, you would like to go back to work rather than depend on your disability benefits. SSA encourages you to do so, and they have special rules called "work incentives" that can help you make the transition back to work. These incentives include, but are not limited to, continued monthly benefits and Medicare coverage while you attempt to work on a full-time basis.

    The law requires that SSA review your case from time to time to verify that you are still disabled. SSA will you if it is time to review your case, and we still keep you informed about your benefit status. You should also be aware that you are responsible for letting us know if your health improves or you go back to work.

    In general, your benefits will continue as long as you are disabled. However, the law requires that SSA review your case periodically to see if you are still disabled. How often SSA will review your case depends on whether your condition is expected to improve.

    If medical improvement is "expected," your case will normally be reviewed within six to 18 months after your benefits start.

    If medical improvement is "possible," your case will normally be reviewed no sooner than three years.

    If medical improvement is "not expected," your case will normally be reviewed no sooner than seven years.

    Two things can cause us to decide that you are no longer disabled and to stop your benefits.

    Your benefits will stop if you work at a level SSA considers "substantial." In 2003, average earnings of $800 or more per month ($1,330 or more per month if you are blind) are usually considered substantial.

    Your disability benefits will also stop if we decide that your medical condition has improved to the point that you are no longer disabled.

    You are responsible for promptly reporting any improvement in your condition, if you return to work, and certain other events as long as you are receiving disability benefits. The booklet SSA sends to you when your application is approved explains what you need to report to us.

    If you're like most people, you would rather work than try to live on disability benefits. There are a number of special rules that provide cash benefits and Medicare coverage while you try to work. SSA call’s these rules "work incentives." For more information about Social Security work incentives, see Working While Disabled...How We Can Help . www.socialsecurity.gov/pubs/10095.html

    Social Security Disability (SSD) for People with Mood Disorders.
    psycom.net/depression.central.ssd.html
  3. rainvet

    rainvet New Member

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    Evaluation Under Social Security

    II. Simple Steps To Use When Fighting Your SSD Case

    by Linda Fullerton [email protected] President/Co-Founder - Social Security Disability Coalition

    A. Social Security pays only for total disability

    Social Security pays only for total disability. No benefits are payable for partial disability or for short-term disability. You are disabled under Social Security rules if you cannot do work that you did before and if they decide that you cannot adjust to other work because of your medical condition(s). You have a valid claim if you have been disabled or are expected to be disabled for 12 consecutive months, or your condition will result in your death. You should file your claim within 12 months of the date you first became disabled - Social Security will only pay monetary benefits for a maximum of 12 months prior to the date of your application. This is true regardless of what date you became disabled. To decide whether you are disabled, SSD uses a step-by-step process involving five questions. Are you working? - If you are working and your earnings average more than $800 a month, you generally cannot be considered disabled. If you are not working is your condition "severe"?. Your condition must interfere with basic work-related activities for your claim to be considered. If it does not, they will find that you are not disabled. Is your condition found in the list of disabling conditions? For each of the major body systems, SSD maintains a list of medical conditions that are so severe they automatically mean that you are disabled (The "Bluebook of Listings and Impairments"). If your condition is not on the list, they have to decide if it is of equal severity to a medical condition that is on the list. If it is, they will find that you are disabled. Can you do the work you did previously? If your condition is severe but not at the same or equal level of severity as a medical condition on the list, then they must determine if it interferes with your ability to do the work you did previously. If it does not, your claim will be denied. Can you do any other type of work? If you cannot do the work you did in the past, SSD looks to see if you are able to adjust to other work. They consider your medical conditions and your age, education, past work experience and any transferable skills you may have. If you cannot adjust to other work, your claim will be approved. If you can adjust to other work, your claim will be denied. If possible get a copy of your personnel file from your previous employer (contact the human resources dept - give them authorization to send it to you and tell them why you want it - for SSD reasons) documenting how many days you were absent from work (attendance records, sick days, doctor's excuses, leave of absence, warning letters etc) due to your illnesses before you could not work any longer. Keep a copy for yourself send one to SSD.

    NOTE: Once you are approved there is no time limit on disability benefits. You will continue to receive a disability benefit as long as you continue to be disabled and otherwise meet work or other eligibility requirements. However, your case will be reviewed periodically to see if there has been any improvement in your condition and whether you are still eligible for benefits. If you are still eligible when you reach full retirement age, disability benefits will automatically be converted to retirement benefits.

    B. Take as active a roll as possible in fighting your own case

    If you cannot handle it get a family member to help you the less YOU do the longer it will take to process your claim. The actual time it takes to process your claim may be more or less based on the State you live in - disability determinations are made by a Disability Determination Service in the State where the disability applicant lives. These State agencies are required to comply with federally prescribed policies and procedures, which helps assure that the programs are administered consistently from State to State. The nature of your disability; how quickly SSD can obtain medical evidence from your doctor or other medical source; and whether it is necessary to send you for a medical examination. As further assurance of consistency, samples of the State agencies' determinations undergo an extensive quality assurance process performed by Federal reviewers (Currently 7 out of 10 applications get randomly selected by computer for this process). Unfortunately, this
    additional review may cause delays in some cases.

    NOTE: This data is what you are REALLY up against when fighting a claim - taken right off of SSA's own website. No matter what anyone (SSD workers, lawyers etc) tells you, these figures are the true facts. Also the GAO considers Social Security Disability to be a HIGH RISK area for 2003 so things are expected to be much worse when the 2003 reports come oud This information is important - not to scare or discourage you, but to show how bad the system is and how important it is that you do EVERYTHING possible
    here to speed up your claim so it does not fall into those statistics. The current system as it stands is set up to discourage you so they can rob you of your money or in hopes that you will die in the process of trying to get your benefits - then they don't have to pay you! DON'T GIVE THEM THAT SATISFACTION - DON'T BE A VICTIM OF THE SYSTEM - TAKE ACTION NOW - DON'T BE SAD - GET MAD!!!!

    C. Have Doctors are Supportive of Your Claim

    If your primary care doctor or any other doctor is unsupportive of you/your diseases/SSD claim - get rid of them immediately and find a new one. You will almost surely be denied if your primary care
    physician/specialists do not support your claim. Some tips on "How To Talk With Your Physician About

    Supporting Your Disability Claim: can be found at: www.immunesupport.com/lib...fm?ID=3022

    SSR 96-2p: POLICY INTERPRETATION RULING TITLES II AND XVI: Giving Controlling Weight to Treating Source Medical Opinions
    www.ssa.gov/OP_Home/rulin...di-01.html

    SSR96-5p: POLICY INTERPRETATION RULING TITLES II AND XVI: Medical Source Opinions on Issues Reserved to the Commissioner
    www.ssa.gov/OP_Home/rulin...di-01.html

    D. Seeing Specialists

    Make sure you see and get properly diagnosed by any specialists for your medical problems - make sure to mention/document all PHYSICAL and MENTAL problems you may have - ALL are important factors when filing for SSD. (EXAMPLE - Many people who are disabled suffer from depression in some form
    as a result - so it is important that if you have that problem that is diagnosed properly/documented and included in your list of illnesses). Try all possible options to treat your disease before filing for a claim - SSD needs to see that you are trying to get better but that treatments have little or no affect on your condition.

    SSR 96-4p: POLICY INTERPRETATION RULING TITLES II AND XVI: Symptoms, Medically Determinable Physical and Mental Impairments, and Exertional and Nonexertional limitations www.ssa.gov/OP_Home/rulin...di-01.html

    E Get Copies of ALL Your Medical Records

    Get copies of ALL your medical records and tests - keep a set for yourself and send a set to SSD

    F. Make Copies of All of Your Records

    Anytime you fill out any paperwork for SSD make copies of it for yourself before sending it back to them

    G. Filling Out Forms

    When filling out SSD forms answer ALL questions as to how you would feel on your WORST day. NEVER downplay your symptoms or exaggerate them either Explain in detail the frequency, severity and duration of your symptoms and limitations and how they limit your ability to work and function on a daily basis. If you have problems filling out their forms (due to concentration, memory, pain) - make sure you mention that on the form and if it took you several days/weeks to fill them out, or if you had to have someone else do it for you - mention that too.

    SSR 96-3p: POLICY INTERPRETATION RULING - TITLES II AND XVI: Considering Allegations of Pain and other Symptoms in Determining Whether a Medically Determinable Impairment is Severe. www.ssa.gov/OP_Home/rulin...di-01.html

    SSR 96-7p: POLICY INTERPRETATION RULING TITLES II AND XVI: EVALUATION OF SYMPTOMS IN DISABILITY CLAIMS: Assessing the Credibility of an Individual’s Statements. www.ssa.gov/OP_Home/rulin...di-01.html

    H. Make a List of ALL Medications/Supplements You Take

    Make a list of ALL medications/supplements you take. Be sure to list anything that you are allergic to or other reason why you cannot take a medication/treatment that a doctor has recommended (do not use the reason that you cannot afford it). Always ask for and have your doctor give you SAMPLES whenever possible especially for new medicines that they may want you to try - they get tons of them from drug reps - you just need to ask for them. If for some reason they don't have samples - get a trial prescription
    (a few days/one week) so you are not paying tons of money for something you may not be able to take because of allergies or nasty side effects. Keep a daily diary of the intensity and frequency of your symptoms, pain and how it limited your activities that day. Note the things/activities that may have made your symptoms worse. Make copies of all of this information - keep one for yourself, give one to each of your doctors and send one to SSD.

    I. Go through the Doctor's Bluebook of Listings

    Find all the listings you meet and copy and paste them into a document - keep a copy for yourself - send one to SSD
    www.ssa.gov/disability/pr...s/bluebook
    www.ssa.gov/disability/pr.../index.htm

    NOTE: Fibromyalgia/CFS claimants - see these documents:

    SSR 99-2p: POLICY INTERPRETATION RULING TITLES II AND XVI: Evaluating Cases Involving Chronic Fatigue Syndrome (CFS)
    www.ssa.gov/OP_Home/rulin...di-01.html

    Chronic Fatigue Syndrome and Fibromyalgia Patients: Should You File a
    Disability Claim?
    www.immunesupport.com/lib...fm/id/3900

    Completing Disability Forms: Five Critical Tips to Keep in Mind for Chronic
    Fatigue Syndrome and Fibromyalgia Patients
    www.immunesupport.com/lib...fm/ID/3487

    J. Get copy of Residual Functional Capacity Questionnaire

    Make copies for ALL your doctors to fill out and in your own words make up a letter answering all the questions - make sure to include how these diseases affect your life. You may wish to revise this sample to better reflect your own limitations, then ask your doctor to fill out your own version instead of whatever DDS sends: pbcers.org/rfcq.htm. A guide for providers on what to include in a report on your disability - read this and write your own to give to your doctor so he knows the answers:
    www.ssa.gov/disability/pr...-adult.htm
    www.ssa.gov/disability/pr...idence.htm
    www.ssa.gov/disability/pr...elines.htm
    www.ssa.gov/disability/pr...eneral.htm

    SSR 96-8p: POLICY INTERPRETATION RULING TITLES II AND XVI: Assessing Residual Functional Capacity in Initial Claims
    www.ssa.gov/OP_Home/rulin...di-01.html


    SSR 96-9p: POLICY INTERPRETATION RULING TITLES II AND XVI: Determining Capability To Do Other Work-Implications Of A Residual Functional Capacity For Less Than a Full Range of Sedentary Work www.ssa.gov/OP_Home/rulin...di-01.html

    SSR 85-16: TITLES II AND XVI: Residual Functional Capacity For Mental Impairments
    www.ssa.gov/OP_Home/rulin...di-01.html

    K Write All Your Elected Officials

    Write all your elected officials and if you get any responses make copies - keep a set for yourself - send a set to SSD www.congress.org

    L. Helping Doctors Fill Out Paperwork

    Offer to help your doctors fill out any paperwork that they may get from you or SSD.

    M. Get Statements from Family, Friends, Co-Workers and Doctors

    Ask your close family, friends, previous co-workers and doctors to write letters (on 8-1/2 x 11" paper) on your behalf stating how your illnesses affect your life and how they have changed you. Make sure they mention both physical and mental changes in your condition. The letters should include their background/relationship to you - how they know you, how long they have known you and your conditions. They should end with a statement as to why in their opinion you cannot work ANY type of job. Have them get the document notarized (many banks will do this for free) Up to four is sufficient. Make copies - keep a set for yourself and send one to SSD.

    N. Keeping Doctors Appointments

    If SSD asks you to see any doctors make sure you keep the appointment and audio/video tape record the visit - get copies of all that doctor's findings. Be very honest and specific about your condition. DO NOT wear make up or dress fancy - act, dress, look, function like you would on an average day. Make sure SSD doctors know that you have followed all medical recommendations you were given by your doctors and what affect they are having on your condition. If you have not been able to follow doctors recommendations due to side affects that have been problematic to your condition make sure you alert the SSD doctor to that as well. If possible have someone drive you to the appointment who knows about your medical conditions (family/close friend) and whom can also tell the doctor how these diseases affect your life.

    SSR 96-6p: POLICY INTERPRETATION RULING TITLES II AND XVI: Consideration Of Administrative Findings of Fact By State Agency Medical and Psychological Consultants and Other Program Physicians and Psychologists At The Administrative Law Judge and Appeals Coucil Levels of Administrative Review; Medical Equivalence
    www.ssa.gov/OP_Home/rulin...di-01.html

    O. If Your Case Has Been Denied

    If your case has been denied - file your appeal IMMEDIATELY in person if possible (no longer than 60 days). VERY IMPORTANT: get copies of all the records in your SSD file including ALL claim examiners notes and any doctors reports from doctors that SSD had you see - it is your right to have them.
    Note: federal law allows you to reopen the prior claim within one year of the date of the initial denial for any reason. You can reopen a previous claim within four years of the initial denial if SSD finds good cause to do so. Even if you cannot reopen a previous claim you should be able to file a new SSD application if it has been five years or less since you last worked full time.

    SSR 92-1p: POLICY INTERPRETATION RULING: Request Under the Privacy Act or The Freedom of Information Act for Access to Records and For Disclosure Of Material Maintained by the Office of Hearings and Appeals www.ssa.gov/OP_Home/rulin...di-08.html

    P. Use the SSD Website

    Use the SSD website - it has lots of useful info and never be afraid to contact them by phone to ask questions as to the status of your claim: Website: www.ssa.gov or Phone: 1-800-772-1213

    You can conduct your Social Security business 24 hours a day, including weekends and holidays. You can ask to speak to a representative from 7 AM to 7 PM on business days. Some of the services available include scheduling an appointment, changing your address, and signing up to send your Social Security check directly to your bank. You can also use their automated services 24 hours a day to request services such as a replacement Medicare card or Social Security Statement, and a variety of other forms and
    publications. Their phone lines are busiest early in the week and early in the month, so if your business can wait, it's best to call at other times.

    Q. SSA IG

    If you feel that you are being treated improperly report it immediately to the SSD Office of Inspector General and Office of Public Inquiry:
    Inspector General's Office
    Allegation Management Division
    PO Box 17768
    Baltimore MD 21235
    Phone: 1-800-269-0271/410-965-8882
    Rene Johns - Phone: 410-966-9158
    Danny Johnson - Phone: 410-966-9158
    Fax: 410-966-9201/410-597-0118
    E-mail: [email protected]

    Social Security Administration Office of Public Inquiries
    Phone: 410-966-3000
    Contact: Mary Ann

    R. Utility Shutoff

    If you are facing utility shutoff, foreclosure on your house or bankruptcy due to waiting for your claim to be processed - make copies of any letters/notices and send them to SSD/elected officials and your lawyer
    if you have one requesting a dire needs review of your case

    S. Pre-Hearing Review

    If you have been denied and have been waiting too long to get a hearing - look into getting what is called a Pre-Hearing review of your case.

    SSR 97-2p: POLICY INTERPRETATION RULING TITLE II AND TITLE XVI: Prehearing Case Review by Disability Determination Services
    www.ssa.gov/cgi-bin/cqcgi...C_TEXT=YES

    T. Taping Testimony

    If you have a hearing scheduled bring any new medical evidence, family, friends, doctors to speak on your behalf and ask to record it on audio/video tape. Be very honest and specific about your condition. DO NOT wear make up or dress fancy - act, dress, look, function like you would on an average day. If possible have someone drive you to the hearing who knows about your medical conditions (family/close friend) and can also tell the judge how these diseases affect/have changed your life. Make sure judge knows you have followed all medical recommendations you were given by your doctors and what affect they are having on your condition. If you have not been able to follow doctors recommendations due to side affects that have been problematic to your condition make sure you alert the judge to that as well.

    U. Representation

    You may chose to fight your case alone (it is NOT mandatory to have a lawyer) or seek legal/advocate representation. You can hire a lawyer - very important to actively keep after a lawyer if you hire one. Since they get paid 25% of your retro pay or current cap of $5300 it is in their best interest for your case to drag on - the longer it takes to process the more they get. You may be able to take advantage of legal-aid or pro-bono services. You can get a paralegal or in some cases free
    advocacy from the Centers for Independent Living in your area: www.abledata.com/Site_2/ind_lvng.htm
    Disability Legal and Advocacy Resources:
    www.makoa.org/legal.htm

    III. Social Security Programs and Web Resources

    Applications for this program can be obtained through this website: www.ssa.gov/applyforbenefits/

    For more information on this program and how to apply, call Social Security's toll-free number: 800-772-1213. People who are deaf or hard of hearing may call Social Security's toll-free TTY number: 800-325-0778

    Social Security Disability Coalition: FREE knowledge and support with a focus on reform of the Social Security Disability System groups.msn.com/SocialSecu...yCoalition
  4. rainvet

    rainvet New Member

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    Evaluation Under Social Security ?

    Site you can go to get your questions answered about Social Security www.severe.net/

    Links to Social Security Disability Ratings
    208.56.213.87/listings.html

    General Accounting Office Report Number - GAO-02-322, dtd February 2002, Social Security Administration: Disappointing Results From SSA’s Efforts to Improve the Disability Claims Process Warrant Immediate Attention, clearly states, that based on the GAO’s research we are approaching a crisis level in the process and that immediate steps must be taken to remedy the rising backlog of cases pending. This report further states that previously implemented costly changes in 10 Prototype states, and the nationwide Hearings Process Improvement Initiative implemented nationwide, are having negligible results, and in some cases, depending on which initiative you are looking at, are increasing processing times. To access this report go to the General Accounting Office site at www.gao.gov. On the left hand side of the screen you will see a search box titled Full Text Search. Type in GAO-02-322 and hit enter. This will open the associate PDF file for you. The report is approximately 33 pages long.

    IV. Providing Medical Evidence to the Social Security Administration for Individuals

    A. Guide for Health Professionals
    When an individual applies for Social Security disability benefits, we must decide whether he or she is disabled under the law. We base our decision on information you provide and other evidence, including information provided by the individual. The following guidelines will help you understand the kind of information we need.

    B. Definition of Disability
    Under Social Security law, an individual is considered disabled if he or she is:

    -- unable to do any substantial gainful work activity because of a medical condition (or conditions), that has lasted, or can be expected to last, for at least 12 months, or that is expected to result in death;

    -- or, in the case of an individual under the age of 18, if he or she suffers from any medically determinable physical or mental impairment of comparable severity.

    The medical condition(s) must be shown to exist by means of medically acceptable clinical and laboratory findings. Under the law, symptoms alone cannot be the basis for a finding of disability, although the effects of symptoms may be an important factor in our decision whether a person is disabled.

    If the medical evidence alone shows that a person is clearly disabled or not disabled, we decide the case on that information. Otherwise, we go on to consider other factors, such as functional capacity in light of the person's impairment(s), age, education, and work background. For a child under age 18, we generally consider the child's ability to function independently, appropriately, and effectively in an age-appropriate manner.

    C. What We Need From You

    We need information from you that will help us to determine the existence, severity, and duration of the person's impairment(s).

    Your report should include a thorough medical history, and all pertinent clinical and laboratory findings (both positive and negative) from your examination of the person. Copies of laboratory results should be provided if available. Also, provide the results of any mental status examination, including any psychometric testing. Longitudinal clinical records and detailed historical notes discussing the course of the disorder, including treatment and response, are very useful for us since we are interested in the impact of the illness over a period of time.

    You should also include a statement of your opinion about what work-related activities the person can still do despite his/her impairment. Tell us your opinions about both physical and mental functions and, to the extent possible, the reasons for your opinions, such as the clinical findings and/or your observations of the person. These opinions should reflect the person's abilities to perform work-related activities on a sustained basis, i.e., 8 hours/day and 5 days/week. Your descriptions of any functional limitations you noted throughout the time you treated the patient are very important. Examples of work-related functions include:

    --Physical work-related functions: Walking, standing, sitting, lifting, pushing, pulling, reaching, carrying, and handling.

    --Mental work-related functions: The ability to understand, remember, and carry out simple instructions, the ability to use appropriate judgment, and the ability to respond appropriately to supervision, co-workers, and usual work situations, including changes in a routine work setting.

    D. The Claim Adjudication Team

    Our adjudication team consists of a physician or psychologist and a specially trained disability examiner working in the disability determination services (DDS) in the State in which the claimant lives.

    If the team believes there is not enough information to make a decision, they may call or write you to find out if you have the needed information. If you do not, they may ask you or, in some circumstances, an independent medical source, to provide the information by performing tests or an examination for a fee paid by the DDS.

    Social Security law requires that a disabling impairment be documented by medically acceptable clinical and laboratory findings. Statements merely recounting the symptoms of the applicant or providing only a diagnosis will not establish a medical impairment for purposes of Social Security benefits. We must have reports documenting your objective clinical and laboratory findings. Thus, it is essential that you submit all objective findings available concerning your patient's condition, even if they relate to another disorder or establish that the person has a different condition.
  5. mwkolander@earthlink.net

    [email protected] New Member

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    The SS departments job is to cheat you if they can, pure and simple! This money comes out of the same account as most GI disability and comp. This is why all politician now draw their money for retirement from the General Fund! Do you think that when SS goes broke there will be a single veteran who gets a dime, for SS or Disability or comp? I think not! I served for the dream my founding fathers had, but even Franklin doubted we could hold on to it! He was correct!
  6. TinCanMan

    TinCanMan Active Member

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    Must be a full moon.

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