Articles Tagged with “Social Security disability”

A diagnosis of cancer – even one that is treatable – cannot be taken lightly. Although significant progress has been made in the field of cancer research and treatment, cancer still takes the lives of millions of people worldwide every year. There are over 100 types of cancer and treatment can vary for individuals on a case-by-case basis. Often, cancer and the treatment of cancer (which may include surgery, chemotherapy, and/or radiation) can force individuals to stop working.

Some may assume that a cancer patient who applies for disability benefits will easily be approved for disability benefits. However, this is not always true. It is not enough to prove a diagnosis of cancer and expect to receive disability benefits. Rather, the individual must show that the cancer and/or cancer treatment is causing severe symptoms that would prevent the performance of work and that they meet the applicable definition of “Disability”.

To improve the chances of being approved for disability benefits, the patient should have their doctor clearly document all of their symptoms, including pain, headaches, fatigue, nausea, numbness, dizziness, inability to concentrate, memory problems, difficulty walking or standing, emotional difficulty, and any other symptoms that affect functioning. This means that the patient must maintain treatment for all medical professionals they see, including oncologists, surgeons, family doctors, pain management specialists, and others.

The individual should also carefully track the symptoms they experience after surgery, chemotherapy, or radiation. Each of these forms of treatment may come with severe side effects. For example, chemotherapy may cause peripheral neuropathy. If a chemotherapy patient experiences neuropathy, they should have their doctor carefully document their symptoms of pain and numbness, and also undergo appropriate testing (EMG) to prove that the patient is experiencing neuropathy. Another possible side effect of chemotherapy is “chemo brain”. If an individual experiences chemo brain, they should undergo a mental status examination to document their forgetfulness, trouble concentrating, trouble multi-tasking, taking longer to finish tasks, or other memory problems.

Radiation affects people differently, but it may cause skin changes, tiredness, diarrhea, or trouble eating, among other side effects. Again, it is important to have medical providers document each and every symptom experienced. If a disability claim is missing documentation about each symptom, then it may not accurately depict the severity of the individual’s condition.
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More students than ever are graduating with student loan debt. Tuition has skyrocketed in the last few decades and it is now common for college graduates to owe tens of thousands of dollars by the time they earn their undergraduate diploma. If an individual becomes disabled before they pay back their federal student loan debt, they may face a very difficult situation.

If an individual took out student loans to finance their education, then these loans are currently not dischargable by bankruptcy unless that individual can prove that repaying the loan would cause an “undue hardship“. Proving an “undue hardship” is an extremely high standard to show unless the individual has a severe disability. The U.S. Department of Education’s website provides the reasons for which a student loan may be forgiven, cancelled, or discharged: Department of Education’s website.

Federal student loans may be discharged if the borrower suffers a total and permanent disability. According to the U.S. Department of Education, there are three ways for an individual to prove that they are totally and permanently disabled:

1. If you are a veteran, you can submit documentation from the U.S. Department of Veterans Affairs (VA) showing that the VA has determined that you are unemployable due to a service-connected disability.
2. If you are receiving Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits, you can submit a Social Security Administration (SSA) notice of award for SSDI or SSI benefits stating that your next scheduled disability review will be within five to seven years from the date of your most recent SSA disability determination.
3. You can submit certification from a physician that you are totally and permanently disabled. Your physician must certify that you are unable to engage in any substantial gainful activity by reason of a medically determinable physical or mental impairment that – Can be expected to result in death,
– Has lasted for a continuous period of not less than 60 months, or – Can be expected to last for a continuous period of not less than 60 months.

The Department of Education allows individuals to apply for a “Total and Permanent Disability (TPD) Discharge” for federal loans online at the following website: http://www.disabilitydischarge.com/home/
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When a person has a medical problem affecting his heart or circulatory system, he may have work restrictions that prevent the ability to continue working. Depending on the severity of the heart condition, working may put a person at risk of suffering a heart attack or other life threatening cardiac event. In these situations, a person with cardiovascular impairments may qualify for short term disability benefits, long term disability benefits, and/or Social Security disability benefits.

Because a heart condition can be life threatening, it is crucial that a person with a cardiovascular problem seek immediate medical attention. When a patient presents with chest pain, palpitations, syncope, or other cardiovascular symptoms, it is common for physicians to order extensive testing. Testing for heart conditions may include echocardiograms (echo), electrocardiogram (ECG), exercise tests, drug-induced stress tests, Holter monitor tests, cardiac catheterization, cardiac computerized tomography (CT) scans, cardiac magnetic resonance imagings (MRI), chest x-rays, and blood tests.

Following the appropriate testing, treatment with a cardiologist is required to document the severity of the heart condition. If a person is required to undergo surgery, then she may have to see a surgeon specializing in heart operations. A cardiologist may only require a patient to follow-up on an annual basis, which means that it is important for the patient to also maintain treatment with her primary care provider and other doctors.

If a person undergoes a cardiovascular event such as a heart attack or surgery, but then is able to return to normal functioning, then he might only be eligible for short term disability benefits. However, if a heart condition requires the person to miss at least three months of work, then he may be eligible for long term disability benefits. To be eligible for Social Security disability benefits, the disability must last or be expected to last 12 months or longer.
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Maintaining or obtaining health insurance coverage is a common problem for those applying for disability benefits. Many Americans receive health insurance coverage through their employer. When a disability forces the employee to stop working, they are at risk of losing their health insurance coverage unless they timely pay the hefty premiums pursuant to the Consolidated Omnibus Budget Reconciliation Act (COBRA). Unfortunately, not having health insurance can be very problematic for those applying for disability benefits.

If the disabled individual is able to afford the premiums for continued health insurance coverage under COBRA, then it is probably in her best interest to pay the monthly premiums and maintain her current health insurance coverage. However, many individuals are unable to afford the monthly premiums without the regular income from a job. When a disabled person cannot make these required payments, they will be forced to find new health insurance coverage or forego health insurance at all.

First of all, applying for disability benefits without health insurance coverage is challenging. Without health insurance coverage, the individual is usually unable to afford the out-of-pocket expenses required for regular medical treatment. The individual may miss out on important testing, medications, and regular examinations. Of course, if the patient is not seeing their doctor, there will be a lack of current medical records to document the patient’s disability. For both long term disability claims and Social Security disability claims, a lack of ongoing medical treatment can make it much more likely that their disability claim will be denied.

Second, the claimant should do everything in his power to obtain health insurance. This includes looking for private health insurance via the federal health insurance marketplace: https://www.healthcare.gov/ If the individual cannot afford private health insurance options, they should investigate whether they are eligible for their state’s Medicaid program. For Indiana residents, information about applying for Medicaid can be found at the following website: http://member.indianamedicaid.com/apply-for-medicaid.aspx. Even if an Indiana resident is not eligible for Medicaid, they may still be eligible for another state program, such as Care Select, Healthy Indiana Plan, or Hoosier Healthwise. If the individual already receives Social Security disability benefits, then they should eventually be eligible for Medicare, although there is a two year wait to qualify for Medicare.
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Systemic Lupus Erythematosus (SLE) is an autoimmune disorder that can affect the skin, joints, kidneys, brain, and other organs. Symptoms can vary in severity, but SLE may be severely disabling. If SLE causes disability, then it is essential for the proper documentation to be gathered in order to support a disability claim.

SLE almost always causes joint pain and swelling. Other symptoms may include chest pain, fatigue, fever, malaise, hair loss, mouth sores, sensitivity to sunlight, skin rash, swollen lymph nodes, headaches, numbness, tingling, seizures, vision problems, personality changes, abdominal pain, nausea, vomiting, abnormal heart rhythms, coughing up blood and difficulty breathing, Raynaud’s phenomenon, swelling in the legs, and weight gain. If a patient only has skin symptoms, then this is called discoid lupus; not systemic lupus erythematosus.

Because of the wide range of symptoms, autoimmune disorders can be very challenging to diagnose. For a clinical diagnosis of SLE, a patient must have 4 out of 11 common signs of the disease. 11 of the common signs of the disease are malar rash, discoid rash, photosensitivity, oral ulcers, nonerosive arthritis, pleuritis or pericarditis, kidney disorder, neurological disorder, blood disorder, immunologic disorder, and positive antinuclear antibody (ANA) testing. Objective testing is available to diagnose lupus, although no single test can diagnose lupus. Testing includes antibody tests (such as ANA panel), complete blood count, chest x-ray, echocardiogram, kidney biopsy, and urinalysis. About 95% of patients with lupus test positive for ANA, although ANA testing is not conclusive to diagnose lupus.

If SLE is causing a disability, a claimant needs to see the appropriate specialist and undergo all relevant testing. Rheumatologists are the appropriate specialists to diagnose and treat lupus. If a claimant suffering from SLE applies for disability and has not treated with a rheumatologist, then it will be challenging for them to prove a disability. Even though there is no cure for SLE, regular treatment is necessary to control symptoms. If a claimant does not maintain regular treatment, then their claim may fail to show the severity of their symptoms. Therefore, it is critical for a claimant with SLE to regularly see their doctors, including a rheumatologist.
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Functional Capacity Evaluations (“FCEs”) are a type of test used to determine the severity of someone’s physical impairments. FCEs are common in disability insurance claims, workers compensation claims, and other contexts where the level of a claimant’s injury or sickness needs to be evaluated.

FCEs are usually administered by a physical therapist or physician who specializes in occupational medicine. Common measurements during an FCE include how much the claimant can lift, how much they can push and pull, how long they can walk and stand, how long they can sit, the ability to reach in all directions, the ability to grasp and manipulate with each hand, the degree to which a claimant can move all joints, the ability to squat and bend, and the ability to stoop and balance. FCEs can vary in duration: some FCEs are very brief – only a couple of hours – and some FCEs are actually performed over the course of two days.

In long term disability insurance cases, many insurance policies allow the insurance company to request that a claimant undergo an FCE at a facility of their choosing. A claimant’s refusal to undergo such testing may give the insurance company grounds to deny disability benefits. Therefore, it is likely that the claimant will have to comply with the insurance company’s request for an FCE. However, a claimant may want to consider the following tips before attending an FCE:
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Applying for disability benefits from the Social Security Administration is a layered process. If a claimant is denied initially, then they must file a request for reconsideration. If their request for reconsideration is denied, then they must file a request for a hearing before an Administrative Law Judge. Claimants should be aware that each of these appeals must be filed within 60 days of receiving a denial letter.

At the hearing level, the claimant’s chances of success improve. However, even strong claims can be denied by an Administrative Law Judge for a variety of reasons. It is a nationwide trend that more Social Security disability cases are being denied.

Appeals Council

When an Administrative Law Judge denies a claim, then the next step is to request a review from the Appeals Council. This request must be made within 60 days of the denial notice. The Appeals Council is located in Falls Church, Virginia and performs a review of the claimant’s evidence. There is no hearing at this stage, and requests for review must be made in writing. Unfortunately, the time it takes for the Appeals Council to make a decision is extremely long. The Social Security Administration’s website states that “the average processing time was 395 days” for the period of October 2011 – September 2012.
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Most disability insurance policies do not explicitly require that a claimant provide objective evidence to support their disability. Yet, it is all too common when a claimant receives a denial letter in the mail from their insurance company claiming that disability benefits have been denied due to a lack of objective evidence. Unfortunately, many courts have determined that insurance companies are permitted to rely upon objective evidence when making a determination of disability.

Objective medical evidence is documentation from tests including but not limited to: medical resonance imaging (MRIs), x-rays, blood tests and other chemical tests, electrophysiological studies (electrocardiogram, electroencephalogram, etc.), and psychological tests. Unfortunately, not all medical conditions are detected in these various types of objective testing, which can put some disability claimants in a challenging condition. For example, someone with fibromyalgia may not be able to produce traditional objective medical evidence of their condition. For more information about fibromyalgia, see this entry: Fibromyalgia Disability Claims.

In order to improve the chances of being approved for disability insurance benefits, a claimant should make sure that their treating providers have ordered all of the necessary tests to properly diagnose their condition. Without objective documentation, the insurance company is much more likely to deny benefits. For example, a claimant with Multiple Sclerosis should undergo any applicable testing, like an MRI of the brain, a spinal tap, and tests measuring electrical activity in the brain. For more information about Multiple Sclerosis, see this entry: Multiple Sclerosis Disability Claims.
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