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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

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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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December 11, 2012

Depression and Your Indiana Social Security Disability Appeal

Depression seems to rear its head in the majority of the claims I handle in front of the Social Security Administration (SSA).  While some of my clients suffer from depression alone others may suffer from depression due to their physical disabilities.  I am sure I am not alone when it comes to a large portion of my clients suffering from depression, in fact I am sure the Administrative Law Judges who preside over the hearings I attend routinely examine medical records with a diagnosis of depression.  With this being a common thread I experience, just how do you win your disability claim when trying to receive Social Security Disability Insurance (SSDI) and/or Supplemental Security Income (SSI)? In my experience you need to take a long hard look at who you are getting psychological treatment from.  If you are receiving treatment from a general practitioner you may want to rethink your medical options.  The SSA usually wants you to be seeing someone who specializes in the disability you claim you have.  In other words, a psychiatrist, psychologist, or a mental health therapist may be your best option when trying to prove you have symptoms of depression that are preventing you from working.  A well documented course of ongoing therapy with detailed progress notes can go a long way in convincing a Judge you are disabled.  Hospitalizations for mental illness can also show you are not getting better in spite of treatment and following prescribed medications.  Sometimes I will sit in a hearing and listen to my client testify and think they are certainly clinically depressed by their testimony, but realize at the same time that their medical records are minimal and they have not been seeing a doctor that the SSA is going to recognize.  The truth is you can be … Continued

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November 29, 2012

Social Security Disability Benefits For Back Pain

As an Indiana Social Security attorney, the majority of my clients suffer from back pain. I personally have occasionally experienced back pain that makes it hard to move around, and I sometimes wonder what my life would be like if the pain was present all of the time. I believe it would be difficult, if not impossible, to work a full time job if this was happening to me on a constant basis. I can sympathize with my clients when they describe their pain to me, but I also realize sympathy is not what they want. They want to be able to provide for themselves and their families when they are unable to work due to back problems. It is important for Social Security disability claimants to know there is a very specific way the Social Security Administration (SSA) looks at impairments involving the spine. One of the first things the SSA looks at when examining claims involving the spine is whether or not the individual meets or equals a “Listing”. The SSA publishes a set of guidelines that details what the SSA considers to be disabling conditions. Listing 1.00 covers the musculoskeletal system.  Listing 1.04 specifically covers disorders of the spine, and in order to meet it you must have objective evidence (e.g., medical tests or imaging) of your impairment. MRIs can be of great importance when attempting to show you meet or equal this listing. You usually cannot depend on the SSA to send you for the appropriate testing and imaging; instead your own physician must conduct testing or refer you for testing that proves you have the required criteria. When I am trying to prove that a client meets or equals this listing, I send questionnaires to the treating physicians requesting they provide relevant details about the … Continued

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November 11, 2012

Diabetes and Winning Your Social Security Disability Claim

Practicing Social Security Disability law in Indianapolis has opened my eyes to how many people suffer from diabetes.  Many of my clients suffer from several different disabling conditions at the same time, and more often than not, diabetes is on their list.  At your disability hearing in front of the Administrative Law Judge (ALJ),  the judge is required to consider all of your severe impairments when determining whether you are disabled.  Therefore, it is very important to let your attorney or representative know if diabetes contributes to your inability to work.  I talk to my clients extensively about how diabetes keeps them from working so I can better understand their limitations and present them to the judge. Diabetes mellitus (or simply diabetes) occurs when a person’s blood glucose level, commonly called “blood sugar,” is unacceptably high, usually due to poor insulin production in the body.  Diabetes is labelled as “type I” or “type II”.  The symptoms of diabetes can include: Frequent urination Numbness and tingling in the hands and feet Fatigue Blurred vision In my practice, the most common reason my diabetic clients find themselves unable to work is the tingling or burning known as neuropathy in their hands and feet.  They also suffer other symptoms that keep them from working when they are unable to control their diabetes with medication or insulin.  In my experience as a disability lawyer, the inability to stand and walk can greatly reduce the number and types of jobs a person can perform.  Many of my clients with neuropathy or swelling in their legs and feet cannot sit for very long without pain, and they are required to elevate their legs to relieve that pain.  These limitations reduce their “physical residual functional capacity” – the types of activities they are physically able to perform … Continued

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October 4, 2012

Social Security Disability Benefits and Strokes

I have represented many of my Indiana neighbors who have experienced strokes, and one thing is certain – none of them have been exactly alike.  Some of my clients experienced a wide variety of physical and mental impairments leading up to their strokes, while others seemed to be perfectly healthy until they experienced their strokes.  One thing they all had in common, though, was that having a stroke altered their lives in ways many of us may could never imagine.  As a Social Security disability attorney, I realize that the particular facts of each case always matter.  With that in mind, I collect medical documentation for each of my clients that will paint a clear picture of the symptoms that person experiences, and how it affects his daily life. As I mentioned before, a person may experience many different symptoms after a stroke, and the ability to recover from those symptoms can vary greatly from individual to individual as well.  Some of the symptoms include, but are not limited to: Numbness, tingling, and weakness Difficulty with speech Problems with balance and walking Cognitive problems Vision problems Headaches The Social Security Administration (SSA) does recognize stroke and the symptoms that accompany a stroke as disabling conditions.  In technical terms, a stroke is referred to as a cerebrovascular accident (CVA).  The SSA addresses stroke in its Listing of Impairments under listing 11.04: Central Nervous System Vascular Accident.  I have found that the SSA and most Administrative Law Judges (ALJs) consider these listings first when trying to determine whether a condition is disabling.  However, many times they fall back on a more generalized look at an individual’s physical residual functional capacity to determine if she is disabled.  When the ALJ looks at your physical residual functional capacity, he is deciding whether the symptoms … Continued

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October 1, 2012

Social Security Disability Benefits For Bipolar Disorder

I receive numerous calls every week from Indiana residents telling me they have been denied disability benefits.  People suffering from bipolar disorder or other mental impairments make up a portion of those phone calls.  I cannot represent every potential disability client who calls my office, and there are several factors I have to consider before deciding to represent someone.  Some callers tell me they are bipolar, but they have never been diagnosed by a doctor and are not receiving any treatment.  Unfortunately, your belief that you have bipolar disorder is probably not going to be enough for the Social Security Administration (SSA) to find you disabled. Even if you experience the symptoms of  bipolar disorder,  the SSA is going to want documentation from treating sources to help prove your disability claim is valid. I do understand the difficulty in finding appropriate treatment for mental illness.  If you do not have health care coverage, the cost to visit a therapist, see a psychiatrist, or pay for medication is unaffordable, even for people who are employed.    Fortunately, some hospitals and nonprofit organizations have programs to help people without funds obtain treatment for mental disorders.  I strongly encourage my clients to seek these programs out and do the best they can to get the care they need. Most of my clients receiving care for a mental disability see two different kinds of mental health professionals.  Usually the person who prescribes mental health medications is a psychiatrist.  The patient has periodic appointments with the psychiatrist, who assesses the patient’s need for medications, prescribes the appropriate drugs, and monitors the patient’s progress.  Another individual commonly seen by my clients is a therapist.  The patient often spends more time with a therapist than with a psychiatrist, usually in the form of group or individual counseling.  Most … Continued

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September 27, 2012

Autism and Child Social Security Disability Benefits

One of the most rewarding parts of my job as a disability lawyer is helping disabled children and their families get the benefits they deserve.  After hearing about the daily struggles  families face when they have disabled children, it is hard not to take a personal interest in their cases.  I believe a larger percentage of my practice is made up of Supplemental Security Insurance (SSI) claims involving children than in the practices of many of my fellow Social Security disability attorneys.  In fact, sometimes other attorneys refer children’s cases to me because they simply do not handle children’s disability claims.  I have noticed that more and more of my child clients have been diagnosed on the autism spectrum, and I have found that many of these cases have unique issues that must be addressed in order to enhance the chances of a favorable outcome. The Social Security Administration (SSA) uses six “domains” of functioning to determine how a child’s daily living is affected by the child’s disability.  These domains are: Acquiring and using information Attending and completing tasks Interacting and relating with others Moving about and manipulating objects Caring for yourself Health and physical well-being. A child is considered disabled if the child either has “marked” limitations in two of these domains, or “extreme” limitations in one of them. I have found that many autistic children have extreme limitations in interacting and relating with others.  Individuals with autism may have difficulty holding simple conversations with others, suffer from language difficulties, or repeat words or phrases (echolalia).  I have noticed many of these children do not have the ability to recognize the simple social cues most of us take for granted.  In my experience, most of these kids are smart, and I mean really smart, but their inability to interact … Continued

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