I apologize if there is already a discussion, but I couldn’t find the info. I need some help with my disability being denied.
I was diagnosed in May and have been on short term disability. I got the pain under control with Trileptal & Baclofen, but the drugs make me too loopy to work. My short term memory is shot. My disability from my employer’s insurance company denied my claim. In addition to errors in my file, it seems to me that they just don’t understand. If the pain is under control, then how can I be disabled? The claims person also belittled my memory loss (‘Oh that happens to me all the time, it just means you’re getting older’). I’m 40 years old and went from having a spectacular memory, to forgetting why I walked into the kitchen - in a matter of weeks.
Does anyone have any experience with a disability claim appeal (which I am working on right now). Suggestions about how to talk about information? Experience suing the insurance company?
Also, I'm probably going to have to go off Trileptal because of side effects. Does anyone have advice for the period of time where you have to wean off the old drug and ramp up the new one at the same time?
Dear Sarah,
I have been on the LTD from my employer’s insurance company for the past few years, and am up for a re-review for the long term (till I’m 65) version. I am worried that they will make me have to appeal as well. I called to leave a message for the nurse (nurse?) who is one of the people deciding my case, she couldn’t find my file, and when she finally did, she said “Oh, yeah. Headache.” HEADACHE? I was wordless, and really wish I had said something, but I could not get my jaw to shut!
Since I am fighting for it both with the govt and with the private ins, I got a lawyer. The lawyer is working with me to get the govt disability, but I am taking some of the documentation that they have my doctors fill out, and forwarding that to the private ins.
It seems to me that you might want to call around to as many lawyers as you can, and find one that will appeal the insurance company. You may want to ask your doctor to send you for memory testing and other testing that can quantify what it is that you are dealing with. I KNOW that this level of memory loss is beyond what that dismissive person said to you. But you have to get the testing done that makes the case.
You may very well be able to find a lawyer that doesn’t require payment unless they win your case, then they deduct the charges out of your backpay (what you should have been paid during the time that you appeal). I wish I could offer more advice - it is hard not to get emotionally involved because it is your life they are playing with. But finding a lawyer sounds like the next step.
Best of luck and I will come add more if anything comes to mind.
Lily
The battle for Social Security Disability often doesn’t START until you’re denied TWICE, and you are finally given a HEARING with an Administrative Law Judge. Some states have MUCH longer waiting times for such trial dates, so consider the SETTING. YOU can choose where the battle occurs. If you can bring both an ATTORNEY (typically, those who are paid only if you prevail will only ‘take’ your case if they feel you have good chances) and your DOCTOR, your chances improve markedly. Prepare to pay for their TIME. Pain itself is NOT a sufficient criteria for Favorable SSA Disability Award Status, but to the extent that pain affects your life (non-exertional pain) it will be considered. If you are awarded Full Disability, it will not begin until FIVE MONTHS AFTER your filing date, and you MAY have to reimburse your employer (subbrogation of duplicate disability benefits income). Many employers will DEMAND that you apply for SSA if they award you a Corporate Disability Award, and if you prevail in ONE case, it can help in the other. If you win BOTH, depending upon your former employer, you may have to use Medicare as your Primary Insurance and Corporate Medical as your SECONDARY, once you become eligible for these (another LONG wait). It’s a PROCESS, not an EVENT.
sarah i filed with a lawyer helping me and was turned down ive had 13 surgeries mcs and deep brain stim they told me with my past education and intelligence i could find a lesser job and be able to work ive had since 99 they act like this aint that bad of adeal please give a hard time hope you win then show me what to do
Sarah, if you would like, I can clip and forward your inquiry to a former disability counselor who is herself disabled by facial pain. Send me a note through ■■■■■■■■■■■■■■■■■■■ if you would like me to set up that interaction by email.
Sally: Expect 4 months for the first denial. Once that happens, it will all depend on the lawyer your get and the amount of supporting documentation you have. As Red has said, disability claims is an adventure in and of its self.
sally choate said:
HOW LONG DOES IT TAKE FOR THE FIRST TIME YOU FILE DO YOU HAVE TO CALL THEM ,
OR THEY CALL YOU ,I FILE FOR DISABLTY BUT, I DONT KNOW WHAT AM REALLY DOING,
BUT I HAVE FACIAL NERVES THEY SEND ME TWO DIF DOC TREGEMIAL N AND A EXAMINER OF PSYCHOLOGISTS
I HAVE NO IDEA I WHY I WENT TO PSY ANYWAY HOW LONG DOES IT TAKE PLEASE SOMEONE TELL ME!!
Sally, I did some checking with a friend who was once a disability counselor. Her input was as follows:
Waiting time can differ from state to state. For each phase, there's like a 60 or 90 day time frame. You may do better to go to the local office if there is one and ask. Otherwise, talk with the patient advocate of your insurance company .
Given your writing, I am wondering if you are either having problems typing because of the distractions of your face pain, or perhaps English may be your second language. Either way, it will be wise for you to ask an advocate/capable friend to help you understand the feedback you get when you go to the local disability office or contact them on the phone.
It appears to me from your narrative, that your disability insurance company is sending you for independent medical consults. You need to understand what they hope to establish with such consults, and why you were sent to see a psychologist. Unless the psychologist is specifically trained in the assessment and treatment of depression associated with chronic severe pain, they aren't likely to be useful for much.
In the worst case, some companies pay psychologists to disqualify applicants, claiming that their pain is "psychogenic" (caused by distortions of the patient's thinking). If anyone for ANY reason uses the term "somatoform pain disorder" toward you, you should challenge such a diagnosis immediately and in writing. There is ample evidence in medical literature that such a label is completely inappropriate for anyone with pain restricted to the face. Practice committees of the American Psychiatric Association are now revising and combining the entire class of "psychosomatic" disorders, to fix serious errors and overlaps in the previous descriptions of such disorders in the Diagnostic and Statistical Manual.