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 1 
 on: Today at 10:13:11 PM 
Started by MeowLove - Last post by MeowLove
Hi. Im new here, so sorry if Im doing this wrong.

Im 28 now, and I suffer from Asperger Syndrome (a spectrum of autism), bi-polar disorder, and severe anxiety issues. it was initially easy for me to get approved for SSI benefits, because I had alot of documentation from my high school and psychiatrists that tested me when I was a teen which I presented to get approved. They sent me to a doctor of theirs, got through it, and a few months later; was approved.

Now I just got my first CDR (the long form) in the mail and I am completely freaking out and thinking I'm gonna lose my benefits. My anxiety is making me lose sleep over this and flip out. I cannot get the idea out of my head and thinking about whats gonna happen to me, and if Im gonna lose my home and benefits.

The problem is, the form asked me for medical information in the last 12 months, well I am not physically ill, only mentally, and because of my social anxiety and mental health, I don't really ever leave my room. so I haven't been to the doctor since I got approved, I haven't been taking any medicine, and I have no friends or family that can back up my claim anymore to list as a witness. I also was never given a medicare/medicade card in the mail, which I just found out I was entitled to. so even if I wanted to go to the doctor I couldn't do so, as I had no medical insurance. So most of my form I sent back is blank. I filled out everything else that talks about my condition and wrote/explained all this in the extended answer section at the back of the form.

I did research to see how the SSA reviews these things, and most of the information I've read on the internet and on this forum are saying; the best possible way to continue getting benefits is to keep going to the doctor and present them with the forms when the CDR comes up. As quoted from another member on this forum: "When you have a CDR, you donít have to prove you are disabled (like you did during your application). Rather, SSA must prove you are no longer disabled. If you have had continuing treatment, and have not returned to work, it will be difficult for them to prove otherwise. It should not matter which doctor prescribes your meds, as long as you are continuing to see a doctor, and he/she is prescribing medication."

So my question to you all is:

What's going to happen if I have no medical records in the last 12 months? Will I get flat out denied, or will they send me to a doctor before they determine anything? I feel like if I am seen by a doctor, they will easily determined that I am still disabled, as my conditions are often visible and quite obvious to even non-professionals. (another reason why I'm a shut-in, because I'm embarrassed of myself).

Will they have any sympathy for the fact that they forgot to give me my medicare card and recognize that I wasn't even able to go to a doctor in the first place?

I also read around the internet that it's much easier to continue getting benefits than to get them in the first place, is this true? or is it only easy when you have the medical records. In this forum that the chances to continue receiving SSI benefits is lower than I thought they were, As quoted from another member:
"You can also see what the continuation rates for your state are by going to the State Statistics link above. Click your state on the map, and you can find what the overall average is for your State. The National average is currently 89.9% for SSDI and 60.4% for SSI."

I do not feel very good with a 60.4% chance of keeping my benefits, especially, since my chances are even significantly lowered due to the fact that I have no medical records to back up my claim this time.

And yes, I do know about the 10 days to appeal process, but I cannot afford a lawyer, or back myself up. I have crippling social anxiety, autism, and no money. Plus I heard they make you pay back everything they give you during your appeal process if you lose the case, which would ruin me even more. I cant pay something back if I can't work.

Please help!


 2 
 on: Today at 07:20:43 PM 
Started by KM - Last post by Just Me
Info a doctor puts on a form has to be backed up by medical records in order for it to carry weight. If the info is there, the ALJ should have seen it. If it is not there, it doesn't matter. The ALJ has to have made a mistake in SSA Law in order for the Appeals Council to remand a case.

If the case is remanded back to the ALJ there is no way of knowing if the Appeals Council will instruct the ALJ to have a new hearing or to only go over certain parts of the case. 

Cases the Appeals Council will review-

" If new and material evidence is submitted, the Appeals Council shall consider the additional evidence only where it relates to the period on or before the date of the administrative law judge hearing decision. The Appeals Council shall evaluate the entire record including the new and material evidence submitted if it relates to the period on or before the date of the administrative law judge hearing decision. It will then review the case if it finds that the administrative law judge's action, findings, or conclusion is contrary to the weight of the evidence currently of record."


 3 
 on: Today at 07:09:05 PM 
Started by KM - Last post by KM
I understand new RFCs will be considered new evidence after the fact, right or wrong?

What if I had the Drs update the original reports pointing out the source they used to make the determinations with maybe some explanations? That's about all I know to do here, have no idea what else to do, and my lawyer finally replied simply stating she doesn't know why the originals weren't accepted with no more information on how to increase the chance of advancing my case.

And while I was posting this, in response to Salvette,

That's where I was caught off guard. I was given confidence my paperwork would be all I needed. I felt the questioning was more of a chit chat for the most part, until the ALJ started showing some attitude for my not having prescriptions for a cane and walker as if I had broken some kind of law. I got grilled for that multiple times, believe it or not. Plus I have a hard time being open about all of this pain and mobility stuff and even though it may appear I'm open here, I'm far from it. That cost me a lot in my case as I had no clue everything was going to be turned into evidence to support a denial.

One item the ALJ mentioned in my case floored me as he stated I was doing things I clearly couldn't do, had stated so in several early forms, yet he stated it as fact. It took me a ton of research to find the glitch - I had mistakenly checked a box on 1 form, right next to the paragraph stating I couldn't do this. Rather than question the fact I had stated on MULTIPLE forms I was no longer able to perform this act, he stated I could based on one single box I checked off by mistake.  Multiple forms he could have used to support my case - he chose the one mistake to support his agenda.

If I get another hearing you better believe I'll be outspoken. I was simply mislead and I was expecting fairness and an "impartial" ALJ which was the complete opposite of what I was presented with. That's not just my opinion, it's a fact spread across the internet along with a history he has of a LOT more that made the news nationwide and I won't go into here. He's quite popular for all the wrong reasons. No, I never had a chance... Yet I have to do what I can to build whatever case I can. Thanks for your input! I went into this too dumb and couldn't find anyone to help so I made mistakes that are costing me severely.

 4 
 on: Today at 06:43:53 PM 
Started by KM - Last post by Salvette
Although your medical records and what is, and is not included in them, is extremely important, the main thing I kept in mind when coming my Disability application was explaining how my ailments affect my ability to work. What was also deemed important was how my pain medications affect me and my ability to work. Also, my (very short) work attempts after I left my last full time job, and also how it affects my day to day life, or lack of. Pain is subjective, and also not measurable by any test, so if your in chronic, severe pain is, at the most, managed by otc nsaids, that may not considered "severe" by ssa rules... I've "graduated" to 60mg of morphine a day for the past 7 years after trying everything else for pain, along with neurontin, muscle relaxers, anti depressants, xanax xr and thyroid and other needs and issues.  I'm just giving my info as an example... But as I stated in the beginning, how you're ailments affect your ability to work is what they want you to tell them, at the very least...

 5 
 on: Today at 05:39:05 PM 
Started by sodone - Last post by sodone
howudoingralphie
  well said.

 6 
 on: Today at 03:53:57 PM 
Started by KM - Last post by KM
I was only able to get to a Dr in the last few years due to a lack of insurance. I do have some records and one I was seeing before filing had horrible records I only found out about AFTER filing which is why I fired him. Mentions of spastic "paresis" about 10 months prior to my filing. I confronted him about his horrible records and he would only offer to update them with one vague mention of "musculoskeletal pain". Thank you very much... My Neuro and PCP's records show some numbers related to tests, spasticity, extreme weakness, myelopathic gait, cervical myelopothy, hereditary spastic paraparesis, among a ton of other $5 words which I had made mention of "putting test results in English" and both docs claimed repeatedly their records would meet SSA standards. So there's that I had to deal with. Oh, and the PCP uses hand writing. Let's just say if it were totally readable I might not be here bothering you guys.  Main20 Those RFCs were based off of those tests but didn't mention them - only that they were based on my having HSP. I have a CD supposedly on the way so I can get more details hopefully.

I don't have a medical history of falling as I simply don't run to the Dr for every event. That was in hindsight. The recent one is on record. A couple of previous ones along with one ER visit were dropped from records due to time limits.

The records of complaints were from jobs in the early to mid 2000s when I was last employed. One set of complaints by a foreman demonstrating "how I should walk" led to the next job, the next job pulled "starvation" after about 4 years, the next job closed and by then my situation was beyond me hiding it which prevented further employment. I filed the remarks with my initial app giving names and specifics knowing it was just fluff to SSA. There is no record from that time frame since to make a formal complaint would have put me out of work much earlier as my profession didn't allow for such "nonsense".

 7 
 on: Today at 02:26:06 PM 
Started by KM - Last post by Lit Love
If you have not read this link explaining the full 5 Step Sequential Evaluation Process, you really, really should: https://www.ssa.gov/oidap/Documents/Social%20Security%20Administration.%20%20SSAs%20Sequential%20Evaluation.pdf

Step 2:  Do you have a severe impairment?  Yes.  SS acknowledges that severe impairment as HSP.  A 17 year old diagnosis would not have helped.  And old, lost records do not matter to SS.  You are "majoring in minors" to quote DP.  

I think you want to use logic that if you have had a diagnosis of HSP for 17 years and a reasonable progression of the disease would indicate by this point you have Limitations with regards to ambulating.  That will not be sufficient for many/most ALJs.  Your denial is specific to your not having objective tests.  Again, you don't need to prove the diagnosis.  And submitting proof of the test confirming the strain won't help.

Did your doctor document your Limitations prior to filling out your RFC?  Did your doctor record (a minimum of a year prior to your AOD would be ideal) the progression of your gait disorder, or the spasticity and weakness in your lower limbs?  Has your doctor documented a history of falls?  Have you needed to go to the ER as a result of any falls?

You don't actually need a full blown FCE.  All you need tested is the Limitations on your ability to stand and walk.  

Which reports support total disability?

The records of complaints about your walking problems might help.  When are these from?












 8 
 on: Today at 12:15:21 PM 
Started by KM - Last post by KM
You can also have 3rd party forms filled out regarding your Activities of Daily Living by as many sources familiar with your ability to function as possible. 

I'm a loaner. Anyone other than my wife knows very little about my problems.

Did you make any requests foe accommodations from your former employer? Were you terminated?  Can former co-workers or management document any functional issues?

Requests? Yes! Terminated? No. My profession has very little termination since I was on commission. They "starve" you out by withholding work to avoid legal issues and unemployment. My last employment (outside of "self") was over 10 yeas ago so there's no way to get anyone to remember "my" problems that far back. I do have on record complaints made by employers towards my walking abilities and such and have left jobs due to this causing the starvation issue I mentioned above, but as we all know, it's simply my word and useless.

You are focused on things you believe are important, that aren't.  It is important to have a diagnosis of a severe impairment, but if you can't meet or equal a Listing, and your AOD is prior to your 50th birthday, than your focus then should turn to your ability, or lack there of, to work at the SGA level.  What are your Restrictions and Limitations: walking, standing, sitting, etc.?  Read through some of Different Perspective's posts regarding function.

No, the things in this thread are minor and I stated such. But anything that might support my issue needs addressing. The things I've asked elsewhere mean everything - obtaining evidence to support reports I turned in. Those reports are a huge factor as they do support total disability.

Some of this goes well over my head so bare with me... I was diagnosed with HSP back in 1999. My family was part of a large grant to study the disease involving genetic testing, physical exams, and so on and I was the last "patient" of the day called in for testing. Next thing I know I was used as an example in the test as I was the most advanced case present. I thought little of it as I would never let it beat me. In 2000 I went to a regular Dr who put it in records I have HSP based on the process of elimination - MRIs showed nothing, EMGs showed no Parkinsons, etc, so my diag was "HSP" for a lack of anything else along with a family history. Years later I'm fighting for disability only to find the original grant results must have been shredded as there is no history at the college, no history with the Dr who performed the tests, and so forth. My current RFCs referenced HSP as the factor leading to the limitations and were inadmissible due to a lack of objective evidence and I wonder if that was because of the story I just told? Maybe this wasn't enough to support a claim of HSP? My denial DOES confirm I have HSP, though, as the ALJ stated I do have HSP, and it does extremely limit me, but... So I don't know where the hole is. The recent genetic testing does fully confirm not only HSP but the exact strain and I have sent that along with documentation backing up the fact the other tests will not provide evidence to support it. So, as a last resort I don't know if that will hold weight or not, but there is simply nothing else to offer. (Yes, FCEs are still in the thought process but I need to discuss that with my lawyer provided I get past AC)

 9 
 on: Today at 10:24:47 AM 
Started by KM - Last post by Lit Love
Read this link updating the Evaluation of Medical Evidence: https://www.ssa.gov/disability/professionals/bluebook/revisions-rules.html

If you have a FCE and it provides objective medical evidence that your Limitations support the ALJ set your RFC to less than Sedentary, and your ALJ rejects that evidence, it will be a legitimate argument for appeal.  You may even get lucky and your ALJ might not be available if/when you receive a remand for your 2nd hearing (or you could move to insure a new ALJ). Otherwise, your goal might have to be to reach hearing number 3, which would guarantee a new ALJ.  Heck, there's even a slim possibility that the AC approves you outright.  But, you really should proceed with the expectation that eventually SS policy will be followed. 

You can also have 3rd party forms filled out regarding your Activities of Daily Living by as many sources familiar with your ability to function as possible. 

Did you make any requests foe accommodations from your former employer? Were you terminated?  Can former co-workers or management document any functional issues?

You are focused on things you believe are important, that aren't.  It is important to have a diagnosis of a severe impairment, but if you can't meet or equal a Listing, and your AOD is prior to your 50th birthday, than your focus then should turn to your ability, or lack there of, to work at the SGA level.  What are your Restrictions and Limitations: walking, standing, sitting, etc.?  Read through some of Different Perspective's posts regarding function.


 10 
 on: Today at 09:48:21 AM 
Started by julia2011 - Last post by Shep3300
I agree Just Me, but that wasn't her question. Her question was can the government obtain records/info on what she purchases with her Direct Express card....simple answer NO....unless in very rare instance, which requires a warrant from a court.

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