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Topic: Newbie  (Read 459 times)
stinkyjo326
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« on: August 03, 2017, 07:59:30 PM »

I am a new member and have already found this site very helpful.  I am currently on dialysis and have been do about one year.  I applied for disability before my kidneys failed completely and was denied twice,  while waiting for a hearing , had to start dialysis.  I have been waiting (and not having any income) for almost two years now.  In addition to renal disease I have congestive heart failure, diabetes and high blood pressure.  Like many of you, my situation has become quite dire while waiting.  I think they want us to give up or die.  Well,  I will do neither anytime soon!   Keep up the fight!
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Kicksnomore
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« Reply #1 on: August 03, 2017, 08:09:08 PM »

 Welcome07  Sorry about your kidney problems.  This is a great site and you will find people that understand and support you in this process.  Good luck.
Logged
Age at Application: 50
Disability: Rheumatoid Arthritis
Date Applied: 3/15
First Approval/Denial Date: 6/15
Reconsideration Approval/Denial Date: 9/15
Date Hearing Notice Received: 4/17
Hearing Date: Scheduled for 7/17
Lit Love
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« Reply #2 on: August 03, 2017, 09:03:05 PM »

I am a new member and have already found this site very helpful.  I am currently on dialysis and have been do about one year.  I applied for disability before my kidneys failed completely and was denied twice,  while waiting for a hearing , had to start dialysis.  I have been waiting (and not having any income) for almost two years now.  In addition to renal disease I have congestive heart failure, diabetes and high blood pressure.  Like many of you, my situation has become quite dire while waiting.  I think they want us to give up or die.  Well,  I will do neither anytime soon!   Keep up the fight!


Do you have an attorney? 

Has an OTR request been made?
 
Is your condition considered End Stage Renal Disease?
https://www.ssa.gov/OP_Home/ssact/title18/1881.htm
https://secure.ssa.gov/poms.nsf/lnx/0481010144

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Different Perspective
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« Reply #3 on: August 03, 2017, 10:43:16 PM »

Newbie, Lit Love is correct.  You need to file a request for an On The Record decision soon.   Taken at face value, it certainly appears your condition meets the requirements of Listing 6.03 AS OF THE DAY dialysis started.  All you need is verification from the dialysis center of the reason for the dialysis.   (See https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/downloads/cms2728.pdf.) The dialysis center should already have that form completed and in your record.

Now comes the hard part.  To make an OTR decision, the Office of Disability Adjudication and Review must make a fully favorable decision.  It cannot make the Established Onset Date different from what was offered as the Alleged Onset Date.  That means that unless the ODAR has enough evidence to go back through the two previous determinations and say you have been disabled several years ago, you will have to go to a Hearing at some unknown time in the future and probably still have the EOD set as of the day you went on dialysis. 

I am about to go WAY out on a limb and say some things I should not.  This is only my opinion without the benefit of reviewing your case. 

I think you should seriously consider filing the request for an OTR decision and modify your AOD to the date you started dialysis.  If you decide to go that route, you should make sure the form that states when and WHY you started dialysis and attach that form to your request for an OTR decision. 

As you continue to read this forum, you will see that I rarely, if ever, suggest an applicant try to adjudicate their case without help from a representative who understands SSA rules.  Your case may be the exception.  If you do not have representation, you may want to write your OTR request yourself.  You have nothing to lose by trying. If the ODAR has not granted an OTR record 30 days before your scheduled Hearing, you will still have time to find a competent representative - especially if you show him/her the form mentioned above.

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Additional Info: My Different Perspective comes from a lifetime of being near, working with and for those with disabilities, working for the Easter Seal Society, working for the Disability Determination Services (20+ years) and working as a case assistant to an attorney who, until he retired, worked on SSA disability cases exclusively and have attended approximately 185 Hearings. I have great empathy for the truly disabled and greater antipathy for those who try to game or scam the system. With my background, I quickly make distinctions between the two. I am ready to admit my error as soon as the evidence proves me wrong. Any posts I make are based on my experience, memory and current research. Anything, particularly opinions, I post should be verified by someone who has access to the entire case record and not just selected shorts offered by those seeking information, preferably by a competent attorney or non-attorney representative who thoroughly understands SSA law.
Lit Love
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« Reply #4 on: August 03, 2017, 11:50:30 PM »

Poms link regarding procedure for amending your AOD:  https://secure.ssa.gov/apps10/poms.NSF/lnx/0425501230

If the immediate Medicare coverage would help, that's also a factor to consider.

If you don't have a Rep, the OTR request shouldn't be overly complicated and we can help and or you can request help from your local Congressperson or Senator's office.
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Helper
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Posts: 2192


« Reply #5 on: August 03, 2017, 11:59:40 PM »

Poms link regarding procedure for amending your AOD:  https://secure.ssa.gov/apps10/poms.NSF/lnx/0425501230

If the immediate Medicare coverage would help, that's also a factor to consider.

If you don't have a Rep, the OTR request shouldn't be overly complicated and we can help and or you can request help from your local Congressperson or Senator's office.

Medicare coverage & SSDI onset date is not a factor since the OP is on dialysis though - they will get Medicare on the first day of the 4th month of dialysis.  (I am sure the dialysis center will help with the paperwork since they want yo get paid.)
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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
boodrow
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Posts: 106


« Reply #6 on: August 04, 2017, 12:19:28 AM »

In addition to renal disease I have congestive heart failure, diabetes and high blood pressure.  Like many of you, my situation has become quite dire while waiting.

 Hey stinkyjo326, My brother received a kidney transplant in 2014 and I am a direct witness of exactly what you are going through. He received disability because total renal shutdown/ESRD is an automatic disability. You are receiving dialysis which may very well also receive priority as a total renal shutdown/ESRD. I am pretty sure that my brother did not even need a lawyer. I sure wish that you and my brother could have a talk because he would for sure be a big help too you.

 All I can say at this time is that if you do remain on dialysis then you should strongly consider "Home Dialysis". There are many reasons why this should be your avenue of care my friend. Most importantly is the more often you receive dialysis the closer to normal renal function you get. Clinical dialysis is normally 3 times a week and you have to travel to the clinic.. wait in the lobby... finally get pushed into your dialysis chair like a herd of cattle. While home dialysis can be done 5 or 6 times a week!!! YAAAA!!! You are at home... you can do it relaxed in your favorite chair in front of your TV!!!

 Bottom line is that in the long run your body will hold up for a longer period of time the more often you filter out those toxins. Trust me and Just do it...  Main14

Edit: message me if you want me to connect you to my brother.
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"I find it very easy to say I Love You. It is all I have." Boodrow
Name: Boodrow
Location: MS
Age at Application: 53
Disability: Chronic Ischemic Heart Disease... (RCA) Right Coronary Artery is 100% Occluded. Secondary as a direct result... Anxiety - HTN - Shortness of breath during excersion with near syncopal episodes - VT and/or SVT with a pulse that so far I have been able to correct using the "Valsalva Manuever" <--- This is one step from a Full Cardiac Arrest Situation, not good.
Date Applied: Applied for both SSI/SSDI on 05/16/2014
First Approval/Denial Date: Denied 10/14/2014
Reconsideration Approval/Denial Date: Denied 12/05/2014
Date Hearing Notice Received: 12/9/16
Hearing Date: 2/14/17
ALJ Approval/Denial Date: Denied SSI 6/27/2017 --- SSDI 6/28/2017
Additional Info: I am now a retired Emergency Room Nurse as a direct result from my Heart Problems. Kinda sad that I have directly participated in not only saving countless lifes, but offering an optimal level of well being to thousands of others. Yet, I can't even do the same for myself. If you have found the time to read this then you should know this much, I Love You! That's my story and i'm sticking too it. Boodrow

« Last Edit: August 04, 2017, 04:41:43 AM by boodrow »
grove800
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Posts: 683


« Reply #7 on: August 04, 2017, 12:33:10 AM »

 Welcome08 Welcome02  You will find much information and a willingness to help you as much as they can with the process.   Wishing you a speedy favorable decision. 
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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
Lit Love
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People helped 258
Posts: 3176


« Reply #8 on: August 04, 2017, 12:51:08 AM »

Poms link regarding procedure for amending your AOD:  https://secure.ssa.gov/apps10/poms.NSF/lnx/0425501230

If the immediate Medicare coverage would help, that's also a factor to consider.

If you don't have a Rep, the OTR request shouldn't be overly complicated and we can help and or you can request help from your local Congressperson or Senator's office.

Medicare coverage & SSDI onset date is not a factor since the OP is on dialysis though - they will get Medicare on the first day of the 4th month of dialysis.  (I am sure the dialysis center will help with the paperwork since they want yo get paid.)

I was trying to say the extra benefits covered in Sec. 1881 (which he'd be entitled to upon approval since he's been receiving dialysis for a year) might be well worth giving up some backpay.  Sorry if my post wasn't clear.

Boodrow brought up a good point about accessing dialysis at home, which 1881 will allow.
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Glyn
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People helped 17
Gender: Male
Posts: 384



« Reply #9 on: August 04, 2017, 03:55:40 AM »

 Welcome08 Welcome08 Welcome08 Welcome08 Welcome08
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Name: G R
Location: Mississippi
Age at Application: 43
Disability: Neuropathy, Diabeties, Depression
Date Applied: 02/13/2013
First Approval/Denial Date: Denied 04/18/2013
Reconsideration Approval/Denial Date: Denied
Date Hearing Notice Received: 09/10/2014
Hearing Date: 11/12/2014
ALJ Approval/Denial Date: Denied 03/25/15
Additional Info: Was sent to a PSDY doctor on 3/25/13 Appealed to Appeals Counsel 05/2015 sitll waiting......Got notice 7/2016 that my case is being remanded. Hearing is set for 10/18/16
Minion64
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People helped 1
Gender: Female
Posts: 24



« Reply #10 on: August 04, 2017, 09:24:03 PM »

Welcome to this forum. There are so many good people that will give you advice and help with the process. I do wish you get a favorable decision soon.
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Disability doesn't define me it just makes me stronger and more compassionate about the life we all live.
Name: Carol
Location: Florida
Age at Application: 51
Disability: DDD in neck and back, osteo in knees, vertigo, tinnutitis, arthritis in hands lots of being tired due to some medications, high blood pressure, muscle spasms in back, eye irritation
Date Applied: 4/6/2016
First Approval/Denial Date: denied 6/22/2016
Reconsideration Approval/Denial Date: denied 7/28/2016
Hearing Date: waiting
Additional Info: sent to odar 8/19/2016 waiting for hearing
June
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People helped 1
Gender: Female
Posts: 17



« Reply #11 on: August 07, 2017, 11:15:37 AM »

In addition to renal disease I have congestive heart failure, diabetes and high blood pressure.  Like many of you, my situation has become quite dire while waiting.  I think they want us to give up or die.  Well,  I will do neither anytime soon!   Keep up the fight!

 Forum13

Welcome!

Support16
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Name: June
Disability: Too many! Mental and physical.
Additional Info: I was approved a few years ago, but I want to start a new application because of onset date.
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