Seems like there are a few people applying for SSDI.  Dr Susan (who is
a Rheumatologist)  used to post here quite regularly unfortunately she
doesn't anymore but a few years back she posted this advice about ssdi
and I thought it might be helpful to some of you.

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.

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