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Question About Ssdi


yelloownumber5

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My wife filed for disability.

Her medical condition was that in April 2005 she had her Thyroid removed and filed her FMLA then in Aug of 2005 she was in a car accident and totaled by a 18 wheeler and under treatment of the Spinal Institute since Therapy hasn't resolved her issues. Ironically, she was fired from what while on FMLA, they had thought she exceeded her time off but she didn't and that's another lawsuit in the works. While on FMLA she missed work because she couldn't perform her duties, going to therapy at that time plus all the heavy medication they had her on. She is unable to drive, she has difficulty trying to walk and sometimes just cannot due to the lumbar issues giving numbness in her legs, can't lift probably more than 3 pounds from her cervical issues as well.

She did file for SSDI in Jan of 2006, we received a call then a letter for another appointment date at the local office. During our appointment at the SS Office we were told her SSDI was approved (he showed us the print out of when the SSI started) and they already started her SSI but since it was going to be back dated past the back up her SSDI to April of 2005 they had to figure out how to work around this SSI that was approved in Jan or Feb of 2006. Now we get a letter stating she was denied which seemed strange because it was approved partially (right) because the SSI was reflecting in their system? I'm sure everyone is familiar with the letter but it said they have her records or information from the Spinal Institute which seems strange because I don't see how nor why they would say she is able to work. We have an appointment with her Spinal Doctor later this week......is there anything we should make sure he documents or ask him? I have gone thru the VA C&P's and told her pretty much what to say and do.

Thanks very much,

George

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  • HadIt.com Elder

Its an opinion but it may help you understand. SS makes it very hard and difficult to escape the criteria that she will not be able to work for at least a year. Most Docs are not willing to ever tell a patient that even when they know there is not a chance. I think it really is a weeding out process and the next step is to get the lawyer and appeal.

Good Luck.

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  • HadIt.com Elder

Yellow,

I am no expert , but I have been through this as many others who will chime in.

SSI and SSDI are 2 diffrent animals. SSI is income based vs SSDI which is disability based.

Complete medical records is a must, the Doc's opinion's must state how long the condition may last, the complete restrictive report as to function in any job, the medications they have her on to include any side effects they may cause, and any rehab that may be proposed with the duration of such.

If you have not already, you probably need to seek out a good SS lawyer, as it seems you are headed for a hearing to get your wife what she is entiltled to.

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Its an opinion but it may help you understand. SS makes it very hard and difficult to escape the criteria that she will not be able to work for at least a year. Most Docs are not willing to ever tell a patient that even when they know there is not a chance. I think it really is a weeding out process and the next step is to get the lawyer and appeal.

Good Luck.

Pete53,

Understand and I've heard how you usually are denied 3 times. I guess what I don't understand and maybe they at the local level tell everyone that they are approved but since her SSI actually went into effect on say...... 2/1/2006 but at a local level he was trying to change this to 4/1/2005 but could not figure out how to do it but he (the local office gentleman) would work on it and get back to her and bamm get the letter in the mail disapproved. We did plan on appealing ourselves.......was leary about the lawyer issues because she's dealing with one for two other issues with this.

If we chose a lawyer does anyone have someone they could trust in the Charleston SC area.

Thanks.

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Dont know if this will help- but-

When my husband filed for SSDI disability they also took a SSI application.

He told them he would not be eligible for SSI as he worked all his life and would receive SSA Disability Benefits.

Well- at some point they approved him for SSI and sent him a check for about 800 bucks- his SSA had not been technically approved yet as I recall.

He called them up and told them that although he had 100% PTSD and significant brain damage from a recent stroke, (granted 100% on that too by SSA) he had enough brain power left to determine he could not accept the check because the SSA award would mean he was over -paid. Also he pointed out that he didnt met the income guidelines of SSI anyhow- his income was over the limit.

He had quite a time with them because he was afraid of this check. They told him to keep the check. He would not sign it or cash it.

Two weeks later when he got his SSA award letter they asked for the check back.

He had been denied SSI- properly- and then awarded SSA.

Could this be the case with your wife?

Each state has a disability determination board that comes under the SSA-

if your local office cannot help you, maybe they could-

are they trying to say that your wife has improved to such a degree she is not disabled under their guidelines?

If so, as someone said here-you should get a SSA lawyer right away. The SSA should have a list in your state of lawyers who specifically handle SSA cases.

If she worked for an employer covered by the ADA- she should file a EEOC complaint against them.

http://www.usdoj.gov/crt/ada/

I believe a FLMA complaint can be filed in conjunction with an ADA complaint.

We filed an ADA complaint in conjunction with USDOL complaints over disability discrimination by a federal contractor and we won in the state of NY.

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  • In Memoriam

This is an SSA Reconsideration Form, similar to a NOD. Get more evidence. Go to SSA site re-enter more information in your claim.

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Guest allanopie

Hello George,

You can expect the SSA to deny multiple times, if thats what it takes to make you go away.

After you've been denied "once", you may request, (in writing) a HEARING before the ALJ, (Administrative Law Judge).

This is when you want to present the Dr's statement, that you wife cannot perform even "sedentary work" & is "not" likely to improve.

You want her Dr to explain why her health prevents her from performing even sedentary tasks, such as bending, walking, carrying, etc.

A list of Medications & their side effects that prevent her from these tasks, should be included in the comments.

You can expect the same discouragement tactics the DVA pulls. Evidence, What evidence? from the local SSA office. The Judge is the one you want her to discuss her case with. If your dealing with SSA at the local offices, you can bet your bippy, they will play the same games the VARO's do with Vets.

ANY, & I do mean "ANY" error on the part of the SSA is a CUE claim. Meaning you may appeal anytime & they have to pay retro.

It is required that you must have 20 earned credits in 40 qtrs worked

After 8 yrs, I appealed to the SSA regarding the granting of SSI instead of SSDI. The bases the SSA used to deny SSDI, was that I had earned 20 credits in, ONE MONTH, less of 40 qtrs. Eight yrs later I discover as a Vietnam Era Vet, my service time credits may be used to apply it toward earnings, if i become disabled & fall short of credits for SSDI benefits. Since NO ONE at the local SSA office ever heard of the SSA regulations regarding veterans, it was my guess it wasn't applied to my situation. After I produced the codes & proved I could file suit against the SSA for failure to train their employees to provide these benefits to Veterans, I finally convinced them the law was on my side. They eventually came back with, "OH" we applied that to your claim yrs ago. You still don't qualify is all they would say on the phone. After a yr of failing to produce "on paper", just how it was mathematically applied & I still came up short, I simply requested another hearing before the judge. Shortly after I sent in the request, I was awarded the claim for SSDI & sent the retro.

Hears something odd that happened during all of this. I was talking to someone at the local SSA one day & was asked what happened? The guy asked, why are you appealing after all this time, I thought the RO was going to take care of you with "VA PENSION"?

It's much easier to understand if you realize they are set on cheating you out of it, every step of the way.

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Thanks Everyone.

Allan,

Yes, we are just at the local level with the SSA. We are doing her reconsideration, appeal or what it is called. I know we have 60 days to appeal, should we do the ALJ? In the disapproval letter it did list most of her records, so, I'm not sure what they are reading or if things are just not recorded. She honestly cannot physcially now, I would pay SSA if they could reverse this as it never would have happened.......even if she physically could the meds would not enable her to do such, if we got passed that the mental side of her accident and driving would not allow her to do such but I understand it's not their job to worry about her driving.

We have an appointment to see her Spinal Doctor this week and we are going to or try to have several of her limitations documented. I do know he knows but not so sure what he actually puts down. I could see if she just started her treatment or something but this happened Aug 2005 and she has been through Physical Therapy, Injections, using the TENS, and back to the more so conservative care trying to wait out time over having surgery: she had Thryoid Surgery (T.T.) in April of 2005 and this didn't go so plesant and with the accident they still don't have her "levels" to where they should be and was hospitalized once because her calicum had fell too low and this is or I think it does impeede her progress with this. She just had an X-ray in which every facial muscle was still unattached. Now we found out last week that they said she needs her gallbladder out because since her accident she has been getting very severe stomach pains.

Get this, the 18 wheeler that crushed her, well he asked for a "jury trial", wouldn't that kill him? but it does give me time to drive and stay employed, but the Sherriff asked my wife if she would let him strike the ticket off his record so he won't "ruin" his career. I didn't hear that part or I may have been locked up for at least being disrespectful at the least.

Off topic and dealing with the VA and VAO. I have sinus problems but they say it is due to my deviated septum which is from trama.....However, I think it was due to being stationed in the old building and it was during this time I developed the sinus infections.....probably 2/3's of our building did. Ironically, while I was stationed there at Goose Creek I went to the Branch Medical Clinic and told them of several people all having the same symptoms and when we went into the overhead a few times we seen all the crap up there but I asked for a air quality or some kind of testing which they disreguarded just as me having sinus problems. I drafted up a letter to the Naval Hospital because I had heard they had some air quality test completed. My VAO is like "whatever". When I gave him my original claim he was like you won't get anything, I'm currently at 50 percent with the addition the VA does, lol. As well I have Carpal Tunnel verified by two test the EMG and another that I can't remember but the VA Doctor keeps saying, NO. One last question, is there a blanket percentage or something for Degenitive Disc Disease? I have been diag with DDD, however, I didn't know you even claim DDD as a whole. It was put on my first claim something like DDD (C5-C6) but it was rated as shoulder this and C5-C6 something.

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So, when she goes for her hearing should she be on every drug they perscribed to her so she cannot function for the hearing process? If she takes everything for her spine she's not able to do much at all.....she just is knocked out.

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Yellownumber5,

Have your spouse attend her ALJ as if it were just another day. Too not take her medictions because of a hearing could skew the opinion of the ALJ. ALJs do not ncessarily have to follow the letter of the law when making decisions. An ALJ can make a decision from the bench, go over the transcripts and send you the findings later on, or can make a decision by OTR. Meaning On The Record alone.

So advise your spouse to take her medications when she goes to the ALJ. If they make her too drowsy and she cannot function it will be noted. But if she does not take them, it could be construed as an attempt to "look sick" and could result in a negative decision. If all your medical records are current and concise, the ALJ will have all that information. The ALJ will ask several questions pertaining to her ability to engage in activities. Then the ALJ will ask the Voc Rehab specialist if any of her skills are transferable. If they are not, then the decision will be favorable.

Patrick

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Patrick,

Thanks. She was denied the first time. We seen her Spinal Care Doctor and he said he has stated that she is not able to fulfill her current job duties......SS said they had his records but they still denied it, I guess it's a routine....in a way I don't understand because she was in an accident involving an 18wheeler with treatment that night and ongoing......Aug 29th will make one year.......she was fired from her job because she was on FMLA and the employer thought they didn't need to follow DOL's regs.

Question about the ALJ, we never been to one and hadn't heard much.....will the judge have her records or are there certain things we need to get together?

Thanks much,

Yellownumber5,

Have your spouse attend her ALJ as if it were just another day. Too not take her medictions because of a hearing could skew the opinion of the ALJ. ALJs do not ncessarily have to follow the letter of the law when making decisions. An ALJ can make a decision from the bench, go over the transcripts and send you the findings later on, or can make a decision by OTR. Meaning On The Record alone.

So advise your spouse to take her medications when she goes to the ALJ. If they make her too drowsy and she cannot function it will be noted. But if she does not take them, it could be construed as an attempt to "look sick" and could result in a negative decision. If all your medical records are current and concise, the ALJ will have all that information. The ALJ will ask several questions pertaining to her ability to engage in activities. Then the ALJ will ask the Voc Rehab specialist if any of her skills are transferable. If they are not, then the decision will be favorable.

Patrick

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The problem with your regular doctor is he or she does not know the rules as it pertains to Social Security. A lot of doctors write "cannot work" letters, but never get into the reason she cannot perform any activities. Social Security works on the premise that one is "unable to particiapte in substantial gainful activity." Since employment is an activity, you must show that she is unable to perform any OTHER activities. Once you can establish that and show that her works skills are not ransferable, then and only then will you get a favorable decision.

As stated before the ALJ will ask questions about background, education, and work sills; and then ask the Voc Rehab person that will be present if there are any skills she has available to her to perform functions. If the Voc Rehab person says there are no transferable skills, then the decision will be favorable.

Patrick

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Patrick,

Thanks again. I just downloaded a few sections of the "blue book" and will ensure my wifes doctor does documentation geared to their guidelines.

It just gets me that a person could be in an automoblie accident with an 18wheeler, unable to work and doctor says this......been out of work for a year but they will give crap about it and say you are able to do your duties you last held, it's not a problem proving she cannot work period! I think the Judge will be much better but then again I'm not sure but much of what the blue book says will be documented.

Thanks much,

Yelloow

The problem with your regular doctor is he or she does not know the rules as it pertains to Social Security. A lot of doctors write "cannot work" letters, but never get into the reason she cannot perform any activities. Social Security works on the premise that one is "unable to particiapte in substantial gainful activity." Since employment is an activity, you must show that she is unable to perform any OTHER activities. Once you can establish that and show that her works skills are not ransferable, then and only then will you get a favorable decision.

As stated before the ALJ will ask questions about background, education, and work sills; and then ask the Voc Rehab person that will be present if there are any skills she has available to her to perform functions. If the Voc Rehab person says there are no transferable skills, then the decision will be favorable.

Patrick

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Free Representitives? In a case that is pretty clear like this would it be okay to use them? Also, does she need to do anything before she submits her info for the ALJ if she decides to use a lawyer or just the free Rep.

Tks

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Yellownumber5,

Have your spouse attend her ALJ as if it were just another day. Too not take her medictions because of a hearing could skew the opinion of the ALJ. ALJs do not ncessarily have to follow the letter of the law when making decisions. An ALJ can make a decision from the bench, go over the transcripts and send you the findings later on, or can make a decision by OTR. Meaning On The Record alone.

So advise your spouse to take her medications when she goes to the ALJ. If they make her too drowsy and she cannot function it will be noted. But if she does not take them, it could be construed as an attempt to "look sick" and could result in a negative decision. If all your medical records are current and concise, the ALJ will have all that information. The ALJ will ask several questions pertaining to her ability to engage in activities. Then the ALJ will ask the Voc Rehab specialist if any of her skills are transferable. If they are not, then the decision will be favorable.

Patrick

You want to know how silly the SSD can be , in my case I had 4 doctors and 6 years of treatment on my side and they had one doctor i never saw in person say he thought i should be denied because i proved i was able to work at something like laundry folding .. he based his finding on ,, one i visited my children , two i was able to use a computer and three i took an airline flight all by myself.. its really sad how do they sleep at night seems they would rather starve you out , hope you will steal and get caught or work for food then give you a benefit YOU paid for with your many years of work

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Free Representitives? In a case that is pretty clear like this would it be okay to use them? Also, does she need to do anything before she submits her info for the ALJ if she decides to use a lawyer or just the free Rep.

Tks

Hire a SSD Lawyer well worth the money ,, i found one in oregon who is also a vet and 75 years old . He knows the ins and outs of the system and he keep up the pressure till i won but it took 2 1/2 years

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