October 2, 2014

Lupus and Your Indiana Social Security Disability Claim

As an attorney representing many individuals across Indiana in their Social Security Disability Insurance (SSDI) and/or Supplemental Security Income (SSI) claims, I see a wide variety of disabling conditions.  Recently I have encountered more individuals diagnosed with lupus than before.  I would like to discuss some of the symptoms of lupus and how the Social Security Administration (SSA) addresses these symptoms when evaluating how lupus affects a person’s ability to work. Lupus is an autoimmune disease that can affect many parts of the body.  While it is considered a chronic disease, the severity can differ from individual to individual.  Symptoms of lupus can include, but are not limited to: Joint pain or swelling Oral ulcers Severe fatigue Fever Chest pain Rash Sensitivity to sun or light Anemia Involuntary weight loss The SSA does recognize lupus in its Listing of Impairments.  If your symptoms meet or equal the requirements in Listing 14.02: Systemic Lupus Erythematosus, you may be granted Social Security disability benefits.  Another way to win your disability claim with the SSA is to show that your “physical residual functional capacity” is so low you simply cannot work.  You may not be able to sit, stand, or walk long enough at a time or lift enough weight to be able to perform a substantial number of jobs in the national economy.  The pain and fatigue you experience from lupus may also prevent you from staying on task, working a full eight hour day, or making it to work every day.  If you are unable to perform work tasks adequately and consistently for eight hours per day, five days per week, you may meet Social Security’s definition of disability because you are unable to perform a full-time job. In my experience, comprehensive, up-to-date medical records from a specialist can greatly enhance … Continued

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September 12, 2014

Social Security Disability Benefits for HIV/AIDS

Acquired Immunodeficiency Syndrome (AIDS) is a disease that affects the body’s immune system.  AIDS is the last stage of the infection caused by the human immunodeficiency virus (HIV).  By attacking the immune system, HIV hinders the body’s ability to fight off infections.  HIV can be transmitted through sexual contact, exposure to infected bodily fluids, childbirth, or breastfeeding. Some symptoms of HIV infection may include a flu-like illness appearing two to four weeks after exposure to the virus.  After this illness, there is usually a latency period, typically lasting from 3 years to over 20 years, in which the patient will have very few, if any, symptoms.  Near the end of the latency period, fever, weight loss, gastrointestinal problems, and muscle pains may occur. Once HIV infection progresses to AIDS, more symptoms may occur.  These could include pneumocystis pneumonia, cachexia (HIV wasting syndrome), esophageal candidiasis, or respiratory tract infections.  People with AIDS also have a greater chance of contracting infections, viruses, and cancers. In order to meet the Social Security Administration (SSA)‘s listing for HIV infection, you must  have documentation of laboratory testing showing you are infected.  You also must be able to show that you suffer from one of the following: Bacterial infections: mycobacterial infections, nocardiosis, or salmonella (recurrent non-typhoid); or multiple recurrent bacterial infections requiring hospitalization or intravenous antibiotic treatment three or more times in a twelve (12) month period Fungal infections: aspergillosis, candidiasis (at a site other than the skin, urinary tract, intestinal tract, or oral or vulvovaginal mucous membranes), cocidiodomycosis (at a site other than the lymph nodes),  cryptococcosis (at a site other than the lungs), histoplasmosis (at a site other than the lungs or lymph nodes), mucormycosis, or pneumonia (or extrapulmonary infection) Protozoan or helminthic infections: cryptospridiosis, isosporiasis, or microsporidiosis, with diarrhea lasting for one (1) month or longer; extra-intestinal strongyloidiasis, or toxoplasmosis of an organ other than the liver, spleen, or lymph nodes Viral … Continued

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September 5, 2014

Brain Injury and Social Security Disability Benefits

Practicing Social Security disability law in Indiana has brought me into contact with a variety of disabling conditions and brain injuries are no exception.  This type of disability may result in the inability to work due to physical and/or mental impairments.  Your inability to sustain a forty (40) hour work week can result in qualifying for disability payments. The Social Security Administration (SSA) does recognize neurological impairments in its Listing of Impairments.  While Traumatic Brain Injuries (TBIs) do not a have a listing it is given mention in this listing.  A specific listing of 11.18 Cerebral Trauma may be of interest when examining brain injury.  It is important to note the listings under 11.00 may also be of interest considering the facts of each case. Do all brain injuries meet or equal one of the listings the SSA recognizes?  No, and that does not necessarily mean you will not be found disabled.  The SSA also recognizes the fact that your residual functional capacity may be at a level that you cannot perform substantial gainful activity.  This means that you are physically or mentally unable to perform work like activity on a full time basis.  Many of my clients with TBI’s have difficulty staying on task, fatigue, and memory issues that simply make it impossible for them to engage in a competitive work atmosphere. With any Social Security disability case medical records are usually the key to a successful outcome.  MRI’s of the brain and other objective testing can greatly enhance the chance of a favorable outcome with the SSA.  In my experience, statements from treating physicians especially those who specialize in a certain field as in neurology in these claims can be very beneficial. At my law office I represent individuals with many disabling conditions including but not limited to … Continued

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September 1, 2014

Medical Expert Testimony at Your Social Security Disability Hearing

When the day finally arrives for your Social Security disability hearing, you may find that the Administrative Law Judge (ALJ) has asked one or more doctors to testify about your ability to do work-related activities. Some, but not all, Administrative Law Judges call on medical experts to testify at hearings. You may be wondering how a doctor who has never seen you before can testify about your medical conditions and how they affect your ability to work.   In my experience, medical expert testimony at a disability hearing has both advantages and disadvantages.  An experienced disability attorney knows how to prepare for a hearing to maximize those advantages while defending against the disadvantages. Some doctors who testify at hearings appear in person, but many testify over the phone. Social Security pays each medical expert a flat fee to review a claimant’s medical file and provide unbiased testimony at the hearing.  In my experience, the Social Security Administration (SSA) has difficulty finding qualified doctors to testify; most practicing physicians have neither the time nor the financial incentive to work as a medical expert for Social Security.  Most of the doctors I see at hearings are retired general practitioners.  While  the ALJs typically request testimony from doctors who specialize in the claimant’s impairments, it is often difficult for Social Security to find such a specialist who is available to testify. Each medical expert at your hearing is expected to have reviewed all of the medical records in your file and be prepared to present his opinions on the following issues: Your medical diagnoses Whether your impairments meet or equal the definitions set out in Social Security’s “Listing of Impairments” The physical and/or mental work-related limitations caused by your impairments The ALJ will likely ask the medical experts some additional questions, and you or your representative will have an opportunity to ask questions as well. Many judges … Continued

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August 26, 2014

What Should I Say At My Social Security Disability Hearing?

When I prepare my Indiana neighbors for their day in front of an Administrative Law Judge (ALJ), the majority of the conversation revolves around what type of questions the ALJ will ask them.  I have represented clients in front of many different judges, and I have found that each ALJ has a unique style of asking questions – some ask a lot of questions; others prefer to have the representative take most of the client’s testimony.  Therefore, I try to tailor each of my clients’ preparation to be ready for the particular judge who will be hearing the case.  In spite of their differences, though, in my experience most judges cover the same general topics in their hearings. Many, but not all, judges are going to check your credibility.  While objective test results can prove that you have a certain medical diagnosis, the severity of the pain or other symptoms you experience due to that diagnosis can only be explained by you.  Therefore, the judge will likely ask you to explain your symptoms, rate your pain, or describe the ways your pain or other symptoms limit your ability to perform certain tasks.  If a judge believes you are exaggerating or lying about these things, you may find yourself with an unfavorable outcome.  I try to always tell my clients to be truthful yet realistic about what they can or cannot do.  In my experience, credibility is especially important for my clients whose disabilities cannot be diagnosed with objective testing, like mental illness, fibromyalgia, or migraines. Most judges will ask you about your activities of daily living.  These can include but are not limited to cleaning your home, doing dishes, laundry, yard work, bathing or showering, dressing yourself, taking care of children, shopping, using the computer, hobbies, and going out with friends and … Continued

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August 21, 2014

What is a closed period of disability?

In order to qualify for disability benefits, you must have a disability that has lasted or is expected to last at least twelve months.  Although, sometimes I work with clients whose health problems lasted more than twelve months, but they have recovered and are now able to return to work.  Even though they are relieved to be able to return to full-time employment, these clients want to know if they can receive disability benefits for that time period in which their conditions kept them from being able to work. In cases like these, we ask the Social Security Administration (SSA) for a “closed period of disability.”  In other words, we acknowledge that the client does not presently meet Social Security’s definition of disabled, but we argue that the client did meet that definition in the past.  For example, Betty had to stop working in October of 2012 after she injured her back.  She spent nine months trying different types of treatments, from physical therapy to injections, but nothing helped.  Finally, her doctor scheduled her for back surgery in August of 2013.  It took another six months of recovery and rehabilitation, but Betty was finally able to return to work full-time in February of 2014. Assuming that Betty met Social Security’s requirements for disability from the time of her injury in October 2012 until she returned to work in February 2014, she could receive benefits for a closed period from October 2012 to February 2014. An applicant for a closed period of disability must meet two criteria: Her impairments must have prevented her from performing substantial gainful activity for at least twelve continuous months; and She must have applied for disability either before her disability ended or within fourteen months of her disability ending. Most of my cases involving closed periods of … Continued

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August 8, 2014

Social Security Disability Benefits for Learning Disabilities

Many of the children I represent in claims for Supplemental Security Income (SSI) have been diagnosed with some type of learning disability.  While Social Security Administration (SSA)‘s Listing of Impairments does not specifically address learning disabilities, its evaluation process does consider the effects of learning disabilities on a child’s ability to function. Some of the children I represent have learning disabilities related to mental impairments such as attention deficit hyperactivity disorder (Listing 112.11), mood disorders (Listing 112.04), anxiety disorders (Listing 112.06), or intellectual disabilities (Listing 112.05).  Other children have learning disabilities that are less easy to categorize, so Social Security evaluates them differently.  Once Social Security determines that a child’s impairments do not medically meet or equal one of its Listings, it then evaluates the child’s combination of impairments to see if he or she “functionally equals the listings.”  If the child has marked impairments in acquiring and using information,  attending and completing tasks, interacting and relating to others, moving about and manipulating objects, caring for himself, or health and physical well-being, Social Security may find the child meets its definition of disability. In order to show Social Security that your child is disabled, you first must show that he or she has a medically determinable impairment.  Helpful evidence includes: Medical diagnoses and treatment notes Therapy/counseling notes Clinical test results Other medical findings Next, you must show how your child’s medically determinable impairments keep him or her from functioning at an age-appropriate level.  Evidence of these limitations includes: Individual Education Plans (IEPs) School grades Results of standardized testing Evaluations and treatment notes from occupational and physical therapy or other types of rehabilitation School or day care discipline reports Written comments from teachers regarding the child’s ability to work at grade level, complete assignments, work without supervision, and behave appropriately in a classroom environment … Continued

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July 24, 2014

Social Security Disability Benefits for Hepatitis C

Hepatitis C (HCV) is a medical condition in which the patient’s liver is inflamed.  In some cases, HCV can lead to cirrhosis (replacement of liver tissue with scar tissue) of the liver.  Hepatitis C is usually spread via organ transplants, transfusions, intravenous drug use, or poorly sterilized medical equipment.  HCV was only proven to be a different condition from hepatitis A and hepatitis B in 1989.  HCV only infects humans and chimpanzees. Chronic infection occurs in about 80% of HCV patients.  A chronic infection is characterized by the presence of viral replication for more than six months.  Most patients with chronic HCV infection exhibit few symptoms, if any, during the first few decades after their initial infection.  Early symptoms may include fatigue or mild cognitive problems.  After several years of an individual being infected, hepatitis C may lead to cirrhosis or liver cancer.  Some other symptoms may include: Joint pain Belly pain Itchy skin Sore muscles Dark urine Jaundice Traditionally, the typical treatment for hepatitis C has been interferon injections.  Unfortunately, though, these injections tend to cause flu-like side effects.  New drugs are being introduced to replace interferon treatment, and if a patient’s HCV symptoms are not severe, his doctor may recommend waiting for the new drugs to be released rather than enduring interferon treatment.  Patients with hepatitis C are typically advised to avoid alcohol and any type of medication or drug that is harmful to the liver. The Social Security Administration (SSA) has a listing for chronic liver disease in its Listing of Impairments at Section 5.05. Simply being diagnosed with hepatitis C is not enough on its own to meet the criteria to receive Social Security disability benefits.  Your medical records must also show that you have complications such as hepatorenal or hepatopulmonary syndrome, internal bleeding, or fluid in the peritoneal or pleural cavity. Even if you do … Continued

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July 10, 2014

How Do Drugs And Alcohol Use Affect My Disability Claim?

Your social security disability claim may be denied due to alcohol or drug use.  The way this information usually gets to the Social Security Administration (SSA) is through the medical records.  Most doctors offices ask questions concerning drugs and alcohol when patients go in for a check up.  Some hospitals will conduct drug tests while patients are in for a procedure. Below is a paraphrased version of what the SSA’s Federal Regulation 416.935 says concerning drugs and alcohol: If the SSA finds that you are disabled, they must determine if your drug or alcohol addiction is a contributing factor to your disability.  This does not apply to claimants when applying because of blindness. If you stopped using drugs or alcohol, would the SSA still find you disabled? Would your current physical or mental limitations remain if you stopped using drugs or alcohol? If the SSA determines that your remaining limitations (after removing the drug or alcohol use) would not be disabling, you may not receive benefits. If the SSA determines that your remaining limitations (after removing the drug or alcohol use) are still disabling, you may be found favorable for benefits. How the SSA looks at drug and alcohol use varies from case to case.  In cases where the claimant is claiming mental health issues, the SSA will look and determine, in their opinion, if the claimant stopped using drugs or alcohol, would the condition still exist?  This can be a gray area with mental health cases because far too often I see drugs or alcohol become a coping mechanism for mental issues. If you have drug or alcohol issues, your case may be harder to win, but this does not mean that it is impossible.  We must prove to the SSA that the drug or alcohol issues are independent … Continued

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July 9, 2014

Social Security Disability Benefits for Fibromyalgia in Indiana

Fibromyalgia is a condition where a person experiences widespread pain and painful responses to pressure.  Fibromyalgia may also be associated with depression, anxiety, and other stress related disorders.  Other symptoms may be, but are not limited to the following: Fatigue Sleep disturbances Joint stiffness Bowel/bladder issues Numbness/tingling Cognitive dysfunction Difficulty swallowing The cause of fibromyalgia is unknown.  Currently, it is believed to involve a combination of genetic, environmental, psychological, and neurobiological factors.  There is some evidence that certain genes increase the risk of developing fibromyalgia.  These happen to be the same genes that are associated with other functional somatic syndromes and depression. Lifestyle may also contribute to developing fibromyalgia.  Stress is believed to be a factor in developing fibromyalgia.  Lifestyles like such as smoking, obesity, or lack of physical activity may also increase the risk in developing fibromyalgia. A single test to diagnose fibromyalgia does not exist.  Most doctors diagnose patients with a process called a differential diagnosis.  This means that the doctors take into consideration the patient’s age, gender, symptoms, medical history, and other factors to narrow down the diagnosis to the most likely option. The American College of Rheumatology (ACR) defines fibromyalgia with the following criteria: A history of widespread pain lasting more than 3 months, affecting all 4 quadrants of the body (both sides, above and below the waist). Tender points – there are 18 designated tender points (even though a person may feel pain in other areas).  However, a diagnosis is not based on the tender points alone. Fibromyalgia is not degenerative or fatal, but the chronic pain is persistent.  Most patients report that their pain does not improve over time.  There is no universally accepted treatment or cure for fibromyalgia.  Some doctors do recommend psychological therapy, medication, and/or exercise to help with the symptoms. The Social Security … Continued

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