Topic: Update: SSDI denied, can't seem to catch a break
sammy
Frequent Contributor (5K+ posts)
Member # 13952
posted
*10/5/10* Scroll down to the bottom for update today
I've been having a rough time lately. Keep getting hit with more stresses and difficult situations to deal with. Examples: My current insurance keeps denying meds (even orals now) requiring constant prior auths and appeals. Old insurance denied my 5th and final appeal leaving me with a large outstanding bill. Then my PICC line broke and I had to be off meds for several days. Finally got a new PICC and hate it. To top it all off I've been feeling really bad this week, probably herxing.
This afternoon I received my "Notice of Disapproved Claims" from Social Security. I knew that I would likely be denied first time around at least because of my age but it was hard seeing the denial in writing. I had hoped that it would be approved because I really need the help.
I miss working so terribly. I would love to go back tomorrow but I'm not well enough. It really breaks my heart. Then SS tells me that my condition is not severe enough to keep me from working. That I "could perform all work activity requiring no more than Simple Unskilled Tasks". And that I "could perform other jobs as they exist in significant numbers in the national economy".
My job was highly skilled. I worked hard to earn my degree and license and took pride in what I did (and will do again). Somethings wrong if I cannot do the job that I love so dearly. They don't understand, I would work if I could. I can't even make a 15min trip to the grocery store right now.
Oh and they said that my "most recent evaluation noted significant improvement in my symptoms". Where did they get that information? Certainly not my LLMD. He said that they had not requested new information since the spring. I wish these "significant improvements" were true but it's not so.
I have to travel out of state to see my LLMD next week so now I'm going to have this situation hanging over my head the whole time. How do I go about finding a good lawyer to help me appeal this SSDI/SSI denial?
I'm feeling really heartbroken and defeated right now. It's so hard to keep fighting when you feel so sick.
Thank you all for understanding. I greatly appreciate any wisdom and advice you have to offer.
[ 10-05-2010, 06:27 PM: Message edited by: sammy ]
Posts: 5237 | From here | Registered: Nov 2007
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lymeladyinNY
Frequent Contributor (1K+ posts)
Member # 10235
posted
Sammy, I'm so sorry for what you are going through. I remember when I kept getting denied for SSDI. I would feel sucker-punched.
I finally did have to hire a lawyer. There is probably a Social Security Disability lawyer right in your phone book.
I went before a judge who noted I was in a wheelchair having uncontrollable tremors. He asked, "You worked for 20 years non-stop prior to the date you say you became disabled?" I said, "Yes."
That was it - I left the room and my lawyer said, "Congratulations." Shortly after, I got approved for Social Security.
A judge who is a good judge will look at you and make his assessment without bias. I had to give a good chunk of my back social security to the lawyer, but hey, I got it! And Medicare now, too.
So, I know it's disheartening to be denied and it kills you to not be able to work doing what you love. I understand.
It really wasn't that hard to prove my case. My lawyer, when gathering my medical records, called the SS people "a bunch of idiots". He thought it was really obvious I wasn't able to work.
I hope you have good fortune coming your way, and I hope you eventually get well enough to return to work. It can happen!
Take care - Lymelady Julie
-------------------- I want to be free Posts: 1170 | From Endicott, NY | Registered: Sep 2006
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posted
Im so sorry that things are piling up negatively right now. Sounds like the SS denial was the icing on the cake. They almost always deny the 1st time. Time to get a lawyer. My yellow pages are full of attornies names that handle disability. Good luck and dont give up!
Posts: 624 | From Oklahoma | Registered: Jun 2010
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posted
Sammy, so sorry things are not going well for you. There are tons of lawyers that just deal mainly with SSDI. You don't have to pay them unless you get approved.
You got your picc in your other arm, right. That took a little getting used to for me, but I liked my 2nd one better. It was much sturdier than the the 1st.
Posts: 847 | From upstateNY | Registered: Dec 2007
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METALLlC BLUE
Frequent Contributor (1K+ posts)
Member # 6628
posted
Hire a lawyer. I did that from the getgo and I got mine pushed through eventually.
-------------------- I am not a physician, so do your own research to confirm any ideas given and then speak with a health care provider you trust.
springshowers
Frequent Contributor (1K+ posts)
Member # 19863
posted
Hi There is a lawyer who advertises to help people who has FMS and CFS and knows that sort of thing. I did not use a lawyer and got it approved myself.
I sent in a booklet that was hardbound and very ogranized and throughough and very documented with lots of labs and doctor notes and letters and letters from family etc.
Not to much and not too little and divided up in to categories and such.
Sometimes its the presentation and also make sure to not leave out very specific descriptions of your daily life and what you can and can not do and for how long etc..
I think you should apply again and fight it yourself if you can handle it. if you want to PM me maybe i can give you more ideas? And it would depend on what your first application looked like?
I wish you the best and do not give up.. You will get it!!.. they just sometimes make it difficult.
Posts: 2747 | From Unites States Of America | Registered: Apr 2009
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sammy
Frequent Contributor (5K+ posts)
Member # 13952
posted
Thank you all for understanding.
At this time I don't feel like I can handle any more paperwork or even attempt to organize an appeal. It is too mentally exhausting and overwhelming to even think about.
I'm going to call around and find a lawyer to help me. I need help.
At least now that some time has passed I am able to think about this situation rationally without crying. When I told my LLMD about the denial he offered to write me another letter for the appeal. He said that I have to keep trying so I will.
Hugs to you all Thank you for being here for me.
Posts: 5237 | From here | Registered: Nov 2007
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Rumigirl
Frequent Contributor (1K+ posts)
Member # 15091
posted
Yes, Sammy, don't give up. I understand why you'd want to, however! And do get help, because this stuff is severely overwhelming.
Besides getting the help of a disability lawyer, maybe it would help to hire a college student (or a nurse or whatever) to help you organize or gather records, xerox, etc. Anything to take some of the burden off you.
Posts: 3771 | From around | Registered: Mar 2008
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sammy
Frequent Contributor (5K+ posts)
Member # 13952
posted
Hey all, I was able to get in with a lawyer today. He was recommended to me, specializes in social security cases. He seemed intelligent and compassionate. Said he thinks that I will eventually win my case but it may take up to 2yrs from now (6mo for the appeal process, 18mo wait to see the judge).
Disappointing because I want to be well in 2yrs. I need the help now to pay for medical expenses so that I can get better.
So he told me to expect another denial. I guess they don't pay much attention to appeals in the state of OH. They want people to give up while waiting to see a judge. He said that it is also going to be difficult because of my age and education. Which is so not fair.
I've got to keep praying that God will continue to provide for me and that if it is his will that I will qualify for SSD and SSI with this appeal.
Posts: 5237 | From here | Registered: Nov 2007
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posted
Best of luck. As I understand it, you get back pay when you eventually win your case. Of course, the attorney takes a chunk too.
We hope you are well in two years also, but this is good to do anyway, just in case.
Try to talk to people with lyme who have done this and read old posts on the subject, because it seems that you want to concentrate on your ability to do things not on the lyme diagnosis.
Posts: 8430 | From Not available | Registered: Oct 2000
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sammy
Frequent Contributor (5K+ posts)
Member # 13952
posted
You are right lou. We have to prove how debilitated we are, how much these symptoms affect our everyday lives. He asked me all kinds of questions like how long I can sit in one place, stand still, walk, what causes or relieves pain and fatigue, etc. I was in the attorney's office for almost 2hrs. I was surprised and pleased by how much he wanted to know with the first visit.
Posts: 5237 | From here | Registered: Nov 2007
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posted
Glad you found a lawyer you trust. If i could give you one piece of advice...keep any allowances you have to make for any inabilities you might have. If you cant sit..state it as that. Dont disclose that if you sit at a 90 degree angle with 12 pillows propping/supporting various parts of your body you can sit for 30 mins. Just an example. Those of us with disabilities find ways that might afford us a minimum of ability for a short time. Just state what you cant do and leave it at that. I read that on a disability board and it seemed like good advice.
Posts: 624 | From Oklahoma | Registered: Jun 2010
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posted
sammy....i was advised its 2 yrs here in NC also........i'm starting mine with an attorney as like you....the thought of all that paperwork is overwhelming.......i would rather them help me from the beginning..............
-------------------- Oct 09 Positive CDC Western Blot Jan 10 Positive Babesia Duncani Jan 10 Cd57 28 Mar 10 EBV, IgM, IgG HHV-6 IgG Posts: 739 | From NC | Registered: Oct 2009
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posted
Sammy, Thank you for taking time for every ones questions and being so helpful to me when I had questions about insurance and PICc lines while you were in the midst of the chaos you are enduring.
You are a very strong and compassionate person. I wish you all the best in your healing.
I know I couldn't even endure an insurance appeal when I had to do it. My husband did it and we were denied and I gave up. I just didn't have any energy or brain cells left to give.
It's a blessing to have parents who love and support you. All the best to you.
-------------------- Bart Henslea 1976 Fibro/CFS/arthritis 2004 Lyme diagnosed 2007 3 1/2 years treatment with oral combos, Cowden, IV roc. BW herbs. Off all abx in 12/10. Feeling good. Posts: 647 | From NY | Registered: Dec 2007
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