BETTY NOTE: Look at the female MD''s DETAILED BACKGROUND right below this paragraph. Print off her detailed responses as to why she could NOT do her job, and then apply that to YOUR own job as to why you no longer can do any type of sustainable work now nor in the foreseeable future! NO LONGER GOOD 5-17-06:
http://www.cfids-me.org/socsec.html
*************************************
An online friend of mine from disinissues web site posted this info today, so I have copied it over here.
Subject: fibro/CFS disability info [Disinissues] what does an Functional Capacity Exam entail ?
Lyme, fibro, & CFS support group members who are/will be filing for SS Disability insurance benefits, please go to the web page shown below.
There were 9 pages of info I printed below area where you can order from fibro network a 70 page packet.
I too plan on including this info when I send my FINAL packet of info to chief ALJ before my June 16, 2005 hearing...my last chance!
=======================================
Please read the site mentioned on: WHY DISABILITY TESTING FOR FMS IS OFTEN MISLEADING ADVICE FOR FM/CFS PATIENTS AND THEIR DISABILITY TEAM.....
Also after this article are the following articles:
WHAT COULD BE CAUSING DELAYED-PHASE FLARES?
BENNETT'S METHOD FOR ASSESSING FUNCTION IN FMS..
TECTONIC CHANGES IN DISABILITY LAW by lawyer Joshua Potter, CALIF.
MEDICALLY DETERMINABLE IMPAIRMENT REQUIREMENTS FOR CFS & FMS
DOCUMENTIONATION...VIEW IT AS AN INSURANCE POLICY
I printed this out in larger print for my eyes....9 pages! Will read it thoroughly and mark up 2nd copy to go to ALJudge for my 2nd hearing as medical evidence also....
by windy Bettyg
![[Big Grin]](biggrin.gif)
Posted by lymednva (Member # 9098) on :
The key to my winning my SSDI was the neuropsych testing that my attorney sent me for almost as soon as I hired him.
This psychologist was very thorough and picked up on small things, unlike the ones I was sent to by my LTD company.
I also had a letter from a CFIDS researcher (that was my dx at the time) and tons of info from my doctor, as well as his forms filled out with all the necessary info. He is quite experienced with disability, so that didn't hurt. He knew what they would be looking for.
You need as much documentation from professionals as you can get. That way it's not just your word against theirs. That is why just a letter won't cut it.
Posted by hopeful4 (Member # 8486) on :
Hi Ann,
I'm making an assumption that you are talking about Social Security Disability. Is that correct?
I'm not sure what "letter" she is referring to. When I applied, I had tons of paperwork forms to fill out, and some for members of my family to complete.
My first application was denied. That's common. So I went to an attorney specializing in SSD. She filed an appeal, for which I won a "partial" award. It took a long time.
At the time, I didn't know I had lyme. I was diagnosed w/CFIDS. However, I didn't win the award on that, I won it on a psych evaluation with a diagnosis of depression.
I strongly suggest that your friend contact an attorney who specializes in SSD. That gives her the best chance of winning. My attorney is also helping me appeal my case to try to get the remainder of the award.
Also, check out Scott Davis's website and articles on how to win SSD:
http://tinyurl.com/j3mov
He has the following articles:
Articles on Social Security Disability and Various Other Disabilities
1. NEW! Five Reasons Judges Approve Social Security Disability Claims
2. How to Prepare for Your Social Security Disability Hearing before an Administrative Law Judge
3. Winning Your Social Security Disability Claim: 15 Mistakes You Can't Afford to Make!
4. How Does Social Security Define ``Disability'' Anyway?
5. Does having an attorney determine whether you win or lose your Social Security Disability case?
6. Obtaining Social Security Disability: How to Begin the Process
7. Seven Important Steps to Winning Your Disability Case
8. Why it is Important to Persevere in Your Disability Claim
9. How To Talk with your Physician about Supporting your Disability Claim
10. Winning Your Disability Case in Three Words...Frequency, Severity and Duration
11. Five Critical Tips to keep in Mind when Completing Disability Forms
12. Here's a ``Golden Nugget''...win your disability case by obtaining your personnel file from work
13. Winning Your Disability Case with the Help of Co-Workers, Family Members and Friends
14. Obtaining Disability Benefits . . . David vs. Goliath
15. Why it is Important to Address Psychological Issues in your Chronic Pain Disability Case
16. How to Win Your Hepatitis Disability Case
17. Not Filing a Disability Claim is a Financial Disaster Waiting to Happen
Wishing her good luck, and perserverance.
Hopeful4
Posted by Ann-OH (Member # 2020) on :
Thanks so much for all the good info!
I sent it on to her and will let you know how she does.
Ann - OH
Posted by ConnieMc (Member # 191) on :
I wrote the following for my LLMD:
Guidelines for Use in Writing Letters/Reports in Support of Social Security Benefits for Patients With Tick-borne Diseases
By: Connie MS, CRC, CVE, CCM
Disability Advocate
General principles of focus to consider when preparing this report:
1. The report/letter must have a longitudinal perspective that allows Disability Determination Services (DDS) to see the frequency, duration.,
and recurrence of major symptoms of tick-borne diseases. Medical records will generally show this, but a letter needs to state the general course of disability thus far, as well as the projected length of the disabling condition.
2. The report/letter must include descriptions of all treatment regimens and responses to therapy must be given. For example, oral antibiotics, and general response. Did this result in limited improvement, which necessitated the initiation of intravenous therapy?
3. The report/letter must include any significant restrictions the patient has experienced in his/her normal activities since the onset of the diseases. Here, we are asking the physician to describe changes in lifestyle, such as household, personal care, and social activities, as may be determined through history. Also, the physician can report any
observed limitations such as walking, climbing, etc. as the patient functions in the exam room. A ``Incapacity Checklist'' can be helpful, and
the physician can have the patient complete this for reference before the support letter is written. (A copy is at the end of this document). The patient needs to provide specific examples of limitations in function,
which the doctor can document in the letter. The advocate can then obtain supporting statements from others (friends, family) to confirm what the
patient has reported to the doctor.
4. The report/letter must report on any objective testing which has been done to determine the appropriate diagnosis. For example, any positive lab studies, and other supporting evidence such as positive SPECT scan
results, positive findings of joint inflammation on x-rays, etc. Any testing which supports the presence of illness is acceptable. Includes
the clinical examination, not just lab studies.
Once the above is established, the physician must then identify and describe the most significant and disabling symptoms frequently associated
with TBD. For example:
1. Fatigue - the existence of chronic and/or recurrent debilitating tiredness, which is demonstrated by an inability to perform basic minimal tasks of daily living (ADLs).
2. Neuropsychological - the existence of forgetfulness and distractability, inability to concentrate, memory impairments, confusion,
difficulty thinking, photophobia
3. Neurological - numbness and tingling, sensory impairment.
4. Pain - recurrent and chronic pain which significantly impedes the performance of ADLs and unrelieved by prescribed treatment. Location of
such pain and any objective findings utilized to diagnose the origin of such pain. This includes chronic headaches and myalgia.
5. Sleep disorder - Any disruption of normal sleep patterns that is recurrent and does not respond to treatment.
6. Depression - Is depression primary or secondary? Is it related to the patient's reaction to the daily physical symptoms? Are there other psychiatric symptoms present which are apparent to the physician?
7. Cardiac - heart block, hypertension, other cardiac complications.
Sample Letter
Re:
DOB:
Please be advised that I have provided medical care for Ms. Blank since 5/7/2003. Ms. Blank carries a diagnosis of persistent Lyme Disease made on the basis of a number of clinical features, including marked fatigue,
chronic relapsing pain, CNS irritability, nonrestorative sleep and severe
cognitive dysfunction. This patient is disabled by incapacitating fatigue and myalgias aggravated by repetitive or sustained physical activities.
Her symptoms are consistent with her discase, which has been confirmed by positive IgM Western Blot in May of 2003. There is also evidence on
examination of persistent disorganization of motor function as evidenced by peripheral nerve dysfunction. She frequently becomes confused during discussion of treatment recommendations, and must rely on others to insure she has information she needs to proceed with recommended treatment.
Ms. Blank has had marked impairment of her daily activities and finds it difficult to get out of bed on most days. She routinely requires
assistance with showering and dressing. She uses a cane for ambulation. She cannot stand for more than 5 minutes to prepare meals, and must obtain
assistance from others. She cannot lift or carry dishes or a gallon of milk. She cannot vacuum or mop or garden. She is unable to do laundry.
She has difficulty managing her medication and must receive assistance
from others to make sure she takes the recommended medications at the recommended times. She has difficulty getting in and out of a car and is unable to drive due to cognitive dysfunction.
Ms. Blank has been treated vigorously with oral antibiotics as well as supplements and other supportive care. There has been limited improvement thus far, and therapy with intravenous antibiotics is recommended for the
near future.
By reason of the unpredictability of the frequency of her multiple physical symptoms, Ms. Blank has been totally and permanently disabled
from engaging in, and more importantly, in sustaining any gainful employment activity, even light part-time sedentary work at home. Ms.
Blank's status has been consistent since I first began seeing her in May of 2003.
It is my opinion that she is likely to remain disabled for the foreseeable future, but, in any event, for not less than 12 consecutive months.
Prognosis remains guarded and uncertain.
Sincerely,
Name: _________________________________Date: _________________
Incapacity Checklist
How does your condition affect:
1. Your daily activities
2. Your ability to stand, sit or walk for a long period
3. Your ability to lift or carry weight
4. Your ability to understand, carry out, and remember instructions
5. Your ability to respond appropriately to your supervisor and coworkers
6. Other physical or psychological functional restrictions
7. Your ability to adjust to the stress of a work environment
Anyone who wants to provide this to their LLMD for use is more than welcome to do this. I have used this same format many times and DDS and ALJs seem to be receptive to it. It includes all the information SSA is looking for to help them allow claims.
Connie
[ 14. August 2006, 12:00 AM: Message edited by: ConnieMc ]
Posted by bettyg (Member # 6147) on :
Connie, WOW; great info you wrote and very detailed! Outstanding job. Thanks for adding it here.
May I add it to my NEWBIE'S LIST I send to newbie's when I greet them with my other disability info I showed above?
Connie, would you make sure you copy this and send to MINOUCAT who has detailed disability, etc. links galore that Treepatrol has in his newbie links? Your info would really help so many folks Connie!
![[group hug]](graemlins/grouphug.gif)
Bettyg
Posted by Ann-OH (Member # 2020) on :
Thank you Connie. Every doc should have this to work from!
I sent it on to my friend and I know she will be very grateful.
Thanks again,
Ann - OH
Posted by ConnieMc (Member # 191) on :
The info I wrote can be used in any way you all want. If individuals want to print out for their LLMD, please do. I researched this thoroughly and have used this successfully in my work.
My LLMD's office uses it for all types of disability letters, not just SS.
Posted by bettyg (Member # 6147) on :
Thank you Connie for giving us all permission to use what you wrote to help others going thru the SSDI process and other situations!
I'll pass it along to others on my lyme/fibro/CFS lists members.
EDITED: I just copied it to Minoucat's disability links and Treepatrol's newbie links.
I copied it to my word, and left your words as is but formatted using bullet for your important points so the MDs would not overlook the critical data needed you explained so well Connie.
Bettyg
![[kiss]](graemlins/kissing.gif)
[ 14. August 2006, 02:00 AM: Message edited by: bettyg ]
Posted by bettyg (Member # 6147) on :
Betty's reformatted version of Connie Mc's info above with bullets for critical/important info!
8-12-2006 from Connie Mc, lymenet.org
I wrote the following for my LLMD:
Guidelines for Use in Writing Letters/Reports in Support of Social Security Benefits for Patients With Tick-borne Diseases
By: Connie MS, CRC, CVE, CCM,
from www.lymenet.org
Disability Advocate
General principles of focus to consider when preparing this report:
1. The report/letter must have a longitudinal perspective that allows Disability Determination Services (DDS) to see the frequency, duration, and recurrence of major symptoms of tick-borne diseases.
Medical records will generally show this, but a letter needs to state the general course of disability thus far, as well as the projected length of the disabling condition.
2. The report/letter must include descriptions of all treatment regimens and responses to therapy must be given; example:
oral antibiotics, and general response.
Did this result in limited improvement, which necessitated the initiation of intravenous therapy?
3. The report/letter must include any significant restrictions the patient has experienced in his/her normal activities since the onset of the diseases.
Here, we are asking the physician to describe changes in lifestyle, such as:
household, personal care, and social activities, as may be determined through history.
Also, the physician can report any observed limitations; such as,
walking, climbing, etc. as the patient functions in the exam room.
A ``Incapacity Checklist'' can be helpful, and the physician can have the patient complete this for reference before the support letter is written. (A copy is at the end of this document).
The patient needs to provide specific examples of limitations in function, which the doctor can document in the letter.
The advocate can then obtain supporting statements from others (friends, family) to confirm what the patient has reported to the doctor.
4. The report/letter must report on any objective testing which has been done to determine the appropriate diagnosis. For example,
any positive lab studies,
and other supporting evidence such as positive SPECT scan
results,
positive findings of joint inflammation on x-rays, etc.
Any testing which supports the presence of illness is acceptable.
Includes the clinical examination, not just lab studies.
Once the above is established, the physician must then identify and describe the most significant and disabling symptoms frequently associated with TBD, tick-borne disease. For example:
1. Fatigue - the existence of chronic and/or recurrent debilitating tiredness, which is demonstrated by an inability to perform basic minimal tasks of daily living (ADLs).
2. Neuropsychological - the existence of forgetfulness and distractability, inability to concentrate, memory impairments, confusion, difficulty thinking, photophobia
3. Neurological - numbness and tingling, sensory impairment.
4. Pain - recurrent and chronic pain which significantly impedes the performance of ADLs and unrelieved by prescribed treatment.
Location of such pain and any objective findings utilized to diagnose the origin of such pain. This includes: chronic headaches and myalgia.
5. Sleep disorder - Any disruption of normal sleep patterns that is recurrent and does not respond to treatment.
6. Depression -
Is depression primary or secondary?
Is it related to the patient's reaction to the daily physical symptoms?
Are there other psychiatric symptoms present which are apparent to the physician?
7. Cardiac - heart block, hypertension, and other cardiac complications.
Sample Letter
Re:
DOB:
Please be advised that I have provided medical care for Ms. Blank since 5/7/2003. Ms. Blank carries a diagnosis of persistent Lyme Disease made on the basis of a number of clinical features, including: marked fatigue, chronic relapsing pain, CNS irritability, nonrestorative sleep and severe cognitive dysfunction.
This patient is disabled by incapacitating fatigue and myalgias aggravated by repetitive or sustained physical activities.
Her symptoms are consistent with her disease, which has been confirmed by positive IgM Western Blot in May of 2003.
There is also evidence on examination of persistent disorganization of motor function as evidenced by peripheral nerve dysfunction.
She frequently becomes confused during discussion of treatment recommendations, and must rely on others to insure she has information she needs to proceed with recommended treatment.
Ms. Blank has had marked impairment of her daily activities and finds it difficult to get out of bed on most days.
She routinely requires assistance with showering and dressing.
She uses a cane for ambulation.
She cannot stand for more than 5 minutes to prepare meals, and must obtain assistance from others.
She cannot lift or carry dishes or a gallon of milk.
She cannot vacuum or mop or garden.
She is unable to do laundry.
She has difficulty managing her medication and must receive assistance from others to make sure she takes the recommended medications at the recommended times.
She has difficulty getting in and out of a car and is unable to drive due to cognitive dysfunction.
Ms. Blank has been treated vigorously with oral antibiotics as well as supplements and other supportive care. There has been limited improvement thus far, and therapy with intravenous antibiotics is recommended for the near future.
By reason of the unpredictability of the frequency of her multiple physical symptoms, Ms. Blank has been totally and permanently disabled from engaging in, and more importantly, in sustaining any gainful employment activity, even light part-time sedentary work at home.
Ms. Blank's status has been consistent since I first began seeing her in May of 2003.
It is my opinion that she is likely to remain disabled for the foreseeable future, but, in any event, for not less than 12 consecutive months. Prognosis remains guarded and uncertain.
Sincerely,
Name: ____________________________Date: _________
Incapacity Checklist
How does your condition affect:
1. Your daily activities
2. Your ability to stand, sit or walk for a long period
3. Your ability to lift or carry weight
4. Your ability to understand, carry out, and remember instructions
5. Your ability to respond appropriately to your supervisor and coworkers
6. Other physical or psychological functional restrictions
7. Your ability to adjust to the stress of a work environment
Anyone who wants to provide this to their LLMD for use is more than welcome to do this.
I have used this same format many times and DDS and ALJs seem to be receptive to it. It includes all the information SSA is looking for to help them allow claims. Connie
[14. August 2006]
Posted by bettyg (Member # 6147) on :
up; knowing of 2-3 people in this SSDI process right now; hoping they will see Connie Mc's excellent info.
If you do, go to my post where I reformatted it with bullets for important/critical stuff where a MD could check off making sure they send DDS or the admin law judge everything they should be ending. Bettyg