I snooped out a few:

From: Susan Hoch MD)
Subject: Re: !Help ASAP! SS disability interview
View: Complete Thread (25 articles)  
Original Format
Newsgroups: alt.support.arthritis
Date: 1998/03/19


I must second Anne's great recommendation here.
Realistically, you are the one RESPONSAIBLE for making sure that the
Social Security administration has the documentation necessary for you
to meet their Blue Book criteria.

1. Social Security is not going to call your docs and hunt around for
records they have not received.

2. The best way to make sure that Social Security has your records is
to get the copies from all your docs in your own hands, make an extra
copy in case Social Security loses them and hand carry them to social
security making sure they are in your file.  My office, which
generally works well, has occasionally failed to send records but more
often, we have sent records which somehow never got to the patient's
file.

3. Make sure your records do two things

A. Make sure your records show that you are disabled - i.e. if the
doc's notes says - Doing well, no problem - sorry you have a big
problem.  If the doc's notes say - unable to dress herself, has
difficulty moving from chair to examining table etc, then you have
good documentation.  So it pays to look at the notes BEFORE you submit
them and see if they are going to help you.  If not, ask your doc to
dictate a letter telling Social Security what your disabling condition
is and how it has disabled you from working and functioning.  Most
rheumatologists are quite used to writing such letters.

B. Make sure the records indicate what diabling condition you have and
even better, what it's code is in the Blue Book.  The Blue Book is the
Feds list of disabling conditions - you can find it on the net at the
Social Security site and each conditon has criteria and a code.  I
always indicate in my letters a sentence like the following

Mrs ________ suffers from rheumatoid arthritis, a disabling condition
listed in the Social Security Blue book on page _____, Code Number
_______.  Remember your forms are being processed by a clerk with a
high school educatioin.  If they see their own codes, it helps.

Where you get into trouble is where the condition is not listed, for
example, yesterday I dictated a letter for a patient with sarcoidosis
which is not a listed disease.  Fibromyalgia is not listed either.
When it's not listed, you have to compare it to something that is
listed and indicate how it is disabling.

Get a lawyer - yes, I don't love lawyers either but there are good and
decent ones out there.  For any of you in the Phila area, I have two
wonderful disability lawyers my office uses - they have never lost a
case for our patients and no one seems to have felt ripped off.

Regards,

Dr Susan

Visit my website:
http://www.mzuschlag.com

Here is the second that might help:

From: Susan Hoch MD
Subject: Re: Disability
View: Complete Thread (125 articles)  

Newsgroups: alt.support.arthritis
Date: 1998/01/01


Skipper, I am sorry to hear about your problem with SSI but
not surprised.  Many SSI applications are turned down initially; I
tell my patients not to take it personally.  Remember your application
is being read by a clerk with a high school education, not by someone
with medical training.  They have a book in front of them, put out by
the Social Security administration which lists by codes, the
designated impairments.  If your medical information matches the
listed impairment and better yet, if you doc has the same book in
front of him or her and uses the social security code for your
disease, then it is more likely that you will get it on the first go
round.

If you have rheumatoid arthritis,  it is a listed impairment
(I can;t give you the code  right now because I'm at home and the
guideline are in my office but you are welcome to e-mail me privately
for this.  For RA you need to have had the disease for more than 3
months with continued activity and need either a positive rheumatoid
factor or an elevated sedimentation rate or a positive ANA or a biopsy
of a nodule(the guidelines are a bit strange).  So RA isn't a problem.
Much more of a problem is back pain for example from disc disease
because nerve root involvement as demonstrated on EMG must be
demosntrated.  Lupus is a problem because the guidelines are purposely
vague describing frequent exacerbation without describing what
frequent is.  Lupus is almost always turned down initially but will
win on appeal. Fibromyalgia is not a listed impairment so unless the
patient has another problem such as depression and can get disability
under mental illness, it is always an appeal case.

My recommentations for patients are as follows:
1. Make sure that your records get to the social security office.
Make sure that all of your docs send them out.  Even better, pick them
up yourself, and hand deliver them (keep copies in case your file is
lost).  Remember, the clerk reading them is not going to follow up on
Dr Jones" records that you indicated would be coming.  It's your job
to make sure all your documentation is there.

2. Look at the records yourself and make sure they say what you want
them to say.  For example, if you have back pain and nerve root
involvement, make sure the notes say so, because if all your doc says
is low back pain and he/she doesn't comment on the nerve involvement
in his/her notes,  it's a turndown. If you don't think your docs notes
are adequate you have two choices:
1. ask your doctor to write a letter to social security indicating
what impairment you have (and even better using the code) and how this
impairment makes you disabled from your present job,

example: Mrs X.Y. developed rheumatoid arthritis involving her hands,
wrists, knees, and ankles in March 1997. She was rheumatoid factor
positive with a titer of 1:512 and had an elevated sedimentation rate
of 55 mm/hr.  Despite medical treatment, her disease continues to be
active today,  9 months later.  She previously worked as a secretary
and has been unable to work at her occupation which requires extensive
typing since July 5, 1997.  In my medical and professional opinion,
Mrs XY satisfies the Socia; Security Administration guidelines for
disability due to her rheumatoid arthritis (code I think1.01 A and B -
this code may not be right).

Trust me, this letter will help and if you are denied with
such a letter in your file, a disability lawyer will love this letter
because it will make his/her job easier.

2. If your doctor isn't going to support you and if his/her
documentation isn't supportive, then, in my opinion, you need another
doc.

3.  Most important, if you are applying for disability, you cannot
continue to work.  This is the catch 22 of disability - you need to
work for the income but you can't because you are disabled.  You must
stop working to be eligible for disability.  

4. If you are fired because you could not do your job because of
disability, you have several potential choices.  One is, to go on
unemployment.  The problem with unemployment is that it assumes that
you are ready and able to work should a job appear.  If you are
disabled, that is not going to be the case.  If you can prove that you
were fired because you could not do the job because of a federally
recognized diabling condition (again RA, not fibromyalgia), then you
may be able to sue and win under the American with Disabilities act.
Many people don't want the hassle and don't want to deal with lawyers.
I can understand that.  However, it becomes sort of like polluters.
If I can dump pollution in the river and no one stops me, I'll keep
dumping.  If a company can fire people because their disability alters
what they can do in the workplace. they are going to keep doing it
until someone slaps them in the pocketbook and in the media where it
hurts.  The final option, is that if you are fired and are disabled,
go immediately to social security and begin  the process since it may
take up to a year.

5. Remember disability need not be the end.  The same system that
brings you disability has vocational rehabilitation.  I have patients
who couldn't work at certain jobs who are now getting further
education, for example a secretary who is going to college, a waitress
who is studying psycology to deal with drug addicted clients, a prison
guard with lupus who is going back to college to study criminal
justice.  All of these patients now have income from social security,
health insurance through social security and may someday be back in
the work force and off social security.

I'll be glad to discuss specific issues with people if they
wish.

Wishing you all a healthy happy New Year.  May we learn more
about how to treat, cure and prevent various arthritic conditions in
1998.

Regards,

Dr Susan

Visit my website:
http://www.mzuschlag.com

Here you go Lady A-
This is a post that LadyAndy reposted in Jan 00.  Sorry but I don't know when
Dr. Susan originally posted it.  Tery

"I am sorry to hear about your problem with SSI but not surprised.  Many SSI
applications are turned down initially; I
tell my patients not to take it personally.  Remember your application
is being read by a clerk with a high school education, not by someone with
medical training.  They have a book in front of them, put out by the Social
Security administration which lists by codes, the
designated impairments.  If your medical information matches the listed
impairment and better yet, if you doc has the same book in front of him or her
and uses the social security code for your disease, then it is more likely that
you will get it on the first go round.

If you have rheumatoid arthritis,  it is a listed impairment (I can;t give you
the code  right now because I'm at home and the
guideline are in my office but you are welcome to e-mail me privately for this.
For RA you need to have had the disease for more than 3 months with continued
activity and need either a positive rheumatoid factor or an elevated
sedimentation rate or a positive ANA or a biopsy of a nodule(the guidelines are
a bit strange).  So RA isn't a problem.  Much more of a problem is back pain
for example from disc disease because nerve root involvement as demonstrated on
EMG must be demosntrated.  Lupus is a problem because the guidelines are
purposely vague describing frequent exacerbation without describing what
frequent is.  Lupus is almost always turned down initially but will win on
appeal. Fibromyalgia is not a listed impairment so unless the patient has
another problem such as depression and can get disability
under mental illness, it is always an appeal case.

My recommentations for patients are as follows:
1. Make sure that your records get to the social security office.
Make sure that all of your docs send them out.  Even better, pick them up
yourself, and hand deliver them (keep copies in case your file is lost).
Remember, the clerk reading them is not going to follow up on Dr Jones" records
that you indicated would be coming.  It's your job to make sure all your
documentation is there.

2. Look at the records yourself and make sure they say what you want them to
say.  For example, if you have back pain and nerve root involvement, make sure
the notes say so, because if all your doc says
is low back pain and he/she doesn't comment on the nerve involvement
in his/her notes,  it's a turndown. If you don't think your docs notes are
adequate you have two choices:
1. ask your doctor to write a letter to social security indicating what
impairment you have (and even better using the code) and how this impairment
makes you disabled from your present job, example: Mrs X.Y. developed
rheumatoid arthritis involving her hands, wrists, knees, and ankles in March
1997. She was rheumatoid factor positive with a titer of 1:512 and had an
elevated sedimentation rate of 55 mm/hr.  Despite medical treatment, her
disease continues to be active today,  9 months later.  She previously worked
as a secretary and has been unable to work at her occupation which requires
extensive typing since July 5, 1997.  In my medical and professional opinion,
Mrs XY satisfies the Social Security Administration guidelines for
disability due to her rheumatoid arthritis (code I think1.01 A and B - this
code may not be right).

Trust me, this letter will help and if you are denied with such a letter in
your file, a disability lawyer will love this letter because it will make
his/her job easier.
2. If your doctor isn't going to support you and if his/her documentation isn't
supportive, then, in my opinion, you need another doc.
3.  Most important, if you are applying for disability, you cannot continue to
work.  This is the catch 22 of disability - you need to work for the income but
you can't because you are disabled.  You must
stop working to be eligible for disability.
4. If you are fired because you could not do your job because of disability,
you have several potential choices.  One is, to go on
unemployment.  The problem with unemployment is that it assumes that
you are ready and able to work should a job appear.  If you are disabled, that
is not going to be the case.  If you can prove that you were fired because you
could not do the job because of a federally recognized diabling condition
(again RA, not fibromyalgia), then you may be able to sue and win under the
American with Disabilities act.  Many people don't want the hassle and don't
want to deal with lawyers.  I can understand that.  However, it becomes sort of
like polluters.  If I can dump pollution in the river and no one stops me, I'll
keep dumping.  If a company can fire people because their disability alters
what they can do in the workplace. they are going to keep doing it until
someone slaps them in the pocketbook and in the media where it hurts.  The
final option, is that if you are fired and are disabled, go immediately to
social security and begin  the process since it may
take up to a year.
5. Remember disability need not be the end.  The same system that brings you
disability has vocational rehabilitation.  I have patients who couldn't work at
certain jobs who are now getting further
education, for example a secretary who is going to college, a waitress who is
studying psycology to deal with drug addicted clients, a prison guard with
lupus who is going back to college to study criminal justice.  All of these
patients now have income from social security,
health insurance through social security and may someday be back in the work
force and off social security."

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Char

"Remember, I'm pulling for ya'. We're all in this together." Red Green