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Topic: VET PTSD Support Letter  (Read 3575 times)
digiview3
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Wife USAF Vet - Medically Discharged for PTSD/MST.


« on: April 08, 2012, 03:41:46 AM »

My wife is a vet and was medically discharged for PTSD and Bulimia.  How much weight does a favorable C&P Exam stating she in "Unemployable" have with Social Security?  We included the C&P Exam and a detailed self-report and medical records with the application.
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John - Fighting for my Wife

Me: SSDI Approved 12/2008 Wife: SSDI Approved Bench Decision ALJ Level 06/19/13
Me: Medi-Cal/Medicaid Approved 09/2010 Wife: Pending
Me: Medicare Approved 01/2011 Wife: Approved
Name: John and McKyla
Location: CA
Age at Application: Me: 40 Wife: 27
Disability: Me: Cerebral Palsy, Hip Deformity, Chronic Pain, Speech Impairment, Hypertension, Asthma/Wife: Chronic PTSD/MST, Major Depression Disorder, Dysthymic Disorder, Borderline Personality Traits, Social Anxiety, Panic Attacks with Agoraphobia, Chronic Fatigue, Restless Leg Syndrome, GERD, Bulimia Nervosa
Date Applied: Me: 01/2010 Wife 02/24/2012 Wounded Warrior Program
First Approval/Denial Date: Me: Approved Onset Date 12/2007 Wife: Approved Bench Decision
Reconsideration Approval/Denial Date: SSDI Approved Bench Decision 06/17/13
Hearing Date: 06/17/13
ALJ Approval/Denial Date: ALJ Approved - Bench Decision
Additional Info: Me: Approved on initial application Wife: USAF Medically Discharged Service-Connected Disabled Vet 100%/SSDI Approved ALJ Bench Decision
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« Reply #1 on: April 08, 2012, 07:32:56 AM »

Welcome digiview & wife:

The SSA ruling SSR 06-03p describes how SSA views the opinions of other government entities (Paragraph II. Decisions on Disability by Other Governmental and Nongovernmental Agencies):

http://www.ssa.gov/OP_Home/rulings/di/01/SSR2006-03-di-01.html

The paragraph is prefaced with a quote from the CFR:

"...a decision by any nongovernmental agency or any other governmental agency about whether you are disabled or blind is based on its rules and is not our decision about whether you are disabled or blind. We must make a disability or blindness determination based on social security law. Therefore, a determination made by another agency [e.g., Workers' Compensation, the Department of Veterans Affairs, or an insurance company] that you are disabled or blind is not binding on us".

It does, however, go on to describe how the opinions can be considered in arriving at a decision and a link to SSR 96-2p, describes how outside opinions are weighted.

I hope that helps, and wish you the best.

Pati
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The best way to pay for a lovely moment is to enjoy it. (Richard Bach)
Name: Pati
Location: East Tennessee
Age at Application: 53
Disability: Small Fiber & Autonomic Neuropathy; Sjogren's Syndrome; DJD
Date Applied: 02/19/2009
First Approval/Denial Date: Approved 10/26/2009
Date Award Letter Received: 11/17/2009
Date Back Pay Received: 10/25/2009
Additional Info: Assigned to DQB on 10/5/09. Approved.
Bonzai
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Technical Support


« Reply #2 on: April 08, 2012, 08:52:40 AM »

In my denial of benefits (I am a 100% service-connect veteran), the ALJ used the 20 CFR 404.1512(3)(5) and wrote that "Even though the Department of Veterans Affairs determined the claimant has a 100% rating, the Social Security Administration is not bound by their assessment. Furthermore the ultimate issue of disability is reserved to the Commissioner of the Social Security Administration (Regulations 404.1527 and SSR 6-5p)".

It was one of the issues that the Social Security Appeals Council specifically told the ALJ he has to address because they wrote "Social Security Ruling 06-03p directs the Administration to evaluate all of the evidence in the case record and specifies that a decision made by another governmental or non-governmental agency cannot be ignored.".

So a decision made by another agency must be considered by the Social Security Administration, but is not binding provided the ALJ can support a different finding.  I know in my case the ALJ was just looking for reasons to deny, as he has a very low approval record he seems proud of.  I know he is going to try and deny me a second time, but he has seven issues to address in the remand.
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"If one of these engines fails, how far will the other one take us?"
"All the way to the scene of the crash!" - Ron White
Name: Bonzai
Location: TN
Age at Application: 47
Disability: BP 1, OSA, HTN, DM II, Arthritis Knee
Date Applied: Feb 08
First Approval/Denial Date: Denied Dec 08
Reconsideration Approval/Denial Date: Denied Mar 09
Hearing Date: second hearing June 2012
ALJ Approval/Denial Date: Approval - Aug 2012
Date Award Letter Received: Oct 2012
Date Back Pay Received: Late Sept 2012
Additional Info: remanded
SSDAdmin
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« Reply #3 on: April 08, 2012, 10:17:17 AM »

digiview,

Thank you and your wife for your sacrifices to our country.  I am sorry for all she has been through and hope we can help you both through this process.

Marci
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I speak from experience not expertise.
Name: Marci
Location: Florida
Age at Application: 35
Disability: Arthritis, Degenerative Disc, Migraines, Foot Injury
Date Applied: September 2005
First Approval/Denial Date: Denied February 2006
Reconsideration Approval/Denial Date: Denied October 2006
Date Hearing Notice Received: October 2008 two weeks before hearing
Hearing Date: October 2008
ALJ Approval/Denial Date: Letter Received December 2008
Date Award Letter Received: January 2009
Date Back Pay Received: February 2009
Additional Info: Approved at hearing, no Attorney
digiview3
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Wife USAF Vet - Medically Discharged for PTSD/MST.


« Reply #4 on: April 08, 2012, 11:38:38 AM »

Thank you everyone for your feedback.  I'm told that in California where we live, SSA has to give great weight to the decision and rating by VA.  My wife PTSD, Depression, Social Anxiety, and Bulimia Nervosa due to Military Sexual Trama aka rape twice while in service and is documented in her service records.  She was medically discharged.
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John - Fighting for my Wife

Me: SSDI Approved 12/2008 Wife: SSDI Approved Bench Decision ALJ Level 06/19/13
Me: Medi-Cal/Medicaid Approved 09/2010 Wife: Pending
Me: Medicare Approved 01/2011 Wife: Approved
Name: John and McKyla
Location: CA
Age at Application: Me: 40 Wife: 27
Disability: Me: Cerebral Palsy, Hip Deformity, Chronic Pain, Speech Impairment, Hypertension, Asthma/Wife: Chronic PTSD/MST, Major Depression Disorder, Dysthymic Disorder, Borderline Personality Traits, Social Anxiety, Panic Attacks with Agoraphobia, Chronic Fatigue, Restless Leg Syndrome, GERD, Bulimia Nervosa
Date Applied: Me: 01/2010 Wife 02/24/2012 Wounded Warrior Program
First Approval/Denial Date: Me: Approved Onset Date 12/2007 Wife: Approved Bench Decision
Reconsideration Approval/Denial Date: SSDI Approved Bench Decision 06/17/13
Hearing Date: 06/17/13
ALJ Approval/Denial Date: ALJ Approved - Bench Decision
Additional Info: Me: Approved on initial application Wife: USAF Medically Discharged Service-Connected Disabled Vet 100%/SSDI Approved ALJ Bench Decision
Kittyholic
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The Catwhisperer


« Reply #5 on: April 08, 2012, 01:28:00 PM »

I'm told that in California where we live, SSA has to give great weight to the decision and rating by VA. 

SSDI is not a State program. It is a Federal program, and the rules are Federal - not State - rules. SSA does contract out the medical determination to state sgencies, but ALL state agencies are required to follow the same Federal rules and regulations in regard to evaluating disability.
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The best way to pay for a lovely moment is to enjoy it. (Richard Bach)
Name: Pati
Location: East Tennessee
Age at Application: 53
Disability: Small Fiber & Autonomic Neuropathy; Sjogren's Syndrome; DJD
Date Applied: 02/19/2009
First Approval/Denial Date: Approved 10/26/2009
Date Award Letter Received: 11/17/2009
Date Back Pay Received: 10/25/2009
Additional Info: Assigned to DQB on 10/5/09. Approved.
Bonzai
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« Reply #6 on: April 08, 2012, 06:31:46 PM »

Pati,

Actually there has been a lot of conflict between the different Social Security Districts in assigning weight to a Veterans Affairs determination of 100% disabled.  Nine circuit courts have made rulings on how to give weight to Va disability determinations of 100%, from having to give Great Weight to giving Some Weight - it depends upon the circuit court district that one files in.

The 9th District Court ruled in 2002, that a 100% determination of disability by the Veterans Affairs must be given Great Weight if the case is fully developed.  That was in the case of McCartey v. Massanari.  
Logged

"If one of these engines fails, how far will the other one take us?"
"All the way to the scene of the crash!" - Ron White
Name: Bonzai
Location: TN
Age at Application: 47
Disability: BP 1, OSA, HTN, DM II, Arthritis Knee
Date Applied: Feb 08
First Approval/Denial Date: Denied Dec 08
Reconsideration Approval/Denial Date: Denied Mar 09
Hearing Date: second hearing June 2012
ALJ Approval/Denial Date: Approval - Aug 2012
Date Award Letter Received: Oct 2012
Date Back Pay Received: Late Sept 2012
Additional Info: remanded

« Last Edit: April 08, 2012, 06:53:10 PM by Bonzai »
Different Perspective
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« Reply #7 on: April 08, 2012, 07:50:22 PM »

Patti is correct in stating SSA is not influenced by disability ratings of non-governmental, or even other governmental agencies and Bonzia is also correct.  The often called “ninth circus” Court of Appeals has issued many Rulings that affect the Ninth Circuit only.  Other parts of the country are not bound by these Rulings.  As I understand it, SSA is not bound by a non-SSA determination of disability; it must only consider that determination in its decision (as Bonzai says, that may range from Great Weight to Some Weight).  Aren’t we glad this is a nationwide program with uniform standards across the country?

So what does it take for SSA, as an Agency, to consider someone disabled with a diagnosis of PTSD & Bulimia?

As always, a diagnosis does not equal a finding of disability, therefore, the question to be answered is “How does a medically diagnosed condition affect the ability to perform work related tasks?”  I.e., how does being under weight prevent someone from working?  (This assumes the Bulimia has caused weight loss.  Otherwise, the question would be “How does the PTSD restrict work function?)

SSA has developed a list of conditions that it details in the Blue Book that, if an applicant meets ALL of the provisions required, then s/he is presumed to be unemployable.  (There are tens of thousands of people who work every day with medical conditions that meet the requirements listed in the Blue Book who could be drawing benefits but choose not to do so.) 

See http://www.ssa.gov/disability/professionals/bluebook/5.00-Digestive-Adult.htm#5_08 Section 5.08 for provisions related to weight loss.  Note that the weight loss must be related to a digestive disorder for the requirements of this Listing to be met.  Bulimia is not considered a digestive disorder.  BUT if the applicant has a BMI of less than 17.5 calculated on at least two evaluations at least 60 days apart within a consecutive 6 month period AND there is a medical cause for the weight loss, the applicant may be considered to equal the Listing and be considered unemployable.

Weight loss could be caused by either the PTSD, or the Bulimia.  Section C 12 of Listing 12.00, http://www.ssa.gov/disability/professionals/bluebook/12.00-MentalDisorders-Adult.htm#Top reads: “12. Eating disorders. In cases involving anorexia nervosa and other eating disorders, the primary manifestations may be mental or physical, depending upon the nature and extent of the disorder. When the primary functional limitation is physical; e.g., when severe weight loss and associated clinical findings are the chief cause of inability to work, we may evaluate the impairment under the appropriate physical body system listing. [This goes back to Listing 5.00]  Of course, we must also consider any mental aspects of the impairment, unless we can make a fully favorable determination or decision based on the physical impairment(s) alone.”

You and your wife may want to review Listing 12.04 A1b and 12.06 A (don’t forget, there must be medical evidence that the requirements of the B portion in both Listings are also met) for insight as to how the PTSD and Bulimia may affect work function.  Her condition may meet one of these Listings even without the severe weight loss required in Listing 5.08.

P.S. I hope they caught the bastard(s)!
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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.
Dragon Fly
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« Reply #8 on: April 08, 2012, 08:02:26 PM »

Just to clarify...Bulimia doesn't always make someone underweight, in fact many of us appear to be normal or "over weight." And eating disorders are extremely complex. They are psychologically based and expressed through the physical body. It is very common for an eating disorder to show up with PTSD. The eating disorder is a coping mechanism to block out trauma.

Anyway...digiview...WELCOME to you, and your beautiful wife

I have a few things in common with your wife. The first thing that struck me is, does she know her picture is up on the site? I just know as someone dealing with eating disorders that we can be sensitive about that. Make sure you ask her permission.  Wink Wink Wink Wink Also you might want to encourage her to create a unique account for herself, so she can read, read, read. It is very helpful to gain as much knowledge as possible about what they are looking for, especially because she is young.

It's very important to stress the symptoms of PTSD in terms of work function. Flashbacks, nightmares, hyper vigilance, panic attacks, self harm (which bulimia is somewhat, but it is more so a coping and surviving skill), dissociation, paranoia, sensitivity to sounds, lights, people, loss of concentration, lack of trust, etc. PTSD is a very exhausting and chronic condition for some. Some get triggered and have "episodes." It also can sometimes take years to manifest itself as a mental illness, especially when a person has blocked the traumatic memories out, and/or uses numbing tactics such as drugs, alcohol, eating disorders, etc. which just acts as a self medicating tool but not only prolongs the original problem but often makes it worse and sometimes irreversible. PTSD patients often develop illnesses and chronic pain. Doctors seem to "miss" diagnose or not know the real root of the problem, so medications are used as bandaids when it is really therapy that might help, or vice versa. Source: myself.  crazy crazy angel angel

Is he seeing a therapist? Psychiatrist?

>;<
Dragon Fly
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"And those who were seen dancing were thought to be insane by those who could not hear the music." --  Friedrich Nietzsche
Name: >;<
Location: CA
Age at Application: 37
Disability: Complex PTSD, Major Depressive Disorder, Anxiety Disorder
Date Applied: October 8, 2010
First Approval/Denial Date: Approved verbally March 15th, 2011. Approval letter dated April 5, 2011
Additional Info: 2 weeks in QR, Received backpay April 4th, 2011

« Last Edit: April 08, 2012, 08:20:55 PM by Dragon Fly »
Dragon Fly
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« Reply #9 on: April 08, 2012, 08:13:22 PM »

One more thing to consider about bulimia. It is a symptom of an underlying problem. Unfortunately unless one elaborates on exactly how their ED effects their life and ability to function normally, it can be misconstrued as simply "someone who purges their food intake." I wish it was that simple. A person who is active in their ED is basically suffering from a type of obsessive compulsive disorder, depression, anxiety, sometimes bipolar. Food is just the substance that starts the cycle. But in the mind there are obsessive thoughts, racing thoughts, rituals, self harm, dissociation, nightmares, inability to concentrate, etc. Of course there are the medical ramifications. One can be dehydrated and have heart problems, etc. and it seems like "feeding them" is the obvious fix. If it were that simply it would not be such a huge epidemic in our country. Our children are starting diets as young as 5 years old.

Sorry, climbing off the  soapbox. I obviously have a lot to say about this subject.  talkative But I just know that many people, including many "authorities" in the medical and psych arenas have no clue about the complexities of an eating disorder and what it does to your life.

>;<
Dragon Fly
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"And those who were seen dancing were thought to be insane by those who could not hear the music." --  Friedrich Nietzsche
Name: >;<
Location: CA
Age at Application: 37
Disability: Complex PTSD, Major Depressive Disorder, Anxiety Disorder
Date Applied: October 8, 2010
First Approval/Denial Date: Approved verbally March 15th, 2011. Approval letter dated April 5, 2011
Additional Info: 2 weeks in QR, Received backpay April 4th, 2011
Different Perspective
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« Reply #10 on: April 08, 2012, 08:55:13 PM »

Points well taken Dragon Fly.  Just for a point of reference; when I post, I try to make responses mean as much as possible to as many people as possible, not just the original poster.

Yes, I understand Bulimia does not, necessarily, cause weight loss.  That is why I stated that references to Listing 5.05 assumed weight loss and I further stated that her conditions may meet the provisions of Listing 12.00. 

I did not intend to upset anyone by mentioning provisions of the SSA law that refer to weight anymore than I intended to upset anyone by mentioning mental health issues, both of which I think should be considered as part of the overall case development in this instance.   
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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.
Dragon Fly
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« Reply #11 on: April 08, 2012, 10:24:49 PM »

DP,
Sorry...I should have started my rants with something like..."in addition to the info DP provided"....because I totally agree. Your replies were great and informative and help put the facts as they stand into light.

My responses were just to illustrate the complexities of such disorders, from the perspective of someone who has them and has to recover from them, and those who might have loved ones who don't understand.

 angel
>;<
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"And those who were seen dancing were thought to be insane by those who could not hear the music." --  Friedrich Nietzsche
Name: >;<
Location: CA
Age at Application: 37
Disability: Complex PTSD, Major Depressive Disorder, Anxiety Disorder
Date Applied: October 8, 2010
First Approval/Denial Date: Approved verbally March 15th, 2011. Approval letter dated April 5, 2011
Additional Info: 2 weeks in QR, Received backpay April 4th, 2011
digiview3
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Wife USAF Vet - Medically Discharged for PTSD/MST.


« Reply #12 on: April 09, 2012, 12:20:30 AM »

Yeah my wife has sever PTSD and Social Anxiety with all the simptoms mentioned.  She can't even sleep with me due to the nightmares and waking up screaming.  She hardly ever goes out except to go to therapy and dr appointments.  She currently rated at 10% by VA with increase pending and from her latest C&P exam should be bumped to 100%.  She has been hospitalized twice and has attempted suicide multiple times.  She uses the ED to num herself and has been hospitalized twice for ED too for up to 3 months.  She's only 27 yrs old, such a shame the military has ruined her.
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John - Fighting for my Wife

Me: SSDI Approved 12/2008 Wife: SSDI Approved Bench Decision ALJ Level 06/19/13
Me: Medi-Cal/Medicaid Approved 09/2010 Wife: Pending
Me: Medicare Approved 01/2011 Wife: Approved
Name: John and McKyla
Location: CA
Age at Application: Me: 40 Wife: 27
Disability: Me: Cerebral Palsy, Hip Deformity, Chronic Pain, Speech Impairment, Hypertension, Asthma/Wife: Chronic PTSD/MST, Major Depression Disorder, Dysthymic Disorder, Borderline Personality Traits, Social Anxiety, Panic Attacks with Agoraphobia, Chronic Fatigue, Restless Leg Syndrome, GERD, Bulimia Nervosa
Date Applied: Me: 01/2010 Wife 02/24/2012 Wounded Warrior Program
First Approval/Denial Date: Me: Approved Onset Date 12/2007 Wife: Approved Bench Decision
Reconsideration Approval/Denial Date: SSDI Approved Bench Decision 06/17/13
Hearing Date: 06/17/13
ALJ Approval/Denial Date: ALJ Approved - Bench Decision
Additional Info: Me: Approved on initial application Wife: USAF Medically Discharged Service-Connected Disabled Vet 100%/SSDI Approved ALJ Bench Decision
Dragon Fly
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« Reply #13 on: April 09, 2012, 12:30:24 AM »

JK,
That makes me sad. I'm sorry she's going through this....but I am glad she has you, and very glad she is in treatment.

Please let her know I am here (as well as a whole family of amazing compassionate people) and she is not alone.
>;<
Dragon Fly
Logged

"And those who were seen dancing were thought to be insane by those who could not hear the music." --  Friedrich Nietzsche
Name: >;<
Location: CA
Age at Application: 37
Disability: Complex PTSD, Major Depressive Disorder, Anxiety Disorder
Date Applied: October 8, 2010
First Approval/Denial Date: Approved verbally March 15th, 2011. Approval letter dated April 5, 2011
Additional Info: 2 weeks in QR, Received backpay April 4th, 2011
digiview3
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Wife USAF Vet - Medically Discharged for PTSD/MST.


« Reply #14 on: April 09, 2012, 01:01:49 AM »

DF thank you for your kind words.  We have been married for almost 2 yrs and I've gotten her enrolled in VA Healthcare since January 2011 where she sees a therapist and Psychiatrist for PTSD/MST, ED and finally gets all medical treatment and medications for free.  She didn't think she qualified becare she didn't retire and I did the research and had her enrolled within a week.  I've done all the research for her PTSD/MST claim and for SSDI claim mainly on the Veteran Benefit Network forum for Vets.  She does not go on these forums at all because it's a trigger.  I'm the one that joined the forums to educate myself on PTSD/MST to get her all the benefits she deserved.  She was a very happy and outgoing person until the assaults in 2003.  She told and the Air Force didn't nothing to protect her, they blamed her and harrassed her until she attempted to kill herself and was medically discharged for Depression and Bulimia.  She has a claim in that we filed 18 months ago for PTSD/MST and it's in Administrative/Proceedural Review finally since I have been on them to get her rated which should be minimum 70% with IU...
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John - Fighting for my Wife

Me: SSDI Approved 12/2008 Wife: SSDI Approved Bench Decision ALJ Level 06/19/13
Me: Medi-Cal/Medicaid Approved 09/2010 Wife: Pending
Me: Medicare Approved 01/2011 Wife: Approved
Name: John and McKyla
Location: CA
Age at Application: Me: 40 Wife: 27
Disability: Me: Cerebral Palsy, Hip Deformity, Chronic Pain, Speech Impairment, Hypertension, Asthma/Wife: Chronic PTSD/MST, Major Depression Disorder, Dysthymic Disorder, Borderline Personality Traits, Social Anxiety, Panic Attacks with Agoraphobia, Chronic Fatigue, Restless Leg Syndrome, GERD, Bulimia Nervosa
Date Applied: Me: 01/2010 Wife 02/24/2012 Wounded Warrior Program
First Approval/Denial Date: Me: Approved Onset Date 12/2007 Wife: Approved Bench Decision
Reconsideration Approval/Denial Date: SSDI Approved Bench Decision 06/17/13
Hearing Date: 06/17/13
ALJ Approval/Denial Date: ALJ Approved - Bench Decision
Additional Info: Me: Approved on initial application Wife: USAF Medically Discharged Service-Connected Disabled Vet 100%/SSDI Approved ALJ Bench Decision
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