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Scott Lewis

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October 4, 2013

What documentation do I need for my cirrhosis of the liver disability claim?

As a disability lawyer in Indiana, I speak to clients daily about the documentation they need to prove their Social Security disability claims.   Once you have applied for benefits, the Social Security Administration (SSA) will, with your permission, request medical records from the physicians and other medical providers who have treated or evaluated you for your impairments.  As you proceed through the appeals process, the SSA will request updated information from your providers, and if you reach a hearing, the Administrative Law Judge (ALJ) will make sure that all of your medical records have been added to your Social Security file.  For some impairments, including cirrhosis of the liver, it is very important that your medical records include complete documentation of your symptoms and objective evidence of your condition. Cirrhosis of the liver is evaluated by the SSA as a digestive system impairment.  If you have cirrhosis of the liver, the SSA’s Listing of Impairments Section 5.05 for chronic liver disease requires documentation of at least one of the following: Hemorrhaging due to esophageal, gastric, or ectopic varices or portal hypertensive gastropathy, resulting in hemodynamic instability and requiring hospitalization for transfusion.  Acceptable documentation includes: Endoscopy X-rays Ascites or hydrothorax, in spite of continuing treatment, on at least two evaluations at least sixty days apart.  Acceptable documentation includes: Laboratory tests showing serum albumin of 3.0 g/dL or less Coagulation studies showing increased International Normalized Ratio (INR) Spontaneous bacterial peritonitis.  Acceptable documentation includes: Laboratory tests showing an absolute neutrophil count of at least 250 cells/mm3. Hepatorenal syndrome.  Acceptable documentation includes: Documentation of low arterial oxygenation Echocardiography (ECG) or lung perfusion scan showing intrapulmonary arteriovenous shunting Hepatic encephalopathy.  Acceptable documentation includes: Documentation of abnormal mental state or cognitive dysfunction Documentation of surgical portosystemic shunt placement Documentation of neurological abnormalities such as asterixis Electroencephalogram (EEG) Serum albumin … Continued

Filed under: Medical Treatment, Qualifying Disabilities and Impairments || Tagged under:
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October 2, 2013

Is Human Immunodeficiency Virus (HIV) or Acquired Immuno Deficiency Syndrome (AIDS) a disabling impairment for Social Security Benefits?

Many Indiana residents who have HIV (human immunodeficiency virus) infection or AIDS (acquired immunodeficiency syndrome) contact my Indianapolis office to ask if their condition will qualify them for Social Security disability benefits. If you have HIV/ AIDS and your symptoms keep you from being able to work, you may qualify for benefits from the Social Security Administration. There are two ways to show the Social Security Administration (SSA) that your HIV/AIDS is a disabling condition; you can show that your symptoms “meet the listing” for HIV, or you can show that your combination of impairments reduce your capacity to perform work activities. HIV infection is addressed by §14.08 of Social Security’s Listing of Impairments.  If your medical records show that you fulfill the criteria of this listing, Social Security will most likely find that you are disabled.  First, your medical records must contain documentation that you have HIV infection, either from laboratory test results or other evidence.  Then, you must show that you have at least one of the following: Bacterial infections such as mycobacterial infection, nocardiosis, Salmonella bacteremia, or other recurrent infections requiring hospitalization or frequent IV antibiotic treatment Fungal infections such as aspergillosis; certain types of candidiasis, coccidioidomycosis, cryptococcosis; histoplasmosis; mucormycosis; or Pneumocystis Protozoan or helminthic infections such as cryptosporidiosis, isosporiasis, or microsporidiosis that cause diarrhea; extra-intestinal strongyloidiasis; or some types of toxoplasmosis Viral infections such as certain types of cytomegalovirus disease, certain types of herpes simplex, certain types of herpes zoster, or progressive multifocal leukoencephalopthy Malignant neoplasms such as certain types of carcinoma, Kaposi’s sarcoma, lymphoma, or squamous cell carcinoma HIV encephalopathy with progressive cognitive or motor dysfunctio HIV wasting syndrome with chronic diarrhea or chronic weakness with fever Chronic, treatment-resistant diarrhea requiring IV hydration or feeding Chronic or treatment-resistant infection such as sepsis, meningitis, pneumonia, septic arthritis, endocarditis, or sinusitis Repeated manifestations of HIV infection that do not fit in the above categories but result in significant, documented symptoms and marked limitation in your activities of daily living, social functioning, … Continued

Filed under: Qualifying Disabilities and Impairments, Substantial Gainful Activity (SGA) || Tagged under:
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October 1, 2013

Substantial Gainful Activity (SGA) and your Indiana Social Security Disabilty Claim

As an Indiana resident seeking disability benefits from the Social Security Administration (SSA), you must show that you are unable to engage in Substantial Gainful Activity (SGA).  SGA is the performance of physical or mental activities in work for pay or profit.  Work is substantial if it involves significant physical or mental activities or a combination of both.   Even if work is performed on a seasonal or part-time basis, the SSA may still consider it substantial.  Work is gainful if it is a type of activity that is usually done for pay or profit, regardless of whether a profit is realized. The following types of activities are generally not considered SGA by Social Security: Self-care Household tasks Hobbies Therapy School attendance Clubs/social programs However, even if these activities are not considered SGA, Social Security may look at your ability to perform them when determining whether you are able to work.  If you are able to attend school full-time, or if you participate in hobbies that require a lot of physical activity, Social Security may consider those activities to be “work-like,” and find that even though you are not presently engaged in SGA, you are still able to work.  Therefore, during the application process, the SSA usually asks claimants about their Activities of Daily Living (ADLs).If your impairments do not limit your ability to perform activities such as shopping, driving, and household chores, the SSA may believe you are capable of gainful employment.  The fact that you are not currently engaged in SGA does not necessarily mean that you are not capable of engaging in SGA. Substantial work may, under some conditions, be disregarded if it is discontinued or reduced after a short time because of your impairment.  This type of work is considered an Unsuccessful Work Attempt (UWA).  Therefore, If you attempt to return to work after you have started an application … Continued

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September 16, 2013

Spinal Stenosis and Social Security Benefits

Many Indiana residents suffer from severe back problems that make it difficult if not impossible to work.  While back problems can vary, many individuals complain of back pain.  Back pain can result in an inability to stand, walk, and sit for certain periods of time.  If you have been denied disability benefits from the Social Security Administration (SSA) and believe you are unable to work it may be wise to appeal that decision.  It is important to remember the majority of disability claims are denied by the SSA, and disabling conditions from your back are no exception. People suffering from Spinal Stenosis may experience pain so severe any chance of working an eight hour day would be very difficult.   In your spine there are spaces that may become narrow causing pressure on your spinal cord.  This can occur in any area of the spine. This may result in : Numbness Pain Difficulties in standing, walking, and sitting Weakness The need for the use of a cane or walker In my experience as an Indianapolis Social Security Disability Lawyer, I find it very important that my clients have appropriate objective medical testing to substantiate their claim for benefits.  A Magnetic Resonance Imaging (MRI) test may be the key to meeting or equaling the standards needed to win your claim.  I have found that comprehensive medical documentation from a qualified treating specialist can enhance your odds of proving you are unable to work.  Statements from your treating physicians may also be given weight that is necessary to prove your claim. For many people frustration may set in when going through this process. It is important, in my opinion, that you pursue your appeal if you believe you are unable to work.  Always remember there are time limits when filing a request for … Continued

Filed under: Evaluation Process, Qualifying Disabilities and Impairments || Tagged under:
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May 2, 2013

Irritable Bowel Syndrome (IBS) and obtaining Social Security Disability Benefits

In my Indianapolis disability practice, I see an increasing number of people suffering from Irritable Bowel Syndrome (IBS) and other digestive impairments.  One difficulty these clients experience when trying to convince the Social Security Administration (SSA) they are disabled is that they usually do not have any outward signs and symptoms.  I represent hundreds of clients with many different impairments, and a good number of them require a cane, a walker, or even an oxygen tank.  My clients with digestive issues, though, do not usually need any sort of assistive device.  That being said, after working with clients who deal with IBS and other digestive issues, it is clear to me that their impairments keep them from being able to work a full-time job.   Of course, it is always important to have good, solid, comprehensive medical records, including objective testing, doctor’s statements confirming your disabling condition, and clinical descriptions of the symptoms that prevent you from working. The SSA addresses digestive impairments in its Listing of Impairments under Listing 5.00: Digestive Disorders.  These listings cover gastrointestinal hemorrhaging, chronic liver disease and liver transplantation, inflammatory bowel disease, short bowel syndrome, and weight loss due to digestive disorders.  The listings contain specific symptoms and test results you must demonstrate to the SSA in order to be found disabled based on your medical records.  If you review this listing but find that you do not experience all of the requirements of a listing, it does not mean that you are not disabled under the SSA’s rules; it simply means that you will have to provide additional evidence to show that you are disabled.  For example, a medical expert may review your records and determine that even though you do not precisely meet every requirement of a listing, your symptoms are sufficiently similar to … Continued

Filed under: Qualifying Disabilities and Impairments || Tagged under:
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April 25, 2013

Filing Your Initial Social Security Disability Application

I receive numerous telephone calls from my Indiana neighbors asking how to file an initial Social Security disability application. I typically recommend that they start the application process on their own, because most of the initial application involves providing information to the Social Security Administration (SSA) that only the claimant will know.  It is usually easier to provide that information directly to the SSA rather than to go through an intermediary. There are essentially three ways to file an initial claim: Visit your local Social Security office.  If you want to talk face to face with someone when you file your claim, this is your best option.  One advantage to applying in person is that you can get answers to any questions you may have, and having a Social Security employee assist you with your application should help to ensure you are providing all of the information the SSA wants.  On the other hand, if you go to the office without an appointment you may have to take a number and wait for a long time before finally being able to talk to a Social Security employee. Call the toll free number.  By calling 1-800-772-1213, you can talk to a Social Security employee who can answer your questions.  Most likely, the employee will make an appointment for you to either visit your local office or complete a telephone interview to start the application process. Visit the Social Security’s website at www.ssa.gov.  If you are comfortable using a computer, this is by far the most convenient option.  At Social Security’s website, you can complete your application online without having to make an appointment or spend time waiting at the local office.  The website takes you step by step through the application form and the Adult Disability Report.  Once you have completed all the steps, the website will instruct you to print some pages and mail them to … Continued

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April 22, 2013

Pain and Your Social Security Disability Hearing

I have found through many years of practicing disability law that each person’s experience of pain is unique.  I have noticed that some of my clients who have similar diagnoses and test results describe the nature and intensity of their pain very differently, and their pain affects each one’s ability to complete daily activities to a different degree.  I believe it is important when testifying at your Indiana disability hearing to be realistic about how your pain feels and how severe your pain is. The Administrative Law Judge (ALJ) at your hearing has access to your medical records and is aware of your diagnoses and test results; he will listen to your descriptions of your pain and try to decide if they are consistent with the information in your records. Many times at hearings, the ALJ or your representative will give you a “pain scale” to rate the severity of the pain you experience. A typical pain scale will describe “0” as no pain at all and a “10” as pain so bad you have to go to the hospital.  The ALJ will then ask you to assess your pain on a typical day after you have taken your prescribed medications.  Even when my clients deal with severe pain every day, I tell them to think hard before telling the judge that they experience pain at a “10” on an average day, unless they really do go to the emergency room several times a week.  If the ALJ thinks you are exaggerating your pain symptoms at your hearing, he might not believe other parts of your testimony, either.  In my opinion, it is important to tell the truth at your hearing.  These judges have presided over numerous hearings and have a lot of experience deciding whether people are being honest … Continued

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April 19, 2013

Carpal Tunnel Syndrome and Social Security Disability Benefits

In my experience as an Indiana Social Security disability attorney, my clients who suffer from conditions that cause the loss or limited use of their upper extremities (i.e., their shoulders, arms, and/or hands) have great difficulty finding and maintaining employment.  The Social Security Administration (SSA) generally recognizes that a person with this type of disability finds greatly reduced numbers of jobs available to them in the national and local economy.  When I represent clients at Social Security disability hearings, Vocational Experts (VEs) often appear at the hearings to testify about the availability of jobs for people with specific limitations.  If a claimant is found to be unable to use his dominant hand to perform its full range of movements, the VE usually testifies that there are few, if any, jobs available that will accommodate such limitations. Carpal Tunnel Syndrome (CTS) may cause numbness, tingling, or burning in the fingers, thumb, and hand; sometimes these sensations are also present in the wrist.  Some individuals with CTS experience pain when attempting to use their hands to perform even the simplest of tasks.  While the cause of Carpal Tunnel Syndrome may not be known, it is believed that using or overusing one’s hands in work-related situations may be a dominant factor in causing the symptoms.  Many of my clients with Carpal Tunnel Syndrome have spent significant time performing occupations in which they used their hands extensively working on assembly lines, performing data entry, or using tools. In my experience, some people get temporary relief from CTS with treatments including wearing splints and receiving injections, but they only seems to be short-term fixes.  Some people require surgery to help alleviate the pain and numbness.  This surgery, commonly known as a “carpal tunnel release,” does work for some individuals, but many others have symptoms that … Continued

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April 15, 2013

Depression and Your Indiana Social Security Disability Hearing

I represent my Indiana neighbors in hundreds of disability hearings each year, and find the diagnosis of depression in the majority of them.  From my experience talking to these individuals, I understand how disabling depression can be and how it can prevent anyone from holding down a full-time job.  When the Social Security Administration (SSA) analyzes your claim, it must consider all of the impairments you have, both physical and mental, alone and in combination.  It is important, therefore, when you apply for benefits to let the SSA know about all of the problems that you have that affect your ability to work. One of my biggest challenges representing people with depression comes when I have a client who is receiving all of her mental health diagnoses and treatment from her family physician.  While your family doctor can make a diagnosis of depression and prescribe medications for it, she is not a mental health specialist.  One factor an Administrative Law Judge (ALJ) considers when determining whether your depression is severe enough to keep you from being able to work is whether you are getting treatment from a specialist.  If you have heart problems, most judges expect you to receive treatment from a cardiologist; if you have back problems they want to see records from an orthopedist.  In the same way, if you have depression or another mental health impairment, most ALJs think that you should be receiving treatment from a psychiatrist and attending counseling with a psychologist, social worker, or other mental health professional.  Your chances of winning your claim may be greatly enhanced if you are seeing a psychiatrist and therapist on a regular basis. When I represent a client with depression, I try to obtain statements from his psychiatrist or therapist to submit to the ALJ.  A specialist … Continued

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April 10, 2013

Is it a Good Idea To Continue My Social Security Disability Hearing?

Sometimes it is necessary to think about continuing, or postponing, your disability hearing.  As a disability attorney, I generally do not like to continue hearings.  Because the Administrative Law Judges (ALJs) have such crowded schedules, we have to wait a long time to get to a hearing, and rescheduling a hearing often means even more months of waiting before we finally get in front of the judge.  In my experience, most judges do not want to continue hearings either.  They want to keep things moving along quickly once a case gets to the hearing level. One reason an ALJ does not like to continue a Social Security disability hearing, especially on the day of the hearing, is because a lot of resources have been expended in preparing to hear the case.  Many hearings include vocational and medical experts paid by the Social Security Administration who have reviewed the case file and are ready to testify that day.  If the hearing is rescheduled, all of those experts will have to return to testify on another day. Why, then, would a judge consider rescheduling a hearing?  Oftentimes it is because the case file does not contain all of the claimant’s medical records.  Your medical records are a very important part of your case because they provide hard evidence of your diagnoses, symptoms, and prognosis.  Without all of your records, the ALJ will not be able to get a complete picture of your medical conditions.  If all of your records are not available in time for the hearing, though, the ALJ will often proceed with the hearing, taking your testimony and the testimony of any experts present.  The judge will then hold the record open for a specific amount of time so that the additional medical documents can be furnished at a later … Continued

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