This is from a review I posted in 2010...
We have so many wonderful resources available to us on the internet and here is one I would like to share with you – I participated in a webinar sponsored by the National Multiple Sclerosis Society Social Security Disability Income (SSDI) and here are the highlights:
The speaker was Louise Mosher, a disability attorney who works in Cleveland, Ohio, and specializes in MS cases; all of my notes are from her comments. I hope I have all of this fairly represented but if you have additions or corrections to this, by all means jump in and let us know.
There are five separate steps that take us on the path to qualifying for disability pay. At any of these five steps, the request for SSDI can be approved. She stressed that disability is a LEGAL term and not a medical term when it comes to MS claims. You must document your disability in those terms and medical.
1) Are you working? If you are still working, what impact has your disease had on your work ability? Have you had to reduce your hours or ask for special accommodation to reduce your tasks at your work place? Have these changes produced significant reduction in your income? You must show a history of worsening of your impairment. Few people get SSDI at step #1.
2) How does your MS interfere with your daily activity? What impairments do you have now that contribute to your deficiencies in being able to work? She stressed that if you have other problems you should also list all of them. For example, you may have weakness in your arm from the MS, but you could also have carpel tunnel problems; you need to list them both. Do you have degenerative disc disease on top of having weakness from your MS? She said it is very important to include all of your problems, because they help to paint the entire picture.
3) There is a list of impairments of 14 classes of health problems that Social Security uses to evaluate SSDI requests. She said if you can match those, you will automatically be granted SSDI. The easiest way to find this listing is through http://severe.net. It is an attorneys’ website but they have a large number of links to significant information, including the listing. The specific address for these 14 classes is http://www.severe.net/listings.html. Section 11.09 is the section that pertains specifically to MS.
This listing has several components that you must meet, the most important of which is - Do you have a diagnosis of MS? You must have a diagnosis to proceed.
Can you prove significant disorganization of motor extremities?
Can you prove vision impairment?
Can you prove mental disorganization and disorder? The mental disorder is diagnosed through psychiatric testing as well as organic changes to the brain.
The list of requirements by the SS can be demonstrated though marked cognitive decline, marked social decline, or marked repetitive decline. Repetitive decline is shown through significant reproducible fatigue of muscle function and repeatability (or lack of being able to do so) is important.
She said there is no definition to what “marked” should be and is subject to interpretation by the person reviewing your SSDI request.
She also said the goal is to win SSDI at step #3 and not have to go further in the process.
4) Can you do past relevant work? The evaluator will look at all the jobs you have performed in the last 15 years and what it took to do that job. This part involves the reviewer looking at the functions you still have and what you have to do for your job – this would include grasping with your fingers, moving your fingers, lifting, carrying, pushing, pulling, arms over head, standing in one place, how far can you walk, is sitting in one position a problem?
5) After this 4th step she said the burden shifts to the government to prove that there is a job that you can perform that can be done with the residual functioning capacity you have. If you can sit for 6 out of 8 hours, they will say you can find a job that involves that physical skill, such as answering telephones.
These jobs don’t have to be at the same level of pay or status that you are currently employed at. The test here is there any job at all that you can do? It doesn’t matter if you trained as an attorney – if you can sit at a desk and answer a telephone 8 hours a day, then SS will say you are still able to work.
She said at this point, at these 5 steps, only about 30% of all SSDI cases are approved. That number is from all SSDI claims and not just the ones for MS patients.
If after these 5 steps you still have not been approved for SSDI, you are able to appeal that decision. You have 60 days to file the appeal. If you don’t appeal within that time period, you will have to start your request for SSDI from the very beginning.
She says at this level, 10-15% of the people who appeal the initial decision are approved for SSDI.
Nothing in this process moves swiftly, but it sounds like the appeal process slows to a creep once you have been denied. She said you will have probably spent at least one year filing paperwork to apply for SSDI and get through steps 1-5. She said it will take about one (1) year to 18 months to have your appeal of denial heard AFTER this initial year. This appeal is heard before an administrative law judge.
She said at this level before the judge, 50-90% of the people are granted SSDI. I know that is a wide range, but that is the number she gave. Her strong recommendation at this point is you must have legal representation that understands the ins and outs of Social Security law, if you have not already retained an attorney. She said you will be at an extreme disadvantage if you represent yourself.
The final step in the appeal process if taking it to the Appeals Council. There are several things the Appeals Council can do:
- Outright reject the request to review the case
- Affirm the judgment
- Rule the judge made a mistake and send it back for an additional hearing before the same judge OR
- If the evidence is so clear, the can reverse the judge’s ruling and immediately reward SSDI. However she stressed this is extremely rare.
Other points that were made in the presentation that I feel are significant, in no particular order of importance are:
You want to stick with your doctor as your treating physician, otherwise SS can assign you to one of their doctors for evaluation. The longitudinal history with one doctor is very important and your doctor will be asked to do lots of paperwork on your behalf. Now is not the time to doctor shop/hop.
Keep records of EVERYTHING – phone calls, contact names, dates, paperwork submitted, etc.
Make yourself and your case stand out. Now is not the time to down play your problems or symptoms. However, you must maintain credibility. It does you no good to talk about how you can’t do lifting work with your arms but turn around and talk about buying a gallon of milk at the grocery store (which weighs about 8 pounds!).
Talk about what you CAN still do – help them to see the residual functioning capacity you have rather than let them come to their own conclusion.
Do not overlook fatigue as one of your symptoms. MS fatigue is very real and can easily take you out of consideration for working any job for an extended day.
Your impairment must last at least 12 months (or end in death) for SS to consider it a disability. There is no temporary disability.
If depression is one of your disabilities, it is important that you be in treatment for depression – this can be drugs, but being in therapy is even more evidence on depression.
If you do not have enough credits to collect SSDI on your own work history, you can only qualify on your spouse’s record if your spouse is either retired, disabled or dead.
The older you are, the easier the process is to get SSDI. Young people have a particularly difficult time proving they will be disabled for life.
Working through the process is much like climbing a ladder – it can be tiring and discouraging. Plan on having to complete many forms, often they are asking the same questions over and over.
Don’t expect to be well compensated if you are approved for SSDI. She gave figures which were shockingly low in my thinking. This amount is based on your work history and the income you did make, but has a cap.
This discussion is not the same for Supplemental Security Income (federal welfare) which has much lower income assistance. To qualify for SSI, you have to have few assets (valued at less than $2,000) and is based on income. If I caught it correctly, you can expect no more than $674 a month from SSI.
This is not an easy legal request and you will only be successful if you persevere and stick with it. Once you begin the process, expect to be in it for the long haul.