From: "L Misek-Falkoff" <include@...>
To: <disabilityparty@yahoogroups.com>;
<Chronic_Pain_Cooperate@yahoogroups.com>; <pain-in-the-law@yahoogroups.com>
Cc: <include@...>; <adfonatt@...>
Sent: Monday, February 10, 2003 1:33 PM
Subject: Fw: Acquiring and keeping social security benefits <=from
[invisible-disability] list.


> Thanks to Anne-Marie:
> ----- Original Message -----
> From: "Anne-Marie Vidal" <shadesofjoy@...>
> To: <Undisclosed-Recipient:;>
> Sent: Monday, February 10, 2003 3:00 PM
> Subject: [invisible-disability] Acquiring and keeping social security
> benefits
>
>
> > From Karen G.
> > Hugs,
> > Anne-Marie
> > No Funds=No Research=No Cure
> >
> > Acquiring and Keeping Social Security Benefits for CFIDS and FM
Sufferers
> > (By Alec G. Sohmer, Esq.)
> >
> > Because chronic fatigue and immune dysfunction syndrome (CFIDS) and
> Fibromyalgia (FM) are poorly known medical conditions that are just now
> gaining widespread recognition, many sufferers are unaware that benefits
may
> be available to them - even if they are employed part-time. The inability
to
> provide for yourself or your family may entitle you to Social Security
> benefits. With the proper planning and guidance, it's possible to overcome
> the numerous hurdles on the way to winning your claim. An individual who
> intends to file a Social Security Disability Insurance (SSDI) claim must
be
> unable to engage in any substantial gainful activity due to a medically
> determinable mental and/or physical impairment, which has lasted, or is
> expected to last, at least 12 months or is likely to result in death. A
> separate standard applies for a disabled child, as do other income
> eligibility requirements. Patients must have supporting medical evidence
> from their primary care physician or treating physician. Fortunately,
> patients do not have to wait the 12-month period before applying for
> benefits, as long as the condition is expected to render them unable to
work
> for a minimum of that time. There's an important difference between the
> eligibility requirements for SSDI and Supplemental Security Income (SSI)
> benefits. For SSI, financial resources are considered. A "resource" is
> defined as cash on hand, or other personal or real property that an
> individual owns or retains an ownership interest in, has the legal right
or
> authority to liquidate and is not restricted from using for means of
support
> . For SSDI claims, however, financial resources are not taken into
> consideration.
> >
> > Getting Started
> >
> >
> > The first step in determining your eligibility for SSDI is to
> complete and file a written application. You should visit your local
Social
> Security office for this purpose. Since considerable and specific
> information is required, you should visit or call the office beforehand to
> determine what supporting documentation is required. Because CFIDS and FM
> are not listed as "presumptive" disabling conditions for SSDI purposes,
> expect your initial claim to be rejected.
> > Presumptive impairments are specific physical or mental conditions
> that are so severe that the Social Security Administration (SSA) has
> determined that persons suffering from them are considered totally
disabled.
> If declined benefits, you should appeal. Benefits will be awarded to
people
> with CFIDS or FM should their symptoms be determined to cause
substantially
> the same degree of functional limitation as the listed conditions. After
> receiving the initial rejection, you must file for reconsideration. The
> Request for Reconsideration is the first step in the appellate process,
and
> requires another application. It is helpful to retain a copy of your
initial
> application, as the Request for Reconsideration seeks substantially the
same
> information. Also, you should prepare a detailed list of each and every
> physician who has treated you during your illness. The list should include
> the physicians' names, addresses, telephone numbers, approximate dates of
> treatment and probable diagnoses. Again, be sure to list every physician
and
> other health care providers you have seen - even those who have not
treated
> you specifically for CFIDS or FM. Once again, expect a rejection of your
> claim. Unfortunately, this is often part of the process for people with
> CFIDS or FM. It's time-consuming and frustrating - but don't give up. The
> next stage, Administrative Appeal, is where most CFIDS and FM claimants
are
> successful. CFIDS and FM are not listed among the qualifying conditions in
> the SSDI section of the Code of Federal Regulations. So the Administrative
> Law judge must determine whether your condition meets or exceeds the
> impairments caused by those on the list.
> > Under the statute, the judge will determine whether the impairment
is
> medically equivalent to those listed. Symptoms, signs and laboratory
> findings will be compared with the corresponding medical criteria shown
for
> any listed impairment. All decisions will be based on medical evidence
only,
> supported by acceptable clinical and laboratory diagnostic techniques. Of
> importance, an Administrative Law judge cannot reject a claim based on the
> absence of abnormal laboratory and physical findings in your medical
> history. This violates SSA policy with respect to CFIDS and FM. The
> > SSA has accepted that "there is no dip-stick laboratory test for Chronic
> Fatigue Syndrome.so the disease is not per se excluded from coverage
because
> it cannot be conclusively diagnosed in a laboratory setting. " Hallgring
v.
> Callahan,
> > 975 F.Supp. 84 (D.Mass. 1997) (citing Rose v. Shalala, 34 F.3d 13, 17
(1st
> Cir. 1994); Sisco v. Department of Health and Human Services, 10 F.3d 739,
> 744 (10th Cir. 1993). Further, because the methods for diagnosing CFIDS
and
> FM are limited, the importance of claimant's testimony and credibility are
> enhanced. Reed v. Secretary of Health and Human Services, 804 F. Supp. 914
> (E.D.Mich. 1992).
> > In a nutshell, that means the judge must weigh your personal word
> more heavily than he might in other cases. The Administrative Law judge
must
> use a five-step, sequential evaluation to determine a person's level of
> disability. The judge considers these questions:
> > 1) Is the claimant engaging in substantial gainful activity?
> > 2) Does the claimant have a severe impairment?
> > 3) Does the claimant suffer from an impairment that equals the severity
of
> a listed impairment?
> > 4) Does the claimant possess the residual functional capacity to perform
> past relevant work?
> > 5) Does the claimant possess the residual functional capacity to perform
> any other work that exists in significant numbers in the national economy?
> >
> > In determining what constitutes a severe impairment, the
> Administrative Law judge will consider any condition that significantly
> limits your ability to do basic work activities such as walking, standing,
> lifting, bending, understanding, remembering, using judgment, etc.
Residual
> functional capacity is defined as your ability to complete similar
> activities despite the functional limitations imposed by your impairments.
> > Under the current law, the Administrative Law judge must give the
> claimant increased credibility in assessing his or her own residual
> functional capacity. Fragale v. Chater, 916 F.Supp.249 (W.D.N.Y.1996).
> >
> >
> > After the award
> >
> >
> > Many claimants question whether they may continue to work while applying
> for benefits or attempt work once benefits have been awarded. Many people
> wish to work for not only the extra income, but to overcome their
> disability. Under the Social Security statute, a claimant may return to
work
> for a trial period of nine months (not necessarily consecutive) without
> interruption of benefits. For a minimum of 36 months after the trial work
> period, benefits will continue so long
> > as monthly earnings fall below the substantial gainful activity level.
> Currently, this level is $700 per month for individuals with disabilities
> and $1,170 per month for those who are blind. Even if benefits stop due to
> increased earnings, Medicare coverage can continue for at least 39 months
> after the trial work period ends. After that, Medicare coverage can be
> purchased by paying a monthly premium. Of importance, certain disability
> related expenses necessary for work might be deducted when calculating
> monthly earnings. Therefore, earnings could be substantially higher than
> $700 per month before your benefits are stopped. If you earn more than
$700
> per month (after deductions) during your period of eligibility, disability
> payments will stop. But if you remain medically disabled, benefits may be
> reinstated any time during the next 36 months. During this time, benefits
> will be received anytime your earnings fall below $700 per month. With
> earnings less than $700 per month, benefits will remain indefinitely.
> Medicare coverage will continue through the trial work period and for at
> least 39 months afterwards, so long as you remain disabled.
> > Under the Ticket to Work and Work Incentives Improvement Act of
1999,
> claimants receive a "ticket" to use for vocational rehabilitation and
other
> employment support services. The program is voluntary. While in use,
> regularly scheduled medical reviews will be waived. Should work earnings
> end, reinstatement of benefits may be requested without filing a new
> application. Attorney Alec Sohmer runs a private practice in Brockton,
Mass.
> He assists individuals and businesses in bankruptcy, real estate, advanced
> estate planning, personal injury, small business litigation and Social
> Security Disability, specifically helping those with CFIDS and
Fibromyalgia.
> > Sohmer's Web site deals exclusively with how to apply for
disability
> benefits, as pertains to CFIDS and FM. He may be reached at 508-583-6510,
or
> through the Web site: http://www.disabilityassistance.com.
> >
> >
> > 1999 Ruling Aids CFS Claimants
> >
> >
> > In 1999 the Social Security Administration (SSA) adopted a new
policy
> ruling - SSR 99-2p - recognizing CFS as a potentially disabling condition.
> The ruling provides examples of objective evidence, such as high
> Epstein-Barr titers and a positive tilt table test, which may indicate
CFS.
> The ruling also establishes that the applicant's treating physician should
> be the primary information source about the patient's medical condition.
In
> the past, medical evaluators who see the patient only once to render an
> opinion on the individual's functional capacity often were given as much
> credence as the patient's doctor of record.
> > Attorney Mac Sasser has seen improvement in the handling of
> CFS-related SSDI cases since the ruling was adopted: "Ruling 99-2p is a
big
> step forward for people disabled by CFS. This ruling has improved the fact
> finding and analysis stages, particularly at the hearing level.
"Association
> president & CEO Kim Kenney seconds Sasser's observation. "CFS cases are
> decided more quickly and more often in favor of the applicant than
before,"
> Kenney says. "SSA is gathering data from its offices around the country to
> assess approval rates and identify geographic differences that alert staff
> to the need for additional training on CFS."
> > The CFS ruling is available at
> www.cfids.org/resources/ss-disability.asp. If you have been diagnosed with
> CFS and are filing for benefits, make sure the ruling number, 99-2p, is
> noted in your application. - The CFIDS Association of America
> >
> >
> > Tips to minimize your wait
> >
> >
> > Although the appellate process for Social Security Disability
> Insurance benefits may take as long as two years from start to finish -
> excluding the time spent for diagnosis - there are measures that can
reduce
> delay:
> > Get started now.
> > Prepare a list of each and every physician you have seen. This list
> should include names, phone numbers, addresses, approximate dates of
> treatment and probable diagnoses. Remember to include all physicians,
> whether or not related to CFIDS or Fibromyalgia.
> > Keep documents of medical records, and note how the condition affects
your
> functional capacity on a daily basis.
> > Document all necessary work expenses related to your disability.
> > Talk to an experienced attorney who understands both the condition and
> Social Security laws.
> >
> >
> >
> >
> >
> >
> > [Non-text portions of this message have been removed]
> >
> >
> > Invisible Disabilities List:
> > http://www1.shore.net/~dmoisan/disability/list.html
> > Unsubscribe: invisible-disability-unsubscribe@onelist.com
> >
> >
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http://docs.yahoo.com/info/terms/
> >
> >
>