By Tim Moore on November 29, 2007 8:22 PM
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From my own perspective (a former disability-medicaid caseworker and a former disability claims examiner for the social security administration), I don't find it surprising in the least that individuals who file for disability are unsure as to
who qualifies for disability. After all, its become something of a mantra that 1) no one is
approved for disability on the first application, 2) good disability cases are denied and 3) people who probably shouldn't be awarded disability benefits are routinely approved. Are these "myths" correct? Well, in actuality, about three out of ten applicants for social security disability or
SSI disability benefits actually are approved, so the first part of that mantra is not correct (Of course, the flip-side to that equation is that seventy percent of all cases are initially denied, which is a horrendous statistic). Regarding the second part, there is no doubt that good cases are denied. As a disability examiner, I routinely saw solid disability claims get denied by agency supervisors who were obviously intent on controlling the number of approvals made by their subordinates (sad, but true, this really happens in the state agencies that render medical determinations for the social security administration). In fact, as I've said for quite some time, the mere fact that so many claimant who are denied at the disability claim and
reconsideration levels are
are later approved at disability hearings substantiates the notion that the social security disability system is a little rotten at the core. Regarding the third part, I can't really say that, as an examiner, I saw "bad cases" getting approved. In fact, it was usually quite the opposite.At the hearing level, however, that may be a bit different, and many disability representatives will be quite frank in admitting that when it comes to the differences in decisions made by one group of administrative law judges (within a single hearing office), there sometimes seems to be little rhyme nor reason. To some extent, however, that may also be a factor of subjectivity. Because the truth is, ten different individuals reading the same set of medical records may potentially come to ten different conclusions. Decision-making within the SSD and SSI programs is simply not as objective as the social security administration would have us believe; rather, instead, the process is quite subjective. Now, back to the point with which I began before I wandered so far off-topic
: who qualifies for disability benefits? Basically, anyone whose medical records shows that their condition is severe enough to A) make it impossible for them to perform their past work and B) make it impossible for them to engage in other work (as determined by their work skills, education, age, and physical and mental limitations), in effect, qualifies for disability. This is, of course, a simplified way of explaining how disability determinations are made. But to a large extent, the system actually is simple. From a claimant's perspective, it seems incomprehensible due to the fact that relatively little effort is expended by the social security administration to A) keep claimants informed as to the
status of a disability case and B) advise them more thoroughly regarding the proper completion of paperwork and the timely filing of paperwork (such as for the submission of appeals). Return to the homepage for
:Social Security Disability SecretsAdditional pages at Disability Secrets:Am I disabled enough to qualify for disability? Medical conditions that qualify for disability Requirements to qualify for disability Social Security Disability Criteria Does my condition qualify for disability? What conditions qualify you for SSI disability
By Tim Moore on November 29, 2007 11:12 AM
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It's difficult these days to watch anything on televison without being subjected to a barrage of pharmaceutical ads. In fact, its gotten so bad that the words lipitor and boniva seem to be permanently etched into my waking consciousness. And I have to wonder just how family doctors really feel about all this, this onslaught of drug commercials. I'd guess that, for some, each time a patient starts off with
"Doc, I saw this commercial last night and I really think I need to take..." they experience an immediate pinprick sensation of irritation. Just the same, it can't be all bad. After all, the drug commercials are only informing the public of what the doctors are already being informed of via the friendly pharmaceutical reps that visit their offices to
inform them of their "wares". Ultimately, its up to a physician to determine what to prescribe and, in working with patients, to determine what works and what doesn't. Last night, however, I saw a commercial that piqued my interest. The pharmaceutical in question was something called Lyrica. As a disability examiner, I read medical records all day long so I'm familiar with many drugs. Lyrica, though, is new. And its the first prescription drug approved for the treatment of
fibromyalgia. Which to my mind is great news since A) this will be beneficial to FMS patients and B) this will be another step toward validating this condition and improving the attitudes of physicians (many of whom, unfortunately, don't give a lot of credence toward
fibromyalgia. Interesting thing, though. I went to the manufacturer's website to learn more about Lyrica and found out that the drug was originally developed for peripheral neuropathy (a condition that causes itching, burning, and numbness in the feet and hands of patients with
diabetes. Which makes sense, as far as the application for FMS is concerned since pain is a hallmark symptom of fibromyalgia. Return to the homepage for
:Social Security Disability Secrets
Additional pages at Disability Secrets
:Would a fibromyalgia diagnosis by a rheumatologist help my disability case?Applying for disability with fibromyaglia Can I win a disability hearing if I have fibromyalgia?Is fibromyalgia recognized as a disability by social security? Stress and fibromyalgiawhat chemicals are linked to fibromyalgia? Filing for disability based on diabetesIs there a way to cure diabetes? Type II diabetes and filing for disability
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