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+  Social Security Disability Facts Forum
|-+  SSDI and SSI Disability Application Process
| |-+  Reconsideration Requests
| | |-+  Questions regarding reconsideration process.
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Topic: Questions regarding reconsideration process.  (Read 1056 times)
persephone
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« on: April 12, 2017, 01:55:35 AM »

Hi, I'm new here.

I applied for SSI in August of 2016 and was denied in October of 2016. I was 13 days late getting my appeal for reconsideration in on time due to executive dysfunction and a misunderstanding. My appeal was accepted, though, on January 6th, 2017 after sending in the reasons for missing the deadline. I received a phone call and an update in February stating that my medical records were being reviewed, but nothing since then.

My question might be a bit complicated.

I am Autistic. I was first diagnosed at the age of seven, but my mom chose to 'deny' the diagnosis. I received speech therapy from 1st grade until 4th grade, along with other special accommodations because my mom worked for the schools I went to. I did not have to go to assemblies, recess, or pep rallies, and I was given time separated from the rest of the students when I became overloaded. Despite receiving accommodations, I was not told about my diagnosis, and was removed from school to be homeschooled in the middle of 4th grade. I was officially re-diagnosed in November of 2016, after having waited nearly a year to be approved for testing.

I have "moderate functioning Autism Spectrum Disorder," with notes in my file from my therapist and diagnosing psychologist that I have a history of regression. I also go nonverbal, have meltdowns regularly (three to four per a week, sometimes more), and am unable to do most things on my own, such as grocery shopping and driving. This also affects my ability to go to doctors, as phone calls, taking public transport, et cetera are very difficult for me. I have mixed receptive-expressive language disorder, major depressive disorder, and generalized anxiety disorder, as well as physical problems. Currently, I am diagnosed with fibromyalgia and chronic back pain, and neuropathy 'of unknown origins,' and am awaiting an appointment with a rheumatologist in May to determine if my chronic inflammation/pain and severely low vitamin D levels are due to an autoimmune disease.

I have only worked briefly at Burger King at the age of 18, which was 13 years ago. I worked there less than a week, had a meltdown each day that I did work, and ended up lifting 150lbs of frozen meat by myself because I am unable to process verbal instructions (the injury I received because of this was the beginning of my neuropathy). This is part of the reason why I misunderstood regarding the appeals process - the SSA caseworker insisted on speaking over the phone and I did not understand what I was supposed to do for the appeal. I have not worked since then, living both with relatives and homeless on multiple occasions. I was never able to get beyond the initial interview, if I was able to get an interview at all, and then my physical health deteriorated to the point where I was in a wheelchair for several years and still require the use of a walker now. I was in undergrad for seven years, with a clear history of deteriorating abilities. I ended up in a severe shutdown and regressed to the point where I was unable to process even written language beyond the very basics. I never finished my degree, dropping out after my PCP and therapist both said I would continue to decline rapidly if I did not relieve the sensory overload I had forcing myself to be in college.

My questions are multiple, so I am going to number them for convenience:

1. Does my lack of work history affect the SSI process? I do have a witness who worked with me who can attest to my meltdowns and injury while I worked at BK.

2. How important is non-medical evidence? Do I need to send the SSA non-medical evidence? If so, what exactly -is- non-medical evidence?

3. Since I have been Autistic my entire life, does this affect the reconsideration process significantly? I am confused as to how the SSA will process this information, as they were made aware of me being Autistic back in August, but received my official re-diagnosis sometime in December.

No one has really explained this process to me. I am doing everything on my own, other than what my therapist has been able to help me with, so I am confused if I need to be doing something more. I am worried I have already messed up this appeal and am afraid of needing to go before a judge because I have such difficulty with verbal speech and I do go nonverbal (I am unable to speak sometimes).

I am sorry this is long, and if I posted in the wrong section. Thank you for your time reading this.
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Helper
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« Reply #1 on: April 12, 2017, 06:29:51 AM »

If your reconsideration is denied, you need to hire a representative to help you with the ALJ hearing.  The representative has no fee up front - they are paid from your back pay after you win your case.  The representative's fee is 25%, with a $6000 limit. 



So, it sounds like you are in your early 30s now?  It is too bad you did not get re-diagnosed sooner to apply with an earlier onset date to be eligible for benefits on your parent's work records.  Unfortunately, if you were just re-diagnosed in November of this past year, you are not going to have enough medical evidence for an earlier onset date.

https://secure.ssa.gov/poms.nsf/lnx/0422505001  Nonmedical evidence is basically everything you submit that is not medical records.  So, your report of how you are functioning, the report of the burger place employee, etc.

Even though you have been autistic for years, SSA expects that you are undergoing treatment.  It is possible that SSA may end up adjusting your onset date to when the autism was re-diagnosed, because any records from elementary school are too old.  SSA typically looks at medical records 1 year prior to onset for physical issues & 2 years prior to onset for mental health issues.

Also, are you seeing a doctor for your back problems on a regular basis?

Have you looked into whether your local bus system offers a paratransit service for people with disabilities?  You do not need to be approved by SSA disability to qualify.  But you can typically get a car or bus to pick you up at your front door & drop you off at your destination   (& obviously come back when you are done to take you home) for a very reasonable fee.  Autism or needing a walker usually qualifies.    It would be easier than riding a standard bus.  Trips typically have to scheduled a day or two in advance (but if you know you have a medical appointment it works out well).
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Age at Application: 26 age of onset (but I did not apply until 28)
Date Applied: August 2011
First Approval/Denial Date: November 2011
Additional Info: I was fortunate to be approved on my initial application due to extensive medical records (12+ doctors) & documentation of unsuccessful work attempts even with significant accommodations
Lit Love
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« Reply #2 on: April 12, 2017, 11:30:16 AM »

Did a doctor prescribe the walker?  Do you require it every time you move (ambulate)?  If so, you should meet a Listing.
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persephone
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« Reply #3 on: April 12, 2017, 06:50:35 PM »

Sorry for the late response, my laptop was not working properly.

I'm 31.

My walker was prescribed by one of my doctors, and I have to use it for distances longer than 10 feet.

My PCP diagnosed me with fibromyalgia in March 2016, and I have seen three neurologists since May 2016 who diagnosed me with 'neuropathy of unknown origins.' I have an appointment with the only rheumatologist in my area who will take my medical card for the end of May 2017. My one neurologist noted in my files that he believes I have sciatica, but Medicaid won't approve the lumbar MRI that he wants to do to try to figure out -why- I have it. My right leg is very weak, and I have little control over it even after 16 weeks of physical therapy. The last time I seen my PCP, she put in my file that I now have chronic back pain, but I am not really sure what that entails. It was a questionnaire that explained the things that I am unable to do because of my back pain, including needing help to shower/dress. On top of executive dysfunction, my constant back pain makes it impossible for me to shower regularly, and I am limited to things that don't need to be cooked unless someone makes food for me.

I didn't have any sort of insurance up until I moved back to Ohio from TN after the Medicaid expansion, but not having anyone to help me, I had difficulties finding a PCP. My current PCP does not like me because I 'embarrassed' her when I had a meltdown at the pain management clinic she referred me to. The pain management doctor refused to stop yelling at me while I was having a migraine with aura in his office and was stimming because my migraines cause me to have panic attacks/become paranoid. I need to stim to keep from going into sensory overload, which is doubly important when I am having a migraine, but I had gone partially nonverbal and he did not allow me to write what was going on down. I have an appointment also at the end of May for a new pain management clinic, but I am scared to go.

I started the process for re-diagnosis the moment I began going to a therapist, but Medicaid took eight months to approve me for testing. I was diagnosed with major depressive disorder and generalized anxiety disorder in March 2016. My denial letter stated I had "some nervousness" and "mild depression," but neither of these things were written by my therapist, who showed me what she wrote to the SSA. I am not sure where either of these came from, but I am on anti-depressants and anti-anxiety medication, neither of which allow me to function entirely without depression or anxiety, especially anxiety. I have instances of agoraphobia, with a history of going three years without leaving the house, and multiple people who can attest to that, though I am not sure how much that would help?

The psychologist who diagnosed me noted in his evaluation that I "live in a fantasy world of [my] own making," which my therapist also reported to the SSA, and that I do not have friendships outside of the internet other than my boyfriend, who is also Autistic. I have people who would agree with their findings who have known me since I was 12. Would it be beneficial to have them write something for me in regards to what they know of my behavior?

I do sometimes take the transportation offered by job and family services here, but have difficulty with them as they tend to be smaller and I am claustrophobic. The worst time, though, was when they driver picked up a registered sex offender and forced me to sit next to him despite the fact the driver said he wasn't allowed to be around women. It scares me worse to go with them now, though it would probably be safer than the bus.
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Helper
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« Reply #4 on: April 12, 2017, 08:10:05 PM »

Slight tangent on the transportation  - have you looked into paratransit services offered by your local bus service?  They typically charge a small fee & provide door-to-door service.  It might be easier for you than using regular fixed route bus service.  You typically need to have disabilities to qualify for paratransit (but you do not need to be on SSA disability or anything) - just gave your doctor complete a form.  Paratransit  rides typically need to be scheduled a day or two in advance.
Logged
Age at Application: 26 age of onset (but I did not apply until 28)
Date Applied: August 2011
First Approval/Denial Date: November 2011
Additional Info: I was fortunate to be approved on my initial application due to extensive medical records (12+ doctors) & documentation of unsuccessful work attempts even with significant accommodations
grove800
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« Reply #5 on: April 14, 2017, 04:26:06 AM »

 Welcome01 Welcome07
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😊
Name: Vicki
Location: IL
Age at Application: 59. Age now 62
Disability: Hypogammagobulimannenia , aggressive arthritis spine, 4 level cervical fusion, chronic pain, DDD,COPD,
Date Applied: 7/2013
First Approval/Denial Date: 11/2013
Reconsideration Approval/Denial Date: 5/2014
Date OTR requested: 6/2014
Hearing Date: January 19, 2016
Date Award Letter Received: February 3, 2016. per benefit letter on my SS website
Date Back Pay Received: February 4, 2016 direct deposit
Additional Info: fully favorable letter by mail Feb 6, 2016. Medicare started Dec 2015
persephone
~ Copper ~
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Posts: 4


« Reply #6 on: April 17, 2017, 01:00:09 PM »

I just had a very odd conversation with the SSA.

I was in the ER on February 6th for what is being labeled as 'chronic low back pain.' The caseworker requested updates from my PCP regarding it, I let her know that I was just back in the ER for the same thing except this time my hands and arms are going numb. I am going back to my PCP this Friday, so the caseworker asked me to call her on Monday to let her know that I went, and to let my PCP know they are requesting my medical records regarding the 'chronic low back pain.' When I asked her about non-medical evidence, she told me she never heard of such a thing, then told me to call back on Monday and hung up.

I have a really bad feeling that this is definitely not going to go in my favor. She repeatedly kept telling me she couldn't understand what I was saying because my speech is disjointed. Yes, it is disjointed - I'm Autistic.

I just know this is not going to go in my favor.
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Helper
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« Reply #7 on: April 17, 2017, 01:09:26 PM »

I just had a very odd conversation with the SSA.

I was in the ER on February 6th for what is being labeled as 'chronic low back pain.' The caseworker requested updates from my PCP regarding it, I let her know that I was just back in the ER for the same thing except this time my hands and arms are going numb. I am going back to my PCP this Friday, so the caseworker asked me to call her on Monday to let her know that I went, and to let my PCP know they are requesting my medical records regarding the 'chronic low back pain.' When I asked her about non-medical evidence, she told me she never heard of such a thing, then told me to call back on Monday and hung up.

I have a really bad feeling that this is definitely not going to go in my favor. She repeatedly kept telling me she couldn't understand what I was saying because my speech is disjointed. Yes, it is disjointed - I'm Autistic.

I just know this is not going to go in my favor.

Have you seen an orthopedic or a neurosurgeon about your back problems?

There is not a specific non-medical evidence form that you necessarily need to submit.  Non-medical evidence is evidence that is not from a medical source.  So, it includes completed function reports, 3rd party function reports, letters from family or friends about your condition/function, etc.

If you have additional non-medical evidence, you should submit it.
Logged
Age at Application: 26 age of onset (but I did not apply until 28)
Date Applied: August 2011
First Approval/Denial Date: November 2011
Additional Info: I was fortunate to be approved on my initial application due to extensive medical records (12+ doctors) & documentation of unsuccessful work attempts even with significant accommodations

« Last Edit: April 17, 2017, 01:14:33 PM by Helper »
persephone
~ Copper ~
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People helped 0
Posts: 4


« Reply #8 on: April 17, 2017, 04:24:56 PM »

I just had a very odd conversation with the SSA.

I was in the ER on February 6th for what is being labeled as 'chronic low back pain.' The caseworker requested updates from my PCP regarding it, I let her know that I was just back in the ER for the same thing except this time my hands and arms are going numb. I am going back to my PCP this Friday, so the caseworker asked me to call her on Monday to let her know that I went, and to let my PCP know they are requesting my medical records regarding the 'chronic low back pain.' When I asked her about non-medical evidence, she told me she never heard of such a thing, then told me to call back on Monday and hung up.

I have a really bad feeling that this is definitely not going to go in my favor. She repeatedly kept telling me she couldn't understand what I was saying because my speech is disjointed. Yes, it is disjointed - I'm Autistic.

I just know this is not going to go in my favor.

Have you seen an orthopedic or a neurosurgeon about your back problems?

There is not a specific non-medical evidence form that you necessarily need to submit.  Non-medical evidence is evidence that is not from a medical source.  So, it includes completed function reports, 3rd party function reports, letters from family or friends about your condition/function, etc.

If you have additional non-medical evidence, you should submit it.

I've been to three different neurologists, none of which could tell me anything beyond neuropathy/fibromyalgia. The nerve tests I had done showed that I have extensive neuropathy in my right leg; my right side is extremely damaged and weak, but no one has been able to give me a diagnosis. My last neurologist just gave up because Medicaid refuses to pay for an MRI on my lower back. I have an action tremor in my right hand, my right leg is weak and I am unable to control it beyond very basic moves, I have an abnormal gait, etc. I also have every possible chronic inflammation marker elevated, but negative for Lyme, etc.

For about three years now, I have been experiencing what seems to be increasing nerve issues. Before I moved back to Ohio, I spent almost eight months bedridden in Tennessee because of severe muscle spasms in my back, to the point where even moving so much as to sit up to eat would cause me to throw up. I am still experiencing those muscle spasms, which temporarily eased up, then it was like I was thrown back into a 'flare up' of them and have not come out of it since. The last three months have been a living nightmare because of the pain, but I can't find a doctor who seems to care to figure out what the problem is. This has been happening on and off since I was a teenager, with it just getting increasingly worse the older I get. I am scared to death to be honest. I have no quality of life. I am unable to do even basic tasks with my right arm without severe pain, my back spasms constantly. I am in so much pain and have no clue where to go from here because I haven't found a single doctor yet who can figure out what is wrong with me beyond diagnosing me with fibromyalgia for the billionth time.

There is something really wrong and I have no clue if I will ever find out what it is before it kills me.
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Lit Love
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« Reply #9 on: April 17, 2017, 08:08:52 PM »

Have you had your blood sugar tested?

Can you describe your pain in the various areas?
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