Obsessive Compulsive Disorder Often Misdiagnosed

The National Institute of Mental Health estimates that 2.2 million adults in the United States suffer with obsessive compulsive disorder (OCD). OCD can also affect children, and many are red-flagged as problem children or incorrectly labeled as ADHD in school.

In fact, OCD affects anywhere between 1 and 3 percent of school-age children in the United States, according to Elliott Levin, a licensed clinical social worker who runs a support group for OCD children and their parents. Sadly, in addition to enduring high levels of anxiety throughout their childhood, children with OCD who do not receive treatment are prone to depression and alcohol and drug use, and are less likely to stay in school.

OCD is an anxiety disorder, and associated behaviors are a manifestation of the brain’s attempt to cope with overwhelming, if irrational, feelings of fear. Typical OCD behaviors include repeated checking, perfectionism, chronic procrastination or tardiness, repetitive washing, confessing, and inappropriate touching. However, OCD does not always manifest as a physical action or ritual. Symptoms may be largely internal, such as excessive worrying about safety or death, guilt feelings, self-loathing, etc.

Unlike those without OCD, a sufferer is unable to stop obsessing; it is a neuropsychiatric disorder, the result of a chemical imbalance in the brain. OCD brains get stuck in negative, cycling thought patterns that can be devastating to their self-esteem and overall well-being. Regardless of their individual symptoms, one thing OCD patients have in common is difficulty in their academic, work, and social relationships.

However, this disorder responds well to treatment, and can often be managed within a few months, without medication, by using cognitive therapy. The gold-standard of such therapy for those with OCD is a 6-week program designed by Dr. Jeffrey M. Schwartz, author of the book “Brain Lock,” which uses proven exercises to change the brain’s chemistry.









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How Useful is Calling Social Security about your Disability Claim?

If you have filed a claim for Social Security disability or Supplemental Security Income (SSI) disability, your claim has been sent to a state disability agency for a medical decision. Or, perhaps I should say that your disability claim should have been sent to the state disability agency on the day of your interview or the next day if you provided all of your information including signed medical release forms at the time of your disability interview.

Unfortunately, this is not always the situation, as Social Security claims representatives are dealing with an unprecedented number of disability claims, which can lead to delays.

Should you call to check on your disability claim? Well, a call about the status of your disability claim may alert the claims representative who did your intake that your claim has not actually made it to the state disability agency for processing; consequently, at that point they may be able to locate your claim and "send it down".

Of course, there are other reasons to call the social security office, such as providing updated contact information (for changes regarding an address or phone number). This can be particularly helpful when disability examiners need additional information but have been unable to reach a disability claimant. In such scenarios, disability examiners (the individuals who actually work on processing disability claims for the social security administration) will sometimes call the social security office where a disability application was filed in an attempt to gain additional contact information. However, if a claimant has not kept social security up-to-date, then the social security office will have no additional information to provide to the examiner. And the result could be that a claim is denied for "failure to cooperate" or "whereabouts unknown".

On a practical note, however, I should point out that calling to check on your social security disability claim can be a matter of when and where. What do I mean by this? Basically that the proper place to call for a status update will often depend on where your claim currently is in the system.

For example, if you have only recently filed your claim (say, in the last 2-3 weeks), you may wish to direct inquiries about your case to the social security office where you filed the claim. After this point, however, it is likely that the case will have been transferred to a disability examiner. Therefore, the disability examiner at the state disability agency (usually known as DDS, or disability determination services) should be called for status inquiries. How do you get the number for the examiner? You can easily do this by calling the social security office where you applied and asking them for the number.

Typically, though, for a true status update, the disability examiner (if the case is at the disability application or reconsideration appeal level) will be the preferred source to call. Why is this? Because the disability examiner is the individual who actually works on the case, while the social security office is simply the place where the disability application is taken before it is forwarded to the state disability agency. In fact, if the case is actively being worked (meaning that medical records are being acquired and evaluated), then the disability examiner may be the only source of information as the social security office will have no knowledge of what has and has not been done on the case (translation: the social security office has nothing to do with making the actual decision on the case)









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Animal Observation Holds Key to Understanding OCD in Humans

About 3 percent of the population in the United States has a condition called obsessive compulsive disorder (OCD). OCD causes people to feel driven to perform repetitive behaviors or rituals, such as pacing, hand-washing, repeatedly checking to see if doors are locked, appliances are turned off, etc.

After studying OCD in animals, mental health professionals now believe that, when it comes to helping those with OCD control their symptoms, a picture is worth a thousand words.

Researchers at Tel Aviv University observed animals both at the zoo and in their natural habitat, including bears, rats, and gazelles, noting the different types of compulsive behavior displayed by the animals, as well as which behaviors were actually healthy. They then used the information that they gathered to create an animal database of compulsive behaviors, to which physicians can now refer when evaluating OCD symptoms in their human patients.

Animal observation also lead to the practice of videotaping patients’ OCD actions and then playing the tapes back for those patients, a process now considered to be one of the best behavioral (non-pharmaceutical) methods available for treating the physical symptoms of OCD. People who display compulsive behavior tend to react strongly to the sight of themselves engaged in these actions, and respond better to treatment (perhaps because they are more motivated to do so).









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Ulcerative Colitis and Carpal Tunnel Syndrome

Have you ever wondered if ulcerative colitis can affect teenagers or whether surgery was absolutely necessary for carpal tunnel syndrome? The following article outlines some interesting information on teen ulcerative colitis and carpal tunnel syndrome in the form of Doctor Paul G. Donohue, M.D., answering questions from concerned readers.

The first question comes from a grandmother curious about her sixteen year old grandson’s diagnosis of ulcerative colitis. She would like more information on whether ulcerative colitis is common for teenagers, as well as whether or not this will affect his life expectancy and growth rate. Dr. Donohue explains the signs and statistics of ulcerative colitis, along with non-surgical medicines and surgical procedures that can be helpful for those experiencing the illness.

The second question comes from a patient who has been diagnosed with carpal tunnel syndrome and is curious as to whether her doctor’s recommendation for surgery is absolutely needed if her pain is not severe. In this instance, Dr. Donohue explains nerve conduction velocity and gives an education view of carpal tunnel syndrome.

Read this informative article to find out Dr. Donohue’s edifying answers in relation to these common medical questions.

Ulcerative colitis is no respecter of age









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When do you get Your Back Pay From Social Security Disability?

Social Security disability back pay benefits depend upon two things: established date of onset and month of entitlement. The established date of onset is determined by Social Security when they make your disability claim decision. When you filed your disability claim with Social Security you alleged a date for which you became disabled and unable to work (actually, unable to work and earn substantial gainful activity, or SGA, which correlates to a gross monthly earnings amount--effectively an earnings cutoff amount for eligibility) due to your medical and/or mental condition. To see the current SGA amount, go here: SGA

Social Security disability examiners gather your medical and work information. Once they have all of their information (records, of course, can take quite a long time to get, depending on the sources), they make a medical determination as to when you became medically disabled. If you have not worked since your AOD, or alleged date of onset, and your medical information supports that you were disabled on that date, Social Security will set you your alleged onset date as your established date of onset (it's not uncommon, however, for a claim to be approved with an onset date that is not as favorable as the one alleged by the claimant).

Once an onset date has been set, your date of entitlement will be the sixth month following your established onset date if you receive Social Security disability (this is due to the infamous five month waiting period for which claimants are deprived of their first five months of benefits).

Social Security pays disability benefits back to the date of entitlement. And with wait times being up to two years (or longer) for a Social Security disability hearing, many disability claimants receive very large back payment amounts.

It should be said that though most claimants receive back pay, back pay of disability benefits is not involved in every disability case. For example, some claimants are approved very quickly with no retroactivity, meaning the five month waiting period has yet to be "served out".








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Combat Back Pain With New Surgeries

According to the American Association of Neurological Surgeons, nearly 80 percent of Americans will suffer from back pain at some point in their lives. While some back pain can be alleviated through natural remedies such as yoga, rest, and acupuncture, or nonsurgical therapies such as medication, braces, lumbar traction or steroid injections, some back pain will require surgery. Up until recently the only choice for severe back pain was spinal fusion surgery, an invasive surgery with a recovery time. Now there are more options.

Trans 1 (or AxiaLIF) is a lumbar spine surgery performed with a simple half-inch incision near the tailbone that was approved by the Food and Drug Administration (FDA) in 2004. AxiaLIF is a non-invasive surgery option. Charite, also approved in 2004 by the FDA, is an artificial disc replacement surgery for degenerative disc disease. Both procedures are known to alleviate pain with a shorter recovery time than spinal fusion.








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Urgent Stroke Treatment

A study reported in The Lancet Neurology, led by Peter Rothwell, M.D., Ph.D., of John Radcliffe Hospital, found that urgent treatment – within 24 hours – of a minor stroke or transient ischemic attack not only helped to reduce the risk of recurrent stroke, but also decreased the amount of hospital admissions, reduced the costs associated with the conditions, and reduced the length of hospital stay and reduced the level of disability that was found at six months.

According to the study called 'Early Use of Existing Preventative Strategies for Stroke (EXPRESS), getting treatment within twenty-four hours helped the patients and the health care system. The study was a part of the Oxford Vascular Study (OXVASC) and included nearly 600 patients, some that received immediate treatment (within one day) and others that were sent to clinics by their primary care physicians, who them received treatment recommendations (19 days). The study points to the fact that urgent-care clinics need to be outfitted with ability to treat people with minor stroke and transient ischemic attack.









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What If I Lose My Social Security Disability Case?

If you file for social security disability (SSD) or SSI and your application is turned down, you will be informed of this decision in writing. The notice of denial will state that your application was denied, and give some indication as to why, but, in a usable sense, don’t expect a lot of explanation for the decision. Notices of denial are routine, and the language in them is largely scripted—they read like a form letter, which is pretty much what they are. The letter will also inform you of your right to appeal, which you should definitely take advantage of.

Because you have the right to appeal, the fact that social security denied your disability application doesn’t mean that you have lost your disability case. The important thing to keep in mind is that you can appeal the decision within 60 days.

On the top right-hand corner of the denial notice you will find a stamped date. Your first appeal, which is called a request for reconsideration, must be received by the social security office by the 65th day after that date (social security allows a 5-day “grace” period for mailing).

In essence, filing a disability appeal keeps your claim alive, and you have a much better chance of being approved for benefits pursuing the appeal route than if you start over with a new claim.

If you have a disability representative handling your claim, be sure to call his or her office as soon as you get the denial notice in the mail.

Social security is required to send a copy of the notice to your representative, but it doesn’t hurt to double-check because, for various reasons, there are numerous instances in which either the claimant or the claimant's rep will not receive their copy of the decision notice.

If your social security reconsideration appeal is denied (statistically, this is likely), you will again receive a written notice in the mail as well. However, this does not mean your attempt to win benefits is over (unless you choose to stop at this point, which would be unwise). Again, the letter will inform you of your right to appeal. However, this second level of appeal takes place in a hearing office before a federal administrative law judge.

At hearings, claimants have a statistically better chance of winning a claim. Why? Several factors are at work. The claimant may elect to have representation and improve their chances of winning due to this. The claimant may (directly, or through a representative) provide updated medical records and a medical source statement (otherwise known as an RFC form) from a treating physician.

The adjudication process, of course, is very different in the sense that the claimant will be seen by the decision-maker for their case. And, last, but not least, is the fact that disability judges are not tethered to immediate supervisors who may, at will, exert great influence on the outcome of a case. In other words, disability judges are free to "call them as they see them". And this may account significantly for the fact that most cases that are brought to hearings are approved, despite the fact that they were previously denied at earlier stages in the process.









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Can Heart Failure Lead to Fractures?

Is it possible that those who experience heart failure are also at a higher risk for bone fractures? Even though the two medical conditions don’t seem to be related, a recent study links those with heart failure to a higher risk of osteoporosis. Even though the reasons for the relationship are left unclear, experts are theorizing that patients may be calcium or vitamin D deficient.

In the study, the chance of fracture was 4 times the amount for heart failure patients and for hip fractures alone, that number jumped to over 6 times when including heart attack, rhythm disturbances and chest pain.

The article gives the details of the study, including how many patients were involved, the average age and diagnosis. The article goes on to tell about the one year follow-up and emergency room visits. The study was conducted in Alberta, Canada and was included in the Journal of the American Heart Association, Circulation.

Heart Failure And Fracture Related









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New Study on Heart Failure Favors Whole Grain Consumption

More and more people are accepting the fact that diet is directly related to heart failure, obesity, hypertension, coronary artery disease, and diabetes.

While this may seem common sense to some and very unlikely to others, new studies are constantly generating support for the theory. One study in particular comes from researchers in the Epidemiology departments from the University of Minnesota and the University of North Carolina. The study suggests that eating less eggs and dairy and increasing the consumption of whole grains can lower the risk of these diseases.

The following article outlines the study, which used data from the Atherosclerosis Risk in Communities (ARIC) study. The ARIC study provided researchers with data from over 14,000 adults and followed their progress for nearly thirteen years. The article provides in-depth information about the study and provides evidence that reducing eggs and dairy, while increasing whole grains, could help lower risk for the nearly 5 million Americans that suffer from heart failure related diseases.

Eating Whole Grains Lowers Heart Failure Risk, According To New Study









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Are Social Security Disability Medical Exams Useful?

Generally speaking, Social Security consultative medical exams are not the most useful tool to evaluate an individual's functional ability. Consultative examinations are usually short one-time examinations performed by a physician who is paid by Social Security.

However, there are certainly disability claimants who find that a Social Security medical examination is useful. For instance, there are many disabled individuals who have no medical insurance and negligible finances; consequently they are unable to afford any kind of medical treatment. If you cannot afford medical treatment, Social Security will have no medical treatment records that address your disabling impairments. In a case where an individual has no medical treatment records, a consultative examination is certainly better than nothing.

Not all consultative examinations are preformed because an inindividual has no current medical treatment sources. Sometimes, disability examiners feel that treating source records need to be clarified, so they schedule a consultative examination with a specialist. Often these consultative examinations are scheduled with orthopedists or neurologists. And others are scheduled to address specific limitations. For example ,individuals with severe breathing problems may be sent to a pulmonary function test, or spirometry.

Although consultative examinations fill a need for those who do not have medical treatment sources, for most individuals consultative examinations do not result in an approval for disability benefits. Consequently, if possible it is good to have an established medical treatment history when filing for Social Security benefits.









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Congestive Heart Failure Deaths Increase

Heart attack occurrences are causing fewer deaths these days. This sounds great at first glance, but a Canadian research team reported that this isn’t a decrease in heart attack deaths, but an evolution from heart attack to heart failure. It seems that more heart attack survivors are dying later in life from congestive heart failure. The symptoms of congestive heart failure include shortness of breath, fatigue and swollen legs and/or ankles. Oftentimes these symptoms are simply contributed to old age and not checked out by a doctor.

The Canadian study was conducted over a five-year period, and involved 8,000 heart attack survivors over the age of 65. The study concluded although more people are surviving their heart attacks, they are not surviving congestive heart failure. They found that nearly 75 percent of the heart attack patients developed congestive heart failure, and around 40 percent died from the condition. This study was published in the Journal of the American College of Cardiology.








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Mental Limitations and Social Security Disability SSI

If you have a mental impairment that has prevented you from working for the past twelve continuous months or is expected to prevent you from working for twelve months, you may need to consider filing for Social Security disability and/or Supplemental Security Income disability (SSI). Social Security disability evaluates how your mental condition or conditions limit your ability to perform substantial work activity when making their disability determinations. So what does Social Security consider to be mental limitations that might preclude work activity?

Social Security uses various criteria to determine an individual’s mental limitations and residual functional capacity. The following disability evaluation criteria are what Social Security uses to establish the severity of an individual's mental limitations:

1) Activities of daily living - these might include an individual’s ability to cook, clean, count money, drive, pay bills, and appropriately bathe and groom themselves. Can an individual complete routine daily tasks with independence and effectiveness? Can they participate in these normal activities of their own initiative without the supervision or the directions of another?

2) Social functioning - can the individual interact with others independently, appropriately, and effectively on a prolonged basis? This might include an individual’s ability to get along with family, friends, coworkers, or supervisors. If the person has a history of firings, fighting, evictions, avoidance of personal relationships, or social isolation, they may have significant limitations in social functioning.

3) Concentration, persistence and pace - this addresses an individual's ability to stay focused long enough to complete work setting tasks timely and appropriately.

4) Episodes of decompensation - these are temporary exacerbations or increase in symptoms that cause a loss of adaptive functioning. These episodes of decompensation may cause difficulty in completing routine activities of daily life, maintaining social relationships with family, friends, etc, or staying focused.

Social Security must have medical documentation of your mental condition; they must assess the severity of your functional limitations, and project the duration of your mental impairment. They must have medical evidence from acceptable treatment sources (i.e. psychologist, hospital records, and psychiatrist).

In addition to medical evidence, Social Security disability decision makers may use evidence of failed work attempts, mental status, statements from your third party contact (someone you listed when filed as an individual who knows you and is familiar with your condition), and activities of daily living questionnaires to evaluate the severity of the limitations your mental impairment imposes upon you.

Note: An ADL, or activities of daily living questionnaire, when completed by you, addresses how you feel your mental condition limits your ability to work and perform routine daily activities.








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What is Lymphedema?

If you are like most people, you may not know much about lymphedema. Unfortunately, whether you know about it or not, you may be at risk – nearly 8 million Americans have been diagnosed with lymphedema.

What is lymphedema? It is a lymphatic system condition that is characterized by a buildup of lymph fluid between cells that cannot be filtered out of the body by normal processes. Lymphedema usually affects a limb, such as the arm or leg. Primary lymphedema affects mostly women and is a genetic condition.

Secondary lymphedema can be caused by trauma, tumors, surgery and radiation therapy. In the United States the biggest cause of secondary lymphedema is breast cancer, which usually happens to the arm on the side of the body with breast cancer. Nearly 33 percent of breast cancer patients end up with lymphedema.

Lymphedema starts with swelling, but left untreated in may worsen to include a hardening of the skin, known as fibrosis. If lymphedema is diagnosed early much easier to treat and keep under control. The signs of lymphedema are swelling, a heavy-feeling limb, tight feeling skin, less flexibility and constriction of movement in the affected limb. If lymphedema is diagnosed, physical therapy, manual lymphatic massage, and compression garments can help to maintain or decrease limb size.

If you are at a high risk for lymphedema, such as a breast cancer patient, there are a few things can be done to help prevent from developing lymphedema. Taking good care of one’s skin, washing often and eating a diet high in fruits, vegetables and fiber, can be crucial in prevention. Also, eating a diet low in sodium and low in fat can also help one to avoid the condition.

If you do develop lymphedema, know that it cannot be cured; the condition can only be prevented and maintained. If you suspect that you may be developing the condition and are experiencing swelling of the hands, feet, arms or legs, visit you doctor right away. Early detection and early treatment are imperative.





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Parental Age and Birth Order May Effect Autism

A new study suggests that parental age and order of birth may have huge effects on whether or not a child is born with autism. The Center for Disease Control and Prevention in Atlanta funded the study, which was led by Dr. Maureen Durkin and colleagues from the University Of Wisconsin School Of Medicine. The study was published in the American Journal of Epidemiology, which is a peer-reviewed medical journal.

The researchers analyzed birth data and records from over 250,000 births from 1994, identified over 2,000 children diagnosed with autism by 2002, and then looked at many different factors to find patterns and likelihoods in birth order and parental age. Researchers obtained information from the National Center for Health Statistics, but unfortunately could only find birth information for 1,251 of the children diagnosed with autism. This amount ended up being 58 percent of the actual cases.

Regardless of limited birth information, the study identified that women over age 35 are 30 percent more likely to have an autistic child than women aged 25-29, and males over 40 years old are 40 percent more likely to have an autistic child than younger men. When this older parental age is coupled with the child being the first born for both parents, the chances of bearing an autistic child were nearly tripled.

It is worth noting that the researchers made adjustments for other factors that could have affected the results, such as gestational age, gender, multiple birth, maternal ethnicity and birth weight, thought they did not adjust for psychopathology of parents or infertility treatments. The researchers also noted that older parents may be more likely to notice developmental disorders in their children, and therefore seek diagnosis more often than parents of a younger age.

This case-cohort study is the first large study to show this much evidence that maternal age, paternal age, and birth order may greatly affect the chances of autism in children. Although evidence is strong, there is still not enough solid evidence to make a concrete conclusion, and researchers are hoping to hold larger, longer, more in-depth studies that can back up the evidence found so far.





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Disability Criteria - Medical versus Non-medical Social Security Requirements
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