Michelle M
Frequent Contributor (1K+ posts)
Member # 7200
posted
I have been off work since September of last year, after 14 years on the same job (paralegal, criminal defense firm).
I filed for SSDI in May. It took me a long time to get it all together.
SSDI sent me for a "mental exam." The psychologist was an aloof fellow who resisted any attempts at pleasantries. He administered a daunting battery of tests. Some were ridiculously easy. Some were so hard I wept in frustration. As an example, he would tell me a little story, then ask me to tell it back to him. The details would slip away horribly. Once he told the story again, I could sometimes do a little better.
But still not pretty.
My LLMD got a copy of the testing. He'd been wanting me to do this, if only we could figure out how to afford it, since he said it would be needed. My claim is for migraines and cognitive dysfunction.
It noted, among other things, that I was "valid." (I.e., not lying, apparently, and trying very hard.) "Multiple significant brain lesions from a process of MS or lyme disease, with a history of migraine headaches."
"The claimant has slight impairment in her ability to perform detailed and complex tasks."
"The claimant has slight to moderate impairment in her ability to perform work on a consistent basis."
"The claimant has slight impairment in her ability to complete a normal workday without interruption from a psychiatric condition." {?}
"The claimant has slight impairment in her ability to understand and accept instructions from supervisors."
"Reduced processing speed is noted."
Intelligence testing was around average; however, memory testing was truly pathetic (i.e., scores of 18 where a normal score is 76; 27 vs. 91, etc.)
Prognosis: "Fair." (Whatever that means.)
SSDI also set a neurologist exam for me a week from now. The SSDI person told me that depending on the results of the shrink, they might cancel the neuro. However, they have not.
A friend of mine says that despite showing deficits, SSDI will not much care unless the deficits are "severe."
At the neuro appointment I'm going to keep mum about lyme and bite my tongue (read: stay off my soapbox). I have dual diagnoses of Lyme AND multiple sclerosis, per neuro records plus LLMD's records. I guess I don't really care what he thinks it is so much as how it affects me.
Sorry this is so long. I know some of you have had this testing. What do you think? Did the results matter at all to SSDI? It is very hard to work when you cannot remember instructions and cannot remember at the end of a phone call what went on in the beginning!!
Thanks for your thoughts...!
Michelle
[ 28. July 2007, 10:49 PM: Message edited by: Michelle M ]
Posts: 3193 | From Northern California | Registered: Apr 2005
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bettyg
Unregistered
posted
michelle,
looks fairIntelligence testing was around
"average; however, memory testing was truly patheticly (i.e., scores of 18 where a normal score is 76; 27 vs. 91 , etc.) favorable on the mental testing."
this person actually wrote that??
did you ever get your primary md and LLMD to complete the RESIDUAL FUNCTION CAPACITY questionnaire ....
lenth of time you can:
sit, stand, walk, climb, crawl, bend, use your fingers, lift, etc.
in increments of: under 2 hrs; 2-4 hrs., 4-6 hrs. 8
THOSE WILL HELP YOU THE MOST!! it's NOT the diagnosis you have; it's WHY YOU PHYSICALLY CAN NOT WORK ANY MORE.
i think MS is in covered impairment list! did you check it? is in all the disability info i gave you earlier.
have you had a neurologist in past; YOU can get that same person to do it if they will!
DDS just needs to send them what is needed that wasn't gotten before! good luck; keep us informed!
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Michelle M
Frequent Contributor (1K+ posts)
Member # 7200
posted
Hi Betty. No, the 'pathetic' comment was my own!! The CE's opinions I put in quotes.
I had a neurologist before my LLMD. Saw him numerous times. Had spinal tap, evoked potentials, MRI's, etc.--all abnormal, but in his opinion MS, and not lyme. Still, the documentation is there. I just haven't been treating with a neuro, because why would I? I guess they are sending me to a neuro because my neuro's records are not within the past year.
I'm just wondering about others' experiences with this mental testing. Does their term "mild" and "mild to moderate" mean they think I can do my job despite an inability to remember -- something clearly very important in legal work?
I have also submitted some very strong (if sad) letters from coworkers, including attorneys, concerning my work performance, that were very specific as to what I could not do, and how much of my work was now delegated to others, and how much "covering my back" coworkers were forced to do. (Albeit lovingly.)
My SSDI rep has these; however, I'm sure the psych CE did not. He refused any of the records I brought him, too -- said he had records summary from SSDI already.
I'm thinking no neuro could be worse than my last neuro!!
I might have already done an RFC myself, or something like it, when I applied. My physical symptoms are not much a problem (i.e., sitting and standing), except for exhaustion and falling asleep a lot.
I believe they are treating my claim as a brain disorder.
Michelle
Posts: 3193 | From Northern California | Registered: Apr 2005
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Michelle M
Frequent Contributor (1K+ posts)
Member # 7200
posted
Forgot to add -
"Diagnostic Impression"
Axis I - Cognitive disorder, not elsewhere specified, mild, unkown etiology, may be related to medication side effects or disease process as revealed by MRI findings."
[Note from self: Unknown etiology? Duh?]
Posts: 3193 | From Northern California | Registered: Apr 2005
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sometimesdilly
Frequent Contributor (1K+ posts)
Member # 9982
posted
hi Michelle-
i had lengthy neuropsych testing done by Dr. Fallon at Columbia last year.
With the exception of one memory related category which i failed outright, all of my results showed often significanlty diminished cognitive function but the overall result was that i was now of "normal" ability.
Dr. Fallon warned me that in the world according to SSDI, my results were likely to be interpreted as meaning I am definitely able to work.
SSDi doesn't care if you can't do the work you once were capable of doing- it is asking, can you work at all doing anything.
Still, i received SSDI my first try. It couldn't have been from the neuro testing, and it wasn't because of my labs, which were "borderline" at best by ISDA type standards.
i think what clinched it for me was that i had a brain SPECT scan done - which showed, as objective proof, i had brain damage that was causing the cognitive problems.
and, when i filled out the SSDI form and spoke with them etc., i rarely mentioned Lyme. I referred to my problem as "severe brain encephalitis," and what i hammered on was that duh, i could not follow ANY instructions, written or oral because of memory and processing problems, and so could not do any kind work, ESPECIALLY unskilled rote kind of work.
hope that helps. and for sure, contact your elected reps as soon as possible- dont wait to be turned down, if you are.
dilly
Posts: 2507 | From lost in the maze | Registered: Aug 2006
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Michelle M
Frequent Contributor (1K+ posts)
Member # 7200
posted
Thanks Betty, Dilly, and Cave.
Dilly, for whatever it's worth (likely not much) I have CDC positive blots plus positive babesia WA-1 testing. Plus two MRI's demonstrating 11 medium to large lesions, caused by "severe migraines" or "an infectious process."
My thinking is that the neuro will NOT want to hear much about lyme, so I will stick to symptoms and let him be the doctor. (They like that.)
Cave, I sure hear you -- it made me feel about 6 years old when I could not repeat back a simple story. I similarly had tears in my eyes though otherwise did not snivel too much. In fact, he noted I was "talkative" and "joking" with him. As if this is somehow forbidden, or to be frowned upon.
Very austere fellow.
I figure if an SSDI doctor finds you with "mild to moderate impairment," a non-SSDI doctor would likely find you brain-dead.
Dilly, it is encouraging that you got yours on your first try. I am not without hope. Though working on "Plan B" at the same time!!
Michelle
Posts: 3193 | From Northern California | Registered: Apr 2005
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lymednva
Frequent Contributor (1K+ posts)
Member # 9098
posted
Are you working with an attorney? I found mine invaluable. The first thing he did was send me for neuropsych testing with his choice of examiners, and this guy is top notch! He also wrote a great report.
He had to stop what would normally have been done in one two hour setting because I was losing it so badly and the fatigue was getting to me after about an hour. He noted how my responses just went down the toilet (my words) at that point. So I had to go back again for the rest of it.
Your age has a lot to do with what they expect you to be able to do, too. I was 50 when I left work and that is the magic age where they say you are too old to retrain to do another type of job. (Especially when your brain is worthless!)
I got my SSDI based on this testing. My severe cognitive problems were worth something after all!
-------------------- Lymednva Posts: 2407 | From over the river and through the woods | Registered: Apr 2006
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Michelle M
Frequent Contributor (1K+ posts)
Member # 7200
posted
Hi, Lymed-in-my-home-state!!
I do not have an attorney. None seemed very worked up about taking a case unless it was on appeal (i.e., after a denial).
I know - I definitely SHOULD have gotten a psych eval first through my LLMD. He wanted me to, but without insurance -- OUCH.
I suppose this guy wasn't all bad, when I read how bad it COULD have been (great link Cave).
I will be 49 next week. Seems awfully close to the magic age. Ha -- I can see me being "retrained" when I can't remember what happened half an hour ago!!
Michelle
Posts: 3193 | From Northern California | Registered: Apr 2005
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Michelle M
Frequent Contributor (1K+ posts)
Member # 7200
posted
Thanks, Cave.
I'll definitely hire an attorney if an appeal is needed.
However, I do not have any back pay coming since I just stopped work in the fall and have been on temporary disability since then.
A'course a long, drawn out appeal would change all of that and my salary was high so it could conceivably get to be a chunk of change.
I'm thinking positive. We'll see where THAT gets me!!
Michelle
Posts: 3193 | From Northern California | Registered: Apr 2005
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Ann-OH
Frequent Contributor (5K+ posts)
Member # 2020
posted
There are attorneys that will take disability cases without charges and only take a payment if they win the disability case. It might take you a long time to get a hearing on an appeal, so maybe it would be best to look into that now.
Lots of them advertise on TV here. I know several Lyme patients who have used a local firm and have won. There are some national firms that also have a good record for Lyme patients. You have to have a firm that knows something about Lyme disease, however. They usually will talk to you about your case without charge.
I know you probably know all this already, but I thought it could help and maybe help others who would read this thread.
posted
make sure whoever you hire can take your case to FEDERAL/CIVIL COURT ifnecessary! mine of almost 4 yrs. never told me this until he was quitting me & told me then!
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Michelle M
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Member # 7200
posted
Thanks Ann-OH, Betty, and all of you..
I'm headed Friday to my appointment with the SSDI neurologist.
The SSDI rep told me: "We might make our decision after your psych appointment. If we do, we will call you to cancel you having to go to the neurologist."
So far, they haven't cancelled.. (Not sure whether that's good or bad but hoping it's good.)
Will hope and pray for a decent neurologist and will zip up my mouth on the lyme topic. The shrink attributed my cognitive disorder to "either lyme or multiple sclerosis." I'll pick another time to argue about it!!
Michelle
Posts: 3193 | From Northern California | Registered: Apr 2005
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bettyg
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posted
michelle, good luck Friday and w/decision!! praying for you girl!
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sometimesdilly
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posted
hi Michelle-
best of luck on Friday! hope it goes your way!
dilly
Posts: 2507 | From lost in the maze | Registered: Aug 2006
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posted
I was on disability from a work policy. That company didn't wan to keep paying me (imagine that) so they hired an outside firm to handle my SSDI claim (after I had been turned down). They worked really hard and I think they got a percentage of the lump sum payment.
Don't know if it's OK to mention those kind of company names etc here, so I won't - but if anyone wants to know in private, I'll give you the info.
-------------------- Pam Live well. Laugh often. Love much. Posts: 53 | From Ohio - south/southeast | Registered: Oct 2005
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Michelle M
Frequent Contributor (1K+ posts)
Member # 7200
posted
So I'm done -- on Friday I saw the SSDI neurologist for a consultative exam.
I am still flabbergasted he managed the exam in under 10 minutes!! Wow.
He noted a difference of opinion among doctors as to whether I had lyme or MS, but did not give any opinion.
He asked me about my headaches.
He hit me with little hammers.
It seemed he barely listened to an answer before cutting me off and moving on to the next question.
It appeared he was looking at my medical records (provided by SSDI) for the first time. He excused himself to do so.
In the middle of asking me something, he suddenly said, "Who's the President?"
I was truly dumbfounded. He repeated it.
I could not think of who the president was for perhaps a full minute, during which time I was extremely embarassed and flustered. I told him to just give me a second since I obviously knew who it was, I just couldn't think of it!! Finally, triumphantly, I told him!! God, what an idiot.
I could barely understand him due to a strong accent. However, he did seem very kind. That was just a gut feeling but I nevertheless had it.
He told me not to worry, he would make sure SSDI understood. He repeated this a couple of times almost as some sort of assurance.
A very strange appointment. Hard to imagine what they can get out of it; I am sure he does not disagree with my previous neuro, whom I did not speak badly of.
OK, that turned into a book.
Now, I wait. SSDI says a decision will be made soon - probably in the next few weeks.
Breathe.
Michelle
Posts: 3193 | From Northern California | Registered: Apr 2005
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bettyg
Unregistered
posted
michelle, 10 minute exam!
DDS sent me to a good guy; mine was 60-90 minutes long, and he dictated a wonderful 6 page summary of my testing done! He was kind enough to give me a copy.
they did NOT GO with his comments of support; instead used one of their "flunky" on staff psychiatrists who does NOT see yu but goes to every drs. report and writes in THEIR comments.
don't hold your breath on 2 wks. either; they are unreliable!
I am praying for the best for a POSITIVE, FAVORABLE DECISION for you Michelle!
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