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Author Topic: ssdi appeal question...  (Read 11905 times)

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Offline mitch777

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  • Posts: 3,523
Re: ssdi appeal question...
« Reply #100 on: September 13, 2014, 03:58:02 PM »
So, I found out who my judge is going to be. I checked out his % of approvals and he has the lowest by far. Only 22%! The national average is 44%. Getting more anxious.

I did finish my letter and sent it to my attorney. She liked it and thought it was well written. Also been watching a few youtube videos about ALJ hearings that have been helpful. About 8 weeks to go.
31 years hiv+ (oct. 2013) with a curtsy.

Offline Jeff G

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  • How am I doing Beren ?
Re: ssdi appeal question...
« Reply #101 on: September 13, 2014, 09:03:23 PM »
So, I found out who my judge is going to be. I checked out his % of approvals and he has the lowest by far. Only 22%! The national average is 44%. Getting more anxious.

I did finish my letter and sent it to my attorney. She liked it and thought it was well written. Also been watching a few youtube videos about ALJ hearings that have been helpful. About 8 weeks to go.

You have so many valid issue documented I can't imagine you being denied . I know its nerve wracking all the same .

Offline mitch777

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Re: ssdi appeal question...
« Reply #102 on: September 13, 2014, 09:28:51 PM »
You have so many valid issue documented I can't imagine you being denied . I know its nerve wracking all the same .

Objective "proof" is pretty slim I think. If I get turned down at this point I will feel crushed. It's kind of hard to focus for me when I am feeling so stressed. I know I have zero chance of ever working again. It's beyond nerve racking. I'm bushed, I'm angry at this system for raking me over the coals, and with everything else going on in my life the added pressure of a hearing is, well, it sucks. I feel like a sick circus poodle jumping through the hoops for a "treat" that I should be entitled to at this point in my life.
31 years hiv+ (oct. 2013) with a curtsy.

Offline Since1993

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  • Posts: 106
Re: ssdi appeal question...
« Reply #103 on: September 13, 2014, 10:34:28 PM »
So, I found out who my judge is going to be. I checked out his % of approvals and he has the lowest by far. Only 22%! The national average is 44%. Getting more anxious.

Unfavorable
Favorable
Partially-Favorable

Did the statistic you found separate the three different types of findings?  Favorable and Partially-Favorable are approvals.

Anyway, it is futile to assign ALJ approval ratings to your disability claim because medical evidence of record and your functional ability to earn at least $1070 monthly is what will ultimately decide your approval or denial.  If the Vocational Expert at the hearing states there are no jobs in the national economy you can perform, it will largely improve your chances.  Detailed medical evidence of your diminished Residual Functional Capacity assists the ALJ and Vocational Expert to make the correct decision.  You are likely in later stages of the 5-step Sequential Evaluation Process and if you are approved, it will likely be based on vocational allowance. 

Statistically speaking, your chances of being approved on appeal vs. initial determination are significantly higher.  Keep going to your physicians appointment, keep taking your medications and stay proactive in your disability claim by checking at least monthly on the status of how things are progressing.

The process is long and pain-staking, but knowing you have an attorney should lessen your anxiety because if an attorney took your case, there is a very high probability you will win.  Sometimes you just have to let go and allow the process to unfold, understanding you've given due diligence.  Positive-thinking yields positive results.

Wishing you a positive result!

It is always permissible to private message questions related to Social Security Disability Process, Ryan White/ADAP, Affordable Care Act, Medicaid, Medicare and pharmacy coverage issues.  I am not an expert, but have a lot of experience to share in navigating the maze towards staying linked into care.  Supportive.  Healthcare background.  Not a physician.  Not Mr. Personality, flat affect at times.  Working on it.

Offline zach

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  • not fade away
Re: ssdi appeal question...
« Reply #104 on: September 14, 2014, 01:09:49 AM »
good progress on the letter. and when you speak, come from the heart, you'll nail it man. it is so messed up that the nature of the beast is you don't actually fight the system until you're sickest and weakest. the cards are stacked from the start against.

good luck man, really, i want to see it work out

me, one more month of the waiting period, transitioning from SSI to SSD, losing medicaid, and medicare won't kick in for an additional year. worried there
gonna go up to the mountain, for to find a little peace
looking over the valley, for the beauty i see
out across the hills, forevermore

Offline Since1993

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  • Posts: 106
Re: ssdi appeal question...
« Reply #105 on: September 14, 2014, 02:22:03 AM »
one more month of the waiting period, transitioning from SSI to SSD, losing medicaid, and medicare won't kick in for an additional year. worried there

Zach,

No need to worry.

Once you lose Medicaid, you will be eligible to apply for an Affordable Care Act plan with Advanced Premium Tax Credit/Cost-Sharing Reduction and Ryan White Part B/ADAP assistance which should eliminate out-of-pocket costs associated with HIV-related medications on your states HIV formulary and premium payments.  Just remember to choose a SILVER plan and check the formulary of the insurance plans to make sure the medications you take are covered on their formulary.

Medicare will begin 29 months after your Established Onset Date of Disability, or 24 months after the first date you retroactively begin receiving SSDI disability payments.  Ryan White Part B/ADAP will cover the cost of your Medicare Part D prescription drug plan and co-pays associated with HIV-related medications on your states formulary.  Unfortunately, Medicare Part B premiums will automatically be deducted from your monthly disability payment cannot be reimbursed by the Ryan White Act.

It is always permissible to private message questions related to Social Security Disability Process, Ryan White/ADAP, Affordable Care Act, Medicaid, Medicare and pharmacy coverage issues.  I am not an expert, but have a lot of experience to share in navigating the maze towards staying linked into care.  Supportive.  Healthcare background.  Not a physician.  Not Mr. Personality, flat affect at times.  Working on it.

Offline Blkpoznc34

  • Member
  • Posts: 14
Re: ssdi appeal question...
« Reply #106 on: September 14, 2014, 10:36:38 AM »
Hi Mitch777,

I am sorry you are having to wait and deal with the stress of this long process. I was finally approved five months ago at the ALJ level after a two year wait and denial letters. Just remember that you are your own best advocate. When I told my HIV doctor that I could no longer work due the pain from Peripheral Neuropathy, Fatigue, lack of concentration and a list of other issues. The first thing he told me was I probably would not get approved from my numbers alone even though he has documented all my symptoms. I was also seeing a Neurologist for my PN.

From that day forward I made sure that every visit the doctor and his nurse assistance documented every symptom I was having and I had them make a copy for my records. I asked my HIV doctor and Neurologist to write letters stating that I could no longer work with the reasons why listed. I sent a copy to my attorney so that when my hearing date finally came my medical records were no issue. My attorney said he has never had a client so on top of that. I know that is what my attorney was getting paid to do but I was not leaving that to chance. My attorney had me meet with him in person the day before my hearing date and he went over my entire file and medical history. He told me how the process was going to go and all the potential questions the judge and the vocational specialist may ask. Trust me there were many. On the day of the hearing I had no one to take me so I took a Taxi. Do not drive yourself. The first question the judge asked me was how did I get there today. Just be honest and tell the ALJ and vocational spec. your symptoms and the difficulties of day to day living for you. How you cannot work. During my hearing he even asked how I bath, get my meals, check my mail, handle my finances, my support system, do I have any pets, who does my laundry, grocery shopping....etc. In the end the vocational specialist said there were no jobs that I could perform and that he just happened to be in the parking lot when I arrived and he saw the difficulties that I had getting out of the taxi with my walking cane (which was prescribed my doctor) and bag of paperwork. Even though the ALJ asked me a lot of questions which I answered truthfully he was very sympathetic to my condition and said it was a shame that SSA and their doctors could not see that I am disabled. He wished me well and I got fully favorable decision in the mail about 40 days later.

I hope some of this information helps you in your journey. I have never sat down and wrote such a long response but others on this forum have done it for me in the past and it's time to pass it on. Thank you all BTW...Remember to be honest and it will all work out in your favor. Good Luck... :)

Offline Buckmark

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  • Would you like to tie me up with your ties, Ty?
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Re: ssdi appeal question...
« Reply #107 on: September 14, 2014, 11:03:34 AM »
Mitch,

I'm sure you are very well-prepared.  Try not to think about the judge's record.  Once he sees your situation, he'll concur with your disability.  I know this has been a long and hard road for you, and that you are frustrated and anxious. 

Hugs,

Henry
"Life in Lubbock, Texas, taught me two things:
     One is that God loves you and you're going to burn in hell.
     The other is that sex is the most awful, filthy thing on earth and you should save it for someone you love."
- Butch Hancock, Musician, The Flatlanders

Offline mitch777

  • Member
  • Posts: 3,523
Re: ssdi appeal question...
« Reply #108 on: September 14, 2014, 11:31:44 AM »
Thanks guys.

@Since- 22% favorable, I think his unfavorable was somewhere around 59% and the rest were dismissed. I know it's not logical to assume that it means that I have less of a chance of success based on his #'s but the nervous nellie in me doesn't always listen.

I have had 180 medical appointments in the past 4 years and I will fill 108 prescriptions this year so he will surely see that I am getting regular care.

@Zach- Thanks!

I hope things go smoothly for you in the coming months. I agree with Since but I also remember how the system works where you live. Wishing you the best!

@Blk- Thanks for taking the time to respond.

I have been my own advocate because I'm not sure how competent my attorney is. Disability cases are not her usual work but I'm stuck with her now. I tried to find one that mainly focuses on disability but everyone turned me down because I was self-employed.

I have to keep poking her with a stick. Should be interesting this week or next to see what she received in regards to my medical records. She keeps saying that she plans on speaking with my ID doc but hasn't yet. ::) I do have letters from my neurologist and psychiatrist. My attorney also said that I will be getting tired of seeing her soon as she plans on spending quite a bit of time prepping me. I tend to minimize my issues and I certainly need to snap out of that quick! Maybe she needs to taser me from time to time.

Many of the questions you brought up were listed on a disability website I was reading yesterday. Good to know these things!

Glad you were finally approved!!

@Henry- Thanks! I'll try. lol. Hope you are right about the judge. I just have a vision of him being like Judge Judy. :D




 
31 years hiv+ (oct. 2013) with a curtsy.

Offline britchick

  • Member
  • Posts: 430
Re: ssdi appeal question...
« Reply #109 on: Yesterday at 02:43:37 AM »
mitch777,

Not long to go now.Keeping my fingers crossed for you.You have certainly got all the paperwork and i have a good feeling about your case.

Wishing you the best of luck.

britchickxx

Offline BT65

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Re: ssdi appeal question...
« Reply #110 on: Yesterday at 08:30:03 PM »
I have a good feeling about this also, M.  But, before I collaborate on that I want to say one thing to Since: 

SINCE: Please remember that insurances, including Ryan White, are specific to certain states. For example,what works in Michigan doesn't work in Indiana, and when I was a case manager in Indiana, the insurance was specific to counties.  For instance, where I worked in South Bend, we did not have Ryan White.  So, you need to remember, while doling out the "advice," that plans are different in different states.  If you have specific information about a specific state, you need to provide a link instead of just giving advice like you've been doing. It can be misleading. Please and thanks for your cooperation.

M, I really do have a good feeling about this, and I would not say that if I truly didn't.  You've been through hell and back with this.  Don't give up.  Get ready to wow the judge with all your disabilities (lol).  Really, keep pushing on.  You'll get there.  :-*
I've never killed anyone, but I frequently get satisfaction reading the obituary notices.-Clarence Darrow

Offline mitch777

  • Member
  • Posts: 3,523
Re: ssdi appeal question...
« Reply #111 on: Yesterday at 11:34:01 PM »
Thank you Brit. You have been one of my earliest supporters in this thread and it tickles me pink to know that you still follow my adventure after this much time has passed. That goes for the rest of you too.

 
M, I really do have a good feeling about this, and I would not say that if I truly didn't.  You've been through hell and back with this.  Don't give up.  Get ready to wow the judge with all your disabilities (lol).  Really, keep pushing on.  You'll get there.  :-*


Betty,

It's good to know how confident you are. Yep. Wow him. lol. Maybe I need to get my hair thinned by 80% and turn the rest gray just for affect. lol. Thanks sweetums.
31 years hiv+ (oct. 2013) with a curtsy.

Offline bmancanfly

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  • Posts: 578
  • Medicare For All !
Re: ssdi appeal question...
« Reply #112 on: Today at 09:11:41 AM »
Maybe I need to get my hair thinned by 80% and turn the rest gray just for affect. lol. Thanks sweetums.

Whatever it takes.  Maybe show up looking like Tim Conway's old man in the Carol Burnett Show.   ;)   I hope it gets resolved favorably soon.  What an ordeal they put you through -  it's really a shame.

You mentioned earlier that you were discouraged from applying  because you were self employed.  I'm curious why that would matter.
"The trouble with the world is that the stupid are cocksure and the intelligent are full of doubt."

 Bertrand Russell

Offline mitch777

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  • Posts: 3,523
Re: ssdi appeal question...
« Reply #113 on: Today at 12:20:05 PM »
Whatever it takes.  Maybe show up looking like Tim Conway's old man in the Carol Burnett Show.   ;)   

You mentioned earlier that you were discouraged from applying  because you were self employed.  I'm curious why that would matter.

lol and thanks!

I'm not sure. Nobody was willing to ever explain why. The SSA doesn't care about income as long as it's unearned income. It seemed strange at the time and still does.
31 years hiv+ (oct. 2013) with a curtsy.

 


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