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Author Topic: Just received SSA 455 OCR SM (Disability Update Report) today! Very worried!!  (Read 35890 times)

dianajune

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I've been on Federal Employee disability and SSDI for about 10 years.  The first one was approved in April '03.  The U.S. Office of Personnel Management forced me to apply for SSDI at the same time but I was turned down.  So I lived on the first disability check for about a year, at which time OPM reduced it by a huge amount.  They do this to everyone after their first year...probably because at that point, SSDI should have kicked in.

So, I re-applied for SSDI and was approved.  I had a recertification for SSDI in '09 and it was a nightmare.  I can't remember the form they sent me, but I had to go in for another medical exam.

My SSDI case was based solely on mental health issues as I recall.  I have a history of depression, anxiety and anger issues.  But after I went on disability a whole lot of other things came up.  My weight started to climb again....I'm already morbidly obese.  I have asthma, arthritis (very bad, in my spine, knees, etc).  I have a history of abdominal surgeries:

-Borderline ovarian cancer in '04.  Had a total abdominal hysterectomy, no chemo or radiation was needed, and the prognosis for that diagnosis is good, anyway.  However, this surgery lead to other problems I had in the not so distant past (hernias, see below)

- Gallbladder surgery in spring of '05. (lap)

-Emergency hernia surgery in '09 (less than a month after my SSDI recert).  It was strangulated and had to be repaired, and 10cm of my small intestine was removed.

-Emergency hernia surgery in 2011.  They thought I had a perforated colon but after surgery started, the found it was incarcerated.  Air bubbles in the mesentery made it look like a hole was in the colon.

I was since diagnosed with a third hernia that is so large I look like I'm pregnant on the left side of my abdomen with twins.  I've been told that it's so large it can't get strangulated like the first, but I am concerned.  I was told the first one was so big it wouldn't likely get strangulated but it did.

My most recent hospitalization was in December of last year because of cellulitis.  I'm also a diabetic and my dose of metformin was just increased this past week as my a1c is 7.

I'm probably forgetting other issues as well as there have been so many.  I am worried that my recert will be turned down because I've been unable to see another mental health professional for several years.  I live in a rural area with bad public transit.  The best psychiatrists are in Syracuse and I can't afford to take a bus there (call and ride, which is expensive as I don't have Medicaid).  The only mental health clinic I could take a bus to is in Oswego, but that place is useless.  I went there several years ago when I had a car and they did nothing for me.  Not only that, I still owe money to that hospital so I don't know if I can go back.

More recently I've been coping with severe issues with my IBS, which I've been suffering from for years.  Ever since I was sick last year from the cellulitis and was put on antibiotics, my gut hasn't been right since.  I have diarrhea most every day.  If I was working with something like that I wouldn't be able to hold a job.  Dicyclomine, which was prescribed by a g.i. doc, doesn't help at all.  So I stopped taking it.

I can prove by a number of witnesses (medical personnel and others) that I have trouble getting along with others and stress out easily.  I was banned from my primary care doctor's office earlier this year before I moved to where I now live.  I tried going back to my former doctor from before her and was turned down.  My primary care provider is brand new and I just had my second visit with her during this past week.

Can SSDI hold it against me that I've been unable to see a mental health professional?  I don't have a car, transportation is very difficult and I don't always see a doctor when I need to (inc. regular medical issues).  Copays add up and I oftentimes ration medicine because of that.  My asthma has been getting worse, for example, because I was rationing some Advair I got last year.  It just ran out and my new doctor gave me a couple of samples.  Lower dose, but it's better than nothing.

Help!  I'm freaking out thinking that they will yank the rug out from under me.  I desperately need to keep my SSDI check but am worried that the limitations I have because of the lack of money and transportation will be held against me.  I'm unable to work. 

Spaceshot69

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I am unsure what your asking,  you said you already were approved and have been on SSDI for over 10 years. 

If your asking about a recertification, well I heard it's just like applying, but you said you already went through one of those.

If you want to add more ailments to your disability? I would wait on that until your next reconsideration.  Remember to list the one's that prevent you from working.

Your issues sound like you will not be turned down at reconsideration as long as you keep with treatment.  Not treating your ailments would be labeled as noncompliance and hence no more documentation that you still have such ailments and end your payments.

As a diabetic A1C of 7 isn't bad.  Mine sat at and around 8.3 for the last 7 years that I did work.  Unless you have Feet and Hand loss of nerves (I forget the name) there is a test for this, then as someone in this forum once said diabetes is not cause you to not work there are thousands who work with diabetes.

Last thing to take from this is I don't know what your specially asking for
I've Been banned so here is my update.  I was approved as of May 2014 awaiting pay on Nov 2014.  After the 5 months waiting period and Nov Payment being posted in Dec I will be paid x-mas eve.

dianajune

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I guess my question is this:  If my SSDI approval was based on mental health issues alone, can my benefits be taken away since I've been unable to see a mental health professional for several years?  I have no car and public transportation is very bad where I live.

I know I am unable to work.  I just don't know if SSDI will agree.  I have a host of medical problems on top of mental but I was approved based on mental health issues alone.

Spaceshot69

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This is just a hypothesis but here goes.

If you have not been taking care of any (1 or more) of your issues then they are considered as you being noncompliance and those issue(s) can't be considered in your claim.  As treatment could possibly help you enough to make you employable.  But not having any treatment means we'll never know.  

I hope someone that knows for sure lets you know.  It sounds like you see other doctors, so why can't you see a therapist and a prescribing nurse or psychiatrist?

I read about where the best psychiatrist are in your post, however going to see the crappy ones that do nothing for you (but keep you on SSDI) are better then the alternative.   

That last paragraph is must my opinion I don't mean to offend just something to think about.
« Last Edit: November 01, 2013, 05:34:58 PM by Spaceshot69 »
I've Been banned so here is my update.  I was approved as of May 2014 awaiting pay on Nov 2014.  After the 5 months waiting period and Nov Payment being posted in Dec I will be paid x-mas eve.

dianajune

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Like I said in my original post, I've been unable to see a mental health professional for several years for the following reasons:

I live in a rural area and have no car.  Public transit is very limited.  The only decent psych providers closeby are in Syracuse and I can't afford to take a self-pay bus there.  I don't have Medicaid, so I can't take a Medicaid cab or bus.

There are no psych providers in my area.  Just a clinic with general practitioners and a lab where they do bloodwork and xrays too.

If they had psych providers in my town I would gladly see them.  But they don't.

I'm concerned that if my SSDI was approved on mental health issues alone, that my benefits will be yanked from me even with the extenuating circumstances I just described, and even though I have a host of other health problems on top of the mental ones.

If someone out there could please....please.....please let me know what to expect I would appreciate it.  I am very worried and cannot function at all.  I've been like this all day and the thought of being on pins and needles for several months or however long this will take is torture to me.  I can't handle stress at all.  None.

dianajune

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P.S.  Re. seeing the crummy psychiatric clinic, I still owe that hospital alot of money.  That's another reason I haven't gone back.

Tippy

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So you have a letter stating that SSA is done recert  of your benefits as of now.    You have gotten a form in the mail.

If you haven't gotten any form in the mail, you have time to call around to see if there is anywhere you can get help with the doctor.

If it was long time away, don't worry. 


Tippy
When life gives you lemons, make the best sweetest lemonade there is ..  

dianajune

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Tippy,

I don't understand what you're telling me.  All I can say is I got this form in today's mail and am worried that because I've been unable to see a psych provider for several years, that my benefits will be taken away - even with all the other medical issues I've coped with since being approved.

Who do I go to for help with psych issues if I have no way to get there, and the only place I could take a bus to was horrid (this was when I had a car several years ago)?  They rushed me through appointments and threw pills as me.  That's it.  Besides that, I still owe that hospital alot of money;

I don't know what to do.  I'm literally sick with worry and have been in bed for most of the afternoon.  I am incredibly stressed out.

Diana

serendipity

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deleted
« Last Edit: February 10, 2015, 08:13:20 PM by serendipity »

Spaceshot69

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I am not trying to tick you off.

I am just saying SSA can only determine your state of wellbeing by what your doctors say.  If you don't have a Dr. that treats you for an ailment then they consider that as you do not have that ailment any longer.  

Someone else on these boards said they had an ALJ hearing and the judge saw how they saw a Dr. for depression but the last time was over 2 years ago.  The judge could not consider depression as part of the claim because s/he needed recent treatment information.

If you already had your recertification done, there is noting to do but wait.  If you are worried about the next one, you have time to find a doctor.  I know you have stated that its far and expensive.  I don't mean to sound heartless but I don't think the SSA will accept that excuse.

I've Been banned so here is my update.  I was approved as of May 2014 awaiting pay on Nov 2014.  After the 5 months waiting period and Nov Payment being posted in Dec I will be paid x-mas eve.

Nittany168

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I live in a major city, and my PC will refill my psych meds.  My psych disappeared and I was just to untrusting to see another right away, and he had no problem refilling my meds.  So maybe ask your PCP to refill your meds.  At least it will look like your making an effort to get your meds.

Hudgins17

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I don't understand what you're telling me.  All I can say is I got this form in today's mail and am worried that because I've been unable to see a psych provider for several years, that my benefits will be taken away - even with all the other medical issues I've coped with since being approved.

It comes down to this, dianajune....

If you have no recent medical records showing you are being treated for your mental illness(s), then you will not be recertified/approved for SSDI for mental illness.  It's that simple. 

Not meaning to be harsh, but the fact is that the SSA does not care how difficult it is for you to get treatment.  They only care that you are being treated.  Its up to you to make whatever efforts are necessary to get treatment.

You could reapply based on your physical issues, however you need to keep in mind that Having surgery does not mean you are unable to work.  Having Diabetes does not mean you are unable to work.  Having Asthma does not mean you are unable to work.  Many people work daily with these conditions or combinations of these conditions.  You must prove with recent medical records that your physical issues are disabling to the point that you are unable to work. 

What the SSA will base their decision on is how those medical issues would keep you from working.  Can you stand?  Can you sit?  Can you stoop?....you get the picture.

Spaceshot69

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I don't understand what you're telling me.  All I can say is I got this form in today's mail and am worried that because I've been unable to see a psych provider for several years, that my benefits will be taken away - even with all the other medical issues I've coped with since being approved.

It comes down to this, dianajune....

If you have no recent medical records showing you are being treated for your mental illness(s), then you will not be recertified/approved for SSDI for mental illness.  It's that simple. 

Not meaning to be harsh, but the fact is that the SSA does not care how difficult it is for you to get treatment.  They only care that you are being treated.  Its up to you to make whatever efforts are necessary to get treatment.

You could reapply based on your physical issues, however you need to keep in mind that Having surgery does not mean you are unable to work.  Having Diabetes does not mean you are unable to work.  Having Asthma does not mean you are unable to work.  Many people work daily with these conditions or combinations of these conditions.  You must prove with recent medical records that your physical issues are disabling to the point that you are unable to work. 

What the SSA will base their decision on is how those medical issues would keep you from working.  Can you stand?  Can you sit?  Can you stoop?....you get the picture.

^^^ is what I was trying to say, as nice as I could.  I think this was done better than I did.
I've Been banned so here is my update.  I was approved as of May 2014 awaiting pay on Nov 2014.  After the 5 months waiting period and Nov Payment being posted in Dec I will be paid x-mas eve.

Criszilla

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Can SSDI hold it against me that I've been unable to see a mental health professional?

Welcome.  Yes.  That is one of the major reasons for cessation of benefits.

I don't have a car, transportation is very difficult and I don't always see a doctor when I need to...

Are there any low-cost dial-a-ride type transportation agencies you can avail yourself to?

Copays add up and I oftentimes ration medicine because of that.

Google "copay assistance".  You should come up with a .org website and you can go from there.
« Last Edit: November 01, 2013, 11:25:32 PM by Criszilla »

Criszilla

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I live in a major city, and my PC will refill my psych meds.  My psych disappeared and I was just to untrusting to see another right away, and he had no problem refilling my meds.  So maybe ask your PCP to refill your meds.  At least it will look like your making an effort to get your meds.

Yes.  And some low-cost clinics also have programs where they will mail your prescriptions to you.

 

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