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Old 01-22-2007, 12:03 AM   #1
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What to expect and to do at SS's Doctors' Appts

I'm applying for SSDI for the first time. I have lupus and a benign pituitary tumor and have memory loss, cognitive problems, severe fatigue, skin rashes, joint pain and swelling. I'm in bed about 18-20 hours a day sleeping and the rest of the time, laying on the couch. I can't even do my own grocery shopping or cooking.

I have 3 years of lupus medical files and 2 years of brain tumor files, including MRIs that Soc Sec declined my offer to copy (MRIs are on CDs). Despite having one of the world's best rheumatologists for lupus and world's best neurosurgeons for a benign pituitary tumor (had it removed and it came back), social security is making me go to their docs - an internist and a "psych" exam! Also, the same SS chick kept asking me for my oncologist's info, and I kept trying to explain to her that I did not have cancer and so did not have an oncologist!

Am I supposed to pretend I'm stupid and/or completely paralzyed and/or suicidal at these unqualified doctors' appointments? I don't know what they want or expect me to do! And can I request a different SS person who knows the difference between a benign brain tumor and a malignant one? Have globs of stuff in your brain is bad either way and she seems to disbelieve me because I have no oncologist!

I thought your treating specialists carried more weight than their general docs. And I am afraid they will tell me to touch my nose and then use to deny my claim.

Any advice would be greatly appreciated! Sorry for the long post! Thanks so much.
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Old 01-22-2007, 09:07 AM   #2
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Re: What to expect and to do at SS's Doctors' Appts

Quote:
I can't even do my own grocery shopping or cooking.
If you stated this on your application, then I hope you have payment receipts to document same and/or statements from the person/people that do your shopping & cooking for you.
It will greatly help your case.
Quote:
Am I supposed to pretend I'm stupid and/or completely paralzyed and/or suicidal at these unqualified doctors' appointments?
Nope! They can smell fraud a mile away & your claim will be denied before it gets started.
Make copies of your medical records & send them to these doctors prior to your appointment so that they will have something to refer to.
Also, take a copy to your appointment "just in case".
Quote:
And can I request a different SS person who knows the difference between a benign brain tumor and a malignant one?
Yes. However, you must remember these people are "overwhelmed" with claims & if you do this, your case will be put at the bottom of the pile & reviewed in the order it is received. In other-words, your "new claims rep" will rediary your case file for another 30-60 days maybe. Depending on the backlog in your state.

TIP: Never get on the bad side of the SS claim reps. These folks are the ones who have control of your file & you do NOT want your case to "fall through the cracks."
Keep your frustrations to yourself. Believe me, you are going to get frustrated down the loooooong road.

Sounds like you will eventually need a Social Security Disability Attorney to help you out. Good luck!

 
Old 01-22-2007, 09:52 AM   #3
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Re: What to expect and to do at SS's Doctors' Appts

Thanks very much! All very helpful information. I gave SS my entire medical file when I filed and I will bring a copy to the appts, along with my brain scans. Thanks again.

I had a friend who applied for SSI (not qualified for SSDI) who has AIDS and the doc asked him to touch his toes, and then concluded he was able to work and not qualified for benefits from state disability or SSI. Sad!
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Old 01-22-2007, 10:29 AM   #4
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Re: What to expect and to do at SS's Doctors' Appts

Quote:
Originally Posted by jjcali View Post

I had a friend who applied for SSI (not qualified for SSDI) who has AIDS and the doc asked him to touch his toes, and then concluded he was able to work and not qualified for benefits from state disability or SSI. Sad!
You do realize that there are several stages of AIDS/HIV and with the proper "cocktails" you can live a long & productive life?

Your friend may not have been at the right stage of AIDS and/or financial circumstances to qualify for SSI.
Then again, if he had an attorney, the outcome may have been different.

 
Old 01-22-2007, 04:07 PM   #5
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Re: What to expect and to do at SS's Doctors' Appts

I really recommend you find a good disability lawyer. They can't get money from you unless you win, and IF you win, they can ONLY get 25% of your "backpay." I think most people that "go it alone" have problems jumping SSA's hoops...

 
Old 01-23-2007, 02:59 AM   #6
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Re: What to expect and to do at SS's Doctors' Appts

[QUOTE=jjcali;2756120]I'm applying for SSDI for the first time. I have lupus and a benign pituitary tumor and have memory loss, cognitive problems, severe fatigue, skin rashes, joint pain and swelling. I'm in bed about 18-20 hours a day sleeping and the rest of the time, laying on the couch. I can't even do my own grocery shopping or cooking.

I have 3 years of lupus medical files and 2 years of brain tumor files, including MRIs that Soc Sec declined my offer to copy (MRIs are on CDs). Despite having one of the world's best rheumatologists for lupus and world's best neurosurgeons for a benign pituitary tumor (had it removed and it came back), social security is making me go to their docs - an internist and a "psych" exam! Also, the same SS chick kept asking me for my oncologist's info, and I kept trying to explain to her that I did not have cancer and so did not have an oncologist!

Am I supposed to pretend I'm stupid and/or completely paralzyed and/or suicidal at these unqualified doctors' appointments? I don't know what they want or expect me to do! And can I request a different SS person who knows the difference between a benign brain tumor and a malignant one? Have globs of stuff in your brain is bad either way and she seems to disbelieve me because I have no oncologist!

I thought your treating specialists carried more weight than their general docs. And I am afraid they will tell me to touch my nose and then use to deny my claim.


Hi!

I hear your frustration and I can sooo relate. Took me over 3 years to finally get approved and I grew sooo weary of the fight...

Here're some of things you're up against - first, these people who are deciding your case aren't doctors and have little or no medical training. They base their decisions by using a book of codes which you will see when and if you ask to see the file they have on you. The specialists they send you to are a joke. Their primary interest is in serving SS, not you, and they can be unbelievably, ridiculously and unreasonably biased - I've seen it, been thru it. Why they care so little what your own doctors say is a bit of a mystery to me - your own doctors know you best - these SS specialists don't. Then again, it seems they are determined to keep as many people off of SS as possible, and believe me, it shows.

As mentioned, definitely be honest with the people they send you to. You may have to submit to physical capacities testing, and yeah, they'll know if you're faking. However, there is nothing to stop THEM from LYING on these reports - it happened to me! They forced me into certain positions, then said I it was within normal limits. Some things that I absolutely couldn't do, they said I "refused". Worse, they wrote down that I executed certain things within normal limits...and they never even tested me for it!! So, I was denied twice..and then I asked for a hearing. I kept notes of everything and wrote a "report" of my own. I represented myself. I won. So, when you have been denied twice, that's when to seek legal counsel, if you choose to hire an attorney...and if it comes to that. But I am definitely wishing you an easy time of it!

Hugs
Char

 
Old 01-23-2007, 06:15 AM   #7
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Re: What to expect and to do at SS's Doctors' Appts

Thanks so much for all the great advice, which I will follow. On my friend with AIDS, he has AIDS with about 68 T-Cells. He had HIV with no medication for a decade. He's very fatigued and has a lot of IBS issues, which I personally know can keep you homebound. He cannot work and had no work credits to get SSDI. He was then turned down for SSI. Until I myself became unable to work, I helped him out.

As for me, I'm actually an attorney myself. I researched all of the ICD-9 codes that my doctor put on my SSD benefits application, I included my entire medical file with my application, and I researched Social Security's Bluebook descriptions for medical conditions, which thankfully recently was changed to include lupus as an auto-immune disorder. Before last year, folks with lupus had to have symptoms and limitations that were "equivalent to" an SS-recognized condition. And as for the law on appealing denials, the ALJ is required by law to give more weight to the findings of your treating physicians. So I guess with all that in mind, it seemed pointless to me to have generalists see me when no matter what they say they eventually will be trumped by, lucky for me, leading world-renowned specialists. My brain surgeon was on the cover of Time magazine. Not bragging, just thinking that a judge would feel pretty dumb to ignore his opinion in favor of an internist hired by social security.

Whew! Sorry again for long post. I guess I am worried that because I function (ie can get online, eat, and sit up) for a couple hours a day, they will not understand that the rest of the time I am completely bedridden and incoherent. With the help of about 12 different medications, for two hours a day I can touch my toes and speak coherently (usually in the middle of the night, like now), and the rest of the time I can't take a shower, talk on the phone, or doing anything at all. I get lost driving home in my own neighborhood! So I'm worried that they'll find me qualified to do some crazy job. Believe me, I'd much rather be making my big attorney salary than worrying about social security at age 36.

Thanks ya'll. I guess I am just concerned because I've read all the horror stories on this site about disability benefits, especially for lupus patients because it is not a publicly understood condition, in my experience. One of my old bosses once told me to just put in some eye drops and keep working. ???? Thanks again. I will just hope for the best.
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Old 01-23-2007, 07:04 AM   #8
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Re: What to expect and to do at SS's Doctors' Appts

I think whoever SSA has assigned to your case looks for a specific item in your application -- can you do this or that? If you can do that one thing, everything else is discounted. It seems like the whole case is not reviewed until you reach the ALJ Hearing phase. Because then it is in the hands of a judge whose job it is is to weigh ALL the facets of the case.

I'm hoping that's the how it goes. I have MS and like you, I can do quite well for very short periods of time and then... well.

I spoke with my disability lawyer yesterday and he said he finally got the report he was waiting for from my doctor. He is sending it to the judge and hopes we can completely skip the hearing itself. He must think the report is very convincing... I don't know! We'll see!!!

 
Old 01-23-2007, 07:39 AM   #9
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Re: What to expect and to do at SS's Doctors' Appts

In my husband's case, SSA sent him to a retired orthopedic dr which was very appropriate. The dr. stated that dh could not work in any capacity. He was denied the following week with SSA stating that, in essence, dh's doctors said he couldn't work, the SSA doctor said he couldn't work but the admin believes he can still work. The ALJ through the decision out based on the fact that the 'non treating' doctor supported the treating doctors recommendations. It was a favorable 'on the record' decision.

Nobody can possibly second-guess the inconsistencies that go on with the decision making process. From what I can see, the doctor they send you to only carries weight if the decision is in their favor, meaning a denial. The only thing you can do is to be completely honest and be sure to list everything that is compromising your health. Good luck to you!

 
Old 01-25-2007, 06:04 AM   #10
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Re: What to expect and to do at SS's Doctors' Appts

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If you can do that one thing, everything else is discounted. It seems like the whole case is not reviewed until you reach the ALJ Hearing phase. Because then it is in the hands of a judge whose job it is is to weigh ALL the facets of the case.
This is all sooo true...at least, it was certainly applicable in my case. The primary focus seems to be on what you are able to do, never mind if the majority of it you can't do. It also seems absolutely true that the case isn't reviewed in its entirety (nor fairly!) until it's in the hands of the ALJ.

Quote:
From what I can see, the doctor they send you to only carries weight if the decision is in their favor, meaning a denial.
Also true. In my case, all of the SS doctor's I was sent to stated I could work, despite the fact that my doctors felt I couldn't...and I had documented evidence to support this...which SS obviously completely ignored. I have heard time and time again that SS reviewers pay little attention to our own treating physician's reports, and, ad nauseum, favor their own.

JJcali, I truly hope this won't be the case for you, but just be prepared that, despite having highly esteemed physicians, SS could still discredit their findings. It happens all too often, unfortunately.

BTW, if you have the same "psych" exam that I had, it was a joke. I spent most of the visit playing with puzzles and being asked silly questions that had more to do with intelligence, and nothing to do with anxiety and depression testing. He stated (surprise!!) that I could work. When I complained in my "report" that the ALJ viewed before my hearing, he sent me to a *real* psychiatrist..and she diagnosed me with clinical depression and GAD. Just thought you should know, if you feel the testing is in any way inappropriate. Same with the internist.

Good luck!

Hugs

Char

 
Old 01-25-2007, 05:03 PM   #11
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Re: What to expect and to do at SS's Doctors' Appts

Thanks for the insights! I am familiar with the puzzle tests and short-term memory tests from my other doctors. I am hunkering down for the long haul. Thankfully I found this board and knew where to find the law, so as soon as I realized I would be unable to work for at least 12 months, I applied. I did not wait until I was out of work already for 12 months, because I knew the process was a long one. With my memory problems and fatigue though, along with 7 different doctors and a bunch of different programs I applied for, I am getting pretty confused about which end is up. I forgot I had jury duty this week and did not send them a note and did not show up! Yikes. One day at a time. Thanks again. I do appreciate all the advice and support.
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