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Author Topic: ssdi appeal question...  (Read 14903 times)

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Offline mitch777

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ssdi appeal question...
« on: September 10, 2012, 09:07:10 PM »
hi,

just worried that i may have to appeal the first "normal" rejection notice from SSDI.

anybody know of any statistics in regard to the success rate of appeals?

feeling kinda rotten lately as well.
probably due to the stress of the process.

thanks,
mitch

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

Offline nycpoz33

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Re: ssdi appeal question...
« Reply #1 on: September 10, 2012, 10:07:57 PM »
Not sure of specific numbers, but know from personal experience the odds of having your appeal approved increase dramatically with legal representation.  If you dont have representation currently, get some immediately.

Offline tednlou2

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Re: ssdi appeal question...
« Reply #2 on: September 10, 2012, 11:27:12 PM »
Without looking up the stats, it seems I remember reading that something like 80% are denied on the first round.  And, somewhere near that on the first appeal.  Most have to go before a judge.  I honestly think they have a quota, purposely trying to deny most in hopes they will give up.  That's just my opinion.  Because, the people who I've known who went before a judge had nothing change in their medical situation.  So, it makes me wonder why they got denied twice, but got it when they went before a judge.  Perhaps the judges have more compassion?  I've read that most who go before a judge are often successful. 

Again, I'm just going on memory here and personal experiences.  I think it also depends on the state you live in.  I know some say it is easier to get here in KY than IN, for example. 

And, I've read that it is very important to have legal representation, when you go before a judge.  Having said that, I know someone who appealed the fee his lawyer got, which was $6,000.  When he got his approval letter, it gave instructions how you could appeal the lawyer fee.  He appealed, because his lawyer didn't do anything.  He got all his medical records--actually going to the doctors and hospitals.  His lawyer met with him once and didn't prep him.  His lawyer did send some assistant on the court date, but he said he did all the talking, while the legal rep just sat there.  So, the judge ordered that his lawyer had to forfeit $3,000 back to him.       

Offline britchick

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Re: ssdi appeal question...
« Reply #3 on: September 11, 2012, 01:35:55 AM »
mitch777

Best wishes with your appeal.Please come back and let us know what happens.Im also appealing in the UK.

Yes it is really stressful but will be worth it.

Britchickx

Offline darryaz

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Re: ssdi appeal question...
« Reply #4 on: September 11, 2012, 09:53:00 AM »
Check with your ASO.  Mine has a Legal Aid attorney working with them who helps their clients through the application and appeals process.

Offline mitch777

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Re: ssdi appeal question...
« Reply #5 on: September 11, 2012, 10:35:18 AM »
Thanks for the support!

Was pretty tired last night when I posted this and should have given a bit more backround info.

I did hire a lawyer from the beginning. She seems to have a good feeling how this is going but I have lots of doubts. (always wondered myself if they have some sort of quota to keep as many people as possible off of SSDI)

Poz for 30 years next month and on meds for 17 years.
Counts are "good".
Other health issues are exhaustion, weakness in limbs, inability to concentrate, forgetfullness, and daily pain from headaches since March of 2011.
(sorry to bore those of you who have heard me describe all this before)

My ID doctor is very supportive but said they probably won't give me dissability based solely on my HIV status.
He is hopeful that all of my combined issues will make the difference.

We will see...
Off to my appointment.
Will give you my impression when I return.
(think it might be helpful to others in my situation)

thanks again.
32 years hiv+ (oct. 2013) with a curtsy.

Offline mitch777

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Re: ssdi appeal question...
« Reply #6 on: September 11, 2012, 10:38:45 AM »
oops,

forgot to mention the appointment today is for some sort of neurocognitive test required by the SSDI office.

sounds like fun!
32 years hiv+ (oct. 2013) with a curtsy.

Offline mitch777

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Re: ssdi appeal question...
« Reply #7 on: September 11, 2012, 01:52:59 PM »
OK,
Back from the test.
Turned out to be a short IQ test.
I did well with the cognitive portion but think I did poorly on the memory portion.

I think the concept is that the State wants to see how well the results match the information that I have already submitted to them.
(at least that's what the shrink said)

While I believe my results will match well, she also hinted that the State is getting pretty picky these days.

Just need to hope for the best and prepare for an appeal of their decision if it comes to that.

I will keep you updated as I know this information might be helpful to others.

Mitch
32 years hiv+ (oct. 2013) with a curtsy.

Offline mitch777

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Re: ssdi appeal question...
« Reply #8 on: September 27, 2012, 04:13:48 PM »
update...
ugh! denied as i kind of expected but am still frustrated with the process.
energy and stress dealing with an appeal does not make me a "happy camper".

the ssdi people can say that i am able to work until they turn blue in the face but it does not in any way change what is real.

spoke to my lawyer and on we will go to appeal. i don't really have any additional medical issues than what was submitted the first time so am wondering what it is going to take on the second go-round to alter their decision???

maybe just dealing with a more open minded person at a higher level?
luck?
hmmm...

mitch
32 years hiv+ (oct. 2013) with a curtsy.

Online intaglio

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Re: ssdi appeal question...
« Reply #9 on: September 28, 2012, 10:53:40 AM »
I went through SSDI back in 1999 due to an auto accident/TBI. It took three years and a lawyer to obtain it for me.

The only thing I can add here is that your US senator should have a Social Security advocate working for him/her. Mine did and he helped move the process along.

SSA will send you out letters with timelines indicated. They'll say something like "...you should receive a response in 90 days, etc...." On day 91, you ring up the SS advocate and say "I haven't heard from SSA within the timeframe they said they'd respond." I guarantee you'll have a response within a couple of days.

I was lucky my US senator's office was in the same city I resided in. I had to take the letters to the office so the SS advocate had the documentation he needed when he contacted SSA.

My problem was that I'd wait -and wait -and wait for a response. I found out that if they haven't responded within their timeline, you have to speak up immediately.

SSDI is not designed to help you get disability. It is designed to find ways to disqualify you.

When you get in front of the judge, be honest, but also do not admit you could "maybe do a little work" etc. I was asked point-blank if I thought I could sit in front of a tv screen and watch it for criminal activity. I answered honestly that I could probably do it for about 20 minutes before my "dain brammage" would cause me to totally space out or my anxiety (due to cognitive issues related to the dain brammage) would cause me to flee my post. Basically all my statements had to show I could not do any sort of productive work consistently or for any significant amount of time.
Reality is frequently inaccurate.

Offline mitch777

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Re: ssdi appeal question...
« Reply #10 on: October 09, 2012, 06:00:07 PM »
thanks intaglio.
i tried the congressman route and got a pretty cold shoulder.

i am now seeind a psychiatrist to help document depression, anxiety, fatigue issues and have studied up further on the SSDI detailed requirements which are still kinda vague.

hope by being specific on my appeal by referring to the SSDI "rules" and a doctor to confirm my limitations, we will get past this road block.

what a chore! grrr...

mitch
32 years hiv+ (oct. 2013) with a curtsy.

Offline mitch777

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Re: ssdi appeal question...
« Reply #11 on: November 28, 2012, 08:20:19 AM »
update on my ssdi appeal...

my lawyer got the medical reports from the ssdi to see why i was turned down on the first attempt.
my docs were all helpful EXCEPT the shrink that ssdi sent me to for a "short IQ" test.
hmmm.....
a 15 minute visit repeating 4 words, saying 487 in reverse order, and other silly questions made her somehow come to the conclusion that i was able to work. >:(

my current psychiatrist laughed. :)

now it is "sit and wait" to see how they will be responding to my appeal.
so much fun. :P
32 years hiv+ (oct. 2013) with a curtsy.

Offline osric

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Re: ssdi appeal question...
« Reply #12 on: December 14, 2012, 07:48:59 PM »
i just got my 2nd SSDI denial letter this week and enlisted a lawyer at my ASO to review my case and make sure i'm prepared when i go before the judge. i think there's lots of material missing from what SSI has reviewed, and I've had changes in my condition (worse) since the last appeal so my lawyer is hopeful... we shall see...

Offline synergyhomepage

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Re: ssdi appeal question...
« Reply #13 on: December 14, 2012, 08:36:53 PM »
     Just want to lend my support.....  I am  waiting now for my ALJ Hearing in April and I know how stressful this process can be.  I have found one webisite with lots of helpful info,I can IM it if you like, not many HIV/AIDS cases in thier forums but overall the content has been very informative and helped me understand the process.  And the experts they have can answer your questions.


Offline mitch777

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Re: ssdi appeal question...
« Reply #14 on: December 14, 2012, 08:50:55 PM »
hey osric and synergy,

thanks for keeping this thread alive.
it is important to so many people (me too).

any help would be SO appreciated!

best of luck (it really should'nt even need luck) to both of you.

seems like the ssdi looks at hiv as a pill popping manageable disease these days.
so frustrating and sad. :(
32 years hiv+ (oct. 2013) with a curtsy.

Offline synergyhomepage

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Re: ssdi appeal question...
« Reply #15 on: December 14, 2012, 09:06:20 PM »
This site has been most helpful and informative.  http://ssdfacts.com/ 8)

Offline scotty54

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Re: ssdi appeal question...
« Reply #16 on: December 14, 2012, 11:20:56 PM »
Sit tight and hang in there.  I read that the stats go up quite positively on the second appeal.  I know the stress is a bitch.  It took me a little over a year and had very supportive docs.  Best---
I may not agree with you, but will always defend your right to disagree.

Offline mitch777

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Re: ssdi appeal question...
« Reply #17 on: January 18, 2013, 08:33:51 PM »
This site has been most helpful and informative.  http://ssdfacts.com/ 8)

sorry for such a very sluggish reply Scotty and Syn!
kinda blocked this thread out of my mind to ease the stress involved.
thanks for the kind words and support.

Syn, the link you provided is AMAZING!
ton's of stats that can provide a great overview of acceptance rates and very specific as well.
need to study it further and discuss with my lawyer.

Just filled out the same lenghthy 8 page detail oriented questionaire that I originally filled out on the initial attempt for SSDI.
Ugh!
New issues to add since last May, so am keeping my fingers crossed that it goes through this time.
I am feeling pretty beat these days and it gets exhausting jumping through these hoops. :(

Thanks again!
m.
32 years hiv+ (oct. 2013) with a curtsy.

Offline synergyhomepage

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    • Valley Aids Information Network
Re: ssdi appeal question...
« Reply #18 on: January 18, 2013, 08:59:12 PM »
Mitch


Glad it helped.  I've been going thru this for over a year and learn little things hear and there,  the greatest of which is medical evidence.  I to have neuropathy in my arms and legs, have been talking to my ID Doc about it and to my PCP, but finally realized i should see a neurologist for proper documentation.  Called my PCP and asked for a referral. Hoping it happens soon as my hearing is in 3 months. 

Question, you said that your numbers are good, but have you ever dropped below the magic number of 200 and been classified as Aids?  Would be great if you have not, but it would make meeting the listing requirements easier. 

BTW- I appreciate your normal headedness (is that a word) hear on the forums.  With so much yelling and screaming going one occasionally it is nice to see some just take it in stride and live to survive :)  Best of luck.

Offline mitch777

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Re: ssdi appeal question...
« Reply #19 on: January 18, 2013, 09:37:21 PM »
Mitch


Glad it helped.  I've been going thru this for over a year and learn little things hear and there,  the greatest of which is medical evidence.  I to have neuropathy in my arms and legs, have been talking to my ID Doc about it and to my PCP, but finally realized i should see a neurologist for proper documentation.  Called my PCP and asked for a referral. Hoping it happens soon as my hearing is in 3 months. 

Question, you said that your numbers are good, but have you ever dropped below the magic number of 200 and been classified as Aids?  Would be great if you have not, but it would make meeting the listing requirements easier. 

BTW- I appreciate your normal headedness (is that a word) hear on the forums.  With so much yelling and screaming going one occasionally it is nice to see some just take it in stride and live to survive :)  Best of luck.

Geez,
i'm surprised that your ID doc couldn't produce medical evidence.
So, you are on round 3?
Your 1st appeal was denied?
Any different reason for denial on the second go round?
Sorry for all of the questions.
I hope this works out for you!

fortunately, on your question on the cd4 count, i think the lowest i was ever recorded was around 250.
that was about 18 years ago. been pretty steady in the 500-700 count range for years with undetectable viral load.

just being + for 30 years and a couple of decades of pill popping to control the bugger can take a toll that the "numbers" don't reflect. :(
it's real. it is impossible to prove fatigue via a blood test. it's difficult to prove most of my issues.
my biggest hope is because i added a psychiatrist since the original filing and she is completely supportive.

thank you for your kind words.
you seem pretty normal headedness too! :)
32 years hiv+ (oct. 2013) with a curtsy.

Offline synergyhomepage

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    • Valley Aids Information Network
Re: ssdi appeal question...
« Reply #20 on: January 18, 2013, 09:49:51 PM »


My ID Doc has had his hands full, when a came to him just under a year ago my CD4 was 2 yep two, of course there is a small margin of error in that number and my VL was 1.7 Million.  I had 3 different OI's and we are still working on the basics here.  Currently have a CD4 of 158 and VL is about 60.  Just changed meds, and after a month no change, going to check it again in 2 months and see if I am UD. 


I'll be 43 this year
In Oregon I applied (online by myself) was denied
Applied for reconsideration (online by myself) was denied
Got an attorney and applied for a hearing with an ALJ.

My age it the biggest thing against me, if I were 55, I would have been approved on the first go round my attorney said.  Having AIDS has classified my case as a TERI (terminal illness) and is bieng processed and handled as fast as they can.  Which isn't fast but fasteter by far than normal.  I started the process in April of Last year and will have my hearing in April of this year. 

Offline mitch777

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Re: ssdi appeal question...
« Reply #21 on: January 18, 2013, 09:58:10 PM »

My ID Doc has had his hands full, when a came to him just under a year ago my CD4 was 2 yep two, of course there is a small margin of error in that number and my VL was 1.7 Million.  I had 3 different OI's and we are still working on the basics here.  Currently have a CD4 of 158 and VL is about 60.  Just changed meds, and after a month no change, going to check it again in 2 months and see if I am UD. 


I'll be 43 this year
In Oregon I applied (online by myself) was denied
Applied for reconsideration (online by myself) was denied
Got an attorney and applied for a hearing with an ALJ.

My age it the biggest thing against me, if I were 55, I would have been approved on the first go round my attorney said.  Having AIDS has classified my case as a TERI (terminal illness) and is bieng processed and handled as fast as they can.  Which isn't fast but fasteter by far than normal.  I started the process in April of Last year and will have my hearing in April of this year.

wow. 2 eh?
looks like your numbers are looking alot better! :)
sometimes it takes awhile for cd4 counts to rebound.
sounds like the timing of our cases isn't too different.

please keep me/us up to date with your progress and best of luck to you as well!
32 years hiv+ (oct. 2013) with a curtsy.

Offline mitch777

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Re: ssdi appeal question...
« Reply #22 on: March 30, 2013, 12:07:57 PM »
The sad update...

Just picked up the mail this morning to find another rejection letter from the SSA in regards to my disability claim. :( >:(

They acknowledge that I am partially disabled and am not able to return to work at my previous job.
Here is their description of what they think I am capable of:

"we have determined that you can perform work at the light level of exertion - lifting 10 lbs frequently and standing/walking 6 hours in an 8 hour workday - that is easy to learn and does not require complex tasks or frequent contact with others."

hmmm.... ::)

I am bummed out.
I am not giving up and will continue to appeal to a judge. (round 3)

The waiting list in CT (the last time I looked) was 12-13 months from where I am now to the point of a hearing. :(
The upside to waiting that long is that I will be 55 years old on 3/21/14 and they have different standards for us old people in regards to their expectations of finding new work.

While I am upset with today's news, it didn't surprise me.
Few people get accepted during the first appeal but the statistics show that the majority who get to the hearing stage win their case.

A VERY slow and frustrating process.
Ugh!
32 years hiv+ (oct. 2013) with a curtsy.

Online Jeff G

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Re: ssdi appeal question...
« Reply #23 on: March 30, 2013, 01:24:58 PM »
Mitch , I'm sorry you are getting to run around ... its tough buddy .

Offline britchick

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Re: ssdi appeal question...
« Reply #24 on: March 30, 2013, 05:44:14 PM »
I sometimes think the system wants us to give up.Im so glad that you  will keep fighting.I had a 8 to 9 month battle re DLA here in the UK.

Im thinking of you and please keep up that fight

Britchick xx





Offline mitch777

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Re: ssdi appeal question...
« Reply #25 on: March 30, 2013, 06:24:05 PM »
Thanks Jeff and britchick,

Your support helps more than you know.

The idea of collecting more medical data for another year is NOT fun.
Life goes on.

Oh,...
I checked online for the current data on approval rates in CT at this stage of the process.

Over 85% approved. :)
Guess it takes a person to person experience for the SSA to get it. ::)
32 years hiv+ (oct. 2013) with a curtsy.

Offline bmancanfly

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Re: ssdi appeal question...
« Reply #26 on: March 30, 2013, 10:59:00 PM »
Sorry they're giving you such a hard time Mitch.  It sounds terribly frustrating,  especially when you're not feeling well.

Hope it all works out in the end.  Hang in there.
"The trouble with the world is that the stupid are cocksure and the intelligent are full of doubt."

 Bertrand Russell

Offline BT65

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Re: ssdi appeal question...
« Reply #27 on: April 03, 2013, 05:03:36 AM »
From what I've read, SSA does not have a lawyer at a disability hearing to disprove someone's disability.  Where you would have one proving your disabilitiy.  Apparently the judge is the one who asks the questions regarding the disability.  I think that really improves chances.  And I believe people who really are disabled are the ones who are willing to get it to that level.  Sorry it's taking so long for you.  Hopefully it will all pay off.

Betty
I've never killed anyone, but I frequently get satisfaction reading the obituary notices.-Clarence Darrow

Offline mitch777

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Re: ssdi appeal question...
« Reply #28 on: April 03, 2013, 07:26:50 AM »
Thanks bman and Betty!

I just found out yesterday that they (SSA) didn't get a report from one of my doctors explaining that I sometimes am too tired and weak in the legs to stand more than 15 minutes. >:(
The report was faxed to them on 1/31/13 and the denial letter was dated 3/28/13.
That one report may have been enough to put me over the top.
Now, possibly due to that screw-up, I've got to wait another year to see a judge.

All of the support helps me keep my determination strong to keep plodding forward. :)
32 years hiv+ (oct. 2013) with a curtsy.

Offline Habersham

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Re: ssdi appeal question...
« Reply #29 on: May 04, 2013, 12:16:54 PM »
Hey I myself have been on SSI for two years but the standards are about the same.

Social Security will send a representative to the hearing but their task is to see that people receiving it qualify. They won't specifically argue against you. I believe the figures are 60% are turned down the first time but 80% that go to trial are approved.

There was a show on NPR recently that cited the exact numbers and was quite amusing. It talked about that there aren't many jobs out there that were you don't have to stand.

Good luck and here's the link!

http://apps.npr.org/unfit-for-work/
Because I Can

Offline mitch777

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Re: ssdi appeal question...
« Reply #30 on: May 05, 2013, 09:11:56 AM »
Thanks Habersham!

I have read similar statistics and am hopeful for a good outcome after my hearing.

The link you provided was an eye opener as far as the "new safety net", the huge increase in applicants, and the reasons behind it.

Shocking to see 1 in 4 people are on disability in Hale County, Alabama.
I was expecting the article to suggest the major reason was fraud (although I know it happens), but the reality is more complex than most understand.

Thanks for the info and best wishes. :)

m.

PS- Welcome to the forums! :)
32 years hiv+ (oct. 2013) with a curtsy.

Offline Reishi

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Re: ssdi appeal question...
« Reply #31 on: May 16, 2013, 01:50:08 AM »
Mitch, I'm sorry to hear you're having such a hard time.  Don't despair.  I think the third time's a charm.  Plus, like you said, once you turn 55, that should help your case.

I currently have an SSI / SSDI claim pending, but I'm 20 years younger than you, so I know my chances of getting approved are slim.  I kept delaying the application process because I was too exhausted & fatigued to get through it all.  I was sleeping for 12 hours a day.

The SSA seems completely backwards as far as who gets approved & denied.  People with a vague physical complaint, like "a bad back", seem to get approved every time, while those who are literally at death's door get denied.  I also meet tons of young people who feign mental illness in order to qualify for SSI (many of whom squander their benefits on recreational drugs).

It's just sickening.  The undeserving people seem to have no problem getting on the dole while deserving people are left out in the cold.  Anyway, enough of my rant.  Just wanted to say hang in there.  Don't give up hope.

"Perseverance, secret of all triumphs."  ~  Victor Hugo

Offline darryaz

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Re: ssdi appeal question...
« Reply #32 on: May 16, 2013, 08:43:17 AM »
I listened to a spot on NPR about the lax standards for SSDI approval in Alabama.  A bit frustrating for those of us who live in states with stricter requirements.

I get the impression that lax standards add a layer of stigma to being on disability.  Since it's so easy to get approved it's equated with laziness, at least in that state.

Offline BT65

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Re: ssdi appeal question...
« Reply #33 on: May 16, 2013, 01:10:08 PM »
Darry, I also read the NPR article.  Very interesting.  I can honestly say in this area people on disability abound.  Now, I am not the disability police or judge.  I've been on it due to neurological dysfunction secondary to aids, plus getting on in the first place for being on death's door due to wasting back in the very early 90's.  And now I am a case manager at an ASO and have a couple of clients I wonder about.  One of them receives SSI, yet can go out and roof all day, 5 days a week, for cash.  Which of course is a very physically demanding job.  But he spends his money on crack.  As I said, I'm not the disability police but sometimes it does get frustrating. 

Like my neighbor in the middle apartment where I live.  She's not positive, but does have COPD so needs disability.  But, in the last month she's had Comcast cable, AT&T U-verse, and now there is Dish network hooking up her satellite.  She gets SSI so has not worked to get enough work credits.  And her daughter is with a man, they have two children and neither work.  The man's sister supports them. And the daughter is pregnant again.  But that's generational poverty, where a person really never pulls out of the effects of their childhood concept of how to get by in the world; totally on the system and generosity of others. 

Frustrating, but I believe people make bad decisions no matter what their money source is.  I totally agree there are people who just do not want to work who feign severe mental illness to get approved quicker, since people know it's easier to get approved for mental reasons than physical.  I'm glad I don't make those decisions.  But what can you do.  I just hope the people in this thread who truly deserve disability, like Mitch, get approved, which should have happened long ago.
I've never killed anyone, but I frequently get satisfaction reading the obituary notices.-Clarence Darrow

Offline Reishi

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Re: ssdi appeal question...
« Reply #34 on: May 16, 2013, 04:31:26 PM »
Just today, I received a packet of forms which I have to fill out and mail back to Kentucky.  It already sounds like they're trying to downplay my ailments.  Arthritis is listed as "pain".  I find it disconcerting that I see no mention of my HIV status anywhere.  I think that detail is pertinent.  If 75% of your immune system is destroyed, it's only natural you'll experience fatigue (among other things).

I get the impression that California is one of those states with lax standards.  (I live there, so I speak from experience.)  Another vague ailment which seems to get people approved is chronic fatigue syndrome.  A deaf guy I know gets SSI, which doesn't seem fair because deaf people can work.  They can be computer programmers, web designers, accountants, etc.  There are a myriad of jobs that don't require hearing.

It's astounding to me they would deny anyone with AIDS, which is life threatening, yet approve someone for being deaf, which is not life threatening.  Like I said, it's so backwards.

Offline Buckmark

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Re: ssdi appeal question...
« Reply #35 on: May 16, 2013, 04:59:44 PM »
Just today, I received a packet of forms which I have to fill out and mail back to Kentucky.  It already sounds like they're trying to downplay my ailments.  Arthritis is listed as "pain".  I find it disconcerting that I see no mention of my HIV status anywhere.  I think that detail is pertinent.  If 75% of your immune system is destroyed, it's only natural you'll experience fatigue (among other things).

I get the impression that California is one of those states with lax standards.  (I live there, so I speak from experience.)  Another vague ailment which seems to get people approved is chronic fatigue syndrome.  A deaf guy I know gets SSI, which doesn't seem fair because deaf people can work.  They can be computer programmers, web designers, accountants, etc.  There are a myriad of jobs that don't require hearing.

It's astounding to me they would deny anyone with AIDS, which is life threatening, yet approve someone for being deaf, which is not life threatening.  Like I said, it's so backwards.

It's a slippery slope when you start questioning who should and should not get approved for disability.  It *should* be all about whether or not your ailment prevents you from working.  There are those who say that there are people with HIV or AIDS who are able to work and shouldn't receive disability.  And in some cases, they would be right.   But generalizing about other groups of people, the impact of their ailments, and throwing around terms like "vague ailment" doesn't really help your situation, does it?

"Life in Lubbock, Texas, taught me two things:
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Offline BT65

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Re: ssdi appeal question...
« Reply #36 on: May 16, 2013, 05:45:26 PM »
It's a slippery slope when you start questioning who should and should not get approved for disability.  It *should* be all about whether or not your ailment prevents you from working.  There are those who say that there are people with HIV or AIDS who are able to work and shouldn't receive disability.  And in some cases, they would be right.   But generalizing about other groups of people, the impact of their ailments, and throwing around terms like "vague ailment" doesn't really help your situation, does it?

This is very true.  It's all about whether or not someone can perform what SSA determines as "SGA" or "substantial gainful activity."  Which, this year, means making above $1040/month.  So, after someone is approved, he/she can get a job and make up to that amount and sitll keep the SSDI, which is not the same rule for SSI.  Of course these have been discussed.

Different people can handle different situations, and all differently.  What can baffle one, another can master.  While someone can do one job, another one may never be able to.  One of our clients at the ASO I work at is blind, plus being a LTS'er of AIDs, but still goes and washes dishes at this college, in their cafeteria.  She's amazing-she is totally independent.  I picked her up one time and she was dressed beautifully, hair all in the right places.  I asked her how she can tell which clothes to wear, and she said by the feel.  She lost her sight due to CMV years ago, and her husband died from AIDS.  I've known her for a long time, long before I worked at the ASO.  And she's conquered much.  Yet, another person in this situation may not be able to handle all the issues this woman does.  Who's to judge?  This is why I said I am not the disability police.

However, I do understand frustration about not being able to obtain what we feel is rightfully ours when we can see some people get it without much effort; people we don't believe deserve it.  Like I said, I know a couple people who really could work, but have other issues like drug addiction.  Although can perform work for cash.  But I'm not in their head, so I have no clue as to what they contemplate, except how to get more crack lol. (seriously, and I can say that since I'm a drug addict, though sober). 
I've never killed anyone, but I frequently get satisfaction reading the obituary notices.-Clarence Darrow

Offline mitch777

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Re: ssdi appeal question...
« Reply #37 on: May 17, 2013, 12:18:05 PM »
People have been commenting to me (not on the forums) about this SSDI process and about how frustrating it must be for me to see other "less deserving" applicants get approved easily.
I really don't put too much energy into that way of thinking.
Fraud happens in every area of the government.
Those who commit the fraud will need to live with themselves and the government, well,....uh...., they buy $8495.00 screwdrivers.
I DO know that I would not want to be a judge at a hearing deciding who is eligible.

My biggest fear is that the judge will pay more attention to my appearance than my reality.
Physically, in long pants at least :), I look like a pretty healthy guy.
hmmm...
that gives me an idea...
maybe I should show up at the hearing in a speedo. :)
If my body shape doesn't scare him/her, he/she would definitely have to think twice about my state of mind.

Anyway,
I have an appointment with my attorney this afternoon to fill in all of the info needed for the appeal.
(my attorney has been very slow :(.)

It looks like it will now take until June or July of 2014 for my hearing. ::)
 
There have been many reports lately about vets having to wait 3,4, or 5 years.
Very sad.

Just got to keep pressing onward.
32 years hiv+ (oct. 2013) with a curtsy.

Online Jeff G

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Re: ssdi appeal question...
« Reply #38 on: May 17, 2013, 02:01:39 PM »
Maybe you could send Miss P in after one of his 3 day klonny binges ... you might even get more money and access to his ryan white goverment cheese of the month club .   

Offline Miss Philicia

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Re: ssdi appeal question...
« Reply #39 on: May 17, 2013, 04:21:36 PM »
I'm sure I was on a klonnie comedown post-binge when I went to the SS office in downtown Crooklyn, and I'm sure I looked a royal mess -- emaciated and unshaven, reeking of AIDS.

I also think that I ate at the Wendy's around the corner on Fulton Street afterwards. And please -- government cheese. Indeed I would have been eating that at the time because they'd put me on food stamps while I waited for approval. Oh how the mighty had fallen by that time. And to think just before that I had headhunters calling offering 6-figure salaries.

I also recommend not showering for at least five days, no deodorant, and spritzing yourself with urine. This is about creativity, and some of us have it, and some of us don't. You know, I didn't get my art degree by being lazy.
« Last Edit: May 17, 2013, 04:33:53 PM by Miss Philicia »
"Iíve slept with enough men to know that Iím not gay"

Offline darryaz

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Re: ssdi appeal question...
« Reply #40 on: May 17, 2013, 10:47:43 PM »
I also recommend not showering for at least five days, no deodorant, and spritzing yourself with urine. This is about creativity, and some of us have it, and some of us don't. You know, I didn't get my art degree by being lazy.

Isn't that also how Ted Nugent avoided the draft?

http://gawker.com/5983634/patriotic-american-ted-nugent-shit-his-pants-to-avoid-the-draft

Offline Oceanbeach

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Re: ssdi appeal question...
« Reply #41 on: May 19, 2013, 09:00:50 PM »
Hey Mitch,

I don't understand... You have been poz for 30 years and how could a government clerk expect you to return to work?  I asked the Social Worker at our clinic a few years ago... "What will happen if same sex marriages become legal in California and I marry a lawyer who makes hundreds of dollars per hour?"

Her response was, I would always have my SSDI and Medicare for life because AIDS is my diagnosis, the reason I am disabled.  She added my state aid and my ADAP would be eliminated because his income would be calculated with mine.  It has been 17 years and the federal government has no sense of humor that they are aware of.   8)  Have the best day
Michael

Offline mitch777

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Re: ssdi appeal question...
« Reply #42 on: May 20, 2013, 09:09:56 AM »
Hey Mitch,

I don't understand... You have been poz for 30 years and how could a government clerk expect you to return to work? 

LOL!
I guess I look like a "picture of health" to them "on paper".
Haven't you heard Michael? HIV is a "manageable" disease and we just need to suck it up, engage in life, and get to work! ;)
Infected for 30+ years? Yes. Able to work? No.

I asked the Social Worker at our clinic a few years ago... "What will happen if same sex marriages become legal in California and I marry a lawyer who makes hundreds of dollars per hour?"

Her response was, I would always have my SSDI and Medicare for life because AIDS is my diagnosis, the reason I am disabled.  She added my state aid and my ADAP would be eliminated because his income would be calculated with mine.  It has been 17 years and the federal government has no sense of humor that they are aware of.   8)  Have the best day
Michael
Yup, the logic of the federal government in regards to marriage and benefits is why we would not get married.

m.

PS- Maybe down the road a bit, those who have not taken some of the older meds from the 1980's-mid 90's and who kept the virus UD will be working beyond the 30 year hiv+ point.
It just seems to me that irreversible damage has occurred with me and the "medical proof" is elusive.
I'm not sure if there is scientific evidence available in cases like mine that the SSA would deem admissible and pertinent.
« Last Edit: May 20, 2013, 09:31:42 AM by mitch777 »
32 years hiv+ (oct. 2013) with a curtsy.

Offline RedBear

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Re: ssdi appeal question...
« Reply #43 on: May 20, 2013, 11:36:15 AM »
Hey Mitch,  I worked for an Social Security Atty. early in my career.  While it is true that a second denial may be inevitable.  However keep steadfast in your pursuit.  I don't know what state you are in and are scheduled for a hearing, most people are approved.  In some states they have what is called an Adjudication Officer.  If you fit at least two of the criteria according to the Code of Federal Regulations (CFR) disability they can fast track your case.  I know that they were going to tighten up the guidelines for those with HIV.  Some tips for you.  You must have documentation of your symptoms.  So every time you go to the dr. Be sure to tell them about your symptoms, i.e. fatigue, inability to do household chores, depression that incapacitated your ability to leave the house.  Documentation is the number one thing they look for and your doctor will document everything you tell him, so never say things like I went and partied with friends or took pleasure trips...you'd be amazed how many times I've read medical records with things in the record,yet they are claiming disability.  Another good flag for disability is lack of or ability to perform in the bedroom.  Be sure to tell your doctor this....if you live in Alabama, I know a wonderful law firm; Charles Tyler Clark and associates.  They also have a program there to try to fast track applications; Paid On Record, where an assistance scoures your records and basically points this out stating that according to their own CFR, is how you are disabled,basically they are doing the work for the Social Security Office. If you have already acquired an Atty. ask as to whether their firm have people who works with an Adjudication Officer or have people who write Paid On Record cases.  It is also helpful if you can get your own medical records and give to the firm, it speeds up the process...it takes forever for firms to get the records as they get hundreds of requests daily for same.  That all being said, lately it seems to me that it is basically a numbers game...I was very 'lucky' if you will, that I ended up in the hospital with PCP.  The social workers there filed the paperwork for me and sent the records along.  My T cell count was 4 and viral load over 5,000,000 and nearly died.  But with their help I was approved within 6 months...the waiting period showing that you are unable to perform SGA.  I'm now at UD for viral load and my T cell count is 456, but it fluctuates.  I have good days and bad...mostly anxiety and presently my dentist is watching an area in my mouth that may be Oral KS...it's always something,shingles, infections, etc.  So please if you have any questions feel free and ask me...I can tell you what to say on the forms to hopefully expedite your case...remember big ones are depression, lack of sex, and fatigue...I cannot stress this's enough.   Good luck and let me know if I can help!
Finish each day and be done with it.  You have done what you could.  Some blunders and absurdities have crept in; forget them as soon as you can.  Tomorrow is a new day.  You shall begin it serenely and with too high a spirit to be encumbered with you old nonsense. 
                              Emerson

Offline Reishi

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Re: ssdi appeal question...
« Reply #44 on: May 26, 2013, 01:51:07 AM »
@ Buckmark -  I totally get what you're saying and that did cross my mind.  I didn't mean to sound judgmental, but the reason for my jaundiced view is that I had close relatives with severe disabilities.  There was no doubt they were disabled because their impairments were clearly visible to the naked eye -- amputated limbs, confinement to a wheelchair, that sort of thing.  So I feel slightly resentful when someone who doesn't appear that disabled on the surface is getting the same benefits.  But as BT65 eloquently stated, it's not our place to judge.  We're on the outside looking in, so we never know what issues a person has to deal with.

@ BT65 -  Very well said.  Whenever I see people worse off than myself accomplishing more, it makes me feel guilty and then I force myself to be more productive.

RedBear  said what I was thinking.  It would probably be helpful to emphasize depression and fatigue, and also neuropathy, if there is any. 

Offline mitch777

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Re: ssdi appeal question...
« Reply #45 on: August 15, 2013, 08:26:42 PM »
update...
I had a physical functional test that I was sent to from my ID doc about 6 weeks ago. Didn't really know how well/badly I did until today.
Guess I failed with flying colors! :)
Finally, some objective medical proof!!!
The doc involved was so understanding and supportive. He said that the results of the test and his report would qualify me for disability. It's still a long wait for the ALJ hearing but today's news did wonders for my spirit.
 :)
m.
32 years hiv+ (oct. 2013) with a curtsy.

Offline BT65

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Re: ssdi appeal question...
« Reply #46 on: August 16, 2013, 04:38:01 AM »
That's great news Mitch!  How long has it been, since you first applied, until now, then until the hearing will happen?
I've never killed anyone, but I frequently get satisfaction reading the obituary notices.-Clarence Darrow

Offline darryaz

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Re: ssdi appeal question...
« Reply #47 on: August 16, 2013, 09:55:17 AM »
That's great news.  Glad there's finally light at the end of the tunnel!!!

Offline wolfter

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Re: ssdi appeal question...
« Reply #48 on: August 16, 2013, 10:09:42 AM »
Hope it doesn't appear wrong to congratulate someone for failing at anything, but congrats! ;)
Complacency is the enemy.  ;)  Challenge yourself daily for maximum  return on investment.

Online Jeff G

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Re: ssdi appeal question...
« Reply #49 on: August 16, 2013, 10:24:07 AM »
Congrats Mitch ... in our world of living with HIV a horrible lab result can be a reason to rejoice sometime , bizarre but true .

In all seriousness , I'm sorry you have had to fight so hard for disability , its something you already earned . I hope both the income and diagnosis bring you comfort .

Offline britchick

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Re: ssdi appeal question...
« Reply #50 on: August 16, 2013, 10:32:27 AM »
mitch777

Im so glad that you are getting the assistance from your doctor re SSDI.I know its a long ,painful process, but you didn't give up ..so well done !

britchickx

Offline mitch777

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Re: ssdi appeal question...
« Reply #51 on: August 16, 2013, 10:34:31 AM »
Thanks Betty and Darry,

I applied originally in May 2012, turned down in September and appealed, turned down again in March 2013. Filed the appeal to the ALJ in May. The waiting list at the time was approx. 12-13 months so my guess is that I will still be waiting until June or July of 2014.
I think I will get approved but hope the judge doesn't come back with an offer to reduce the back pay. I've heard they do that sometimes. Seems unfair to say "I'll grant your disability if you agree to forget about your back pay". I feel that I've been disabled years prior to even applying. (nobody to blame but me for that I guess)

And Greg and Jeff...
LOL. Never felt better about failing a test. :)
Ya, it's been a long trip down this road and the waiting gets discouraging. I've come to realize the system is designed to weed out people along the way. Just too bad that those who need it get poked with the cattle prod along the way.

Britchick,
Thanks! I'm still not approved but the support along the way means a lot! :)

m.

(I started typing this while all of your replies were still pouring in. Hard to keep up with you all! lol.)
32 years hiv+ (oct. 2013) with a curtsy.

Offline weasel

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Re: ssdi appeal question...
« Reply #52 on: September 20, 2013, 02:25:43 PM »

    Hey Mitch ,
                      I hope the SS Dept. does not do to you what they did
   to me !

     I waited over two years to see a Judge , My lawyer worked with me and  The V.A. Doctors were very helpful knowing all of my issues .
 In the end it turns out it was almost like they wanted me to so broke that I would BEG them for me SSDI .
   I was told :  "  Give up all back pay or face the Judge and one  wrong word and you are done !  "
   I sat there and cried . There was no option , I do not Gamble ! And that was
 a hard thing to hear from my lawyer . In the long run I did right , I went as long as I could before applying for SSDI  and IF I had waited any longer would have been in a pickle  :-[
  I have a few tips I will share next time we talk  ;)

                                      Weasel 
" Live and let Live "

Offline mitch777

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Re: ssdi appeal question...
« Reply #53 on: September 20, 2013, 02:43:11 PM »
    Hey Mitch ,
                      I hope the SS Dept. does not do to you what they did
   to me !

     I waited over two years to see a Judge , My lawyer worked with me and  The V.A. Doctors were very helpful knowing all of my issues .
 In the end it turns out it was almost like they wanted me to so broke that I would BEG them for me SSDI .
   I was told :  "  Give up all back pay or face the Judge and one  wrong word and you are done !  "
   I sat there and cried . There was no option , I do not Gamble ! And that was
 a hard thing to hear from my lawyer . In the long run I did right , I went as long as I could before applying for SSDI  and IF I had waited any longer would have been in a pickle  :-[
  I have a few tips I will share next time we talk  ;)

                                      Weasel

yup. It's been a long haul. I'm going to be pissed if they try to pull that "give up your back pay" crap. I would like to hear from others that had that happen and how they made out... or not.
Wonder what options you really have if that is presented.
32 years hiv+ (oct. 2013) with a curtsy.

Offline weasel

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Re: ssdi appeal question...
« Reply #54 on: September 20, 2013, 06:22:21 PM »


  "  Wonder what options you really have if that is presented. "

    None in Missouri !   

                                             Best of luck in being Non-functioning  :)


                                                      Weasel

 
" Live and let Live "

Offline wolfter

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Re: ssdi appeal question...
« Reply #55 on: September 20, 2013, 07:37:03 PM »
I thought it was automatic that once approved, they pay from the date you applied.  I was determined to have been disabled a year sooner than when I applied, but they only used the application date as to back pay.
Complacency is the enemy.  ;)  Challenge yourself daily for maximum  return on investment.

Offline Miss Philicia

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Re: ssdi appeal question...
« Reply #56 on: September 20, 2013, 07:54:39 PM »
No, mine was retroactive to the date I was determined to be disabled -- so something like 11 months extra. IIRC there is a limit on how far back they will pay but can't remember what it was, maybe 15 months (?)
"Iíve slept with enough men to know that Iím not gay"

Offline mitch777

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Re: ssdi appeal question...
« Reply #57 on: September 20, 2013, 08:17:26 PM »
I have heard from research on a disability site (not a government site) that many people are faced with this predicament.

I did not apply for SSDI for years after I felt I was disabled. My mistake. It would be sad if they offered me such "a deal". If I felt I was capable I wouldn't have applied. End of story.
32 years hiv+ (oct. 2013) with a curtsy.

Offline weasel

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Re: ssdi appeal question...
« Reply #58 on: September 20, 2013, 08:49:21 PM »
I have heard from research on a disability site (not a government site) that many people are faced with this predicament.

I did not apply for SSDI for years after I felt I was disabled. My mistake. It would be sad if they offered me such "a deal". If I felt I was capable I wouldn't have applied. End of story.

    I also waited a long time , it was a hard decision  to make . The hardest thing I ever did ! 

    Bob was lucky , in that they gave him a full two year back payment .  I really thought the  condition
   of his health was what made them not want to cause another heart attack .
     On the other hand me having an AIDS diagnoses helped but not enough .

                                                                              Weasel
" Live and let Live "

Offline BT65

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Re: ssdi appeal question...
« Reply #59 on: September 21, 2013, 04:42:12 AM »
This link touches on back pay:


http://ssa-custhelp.ssa.gov/app/answers/detail/a_id/151/session/L3RpbWUvMTM3OTc1MjUyNS9zaWQvdzFra3JTQWw%3D


I had a weird situation with disability.  When my daughter's father died, she received survivor's benefits.   Her check was really low as her father hardly every worked.  Then one day, all of a sudden, I got a letter about her payment going up a substantial amount, and the father's name listed on the letter was not correct.  The last name was the same, but not the first.  So, I contacted SSA and told them it was not right.  The rep I talked to insisted it was correct.  So, we just let it go. 

So, when I was approved for disability, I got a letter from SSA stating that the back pay I would have received would be used to pay back SSA from when my daughter was receiving survivor's benefits.  They stated she was overpaid.  Now, that is just typical stuff when dealing with SSA, unfortunately.
I've never killed anyone, but I frequently get satisfaction reading the obituary notices.-Clarence Darrow

Offline mitch777

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Re: ssdi appeal question...
« Reply #60 on: September 22, 2013, 05:26:20 PM »
I guess I just don't understand the mentality (yes, I know, government paper pushers ::).) that a Judge would make someone forfit back-payments if a person is declared disabled at the time of a hearing. Maybe not enough "proof" of disability if evidence mounts up along the legal journey?

I would like to hear from J.R. on this topic in more detail. Specifically, what can I do if presented with this option. Finding something online about this has not been easy. 

I hope my detailed path through this process with the help of the many people who have posted here will be a learning tool for others.

Just trying to understand it all and get my ducks in a row.

By the looks of things, with over 5000 views so far on this thread, disability questions and answers are in the minds of many.
« Last Edit: September 22, 2013, 05:37:45 PM by mitch777 »
32 years hiv+ (oct. 2013) with a curtsy.

Offline BT65

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Re: ssdi appeal question...
« Reply #61 on: September 22, 2013, 05:36:53 PM »
There is no understanding SSA, Mitch.  I'm being reviewed right now because I work part time and have been told I could be cut off from SSDI and have to pay back all the pay since last November.  All because last November I went over SGA by $24.   :o  BTW, the $24 over was because of being paid for a holiday.


Good luck with all this.  Hopefully JR will tune in soon.
I've never killed anyone, but I frequently get satisfaction reading the obituary notices.-Clarence Darrow

Offline mitch777

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Re: ssdi appeal question...
« Reply #62 on: September 22, 2013, 05:42:10 PM »
There is no understanding SSA, Mitch.  I'm being reviewed right now because I work part time and have been told I could be cut off from SSDI and have to pay back all the pay since last November.  All because last November I went over SGA by $24.   :o  BTW, the $24 over was because of being paid for a holiday.


Good luck with all this.  Hopefully JR will tune in soon.

Thanks Betty but I refuse to stop trying to understand the system. Very sorry to hear of your mess! I wish you could just send them a check for $24 and stop the madness. :(

You are scamming the system. Shame on you.  ;D
32 years hiv+ (oct. 2013) with a curtsy.

Offline BT65

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Re: ssdi appeal question...
« Reply #63 on: September 23, 2013, 07:07:33 AM »
Thanks Betty but I refuse to stop trying to understand the system.

Well, good luck.  Just when I think I've gotten SSA's "rules" down, something changes.  I believe they put out a new online "Redbook," (I think that's what it's called) every year.  But, when you get right down to it, it's someone's decision that matters.  So, I would imagine it would depend on the person, their preference, mood, etc. 

I had actually never heard of having to forfeit back pay in order to get disability.  That's a new one.
I've never killed anyone, but I frequently get satisfaction reading the obituary notices.-Clarence Darrow

Offline mikejh

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Re: ssdi appeal question...
« Reply #64 on: September 25, 2013, 05:20:39 PM »
It seems so hard to apply for SSDI around the country. I live in NYC and here if you are diagnosed with aids you can go to HASA and you will be assigned a case worker. If you are unable to work due to disability the case worker send you to apply for SSDI and you can do that in the same office as they are. I was sent there in 2009 and did not even have to fill out the massive paper work that I got from GMHC the lady just asked a round of questions since my personal info was in the system it took 15 minutes. Then I went back to my case worker and she said I will get a letter from Social security. After 4 months I got a letter to see there physicians and went to the appointment with reports and test results that I had picked up from my specialists a total of 7 different physicians. I also took my Meds 18 different and went to my appointment. Social security's physician just looked at me when I gave him the list of my doctors and medications and shakedown his head. I sat there with all notes and test results and the bag with my Meds and he told me to leave. 2 weeks later I got a letter that I was approved.
 I have a lot of issues and have been sent for all kinds of tests and second opinions from my primary doctor and also the fact that he told me to bring all notes and test results to my appointment was to much for that young SSDI doctor so he did not know what to do with all information.

CD4   %
22 Sep 06   37     5  Started Atripla
5   Oct 06   82     9
1   Dec 06  258   13
25 Jan  07  263   14
1   May 07  403   18
6   Aug 07  438   22
7   Nov 07  417   19
30 jan   08  310   19
7   May  08  285   20
6   Aug  08  472   27
12  Nov 08  444   26
11  Feb  09 335    19
10  May  09  460  25

Offline mitch777

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Re: ssdi appeal question...
« Reply #65 on: September 25, 2013, 05:32:17 PM »
Thanks for the post Mike.

An AIDS diagnosis seems to help and NY seems more understanding in many ways as far as SSDI is concerned.

btw, your numbers are looking good! :)

m.
32 years hiv+ (oct. 2013) with a curtsy.

Offline mikejh

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Re: ssdi appeal question...
« Reply #66 on: September 25, 2013, 07:04:46 PM »
Thanks mitch,

Yes ny is probably one of the best states when it comes to benefits,

I was lucky when I started Atripla, my system responded very well, but in other areas I was not that lucky, have very bad neuropathy in hands, arms, feet and legs tried all kind of medications saw 2 neurologists and 2010 I had to go on heavy pain killers and it just get worse and worse with no return.  I'm also lucky to have a private LTD insurance and they have started to give me problems the last 2 months. Every other day I feel like I should just give up the Meds and let life have his way so I don't have to fight with them.
CD4   %
22 Sep 06   37     5  Started Atripla
5   Oct 06   82     9
1   Dec 06  258   13
25 Jan  07  263   14
1   May 07  403   18
6   Aug 07  438   22
7   Nov 07  417   19
30 jan   08  310   19
7   May  08  285   20
6   Aug  08  472   27
12  Nov 08  444   26
11  Feb  09 335    19
10  May  09  460  25

Offline mitch777

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Re: ssdi appeal question...
« Reply #67 on: September 25, 2013, 07:41:09 PM »
Thanks mitch,

Yes ny is probably one of the best states when it comes to benefits,

I was lucky when I started Atripla, my system responded very well, but in other areas I was not that lucky, have very bad neuropathy in hands, arms, feet and legs tried all kind of medications saw 2 neurologists and 2010 I had to go on heavy pain killers and it just get worse and worse with no return.  I'm also lucky to have a private LTD insurance and they have started to give me problems the last 2 months. Every other day I feel like I should just give up the Meds and let life have his way so I don't have to fight with them.
I hear your frustration but it's really not worth paying them the attention that you seem to be focusing on.
Your life is about you, not them. Period.
Also sorry about the pain you are dealing with. There are many people here that can relate. Reach out and ask questions. that is what these forums are about. :) (do a few searches on the topic on the forums to learn what others have said. ;).)
hope you get some relief from your pain.

m.
32 years hiv+ (oct. 2013) with a curtsy.

Offline denb45

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Re: ssdi appeal question...
« Reply #68 on: December 12, 2013, 09:41:47 AM »
Hey Mitch,

just a side note about SSDI

keep in mind that you have to be at least 60% or more disabled for SSDI

unless something has changed, but I don't think it has


good luck


HUGS


DEN
"it's so nice to be insane, cause no-one ask you to explain" Helen Reddy cc 1974

Offline mitch777

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Re: ssdi appeal question...
« Reply #69 on: June 30, 2014, 06:33:26 PM »
It's been ages since my last post here because of the waiting game but thought i would keep the same thread going so that others see the lengthy process.

Just a bit of background...
turned down twice since filing and was waiting for my hearing date.

Well, today I received a letter from the SSA requesting several tidbits (lol) of information so that they can determine whether or not they can make a determination in my favor without having a hearing.

They are requesting ALL of my medical records starting from one year prior to the date I claimed that I was disabled to the present. That would be (i think) since December of 2010. Wow!

Also completed recent medical treatment, medications and work background questionnaires.

If they cannot make a decision on the record they will schedule a hearing.

I called my ID doc's office since that is the bulk of my records and they said I had to make a request in writing with the the Medical Records Department and that it would take 2-4 weeks to receive them.

How much fun is this?

Anyway, I'm happy to see the progress.
32 years hiv+ (oct. 2013) with a curtsy.

Offline zach

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Re: ssdi appeal question...
« Reply #70 on: June 30, 2014, 06:45:31 PM »
well damn, wish i'd been around for this thread when it was active.

after a quick read of previous posts, i'll throw my experiences in for perspective

i lost back pay, my disability onset date was determined not the date i started the process, but the date i was admitted to the hospital this year

aids dx did not help my case whatsoever

neither did wasting, or myelitis

suspicion of TB is what is listed. i do not, did not, and have never had tb. the county i live in compelled me to take tb meds, a nurse came to my home daily to give me a cup of pills and watch me swallow them.

i have since conclusively tested negative for tb.

i lost half of foodstamp when ssi started, expect to lose the rest once ssdi payments begin, 5 months after disability onset date

in the meantime, i get ssi, but i do not know if that will continue when ssdi kicks in. they call it concurrent, but no one seems to have an answer if i will or will not be concurrent.

my fear is that someone in the chain of communication is going to cry foul over the whole TB thing. it made no sense to me at all.

 

Offline initforlife

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Re: ssdi appeal question...
« Reply #71 on: June 30, 2014, 08:03:06 PM »
Zach, from what I understand is your ssi will stop once your ssd starts like  you , I'm waiting my 5 months right now too.  My ssd will start in Aug but I won't get a check till Sept, so until then I get ssi which I get the first of the month and in Sept it will switch to the  3.  I think the only way you will still get ssi is if your ssd is not as much  as your ssi and I believe they will make up the difference with ssi
sometimes it is best to say nothing at all. then to offend

Offline mitch777

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Re: ssdi appeal question...
« Reply #72 on: June 30, 2014, 09:24:07 PM »
Zach,

I don't even know how to begin replying to all of that. Thanks for listening to my saga. I really do hope it works out for you but I would encourage you at the same time, if you are up to the crapola, to delve into the unanswered questions. The system really sucks on the way to disability. I haven't dealt with SSI so I don't know the "rules" let alone your transition into SSDI. I truly wish you smooth sailing if that is even possible. It's exhausting but what other choice do we have?

What boggles my mind more than anything else is that I doubt more than 5,000 or so people on the entire planet have been living with this bugger longer than me (or is it I) out of the 30+ MILLION infected.

I'm one of the oldest living guinea pigs and our government still is unable to determine if I am disabled? I have read about others that have been poz for 25 years and still are able to work but I was fading fast at that point. Heck, I didn't even apply until I was 29 years pos. This October will mark my 32nd year.

Just plodding through the bureaucracy...

UGH! or le sigh as Henry says. lol.


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

Offline bmancanfly

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Re: ssdi appeal question...
« Reply #73 on: July 01, 2014, 04:29:33 PM »
Sorry you have to endure this Mitch.  Hopefully there is a satisfactory resolution in the near future.    Hang in there.
"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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Re: ssdi appeal question...
« Reply #74 on: July 01, 2014, 06:32:15 PM »
Thanks bman. I've been hanging in for so long that at this point it has become the norm. 

Getting this most recent letter finally showing some progress just brings those frustrations with the system back to the surface.

I actually do feel pretty confident of a good outcome but I will be madder than a wet hen (my grandma's favorite phrase) if they try to deny any of my back pay.

Meeting next week with my attorney to get this ball rolling.
32 years hiv+ (oct. 2013) with a curtsy.

Offline zach

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Re: ssdi appeal question...
« Reply #75 on: July 01, 2014, 06:43:01 PM »
wanna see a mad hen, get hold of her while she's broody

where was your granny from? kind of an old southern saying

Offline mitch777

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Re: ssdi appeal question...
« Reply #76 on: July 02, 2014, 10:48:22 AM »
wanna see a mad hen, get hold of her while she's broody

where was your granny from? kind of an old southern saying

Minnesota.

I posted this picture of her once before but thought you might enjoy it.
 
32 years hiv+ (oct. 2013) with a curtsy.

Online Jeff G

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Re: ssdi appeal question...
« Reply #77 on: July 02, 2014, 10:57:04 AM »
I love her hunting outfit ... is that Macy's answer to stylish camouflage ? 

Offline zach

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Re: ssdi appeal question...
« Reply #78 on: July 02, 2014, 01:47:22 PM »
wow man, that is a fantastic picture
i got one for ya, gimme second

thats mine


Offline mitch777

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Re: ssdi appeal question...
« Reply #79 on: July 02, 2014, 02:26:14 PM »
Nice smile she's got there Zach. Where's the picnic basket?

Yep, Macy's camouflage. lol.
32 years hiv+ (oct. 2013) with a curtsy.

Offline zach

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Re: ssdi appeal question...
« Reply #80 on: July 02, 2014, 02:42:38 PM »
the story is thats where he proposed. i've stood there, its on my families property, i've thought of reproducing the shot with a cousin thats engaged. she's got a board on pinterest she thinks i haven't seen with ideas for wedding pictures. my wicked self is gonna make her cry with this idea

Offline mitch777

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Re: ssdi appeal question...
« Reply #81 on: July 02, 2014, 02:45:43 PM »
How romantic. Be wicked.
32 years hiv+ (oct. 2013) with a curtsy.

Offline BT65

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Re: ssdi appeal question...
« Reply #82 on: July 03, 2014, 07:36:51 AM »
Zach, whether or not you continue to get SSI once your SSDI becomes active depends on how much your SSDI is.  I do not know what SSA considers "too low" on SSDI, but if your SSDI is below whatever SSA has determined is "too low" of an amount, SSI will make up the difference.  This much I do know.

Mitch, I know how frustrating dealing with SSA is, and I know you know this.  I hope your meeting with your lawyer goes well and that you get all the back pay you deserve, because you do deserve it.  You've been through hell with this.  Hang in there sweetie, I have a good feeling about this.  Once SSA gets all your medical records, they may take a look at the huge stack, and decide they don't want to sort through them all and give it to you based on that. 
I've never killed anyone, but I frequently get satisfaction reading the obituary notices.-Clarence Darrow

Offline mitch777

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Re: ssdi appeal question...
« Reply #83 on: July 03, 2014, 10:17:44 AM »
Thanks Betty. That's the plan, bury them in paperwork. I imagine there may very well be over 100 pages for the time period that they are requesting.
32 years hiv+ (oct. 2013) with a curtsy.

Offline mitch777

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Re: ssdi appeal question...
« Reply #84 on: July 18, 2014, 09:57:13 AM »
I couldn't remember the date that was put down as my disability start date when we filed. I asked my attorney last October and after fingering through my file she said it was 12/31/11. Well, when i went to see her to sign some medical release forms I found out that the date we used was 1/1/2006!

Now I have to dig through my medical files to see what she needs to request from my docs starting 1/1/2005. 14 1/2 years of records!

Such a fun project. lol. A trip down my medical memory lane. Ugh.
32 years hiv+ (oct. 2013) with a curtsy.

Offline BT65

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Re: ssdi appeal question...
« Reply #85 on: July 18, 2014, 04:41:35 PM »
Oh M, you poor thing.  I wish you could just blink your eyes and make it appear. 

Does your attorney give any guess of how long she believes this may continue to take? 
I've never killed anyone, but I frequently get satisfaction reading the obituary notices.-Clarence Darrow

Offline mitch777

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Re: ssdi appeal question...
« Reply #86 on: July 18, 2014, 06:56:31 PM »
Oh M, you poor thing.  I wish you could just blink your eyes and make it appear. 

Does your attorney give any guess of how long she believes this may continue to take?

It wasn't as bad as expected sifting through my records but after a few hours it brought on a headache.  :P

My attorney is lazy and this is not her area of expertise. She hasn't a clue as to how long this will go on but I suspect once we submit the requested info which will probably take 4-6 weeks to gather we will get a hearing date sometime in November or December. Just my guess.

I did wonder how far back-pay is allowed and I found this:
http://www.disabilitybenefitscenter.org/blog/back-pay-limit

Encouraging but who knows what the judge will decide.
32 years hiv+ (oct. 2013) with a curtsy.

Offline Since1993

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Re: ssdi appeal question...
« Reply #87 on: July 20, 2014, 01:36:38 PM »
It's been ages since my last post here because of the waiting game but thought i would keep the same thread going so that others see the lengthy process.

Just a bit of background...
turned down twice since filing and was waiting for my hearing date.

Well, today I received a letter from the SSA requesting several tidbits (lol) of information so that they can determine whether or not they can make a determination in my favor without having a hearing.

They are requesting ALL of my medical records starting from one year prior to the date I claimed that I was disabled to the present. That would be (i think) since December of 2010. Wow!

Also completed recent medical treatment, medications and work background questionnaires.

If they cannot make a decision on the record they will schedule a hearing.

I called my ID doc's office since that is the bulk of my records and they said I had to make a request in writing with the the Medical Records Department and that it would take 2-4 weeks to receive them.

How much fun is this?

Anyway, I'm happy to see the progress.

Mitch,

Most initial denials of SSA disability benefits are due to insufficient evidence (medical records) to approve the claim.  Making sure your medical records are sent to SSA is extremely important, requiring follow-up with the provider you are requesting them from.  Whatever other information SSA is requesting (regardless how silly or repetitive) make sure to send expeditiously.  Keep in mind when answering questions related to function, pain, etc., make sure to detail how these issues restrict your daily activitites.  Fatigue, diarrhea, depression, all of it.

It is also prudent to contact the Disability Determination Service Adjudicator who is handling your case to make sure they received everything. 

Can't express how important this all is, because not doing it could delay your claim for another year.

Offline Since1993

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Re: ssdi appeal question...
« Reply #88 on: July 20, 2014, 02:07:22 PM »
SSI vs SSDI and Concurrent Claims:

1. Supplemental Security Income (SSI) is a Social Security needs-based disability program for people who haven't worked enough to garner enough credits to receive Social Security Disability Income (SSDI).  Approval for SSI is two-fold.  First, you medical claim has to be approved, then your assets have to be taken into consideration.  You cannot have over $2000 in any bank account at any given time.  You can own (1) home and (1) car.  Retirement accounts, stocks, bonds etc are all considered assets and calculated in determination.  The monthly amount paid for SSI for 2014 is $721.  This amount can be reduced by 1/3 if someone else provides your housing and food.  Automatically eligible for Medicaid.

SSI benefits began one-month waiting after your initial application.  You are required to report any change in assets greater than $2000.

2.  Social Security Disability Income (SSDI) is an insurance program provided by Social Security for people who have worked and achieved enough work credits to qualify.  The Matrix how this is determined is provided by SSA here:

http://www.ssa.gov/retire2/credits3.htm

SSDI is not income-based, meaning, your assets are not taken into consideration but you still have to meet the medical requirements to receive disability benefits.  The maximum amount of SSDI you can receive monthly in 2014 is $2642.  Your monthly benefit is determined by how much money you paid into the system the last ten best earning years of your working years.

SSDI benefits begin after a five-month waiting period after the month of your established onset of disability.  You are not required to report any change in assets.  Medicare eligibility becomes effective 29 months from the established onset date of disability (24 months after 5 month waiting period).

3.  Concurrent SSI/SSDI Claims:

There are times when people who have little to no assets qualify for SSI and SSDI because they also have enough required work credits.

This is how it works:

Once you medically qualify for disability payments, you will be paid SSI  $721 monthly for the first six months (minus 1st month), and then then SSDI payments beginnning the sixth month going forward.   

If your SSDI claim amount is > than $721, your SSI payments payments will cease at month six and you will continue to be an SSDI recipient.  Medicare eligibility begins in 24 months.

If your SSDI amount happens to be less than $721 monthly, you will automatically qualify for SSI.  The distinction here, being, that you would immediately qualify for Medicaid while waiting for Medicare eligbility in 29 months.  This is considered a concurrent claim.

I hope this helps someone.

Offline mitch777

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Re: ssdi appeal question...
« Reply #89 on: July 20, 2014, 02:14:40 PM »
Thanks Since.

My attorney received a more detailed letter from them and it showed what records they already have. We are just supposed to fill in the holes for the time period they are requesting.

I had a physical assessment test about a year ago that showed objective proof of my disability. This will be an important part of the whole package.

As far as filling out those function, pain, etc. forms, my attorney did a pretty good job relating it to my daily activities. I've been told that I am too honest but her guidance did help. Sometimes when I'm feeling rather well I tend to forget or downplay how the aidsy stuff takes a toll on me when I'm feeling like crap. She took care of that! lol.

If they still can't make a determination after this batch of additional records a ALJ hearing will be scheduled. I'm not sure at that point, having all of my medical records already, what more they will be looking for. Maybe I should go on a strict diet and loose 20 pounds. (just kidding)

ps- I'm further into this process than you may realize. I applied well over 2 years ago for SSDI. I've read all of what is available online from the government SSDI website but it was good of you to post it here anyway for others to see.  :)





 
« Last Edit: July 20, 2014, 02:21:02 PM by mitch777 »
32 years hiv+ (oct. 2013) with a curtsy.

Offline Since1993

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Re: ssdi appeal question...
« Reply #90 on: July 20, 2014, 02:53:58 PM »
FYI, on February 26, 2014, The Social Security Administration has published a Notice of Proposed Rule-Making (NPRM) in the Federal Register to alter the listings for Human Immunodeficiency Virus (HIV) Infection disability claims.

http://www.gpo.gov/fdsys/pkg/FR-2014-02-26/html/2014-04124.htm

Offline mitch777

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Re: ssdi appeal question...
« Reply #91 on: August 04, 2014, 11:10:12 AM »
Iv'e got great news to report! I have a hearing date!! November 14th.

I'm not sure why they didn't wait for the medical records that they requested. The hearing will be held in Hartford via video conference with the judge being in Rhode Island. I think Hartford is short staffed still.

Anyway, I hope this all goes well.
32 years hiv+ (oct. 2013) with a curtsy.

Online Jeff G

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Re: ssdi appeal question...
« Reply #92 on: August 04, 2014, 11:12:18 AM »
Congrats ! Its been a long time ah-coming .

Offline mitch777

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Re: ssdi appeal question...
« Reply #93 on: August 04, 2014, 11:15:53 AM »
Congrats ! Its been a long time ah-coming .

Thanks! 2 years and 6 months.

I guess if when approved I would be eligible for Medicare right away. Can't wait to say farewell to Acreedo.  :)
32 years hiv+ (oct. 2013) with a curtsy.

Offline wolfter

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Re: ssdi appeal question...
« Reply #94 on: August 04, 2014, 12:10:29 PM »
You must be doing a happy dance this morning.  I remember how I felt when I finally got my hearing date (after 3 years).  congrats
Complacency is the enemy.  ;)  Challenge yourself daily for maximum  return on investment.

Offline bmancanfly

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Re: ssdi appeal question...
« Reply #95 on: August 04, 2014, 03:14:43 PM »
Great news.  Good luck,  hope you finally get approved.
"The trouble with the world is that the stupid are cocksure and the intelligent are full of doubt."

 Bertrand Russell

Offline BT65

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Re: ssdi appeal question...
« Reply #96 on: August 04, 2014, 07:57:35 PM »
Congrats Mitch!  I know that's a relief.  I will definitely be keeping you in my daily anxieties. :-*
I've never killed anyone, but I frequently get satisfaction reading the obituary notices.-Clarence Darrow

Offline mitch777

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Re: ssdi appeal question...
« Reply #97 on: August 04, 2014, 08:54:47 PM »
Thanks you guys. The congrats will be needed after the hearing I hope.

Planning on writing a compelling letter to attach to this next batch of paperwork from the standpoint of a LTS living 32 years with this bugger. I know the medical reports have the most weight but... who better than me to explain to the judge to get him to understand that I'm one of the oldest guinea pigs around and that there is much more going on that won't show up in a blood test?

Oh! And my attorney called them back today and asked if it would be ok if we had the hearing in person (in Rhode Island). They said no problem so a face to face hearing it shall be.
32 years hiv+ (oct. 2013) with a curtsy.

Offline zach

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Re: ssdi appeal question...
« Reply #98 on: August 04, 2014, 11:05:55 PM »
write the letter, you got it this time.

Offline Since1993

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Re: ssdi appeal question...
« Reply #99 on: August 06, 2014, 02:16:19 AM »
Thanks you guys. The congrats will be needed after the hearing I hope.

Planning on writing a compelling letter to attach to this next batch of paperwork from the standpoint of a LTS living 32 years with this bugger. I know the medical reports have the most weight but... who better than me to explain to the judge to get him to understand that I'm one of the oldest guinea pigs around and that there is much more going on that won't show up in a blood test?

Oh! And my attorney called them back today and asked if it would be ok if we had the hearing in person (in Rhode Island). They said no problem so a face to face hearing it shall be.

Mitch, if are eventually approved, it will likely be based upon vocational allowance since your medical records don't have specific data to indicate you are eligible under the HIV listing alone (legal definition).  Your other ailments will be taken into consideration.  At this point in the process, the most important thing you can communicate to any Administrative Law Judge/Vocational Expert who are present at your hearing, is "how your level of function has been limited by HIV, your other ailments and medications you take."  Trust me, they will ask you many questions about it, so prepare yourself accordingly.  It is your responsibility to provide details of how your function is limited, evidence that you are taking prescribed therapy (continue seeking medical treatment) and how these limitations effect your ability to work.  Be bluntly honest and don't embellish and you should be fine. 

Your chances of being approved exponentially increase at the hearing level.  Good luck.

Good luck.
« Last Edit: August 06, 2014, 02:20:32 AM by Since1993 »

Offline mitch777

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

Online Jeff G

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

Offline Since1993

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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!


Offline zach

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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

Offline Since1993

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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.


Offline Blkpoznc34

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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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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

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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




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

Offline britchick

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Re: ssdi appeal question...
« Reply #109 on: September 15, 2014, 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: September 15, 2014, 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

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Re: ssdi appeal question...
« Reply #111 on: September 15, 2014, 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.
32 years hiv+ (oct. 2013) with a curtsy.

Offline bmancanfly

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Re: ssdi appeal question...
« Reply #112 on: September 16, 2014, 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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Re: ssdi appeal question...
« Reply #113 on: September 16, 2014, 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.
32 years hiv+ (oct. 2013) with a curtsy.

Offline Since1993

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Re: ssdi appeal question...
« Reply #114 on: September 16, 2014, 07:48:29 PM »
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.

Thank you so much for publicly bringing this to my attention.  The gentleman in question was admittedly "worried" about his transition from SSI/Medicaid to Medicare and I aptly gave him possible OPTIONS as to how the process could work.  I typically explain the Ryan White Part B/ADAP process in generic terms, always often deferring and recommending they contact their local ASO who would have more specific information about their states Ryan White/ADAP/ACA programs.  I don't have the time or energy to research every states Ryan White/ADAP information.  I am not a national medical case manager and I absolutely refuse to do that in any internet forum I participate within.

No good deed goes unpunished.  The reason I became involved in this forum was because of the lacking information given to people who asked for help because they were confused with the process.  Sometimes people just want to know their options to know which way things go...just a sliver of hope to solve their worries.  Typical two or three sentence replies to complex Ryan White/ADAP/ACA/Medicare questions were the norm here, or questions going unanswered for days.

I've gotten negative, judgmental feedback in just about every forum I've participated in, even when just posting articles of interest.  I don't do dysfunctional internet forums and clearly, this is not the group of people I want to interact with going forward.  Thank you for spurring this ephiphany. 

Offline BT65

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Re: ssdi appeal question...
« Reply #115 on: September 17, 2014, 04:30:55 AM »
I aptly gave him possible OPTIONS as to how the process could work.  I typically explain the Ryan White Part B/ADAP process in generic terms, always often deferring and recommending they contact their local ASO who would have more specific information about their states Ryan White/ADAP/ACA programs.  I don't have the time or energy to research every states Ryan White/ADAP information.  I am not a national medical case manager and I absolutely refuse to do that in any internet forum I participate within.

Ah, but you give very specific information: 
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.


When I was a case manager at the ASO in SB, Indiana, the only way someone would have their Part D premium and copay paid by ADAP (again, there was no Ryan White at the ASO I was at) was if the client was over 65. 

Also, in Indiana, if someone is approved for Medicaid, it pays the Part B premium.

Nowhere did you refer the person to contact his ASO.

Again, ACA plans, Ryan White/ADAP, Medicaid, are very state specific.  If you do not want to research someone's state's plans, then please do not state specifics.

Also, nice swan song.

I've never killed anyone, but I frequently get satisfaction reading the obituary notices.-Clarence Darrow

 


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