MIL might be denied due to dr.

cmclimer · 11-04-2009, 09:10 PM

Hey all!

I wanted to ask anyone here if they would have any advice for my MIL who has applied for SSI, and had a less than stellar experience with an SSA dr.

A little history: My MIL is 56 y.o., and for the last 2 and a 1/2 years she's had chronic arthritis in both of her knees and absolutely no fluid on either of her knees. She's been seeing free physicians at her local clinic for this since the problem started about 2 and a half years ago, and they have been treating it with steroids about every three to six months with injections. After some time of this treatment, the dr.'s at the local free clinic decided that she really needs a replacement knee, and scheduled knee surgery for one of her knees-which she had earlier this year (apparently, as she was told, you can only have one knee done at a time). During this last six months, she's been trying really hard with physical therapy to get her knee working again, but nothing is making it (along with the other knee) not hurt or work properly. She's been out of work for the past 2 and a 1/2 years due to this problem, and her deceased husband's life ins. $ is about to run out, so she decided it was time to bite the bullet (so to speak) and file for SSI in hopes of still being able to have some sort of income since she can't work. And believe me-I've been watching this poor woman wobble around for the last two years on walkers and crutches-even if she had a desk job-she would have a hard time walking into the building. Heck, she has a hard time driving, and usually gets one of us to drive her somewhere if she needs to get somewhere badly enough. Otherwise, she sits in her apartment riddled with pain, and basically sits where ever she lands until she really has to do necessary things-such as use the bathroom, etc., and even still is using her walker, crutches, furniture, or whatever she can to help support her to get her where she needs to go.

The dr. that the SSA sent her to is 97 years old, came into the exam room on a walker, and then proceeded to tell my MIL that she hasn't had knee surgery. Even with her telling him that she has in fact had knee surgery (while waving the paperwork in his face that so proves that she's had knee surgery-which he didn't want to take the time to read). She even tried to show him her scar, and he told her that that wasn't a scar on her knee, but in fact an injection site from where her prior dr's have injected her with fluid, and not steroids as she was told by her prior dr.'s and was stated in all of her prior medical records. We're talking about a scar that's about 5 inches down the front of her knee. A scar that I saw stapled up after her surgery with my own eyes-as did many others in our family. Heck, her sister drove her to the hospital, and drove her home after her stay in the hospital of a couple of days after the surgery. Also, this dr. thought it was appropriate to ask my MIL to lift her shirt so that he could hear her heartbeat. She told him that she's never had a dr. ask for her to take her clothes off for something as simple as listening to her heartbeat, and that he would have to listen to her heart through her shirt. He wasn't happy about this, but obliged, none the less. All the same to me, it seemed kind of strange and highly inappropriate that he would request such a thing because I also have never had a dr. that needed for me to take my top off in order to hear my heartbeat.

Anyways, we are all anticipating that she will infact be denied for SSI due to what we all as a family feel is negligence on this dr.'s "exam". My mom thought that maybe we should call our state medical board to report this dr. as well as call the SSA to report him to them, as well as to request a new dr. do a new examination. I thought it might do us some good to put in a call to an attorney, but don't know if that would be "jumping the gun"-so to speak-since we haven't gotten a formal denial from the SSA yet. Would anyone here have any additional advice for us? TIA!!!

Cat

hessie28 · 11-07-2009, 03:02 AM

It is sad about some of the doctors they send you to. I had a WC claim. They sent me to the Dr. for the employer. Right away he was a weirdo. He kept the door open. Then he asked if that was my husband in the waiting room. I said yes. He called him in the examing room. The Dr. said to me that a patient once accused him of sexual harassment so he doesn't see a patient alone anymore. Believe me, I can believe it. What a quack. I read the report later where he blamed everything on me just being fat. I was there for a tear in my elbow.

It's scary on what they have working on a case sometimes. I had a Dr. at my hearing that SS requested. He was retired and paid by the state. He was there to only discuss the medical issues. He could not ask me questions etc.

Executor · 11-07-2009, 11:37 AM

Welcome to Healthboards. Many here have quite a bit of experience and thus, can offer lots of support and guidance. I hope you find you time here enjoyable.

A couple of questions for you and then after you answer, I'll offer much more.

(1) Is a lawyer helping her with this or did she file on her own?
(2) Is there any Doc that she sees regularly backing her on her SSDI claim, or is she filing on her own....ie. without asking Drs?
(3) Does she take any type of regular pain meds, or any other type, for her condition?

Regards,

Ex

cmclimer · 11-07-2009, 01:03 PM

Thanks for the replies!

Ex,

She did file for (I thought she told me SSI, but it may be SSDI) on her own. No lawyer involved as of yet. Although, if the SSA denies her claim, then that may be a route that we pursue. She's had her regular dr. as well as many orthopedists (since it's a free clinic, they rotate in and out), and she was told by the personnel and medical staff at this free clinic that they won't prescribe her any pain meds since they've been giving her steroid injections. They told her that she could have one or the other, but she couldn't have both. They did give her anti-inflamitories for the swelling in both legs to go down. The arthritis in both knees causes both of her legs to swell if she's on them too much-hence the reason she usually tries not to move around all too much. But, her legs still swell no matter what she does. I mean a simple trip down the hall to the bathroom, and her legs swell. And the arthritis causes pain in both of her legs as well.

Any words of wisdom would be so appreciative. In my original post, I said that the dr. that SSA sent her to was 97. We only found this out after we looked him up on our state medical board's website after the dr. visit. I think my whole family's jaws hit the floor. My MIL said he was old, but no one, not even her, would have imagined that he was that old, and still able to hold onto his medical license. I still can't wrap my mind around how he's able to perform a physical examination on someone while he, himself, is on a walker. That really just blows my mind.

Anyways, thanks again for the responses. Looking forward to anything else that anybody out there wants to add to help out in the situation.

Cat

Executor · 11-07-2009, 10:47 PM

Quote:

Originally Posted by cmclimer

She did file for (I thought she told me SSI, but it may be SSDI) on her own.

Quite often, the terms are used interchangeably. "SSDI" stands for social security disability insurance.

Quote:

Originally Posted by cmclimer

No lawyer involved as of yet. Although, if the SSA denies her claim, then that may be a route that we pursue.

You may want to think about hiring either a disability lawyer or a disability advocate. They are experts in the process and know exactly how to present an overall application. Quite often, they have worked for SS and know how the system works. Additionally, many have connections with judges and etc. One can't put a value on this type of experience.

Quote:

Originally Posted by cmclimer

Any words of wisdom would be so appreciative. In my original post, I said that the dr. that SSA sent her to was 97. We only found this out after we looked him up on our state medical board's website after the dr. visit. I think my whole family's jaws hit the floor. My MIL said he was old, but no one, not even her, would have imagined that he was that old, and still able to hold onto his medical license. I still can't wrap my mind around how he's able to perform a physical examination on someone while he, himself, is on a walker. That really just blows my mind.

Is your MIL seeing a regular Dr? Has anyone backed her case...ie. come right out and said that she's disabled? This is very important. If so, then that's great for her case. If not, she needs to seek one out who will back her. It's very important to have a Doc who will put in writing that she is disabled. The more definitive your records are, the better your chances are.

Here are a few links that I highly recommend you read that covers many different aspects of SSDI:

(1) Does Having Fibromyalgia Qualify for SSDI?
http://www.healthboards.com/boards/showthread.php?p=4092513#post4092513

(2) "Not sure how to feel"
http://www.healthboards.com/boards/showthread.php?t=666967

(3) "Unfavorable Decision"
http://www.healthboards.com/boards/showthread.php?t=713731

The above aren't necessarily directly related to your MIL's case, but are great threads in terms of a a general overview of SSDI. They will educate you on how the system works and what goes on with an application. Knowledge is power and will only help your cause.

Regards,

Ex