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Author Topic: Did anyone have and M.E. & V.E. At their hearing?  (Read 997 times)

Just Me

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Re: Did anyone have and M.E. & V.E. At their hearing?
« Reply #15 on: April 18, 2017, 04:38:17 PM »
Sometimes doctors will write things in medical records they don't say to patients.
Hope the size of a mustard seed can produce Faith that can move mountains.

Mjwhite1

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Re: Did anyone have and M.E. & V.E. At their hearing?
« Reply #16 on: April 18, 2017, 06:53:18 PM »
The VE answered no to jobs for a hypothetical worker with whatever limitations, restrictions and RFC were included.  The ALJ doesn't have to accept the limitations and restrictions your docs purported.  The RFC forms your docs filled are not the same as an internal RFC rating, (at this stage the ALJ sets the RFC rating.)

It is best to have objective medical evidence such as a Functional Capacity Evaluation performed prior to your docs filling out RFC forms.

I actually underwent a de Quervain's release during reconstructive surgery for my wrist.  It is considered a very easy and uncomplicated procedure from what a few hand surgeons explained to me. Read this: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2899112/

You may have developed another issues, such as CRPS from the surgery (surgery in the wrist or hand is one of the common triggers), or been misdiagnosed originally.  Without such a diagnosis, being approved will be highly unlikely.
http://www.rsdhope.org/what-is-crps1.html

Whether an ALJ uses a ME or not, a VE, or both, is entirely at his or her discretion.  SS usually notifies the claimant prior to the hearing.

I would recommend you appeal if you're denied and see a neurologist.  If CRPS is a possibility, you should see a CRPS specialist.


Thank you! Can I request a fce from my doctor or can I get one form an outside facility? (Kaiser is very unhelpful when it comes to this sort of thing, and the rfcs took begging and pleading and now they won't fill them out at all)

That is what I have been told and what the me said. I did have one dr suggest crps, but when I got to that specialist, they said it was not CRPS. My diagnosis is always listed as bi-lateral joint and wrist pain or dequervains. I agree that the diagnosis may not be right, but no one has come up with anything other than that, and I have spent countless hours researching hand/wrist pain. We have done so many tests and tried so many different medications and nothing has done anything. Except acupuncture, which made the constant pain go away, now it only hurts when I actually use my hands.
Disability: Somatic Symptom Disorder with chronic hand pain, Borderline Personality Disorder, Major Depressive Disorder, GAD, PTSD, Mild OCD... 
Onset: 2/18/13 (32)
Applied: 10/05/14 (33) - Denied
Reconsideration: - Denied
A.L.J. Hearing Date: 04/26/17 - Denied 6/10/17
A.C. Appeal - 07/27/17

Lit Love

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Re: Did anyone have and M.E. & V.E. At their hearing?
« Reply #17 on: April 18, 2017, 07:01:22 PM »
Can you please describe the pain?  Those with CRPS often describe it similarly.  And there are docs that claim to be CRPS specialists and aren't...

Helper

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Re: Did anyone have and M.E. & V.E. At their hearing?
« Reply #18 on: April 18, 2017, 07:07:01 PM »
The VE answered no to jobs for a hypothetical worker with whatever limitations, restrictions and RFC were included.  The ALJ doesn't have to accept the limitations and restrictions your docs purported.  The RFC forms your docs filled are not the same as an internal RFC rating, (at this stage the ALJ sets the RFC rating.)

It is best to have objective medical evidence such as a Functional Capacity Evaluation performed prior to your docs filling out RFC forms.

I actually underwent a de Quervain's release during reconstructive surgery for my wrist.  It is considered a very easy and uncomplicated procedure from what a few hand surgeons explained to me. Read this: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2899112/

You may have developed another issues, such as CRPS from the surgery (surgery in the wrist or hand is one of the common triggers), or been misdiagnosed originally.  Without such a diagnosis, being approved will be highly unlikely.
http://www.rsdhope.org/what-is-crps1.html

Whether an ALJ uses a ME or not, a VE, or both, is entirely at his or her discretion.  SS usually notifies the claimant prior to the hearing.

I would recommend you appeal if you're denied and see a neurologist.  If CRPS is a possibility, you should see a CRPS specialist.


Thank you! Can I request a fce from my doctor or can I get one form an outside facility? (Kaiser is very unhelpful when it comes to this sort of thing, and the rfcs took begging and pleading and now they won't fill them out at all)

That is what I have been told and what the me said. I did have one dr suggest crps, but when I got to that specialist, they said it was not CRPS. My diagnosis is always listed as bi-lateral joint and wrist pain or dequervains. I agree that the diagnosis may not be right, but no one has come up with anything other than that, and I have spent countless hours researching hand/wrist pain. We have done so many tests and tried so many different medications and nothing has done anything. Except acupuncture, which made the constant pain go away, now it only hurts when I actually use my hands.

You can go to an outside facility - but you will likely have to pay out of pocket.  It usually costs a couple hundred dollars.

Mjwhite1

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Re: Did anyone have and M.E. & V.E. At their hearing?
« Reply #19 on: April 18, 2017, 07:20:52 PM »
Can you please describe the pain?  Those with CRPS often describe it similarly.  And there are docs that claim to be CRPS specialists and aren't...

Yes, the most prominent is a burning, prickling, and stinging feeling in the base of my thumb up to my wrist. The more I persist with movement, the pain travels up my forearm. My pinky finger and ring finger have trigger finger, especially in the winter months. Occasionally with tingling or numbness but this is not often. When aggravated recently I will get these pulsating moments of feeling like something the size of a pencil has been stabbed through the middle of my wrist (I don't know how else to explain it) and I also get a pulsating/wavy burning prickling pain on the pinky side of my finger, hand, and wrist. I don't have any signs of anything on the outside of my skin, which I think was a common thing for CRPS.

I also fail the Finkelstein test every time, with both hands. I am always tender to pressure at the thumb area, regardless of recent use or not.

Does that help?
Disability: Somatic Symptom Disorder with chronic hand pain, Borderline Personality Disorder, Major Depressive Disorder, GAD, PTSD, Mild OCD... 
Onset: 2/18/13 (32)
Applied: 10/05/14 (33) - Denied
Reconsideration: - Denied
A.L.J. Hearing Date: 04/26/17 - Denied 6/10/17
A.C. Appeal - 07/27/17

Mjwhite1

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Re: Did anyone have and M.E. & V.E. At their hearing?
« Reply #20 on: April 18, 2017, 07:25:51 PM »
The VE answered no to jobs for a hypothetical worker with whatever limitations, restrictions and RFC were included.  The ALJ doesn't have to accept the limitations and restrictions your docs purported.  The RFC forms your docs filled are not the same as an internal RFC rating, (at this stage the ALJ sets the RFC rating.)

It is best to have objective medical evidence such as a Functional Capacity Evaluation performed prior to your docs filling out RFC forms.

I actually underwent a de Quervain's release during reconstructive surgery for my wrist.  It is considered a very easy and uncomplicated procedure from what a few hand surgeons explained to me. Read this: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2899112/

You may have developed another issues, such as CRPS from the surgery (surgery in the wrist or hand is one of the common triggers), or been misdiagnosed originally.  Without such a diagnosis, being approved will be highly unlikely.
http://www.rsdhope.org/what-is-crps1.html

Whether an ALJ uses a ME or not, a VE, or both, is entirely at his or her discretion.  SS usually notifies the claimant prior to the hearing.

I would recommend you appeal if you're denied and see a neurologist.  If CRPS is a possibility, you should see a CRPS specialist.


Thank you! Can I request a fce from my doctor or can I get one form an outside facility? (Kaiser is very unhelpful when it comes to this sort of thing, and the rfcs took begging and pleading and now they won't fill them out at all)

That is what I have been told and what the me said. I did have one dr suggest crps, but when I got to that specialist, they said it was not CRPS. My diagnosis is always listed as bi-lateral joint and wrist pain or dequervains. I agree that the diagnosis may not be right, but no one has come up with anything other than that, and I have spent countless hours researching hand/wrist pain. We have done so many tests and tried so many different medications and nothing has done anything. Except acupuncture, which made the constant pain go away, now it only hurts when I actually use my hands.

You can go to an outside facility - but you will likely have to pay out of pocket.  It usually costs a couple hundred dollars.

I would be willing to invest in it. Do you know if they offer a multiple day kind of thing? This is the problem with my injury is that the pain is prominent when I am using my hands regularly and since I stopped working, I don't do that. So I all I can do is report to my doctors, and they can see tenderness. I have tried to force myself to use my hand before a visit, but do you know how hard it is to do something you know will cause you pain, just so they can see it? It is very hard! I feel like half of them don't believe me, because my lack of recovery doesn't work with the diagnosis and no diagnostic testing shows anything to explain why I am in so much pain. (Typing this is actually starting to hurt now)

I would love for an opportunity to have someone observe the limitations and the pain involved, it would absolutely be a worthy investment for me. I will bring it up with my attorney, whenever I hear back from them, and when I get denied (which is what the attorney is pretty confident will happen) I think I will invest in this. Since we can't afford to be self supporting anymore and are selling our home to move in with my parents, we will have some money from the sale and I could actually afford to have something like that done.

Thank you so much for bringing it up.
Disability: Somatic Symptom Disorder with chronic hand pain, Borderline Personality Disorder, Major Depressive Disorder, GAD, PTSD, Mild OCD... 
Onset: 2/18/13 (32)
Applied: 10/05/14 (33) - Denied
Reconsideration: - Denied
A.L.J. Hearing Date: 04/26/17 - Denied 6/10/17
A.C. Appeal - 07/27/17

Lit Love

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Re: Did anyone have and M.E. & V.E. At their hearing?
« Reply #21 on: April 18, 2017, 07:37:53 PM »
Have you had a nerve conduction study?

I'm in SoCal as well.  Send me a pm with the specialist you saw.  I know or know of most of the CRPS specialists here.  There can be mild cases of CRPS, which you might have.  If that is the case, they might be able to put you into remission easily.  Do not use any ice on your hand until CRPS is ruled out definitively.  Do you have any issues with temperature regulation dysfunction in your hand?  Or hypersensitivity to touch?

Mjwhite1

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Re: Did anyone have and M.E. & V.E. At their hearing?
« Reply #22 on: April 18, 2017, 07:43:04 PM »
Awesome, will send you a PM.

I have had two, one in the beginning and one last year, both negative. I didn't see a CRPS specialist per se, just sent to Physical Medicine at my local branch. No issues with temp regulation or hypersensitivity to touch, just when pressure is applied to specific locations.
Disability: Somatic Symptom Disorder with chronic hand pain, Borderline Personality Disorder, Major Depressive Disorder, GAD, PTSD, Mild OCD... 
Onset: 2/18/13 (32)
Applied: 10/05/14 (33) - Denied
Reconsideration: - Denied
A.L.J. Hearing Date: 04/26/17 - Denied 6/10/17
A.C. Appeal - 07/27/17

RNyorkiemom

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Re: Did anyone have and M.E. & V.E. At their hearing?
« Reply #23 on: April 18, 2017, 09:20:10 PM »
Hi will caution you on paying for a independent RFC. My PCP did not understand how to effectively answer the questions on the RFC. I went for the testing and it was a week after being diagnosed with DDD and a restriction of lifting more than 5 lbs in any position. I gave the letter to the OT completing to the test and he basicly told me if I didn't' complete the test I would basicly be a inaccurate test.  I opted not to exceed my ortho instructions. I have been seeing him since 1998 and I trust him. I basicly was deemed unable to work, but OT stated I did not put in the effort and I was exaggerating my symptoms despite my ortho instructions. The DDS examiner on recon based the denial on recon on that one statement of refusal and exaggeration. So only go this route if your doctor trust the examiner. The report my doctor received was 58 pages. She signed off on every page not noting the discrepancy and the DDS examiner said that my PCP agreed dispite all the other records that supported my case.
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Mjwhite1

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Re: Did anyone have and M.E. & V.E. At their hearing?
« Reply #24 on: April 18, 2017, 09:43:06 PM »
Hi will caution you on paying for a independent RFC. My PCP did not understand how to effectively answer the questions on the RFC. I went for the testing and it was a week after being diagnosed with DDD and a restriction of lifting more than 5 lbs in any position. I gave the letter to the OT completing to the test and he basicly told me if I didn't' complete the test I would basicly be a inaccurate test.  I opted not to exceed my ortho instructions. I have been seeing him since 1998 and I trust him. I basicly was deemed unable to work, but OT stated I did not put in the effort and I was exaggerating my symptoms despite my ortho instructions. The DDS examiner on recon based the denial on recon on that one statement of refusal and exaggeration. So only go this route if your doctor trust the examiner. The report my doctor received was 58 pages. She signed off on every page not noting the discrepancy and the DDS examiner said that my PCP agreed dispite all the other records that supported my case.


Thank you. Wow! I have lots of RFC's but no FCE's. I am thinking their is a big difference by what I have read?

I will keep this in mind, and discuss more with my attorney and doctor. I feel like it could really help or really hurt if it isn't long enough to have buy symptoms show up.
Disability: Somatic Symptom Disorder with chronic hand pain, Borderline Personality Disorder, Major Depressive Disorder, GAD, PTSD, Mild OCD... 
Onset: 2/18/13 (32)
Applied: 10/05/14 (33) - Denied
Reconsideration: - Denied
A.L.J. Hearing Date: 04/26/17 - Denied 6/10/17
A.C. Appeal - 07/27/17

Helper

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Re: Did anyone have and M.E. & V.E. At their hearing?
« Reply #25 on: April 18, 2017, 10:17:27 PM »
Hi will caution you on paying for a independent RFC. My PCP did not understand how to effectively answer the questions on the RFC. I went for the testing and it was a week after being diagnosed with DDD and a restriction of lifting more than 5 lbs in any position. I gave the letter to the OT completing to the test and he basicly told me if I didn't' complete the test I would basicly be a inaccurate test.  I opted not to exceed my ortho instructions. I have been seeing him since 1998 and I trust him. I basicly was deemed unable to work, but OT stated I did not put in the effort and I was exaggerating my symptoms despite my ortho instructions. The DDS examiner on recon based the denial on recon on that one statement of refusal and exaggeration. So only go this route if your doctor trust the examiner. The report my doctor received was 58 pages. She signed off on every page not noting the discrepancy and the DDS examiner said that my PCP agreed dispite all the other records that supported my case.


Thank you. Wow! I have lots of RFC's but no FCE's. I am thinking their is a big difference by what I have read?

I will keep this in mind, and discuss more with my attorney and doctor. I feel like it could really help or really hurt if it isn't long enough to have buy symptoms show up.

An FCE has actual objective testing to determine how long you can do something or how much of something you can do.
An RFC can be filled out using an FCE report (whuch gives pretty accurate functional abilities for the RFC) or the doctor can kind of guess based on what he expects based on your condition & what you report to him symptom-wise. 

If you find that you do not have CRPS & have somatic wrist pain, doing a FCE & doing something that causes you to have pain as part of the test should not cause permanent harm.  If you have CRPS, then you should ask your doctor if anything in a one time FCE exam would cause permanent harm. 

While doctors give lifting restrictions for typical daily activities for some conditions, some will allow participation in an FCE without restrictions if asked, especially since it is supervised by a physical therapist who should be able to help the patient identify when to stop.  (Obviously, I don't know what a particular doctor would do.)  While it is not unusual for a patient to be tired and in pain after a FCE, obviously you don't want to cause further injury - just likely need a rest day or 2 to recover from the test.

I had the opposite experience of RNyorkiemom at my FCE because I said I was willing to try doing a couple of things & the physical therapist said absolutely not. I was going to the FCE in hopes of figuring out what I could do & get suggestions of modifications to make a work environment better.  And instead the physical therapist said it was completely unsafe for me to be working.  Two of my specialists then signed off on how they agreed with the assessment.  It was submitted as part of my initial application & I was approved.

Lit Love

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Re: Did anyone have and M.E. & V.E. At their hearing?
« Reply #26 on: April 18, 2017, 10:44:15 PM »
It took me several days to complete my FCE, and the pt allowed me significant flexibility in scheduling so that I could return to a baseline pain level after the testing would cause a flare.  As I've described in another thread, by using water displacement tests, he could document that yes, small amounts of fine motor skills really did start an insane cycle of swelling and pain. 

Ice and hot wax baths are the biggest things to avoid causing further damage in a pt's office.  Nerve conduction tests can cause spread, but you've had one already. Any invasive procedure can also cause spread or flares.  Until CRPS is ruled out by a specialist you should avoid any trauma to any part of your body possible.  I had spread to my "good" arm with a tetanus shot that was really scary a few months ago.  Luckily I respond well to steroids and was able to get it calmed down.  I have a whole host of strategies, actually. 

Your avoiding using your limb is typical of CRPS patients.  Are you guarding it as well?  Try using it for short periods more frequently.  If 10 minutes is too much, try 5 minutes once every hour or two, and use a timer.  Inactivity is as much of a problem as too much with CRPS.  It's like Goldilocks and the 3 bears, you have to test everything and figure out what works best for you.

 

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