Sunday, October 28, 2007

Filing For SSDI / SSI Benefits

Because many patients with a chronic illness may have to file for permanent disability at some point, I thought it was important to add a post about the role the medical community plays in this process. Aside from that role, there are multiple ways that a patient can become prepared should the need arise to file for permanent Social Security benefits due to disability. In fact, many of the suggestions that I have previously posted can become key elements during the Social Security application and approval process.

When it was determined that it was time for me to file for permanent disability, I was not looking forward to dealing with Social Security. Most people have heard the numerous horror stories about denied claims, the appeals process, and the length of time it takes for approval, etc. Many of us even know someone who has been through the process and had trouble with getting their claims approved. These horror stories were the nexus of my fears about dealing with Social Security.

When I was ready to begin the process, I went to the Social Security Administration’s website, in order to find out what the process was for filing my claim. I was pleasantly surprised to find that a person can file the initial application for benefits right through the website. What I found out during the online application process is that the application is very long and detailed. Depending on the amount of information a person has, the application process is probably a two to four hour process. In my case, I have difficulties with sitting for extended lengths of time, so it took me two days to complete the application. Their process allows a person to save and return to the application as many times as needed, which was a redeeming feature.

Based on my experience, the following information needs to on hand, prior to starting the application process for Social Security benefits:

1. List of all physicians, including mailing addresses, telephone numbers, and associated dates of contact. (Approximate dates are appropriate. Example: from 01/01/01 thru 12/01/02) This list should also include physical therapists, mental health professionals, physician’s assistants, and any other medical professional / practitioner that the patient has had contact with.

2. Dates that chronic illness began, including various symptoms associated with illness onset

3. List of diagnostic tests, including dates and results

4. List of past and current treatments including physical therapy, prescription medications, surgeries, over the counter medications, etc.

5. List of specific limitations and symptoms that prevent a person from being able to work. Specifics are required and looked at very closely. (Example: how long can a person sit before having to get up and move around, distance a person can walk before taking a break, amount of time a person can stand, etc.)

6. Copies of as many medical records that a person can find.

The application for Social Security itself is the greatest indicator of the amount of detail that Social Security looks at when making a determination for benefits. The more details that supplied during the initial application process, the better the chances are that a claim may be approved. If Social Security determines that there is not enough information to confirm that a person is permanently disabled, the claim most often will be denied.

Although there are many more aspects involved with the Social Security process, I primarily want to point out how some of the suggestions I have previously written about can assist in the process. Let us look at the following:

1. Finding and establishing a good doctor / patient relationship with physicians – This is essential for a person with a suspected or diagnosed chronic illness, but it can also be the most important aspect when filing for disability benefits. Social Security makes contact with a person’s physician(s) both in writing and by telephone, in order to verify a person’s disability status. If a patient does not see a physician often or does not have a good relationship with the physician, the physician’s response to Social Security may not help with the claim, simply because the physician may not be fully aware that any limitations exist. My Primary Care Physician and I had discussed my health issues prior to me filing my application, and he was well aware that his input to Social Security was essential. Because I have a good relationship with my Primary Care Physician and see him on a regular basis, he had enough information about my conditions, symptoms, and limitations to confirm my disability status and back up his opinions.

2. Personal Medical Records File – The person who has copies of his / her own medical records already has a large portion of the information that the Social Security application asks for. This includes diagnostic tests, treatments, information on physicians, etc. Keeping a personal medical file is not only an asset when dealing with the medical community, but it insures that a person does not have to spend hours searching for critical information that essential when filing for Social Security benefits. Additionally, I was able to provide the records I had to Social Security immediately, which allowed them to begin their process of determining my disability status. I believe that being able to provide them with an almost complete set of my medical records, expedited the process, because they were not dependent on sending out requests to the many physicians I have seen or waiting for those records to be sent by my physicians. They would have only had to wait for any additional information that they may have thought necessary to make a determination. Of course, this is only my opinion based on my personal experience.

3. Personal Medical Journal - Keeping a personal medical journal is not only an asset during and after the diagnosis process, but it is a great resource for the person who is applying for Social Security Benefits. Although medical records are important, they may not reflect or detail all of a patient’s symptoms, daily struggles, or the effects that the chronic condition has on the patient’s life each day. Additionally, a personal medical journal is a first hand account about symptoms, dates when symptoms emerged, responses to treatments, and other aspects that may not make it into a physician’s medical records. My journal became my main source for detailing my conditions, symptoms, and especially the progression of those conditions. Although I did not submit my journal to Social Security, I did use the information to insure that the information I was submitting was accurate. If Social Security had denied my claim, I would have then provided my journal during the appeals process.

4. Copies of my written correspondence to my physicians – Written documentation became essential during the diagnosis process, but also assisted me during the Social Security Application process. As with my personal medical journal, I referred to my copies of written correspondence to assist with detailing my symptoms, significant dates, and for general accuracy purposes. Again, I did not submit these copies to Social Security, but would have included them during an appeals process.

The most important thing that I discovered is that no information can be withheld when filing a claim with Social Security. Too much information is better than not enough information when going through this process. For example, I remember how angry I was with some of the specialists’ opinions about my conditions in the early years, along with their written reports that they submitted to my Primary Care Physician. However, during this process their content became less important. The reports actually helped to establish that physical symptoms of chronic conditions existed, as well as a timeline of when I first began seeking treatment and a diagnosis for these conditions. Therefore, during the Social Security process, some records that I once felt were detrimental, became evidence that the onsets of my conditions occurred several years prior to any diagnosis. This information, along with more recent records that indicated the severity of symptoms progression, helped to establish the likelihood that my conditions were both chronic and progressive.

I was pleasantly surprised again when I went to deliver my medical records to my local Social Security office, the day after I submitted my application via the internet. The man I met with was polite and informative. He assisted with helping to fix a problem with the records of my past earnings in order to insure that my award amount was correct in the event that my claim was approved. Additionally, he made sure that I had his contact information in the event that I had any further questions while waiting for a determination on my claim. Almost four months later, this same man called me on a Saturday to let me know that Social Security approved my claim, and advised me of additional documentation that I needed to bring into the local office as a result. Again, I was very amazed.

In my opinion, my experience with Social Security was remarkable considering all of the horror stories out there. I believe that the following factors may have played key roles during the claim process:

1. I have two diagnosed conditions that are considered as qualifying conditions for permanent disability by the Social Security Administration.

2. I have at least seven years of consistent visits to my Primary Care Physician and multiple specialists for diagnostic and treatment purposes.

3. I took extra time to provide as much detailed information as possible while filling out the online application, including information on other minor health conditions not directly related to the two chronic conditions.

4. I had 100% support from my Primary Care Physician who had full knowledge of my past medical history as well as my current conditions, and how these conditions affect my daily life.

5. I made certain that Social Security had access to as many medical records as possible.

6. I made sure that the person, outside of the medical community, who knew the most about my conditions and the associated disabilities, was the person who could best support my claim of permanent disability if contacted by Social Security.

Prior to applying for benefits, I came across an internet site that clearly outlines the Social Security claims process. This site gives complete information on the entire process including application, denials, appeals, hearings, etc. It offers information about legal resources, how Social Security determines if a person is disabled, and answers many common questions that come up during the process. It is one of the best resources out there for anyone who may need to apply for SSDI or SSI benefits. I will include a link to this site under the “Resources for PD, PD-Plus, and Other Movement Disorders” section.

It was a blessing that my experience with Social Security went as smooth as it did. It alleviated the potential for additional stress in my life, which has a tendency to affect my condition in a negative manner. I hope that by sharing my experience and the information that I found valuable that someone else might also have a good experience when dealing with Social Security. My positive experience may have been the result of the depth of information supplied to Social Security, a little help from the Lord, or a combination of both. Regardless, attention to every detail and a little prayer, cannot hurt when dealing with the Social Security Administration.

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