SSD Disability

Someone recently wrote me and said that they had decided to file for disability. They mentioned that they had fibromyalgia, Rhabdomyolysis, and a milder form of manic-depression. Their questions were essentially A) Do people with conditions like this get approved? and B) How should a claim be approached to get speedy results. Here's what I wrote back.

The way the system has bogged down in the last three years, a person's chances of receiving an expedite on their case (this is an option at the hearing level) is less. Expedites are typically only granted for dire need. But, frankly, most people have a dire financial need by the time they get to the hearing level. Since you're just now starting a claim, dire need won't be something you can request an expedite on and expect to receive consideration for.

At the lower levels, people can sometimes call a congressman to try to get their case moved along faster. However, I can tell you from first hand experience that a congressional inquiry is usually only productive, again, at the social security disability hearing level. At the level where disability examiners work on cases, those inquiries just get filed away and that's basically it.

Where you are right now, the best thing to do is make sure that social security has a good record of all your treatment sources, dates of treatment, diagnoses, and names of doctors. You need to make sure they know about all of your medical treatment, including old treatment dates and new treatment dates. This will allow them to gather all the necessary records.

Older records are important for establishing your onset date and this will determine how far back your past due benefits may begin. Social security disability Back pay is determined by when you applied, whether or not the medical records and the established date of onset support the 12 months of retroactive benefits that are potentially available through social security (but not SSI), the five month waiting period which serves as an elimination period (and literally reduces your months of backpay by five), and also whether or not you have any prior applications that might potentially be reopened at a social security disability hearing.

Newer records, of course, will determine whether or not your limitations are currently disabling according to the social security administration definition of disability, and whether or not your disability has either lasted a year, or can be projected to eventually last a year.

Regarding your specific conditions, I will tell you that social security does not focus specifically on conditions but, rather on the limitations caused by conditions. So, the condition itself, to some extent, is irrelevant. If the condition (or conditions) limits your ability to work at the substantial gainful activity level for a year or longer, you will be approved. Now, there is a listing book of mental and physical impairments that lists disability approval criteria for certain conditions, but even the book itself is written so that the severity of a condition will go hand in hand with a claimant's resulting inability to do work and earn a substantial gainful income. In other words, everything in the disability evaluation process is about---functionality.

About mental conditions, let me just say that if you are listing a mental condition (such as depression) on your disability application, it will be helpful if you are actually being seen by a mental treatment specialist, such as a psychiatrist. You'd be surprised how many claimants list depression or anxiety on an application but have never been treated for the condition. Or, they've been given anti-depressants or anti-anxiety meds by their GP and have never gone to a psychiatrist. Trying to win a mental impairment case this way is next to impossible in most instances. And this is what will usually happen if you list one of these conditions without a record of treatment: Social security will send you to a mental examination, known as a consultative medical exam, or CE.

However, the odds of getting approved based on a CE are fairly slim. Social security really likes to see a longitudinal history of treatment because this documents the severity of the condition over time, which is important for mental conditions that tend to exacerbate and remiss (get better and worse), like depression and bipolar disorder.

Hope this helped. Good luck with your case.