5dana8
Frequent Contributor (1K+ posts)
Member # 7935
posted
Hi all I am trying to apply again for ss disability and medicare.
I have been rejected twice already but want to try one more time.Not really for SS but for the medicare benefits that follow in two years.
I have heard from one lawyer that I should apply for CFIDS and lyme on the side because CFIDS is easier to get.Is this true.
The cost of my meds are really a concern and also in home care in the future.
Does any one know if medicare is: Good at covering meds for lyme?
And is medicare good for covering in home care/ I did a search here and couldn't find any information. Thanks a head of time. and hope everyone is having a good thanksgiving weekend .
Take care dana
-------------------- 5dana8 Posts: 4432 | From some where over the rainbow | Registered: Sep 2005
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rosesisland2000
Frequent Contributor (5K+ posts)
Member # 2001
posted
The majority of folks have to get to the 3rd procedure before being approved. I was finally approved after several years and at my second appeal, the third process.
My advice, get to an attorney that specializes in Social Security...and, at that try and get to one (SS Attorney) that you know someone else has had great results from.
And, currently as in the past, Medicare does not pay for prescriptions.
However, starting Nov 15th this year Medicare receipiants can now buy insurance and will be able to get their prescriptions cheaper than in the past without insurance.
Good luck
Editing to add, I think whatever illness your lawyer is telling you that you'd have your best shot at winning, would be the one that I'd be using. Lyme, in some parts of the country are a real stretch for some judges.
posted
Dana, there is a LOT of past discussions about SSDI process & experiences. Use the search feature with SSDI in topic line and under MEDICAL & OTHER.
Also, go to TREEPATROL'S NEWBIE LINKS and look for disabiliity and MINOUCAT'S name, she has extensive web links there!
My advise after taking FIVE years to be approved are as follows:
1. get a RFC, residual function capacity, questionnaire done by your treating dr. who has seen you for years.
2. get a MFC, MENTAL function capacity, done by a psychiatrist. This is what helped my case the most. Approved of severe depression & anxiety.
3. ALJ's will deal with mental illnesses but will not touch fibro, chronic fatigue, and LYME since they are NOT listed in approved list of impairments. LYME IS LISTED IN THERE, but they still will not touch that in Iowa! I have the CHIEF ALJ who heard my 2nd case.
4. For 4 years I had CFS/fibro lawyer, Scott Davis, Phoenix, who then quit me almost 4 years into this since he/staff couldn't satisfy me.
I represented myself at 2nd hearing & Scott did NOT collect a penny since he quit/withdrew from my case.
You can win without an attorney when you are doing ALL the work yourself as I did w/Scott for 4 years.
Do you have family/friends to help you out? Now go and read the DISINISSUES site below and the female MD's DETAILED app which you could use to apply to YOUR situation. Good luck.
It means plenty of reading & action on your part.
Personally, I have found the below my best bet since I learned of its existence 1 yr. ago.
IF YOU ARE TRYING TO GET SS DISABILITY INSURANCE or LONG TERM DISABILITY BENEFITS ==================================================
This message is sent upon subscription, and again monthly. Please let the moderators know if any of the links have changed.
There are many more links, as well as advice, in the "useful" messages in the Files area of the website. Go to http://groups.yahoo.com/group/Disinissues and click on Files.
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!
Betty's note: Here is EVERYTHING about the complete SSDI process; their rules/regulations! BOOKMARK IT PLEASE as you will come back often to read up on the next steps! http://www.ssa.gov/OP_Home/cfr20/404/404-0000.htm
These links are a compilation of several areas of interest which are commonly requested and mentioned. They reflect the collected wisdom of this group. Check them out - you just might find the information you were looking for! Take a look at Files that are not specific to your situation, because they might be helpful anyway - what works for Social Security may work for LTD claims, what applies to CFS may apply to your medical condition.
The Welcome Message and Group Guidelines are also in Files, if you need a refresher on how this group works. You must register with Yahoo to use the website, but note: Be careful not to permit your address to be put into the directory when you register. Put as little as possible into your public profile. You do not need a Yahoo address to use the website. Your email address is what Yahoo calls your "alternate address."
DO NOT FORWARD ANY MESSAGE FROM Disinissues WITHOUT PRIOR WRITTEN PERMISSION FROM THE AUTHOR Do not distribute any member's email address.
NO MESSAGE ON THIS LIST IS TO BE CONSTRUED AS LEGAL ADVICE --------------------------------------------~-> Yahoo! Groups Links To visit your group on the web, go to: http://groups.yahoo.com/group/Disinissues/ To unsubscribe from this group, send an email to: [email protected] Your use of Yahoo! Groups is subject to the Yahoo! Terms of Service.
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, 05 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....
http://www.ilads.org/brochures.html The following is an announcement from ILADS: What you need to Know about ILADS and Lyme Disease and What Psychiatrists Should Know about Lyme Disease are now available in a PDF file on the ILADS web site (www.ILADS.org). They are in a printable version so that if you have a color printer, you can print them up yourself
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5dana8
Frequent Contributor (1K+ posts)
Member # 7935
posted
Hi Betty and Rosesisland Thank you so very much for the information.
I am very grateful for your input and will do the search under the above said titles
You Guys are the BEST Thanks and take care dana
-------------------- 5dana8 Posts: 4432 | From some where over the rainbow | Registered: Sep 2005
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5dana8
Frequent Contributor (1K+ posts)
Member # 7935
posted
Hey Betty Thanks for all the links you posted.
Also what I am looking for is personal testimony's from lyme patients on what bebefits they get.
What are we fighting to get?
Is it worth it?
Considering my low energy and mental capacities.
thanks!
-------------------- 5dana8 Posts: 4432 | From some where over the rainbow | Registered: Sep 2005
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5dana8
Frequent Contributor (1K+ posts)
Member # 7935
posted
Thanks for you guys putting out the posts.
I know how to apply for Medicade/Medicare/SSi....a future lawyer can assist me. I need to know if it is WORTH IT to go thru the entire application process, that is what PERCENTAGE of my prescriptions or in-home health care can be paid by government assistance???
Anyone who has applied successfully and is obtaining benefits, please respond with "Yes, it's worth the application time" or "Forget it...I got benefits and they hardly pay for anything".
-------------------- 5dana8 Posts: 4432 | From some where over the rainbow | Registered: Sep 2005
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bettyg
Unregistered
posted
Dana,
YES, IT IS WORTH IT! I was approved now at age 56, so I will receive 11 years of disability payments prior to going to REGULAR ss payments!
BENEFITS: In my case of fighting for 5 years thru 2 separate SSDI apps; they approved the 2nd one going back 3 years....I was paid 2.5 years lump sum since there is a 6 month waiting period from the DATE THEY STATE YOU ARE DISABLED.
Since my last wait until ALJ hearing was 3 years, I already put in my 2 year waiting time for MEDICARE, so it was approved for hospital last 12-04 and out-patient 7-05.
Only YOUR current insurance company can tell you have things will be handled for meds charges, etc.
I could signup for MEDICARE PART D now, BUT my husband's STATE GROUP retiree/disabled is BETTER THAN what medicare or other companies offer.
My med max is $250! I pay $800 yr. maximum plus $15 co-pay office/lab/xrays, etc. I was blessed my husband retired from a good STATE/FEDERAL group plan. YES, IT IS WORTH IT DANA.
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