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Social Security Disability
Old 04-24-2006, 02:48 PM   #1
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Social Security Disability

My wife worked as a nurse until being diagnosed with metastatic breast cancer 18 months ago. Due to her treatments and mutliple surgeries (6 surgeries), during radiation treatment she got 3rd degree burns on her neck and chest. The burns got infected and she became septic -- had to be re-admitted to the hospital for two weeks an had her mastectomy site re-opened. She has been through hell and has been unable to work. She will have two more surgeries this year.

Due to her illness and the medical therapy she is easily fatiqued and has constant joint pain and stiffness. We are trying to decide if its worthwhile to apply for disability benefits for her. The reality is I don't ever see her returning to nursing -- after her surgeries are over and she has recovered --maybe a less physically demanding job.

In applying for benefits is it best to be represented by a disability attorney or deal with SS individual.

Thanks for any advice.

dwk

Her physicians are supportive of this action. I just don't know if there is a downside. She and I are 51
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Re: Social Security Disability
Old 04-24-2006, 03:01 PM   #2
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Re: Social Security Disability

my wife was able to arrange for disability benefits directly with SSA -- having full support from the physicians is necessary. based on this limited experience, unless you run into problems, I don't think you'll need an attorney
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Re: Social Security Disability
Old 04-24-2006, 04:14 PM   #3
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Re: Social Security Disability

I am on UNUM disability from a job and also SS disability. UNUM "made" me apply for SS disability but saying they would subtract what I would get from SS whether I got it or not. This was part of the contract with my former employer.

I applied for SS dis, and was turned down. UNUM them pad for a lawyer and I got the SS disa.

So I would say try without a lawyer and then try with a lawyer.

In case anyone is interested, my disability is vascular dementia. That's right, I'm demented. It's from a lifetime of diabetes. I couldn't do the high level cognitive thinking that my real-time programming job required. It doesn't affect my everyday life much, except I can't do things like understand complicated forms such as tax returns very quickly.

Mike D.
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Re: Social Security Disability
Old 04-24-2006, 06:24 PM   #4
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Re: Social Security Disability

Apply for her SS Disability at once!

They will expedite it very quickly. Metastatic breast cancer is a flag to them. When we applied for my wife, we worked with a SS administration clerk by phone and he walked it through. Got first payments within 45 days.

She will receive future payments and past payments calculated from the date she was unable to work due to her illness, up to one, year in a lump sum.

The calculations for monthly payments are determined by projecting what she would receive at full retirement with work uninterrupted. My wife received two checks within the 45 days. One for $17,000 + and one for the upcomming month at $1300 +

You both have my prayers. Do not count on her returning to work. Fighting cancer is a full time job.

When she qualifies take a copy of the notice from SS to your county/state property tax office. If you own your home it will qualify you for her share of ownership 1/2,* I assume,
at the reduced disability tax rate.

Check your Personal Messsages.

God Bless
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Re: Social Security Disability
Old 04-24-2006, 06:46 PM   #5
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Re: Social Security Disability

Thought I would reply to this one, since it "hit home" with me.

Our son is 36 and was diagnosed as autistic at a "later age" due to lack of screening programs when he was young.

Being that he didn't know he was such* he proceeded to work while going to college, received a BS in Computer Science, and attempted to acquire work in the "real world".

We knew he had problems from an early age (constant crying - did not sleep overnight for his first 5 years - disassociation with others, etc. etc. etc.)

Anyway, after he was unable to maintain a job after college, he went through a battery of tests (primarily from a neurophyclogist) which classified him as "disabled".

Since he could not hold a job, and since we had no family support, we applied for SSD (based upon his part-time work from high school/college).

Of course, Social Security denied him his claim (as they always do, the first time around).* Luckily, through his Autism support group, we were referred to a lawyer who took these types of cases at no charge (we did find out later, that he was reimbursed from the government for his work).

Needless to say, we could not make any headway until we got the professional (lawyer) involved.* He was certified as disabled, and received (and still receives) his SSD of around $750/mo.*

As far as Medicare, you must wait for two years after SSD is granted, to get coverage.* He does pay for medigap coverage ($90/mo through Blue Shield) and since he is "low income", he gets his drugs under the new Medicare Part D at no charge (other than $2 for shipping).* Prior to this, he paid $159/mo for medigap and $200/mo deductible for drugs.

It was a long "fight", but it was worth it.* You just need to get support from the legal profession to "make the fight".* I know that there are some legal firms that advertise support for SSD, but I suspect that they get part of the meager monthly SSD check to do their work (and being paid by the government to do their work!).* If I'm wrong, please correct me, but this is what my son's lawyer told me...

- Ron
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Re: Social Security Disability
Old 04-24-2006, 06:51 PM   #6
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Re: Social Security Disability

Quote:
Originally Posted by MikeD
I am on UNUM disability from a job and also SS disability. UNUM "made" me apply for SS disability but saying they would subtract what I would get from SS whether I got it or not. This was part of the contract with my former employer.

I applied for SS dis, and was turned down. UNUM them pad for a lawyer and I got the SS disa.

So I would say try without a lawyer and then try with a lawyer.

In case anyone is interested, my disability is vascular dementia. That's right, I'm demented. It's from a lifetime of diabetes. I couldn't do the high level cognitive thinking that my real-time programming job required. It doesn't affect my everyday life much, except I can't do things like understand complicated forms such as tax returns very quickly.

Mike D.
I think this is on par with a pilot not having good enough vision. Wouldn't hurt most people but makes them unable to do their job. A lot of intellegence is speed, not if your can understand it at all. Sorry for your trouble.
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Re: Social Security Disability
Old 04-24-2006, 09:59 PM   #7
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Re: Social Security Disability

Quote:
Originally Posted by rs0460a
Of course, Social Security denied him his claim (as they always do, the first time around).
That's BS.*

If you look at the people who eventually get approved, based on my anecdotal evidence of having worked for SSA for 29 years, many of them are approved the first time around.

Early in my career when I was a Claims Representative in a field office reconsiderations and hearings were a VERY small part of my workload, and CRs are the people who take and adjudicate disability/retirement/survivors claims, not clerks.

http://www.ssa.gov/disability/disabi...lcome_2004.htm

That chart shows FY2004 data.* "In FY 2004, most allowances were made at the initial level (37 out of 53 that are allowed overall for every 100 cases). Only about 4 cases out of 100 go beyond the administrative hearings level, and less than 1 per 100 are pursued in Federal court."


I'll point out that the SSA employees in the field office, while they gather as much medical information as possible (and some claimants are horrible historians) are basically looking at the work record side of thing, though if a claimant meets certain minimum disability standards the CR can determine that a basis for "presumptive disability" exists.* A further evaluation is needed, but they can put someone into pay immediately (presuming the work history and other non-dib factors are OK).* Disability determinations are done by the Disability Determination Services, which is a branch of whatever state you file in, and they are all state employees, not SSA employees.

You also have an SSA quality review organization, the Disability Quality Branch, that reviews a significant number of the DDS determinations before a medical allowance/denial decision is made.*

Both the DDS and the DQB have contract physicians on the staff to supply that level of expertise, though the medical knowledge (of the types of things that SSA deals with) of a competent examiner is usually pretty good.

Things may have changed over the years, but I can remember seeing Administrative Law Judge hearings decisions that included phrases like "in light of the claimants tearful testimony . . .", not to mention the odd ones that were just WRONG based on the statutes and regulations (just because you are a lawyer it doesn't mean that you really understand all the law, or can't screw up).

Your son may have been denied at the initial level, but the reconsideration process very often will correct significant mistakes, and the hearings level gets the very few that are left.

Before you start disparaging an entire agency, and one with a lot of of dedicated employees who are concerned about seeing that the American public gets whatever is due to them under the law and regulations, you might try doing some minimal research and come up with some facts to support your allegations.* It sounds to me that in your son's case, the system basically worked.

cheers,
Michael
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Re: Social Security Disability
Old 04-25-2006, 02:14 AM   #8
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Re: Social Security Disability

Interesting reply, Michael. I have a question;

Those dedicated representatives you speak of down at the claims office...would you describe them as more or less compassionate than yourself?

Just trying to see the big picture here.
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Re: Social Security Disability
Old 04-25-2006, 07:42 AM   #9
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Re: Social Security Disability

When she receives her lump sum payment for (up to one year) being unable to work over the past year or more, that time counts toward the two year waiting period to qualify her for Medicare.

In effect, if she has been fighting this cancer, unable to work over a long enough period of time, you will not only receive needed money but the Medicare might kick in almost immediately.

To repeat: APPLY AT ONCE* * as this starts the clock on any payments and coverage for which she qualifies . No lawyer needed with a diagnosis of breast cancer with mets.
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Re: Social Security Disability
Old 04-25-2006, 07:45 AM   #10
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Re: Social Security Disability

Quote:
Originally Posted by The Other Michael
That's BS.*

If you look at the people who eventually get approved, based on my anecdotal evidence of having worked for SSA for 29 years, many of them are approved the first time around.
Well, I look at the chart, and it shows 63% "initially denied". *I believe that is "most of them, on the first time around".

34.9% of those denied continue (the first pass) to get approved, with only 14.2% getting approved after the second pass.

It takes 3 "passes" to get to the point that you would have "majority approval", often only with the assistance of "legal help".

If you think that 37% of "Many approved the first time" is "good", I would recommend that your standards are too low.

I'm not going to say that there are those who don't try to "cheat the system", but for my wife/me (and my son), we went through "pure hell" (and still do) to work with any government programs.

Call that "BS" - that's your opinion....

- Ron
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Re: Social Security Disability
Old 04-25-2006, 08:03 AM   #11
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Re: Social Security Disability

You have to realize that SS disability requires essentially no earnings for a year -- this is the 'work history' that was mentioned earlier.* So someone who is in a disabling accident or sudden medical condition won't meet the criteria at first -- this is probably why a lot of people are denied initially.* I have a friend who's back was seriously injured in a car accident, and she now can barely walk or stand (or even sit in one position for an hour).* She doesn't qualify yet because she was working up until a few months ago.* Probably will next year, though.* But she had to apply (and be rejected) before she could qualify through work's disability plan.
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Re: Social Security Disability
Old 04-25-2006, 08:15 AM   #12
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Re: Social Security Disability

Quote:
Originally Posted by Robert the Red
You have to realize that SS disability requires essentially no earnings for a year -- this is the 'work history' that was mentioned earlier.*
FYI, the 2005/06 income levels that would disqualify you for SSD are as follows:

- Your disability benefits will stop if you work at a level we consider "substantial." In 2005, average earnings of $830 or more per month ($1,380 or more per month if you are blind) were usually considered substantial. In 2006, that amount increases to $860 or more per month ($1,450 or more per month if you are blind.)

- Your disability benefits also will stop if we decide that your medical condition has improved to the point that you are no longer disabled.


In my son's case, he was not working 5+ years before he filed (took another 18 months after that, going through the appeal process, before he receieved benefits).

And don't forget, at the time (approximately 2 years) you are "approved" for Medicare (assuming you file), you will have an additional amount of money withheld from your SSD, for "Part A" coverage. Any additional "Part B" coverage (medigap insurance), you will be on your own. "Part D" (drug coverage) cost depends on your total income situation.

- Ron
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Re: Social Security Disability
Old 04-25-2006, 08:28 AM   #13
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Re: Social Security Disability

Quote:
Originally Posted by rs0460a
you will have an additional amount of money withheld from your SSD, for "Part A" coverage.* Any additional "Part B" coverage (medigap insurance), you will be on your own.*
Oops, you have to pay for Part B (not A) at the current '06 rate of $88.50.* Part A is supplied as part of the Medicare base coverage...

- Ron
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Re: Social Security Disability
Old 04-25-2006, 10:04 AM   #14
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Re: Social Security Disability

Dwk, I am sorry to hear about your wife's illness. I agree with Ol Rancher--apply for SSD asap and get the clock running. It looks like she has been disabled for some time.



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Re: Social Security Disability
Old 04-25-2006, 02:21 PM   #15
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Re: Social Security Disability

Ron, you don't seem to be considering that many people have their claims initially denied because they don't meet the legal requirements to qualify for disability.

Of that 63% who are denied initially, I read that chart as saying another 3% out of that group get allowed at recon, another 12% at hearings, and 1% at the appeals council.* To me that looks like 37 out of the 53 people that are allowed (which is the number in the the paragraph right above the chart) or about 70% of the claimants, get allowed at the initial determination, or that 16 out of the 63 that are initially denied (about 25%) get allowed at a later point.

So about 54% of the people who file a claim eventually get allowed as meeting the legal requirements for Title II Disability.* In any event "as they always do, the first time around" is an incorrect statement on your part, and my previous post was meant to correct the misinformation that you posted.

Many people who file can be denied just on the basis of their allegations on the claim, as they don't meet even minimal standards for eligibility on either disability or non-disability factors.* Other people can screw themselves up by being poor historians - if they can't tell the CR who their doctors are, the DDS can't contact those doctors to get their medical records.* Some consultative examinations are ordered by the DDS (and paid for by the agency) if it appears they might be needed, but there's a certain burden of proof that falls upon the claimant.

nomo-aloha, I'm not clear on what you are getting at.* Most of the people I worked with were interested in doing an accurate job (and I was in the quality review organization - we were the ones who checked up on the work done by the field offices) and in seeing that claimants got what they were entitled to - whether that was an allowance, back payments when they came up with something that supported that, or a referral to the US Attorney's office for fraud if that was appropriate.

The idea behind having a bureaucracy is to treat people as equally before the law as possible.* Compassion shouldn't come into the process.* I've felt good for getting tangled cases sorted out and people paid the money they were due, and I've felt good about referring people for fraud.* I've felt sorry when denying people who seemed like they could use some help, but they didn't meet the legal requirements for help from SSA (though a standard part of the CR job is to make referrals of people to the local Social Services who might be able to help them, and if it appears that the claimant might qualify for SSI, a concurrent DIB claim will be taken).* * But the employee's job is to administer the laws and regulations, not to say "my you seem like such a pleasant person, I'm going to give you an extra helping of money today, just because the sun is shining and I'm feeling good about things"* or "my, you've been really nasty to me, I'm going to stop the payments you are legally entitled to, how do you like that?"

edited to add: anyone who feels they may be eligible for benefits SHOULD FILE IMMEDIATELY.* If you aren't eligible at this time, it may be possible (depending upon circumstances) for the denied claim to serve at a later time as a protective filing date, and it may extend the period for which benefits can be paid.

Also, Ron, I apologize for being peeved enough to use the term "BS" instead of just pointing out your error, as generally I try to watch that I keep things civil. But three decades of listening to people unjustly slam members of the Federal civil service makes me a bit sensitive on that subject. However, I'll be glad to back you on slamming people when you can do it justly.

cheers,
Michael
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Re: Social Security Disability
Old 04-25-2006, 02:39 PM   #16
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Re: Social Security Disability

I'm going through the process right now. Had 3 back operations, the last fusing 3 vertibray with rods and screws. I was not allowed to return to work. I had to take a disability retirerment from work. (electric utility) I filed for SSD* and was turned down, got a lawyer and I'm waiting. the lawyer told me SSD hearings are 18 months behind in our area. He said my disability was enough to qualify, but I was too young for them.(49) He thinks I should prevale in the next step. So file ASAP. Lucky for me I still have workmans comp. coming in. My first detirmanation was by a state agency contracted by SS. They did not even want to hear my story. You get all this info in the mail and it tells you to notify them if you have Dr. appointment or medical changes, ect. When I called info in to the person handling my case, they made it seem like I was a bother for them, it did not matter what my paper work said, they did not want to hear it. Of course I called in anyway and documented who I talked to. Good luck to your family.......Shredder
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Re: Social Security Disability
Old 04-25-2006, 03:41 PM   #17
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Re: Social Security Disability

Quote:
Originally Posted by Shredder
When I called info in to the person handling my case, they made it seem like I was a bother for them, it did not matter what my paper work said, they did not want to hear it. Of course I called in anyway and documented who I talked to.
Hang in there Shredder...

It takes a while, but if your case is "solid", you will "eventually" will see some "justice".* Just a note on your lawyer - are you paying a fee, or did you question if he would be reimbursed from the Fed's?

Just trying to find out if the statement that my son's lawyer is fact (he's not my lawyer, so he has no responsibilty in anything he says, to me).* He handled the case with NO $$$ (from either my son, nor me), so I suspect that he is telling me the truth (why would a lawyer work for free?)

Take care...

- Ron
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Re: Social Security Disability
Old 04-26-2006, 12:45 PM   #18
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Re: Social Security Disability

Quote:
Originally Posted by rs0460a
Hang in there Shredder...

It takes a while, but if your case is "solid", you will "eventually" will see some "justice".* Just a note on your lawyer - are you paying a fee, or did you question if he would be reimbursed from the Fed's?

Just trying to find out if the statement that my son's lawyer is fact (he's not my lawyer, so he has no responsibilty in anything he says, to me).* He handled the case with NO $$$ (from either my son, nor me), so I suspect that he is telling me the truth (why would a lawyer work for free?)

Take care...

- Ron
The lawyer works on a percentage of any settlement, the % is set by law. I think something like 15% or 20%. My lawyer is a specialist in labor law, SSD, ect. so I'm pretty confident with him. I talked with some of his past clients, and they told me he got a check when they did. In one case he send his client money back as it was more than he was entitled to, kinda of refreshing, considering how lawyers are depicted. Hang in there? Hey what else could I do, it's pretty much out of my hands so I don't worry about it. Hope your son is doing well........shredder
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Advice from MikeD??
Old 11-16-2012, 10:28 AM   #19
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Advice from MikeD??

MikeD:
From your post, you seem to have been in the same boat I am now. I also work in software, highly complicated involving taxes, and have been having issues with memory lately. MRI 6 months ago showed spots, had another one this month. Still same spots. Had all test "neursopschology" testing done yesterday (apparently memory type testing), and it appears (from what little they told me during the testing) that I didn't do well on areas that they expected due to what they believe is vascular changes/damages, vascular dementia, etc. but I will find out more in about 10 days when I return for my followup visit. I am scared. I am in my upper 50's, and seriously worried I will get fired from my job due to mistakes I've been making... before I could qualify for disability with UNUM (my company also uses UNUM for both short and long term disability). I would be ever so greatful for any words of wisdom or encouragement on what to do going forward. Do I approach my HR dept, my supervisior, hide the reason I'm having problems at work, etc. (i.e, I've already gotten a bad review.. after years of glowing ones... and it's all related to "focus".. which I now understand is the very issue I am physically having due to these vascular problems). If I loose my job.. we'll lose everything. I am scared for my health and my job. Any suggestions?? Thanks!
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