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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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May 29, 2014

Social Security Disability Benefits for Traumatic Brain Injuries (TBI)

A traumatic brain injury (TBI)  occurs when an external mechanical force causes damage to the brain.  These injuries may occur as a result of vehicle accidents, firearms, falls, construction accidents, or sports injuries.  A TBI may cause temporary or permanent impairment of brain functioning and might cause structural damage to the brain as well.   Symptoms from TBIs vary depending on the severity of the injury.  In moderate or severe cases, unconsciousness may occur within seconds or minutes.    Milder injuries may cause symptoms including but not limited to: headaches, vomiting/nausea, dizziness, balance problems, and fatigue.  Some common long term symptoms of moderate to severe TBIs may include but are not limited to: changes in appropriate social behavior; problems with sustained attention, processing speed, and executive functioning; and alexithymia.  Alexithymia is a condition in which an individual has problems identifying, understanding, processing, and describing emotions. the Journal of Clinical and Experimental Neuropsychology reports that 60.9% of patients diagnosed with TBI suffer from alexithymia. The Social Security Administration (SSA) recognizes traumatic brain injuries in its Listing of Impairments at Section 11.18 – Cerebral Trauma.  In evaluating whether your TBI meets a listing, though, the SSA refers to other listings that address the specific body systems affected by your injury.  For example, if you suffer psychological or behavioral symptoms resulting  from your TBI, you may meet Listing 12.02 – Organic Mental Disorders.  If your TBI leads to seizures, you may meet listing 11.02 – Convulsive Epilepsy or 11.03 – Nonconvulsive Epilepsy. In order to meet Social Security’s definition of disability, your impairment must have lasted or be expected to last at least twelve months.  TBIs can be difficult to evaluate under Social Security’s standard because their long-term prognoses can be difficult to forecast accurately.  Some TBIs cause very severe symptoms at first but gradually improve, while others grow worse over time.  Therefore, it is very important in your Social Security disability case … Continued

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May 20, 2014

Heart Disease According to the Social Security Administration

The Social Security Administration (SSA) recognizes many cardiovascular impairments as disabling conditions.  Many people use the term heart disease interchangeably with cardiovascular impairments.  The SSA defines a cardiovascular impairment as  “any disorder that affects the proper functioning of the heart or the circulatory system (that is, arteries, veins, capillaries, and the lymphatic drainage).  The disorder can be congenital or acquired.”  The SSA lists cardiovascular impairments under Section 4.00 in the Listing of Impairments.  The Listings define certain diagnoses, clinical findings, and symptoms that the SSA considers disabling.  If you can provide appropriate medical evidence showing that your impairment meets the definitions set out in the Listings, you might be found disabled without having to demonstrate how your impairment keeps you from being able to work. Below are a few cardiovascular impairments that the Social Security Administration addresses in its Listing of Impairments. Chronic Heart Failure Chronic heart failure occurs when the heart is unable to pump enough blood to meet the needs of the body.  Some signs and symptoms of heat failure may include: increased rate of breathing, increased difficulty for normal breathing, pulmonary edema, cardiac asthma (wheezing), and/or apex beat or gallop rhythm.  Heart failure stems from the myocardium muscle losing efficiency, which is usually caused by damage or or overloading of the muscle.  The leading cause of chronic heart failure is coronary artery disease.  The SSA recognizes chronic heart failure in Section 4.02 of the Listing of Impairments.  To meet this listing you must be able to show certain levels of systolic or diastolic failure, severe symptoms as a result of your heart failure, or multiple episodes of acute congestive heart failure. Ischemic Heart Disease  Ischemic heart disease is more commonly known as coronary artery disease.  This condition happens when blockages in the arteries reduce blood flow.  Ischemia is defined as “reduced blood supply.”  The leading cause of ischemic heart disease … Continued

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March 28, 2014

Expedited Social Security Disability Hearings for Veterans

“Starting March 17, 2014, veterans who have a VA compensation rating of 100% permanent and total (P&T) may receive expedited processing of applications for Social Security disability benefits.” This is a direct quote from the Social Security Administration’s website. This is great news for 100% disabled veterans.  In my Indiana law office, we have already seen the results of this rule.  Social Security has called us to schedule expedited hearings for several of my clients who are disabled veterans, in some cases cutting months off of their expected waiting time for their hearings. Unfortunately, I have had to explain to my clients that just because the VA has assigned them a disability rating of 100% permanent and total, it does not mean that Social Security is required to find them disabled as well.  The Veteran’s Administration and Social Security have different rules and different definitions of disability, so they do not always reach the same conclusion after evaluating the same person.  While your VA disability rating letter is important evidence in your Social Security disability claim, it does not guarantee you will be found disabled.  The only advantage this rule gives to veterans with a 100% VA rating is a faster processing time for their claims. There are a few ways to apply for Social Security Disability benefits: Complete your application online. Call the Social Security Administration at 1-800-772-1213 (TTY 1-800-325-0778 for deaf or hard of hearing). Call or visit your local Social Security Administration office. If you want to apply in person, it is best to call beforehand to schedule an appointment. To receive the expedited hearing: Identify yourself as a “veteran rated 100% P&T” If you apply in person or over the phone, inform the Social Security representative that you have a veteran rating of 100% P&T. If … Continued

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March 4, 2014

Social Security Disability Benefits for Claimants with Diabetes

Diabetes (also known as diabetes mellitus) has two main types.  Type 1 DM (diabetes mellitus) comes from the body’s inability to produce insulin.  People with this condition typically have to inject themselves with insulin or wear an insulin pump.  Type 2 DM stems from the body’s resistance to insulin – that is, the body’s cells cannot properly use insulin.  Type 2 DM is also known as adult-onset diabetes. Some symptoms of diabetes may include: weight loss frequent urination increased thirst increased hunger skin rashes blurred vision These symptoms may onset in a matter of weeks after triggered (usually by certain infections from the environment) for type 1 patients as opposed to slowly or not at all for type 2 diabetes patients.  Type 1 diabetes is usually inherited, with certain infections bringing it out.  Type 2 diabetes is typically caused by lifestyle habits and genetics.  There is no known cure for diabetes. Diabetes can often be controlled with medicine and/or lifestyle changes.  Sometimes, though, in spite of the patient’s best efforts, symptoms persist.  For example, some medical conditions might prevent the patient from being able to tolerate necessary medication or endure an exercise program.  Consistent access to treatment and medication is another hurdle many patients face due to lack of insurance and financial resources. Diabetes can be a very debilitating condition, and it is possible to receive Social Security Disability benefits because of it.  There is not a specific listing for diabetes in the Social Security Administration’s Listing of Impairments, but diabetes is addressed  in Section 9.00 – Endocrine Disorders.  Simply having a diagnosis of diabetes is not enough to meet Social Security’s definition of disability.  Your diabetes must cause functional limitations that prevent you from performing work-like activities on a regular and continuing basis. Diabetes may cause some symptoms that … Continued

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January 9, 2014

Is Chronic Pain Syndrome Recognized as a Qualifying Disability?

Even though the Social Security Administration’s (SSA) listing of impairments is relatively long, chronic pain syndrome is not specifically listed. But this does not mean that you cannot receive Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) for your condition.   The SSA’s listing of impairments is very detailed and has listings for most health issues. There are a handful of listings that might be related to your back pain.  They may include but are not limited to: 1.00 Musculoskeletal System 5.00 Digestive System 11.00 Neurological 12.00 Mental Disorders 14.00 Immune System Disorders If you have chronic pain due to any of the conditions on the SSA’s listing of impairments, it is possible that the SSA will approve your claim in the initial application or the reconsideration stages.  However, this is rarely the case.  It is normal for a claim to go all the way to the hearing stage, which usually takes about a year. In my experience, to have the best possible chance at winning your disability claim, you need to have as thorough and up to date medical records as possible.  No matter how severe your chronic back pain is, it does not qualify by itself for Social Security Disability benefits.  We must prove to the judge that even though you do not meet listing exactly, your limited functionality keeps you from working a normal eight hour per day job.   If your case does meet a listing exactly, we must prove that you have a “residual functioning capacity ” (RFC) low enough that you cannot work a normal eight hour job.  In determining your RFC the Social Security Administration may look at a few things including but not limited to: Sitting, standing, and walking limitations Lifting and carrying limitations Postural limitations Limitations of manipulation of your hands If you have … Continued

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January 1, 2014

Social Security Disability Benefits for Chronic Migraines

At times it may be difficult, it is possible to receive Social Security Disability benefits for severe migraines. My clients who suffer from this type of headache have migraines that can last from 2 to 72 hours, and are very debilitating. It is important that you have thorough medical records to document the persistence and severity of the migraines to prove how they affect your ability to work. Most doctors believe that migraines are a neurovascular disorder. The exact mechanism for the head pain is still up for debate, but some patients with debilitating migraines can feel an “aura”, or a spreading of pain throughout the brain and surrounding blood vessels. Migraines can be diagnosed by using the “5, 4, 3, 2, 1 criteria” according to the International Headache Society. This can be used for patients whether they can feel the aura or not. According to the I.H.S. symptoms of migraines include: Five or more attacks (two if patient can feel the aura) 4 hours to 3 days in duration Two or more of the following: Unilateral (affecting only half of the head) Pulsating Moderate or severe pain intensity Aggravation by causing avoidance of routine physical activity One or more of the following Nausea and/or vomiting Sensitivity to both light and sound Social Security does not have a specific listing for migraines in its List of Impairments, but this does not mean that you cannot receive disability benefits if your migraines keep you from being able to work. With a solid documented medical history, a good case can be made for social security benefits. From my experience, some of the most important evidence in showing the Social Security Administration that migraine headaches keep you from working are medical records showing a history of consistent treatment, preferably by a migraine specialist.Some … 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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