Disability
Related: About this forumAny point in a 30 year old applying for SSDI/SSI? In Georgia?
I'm "only" 30 and have heart problems that basically prevent me from doing anything that even comes close to raising my heart rate.
I also have crippling social anxiety, but that doesn't seem to be a disability according to SS.
I've already applied once, when I was 27. Took me 3 years for SS to deny me 3 times and basically ask why I even bothered. Had a lawyer, but he literally chuckled when I explained what was wrong with me, in our first meeting. He didn't even try and later simply gave up, without so much as a "I'm sorry."
So I ask, is there any point in me, a 30 year old, even trying anymore?
I can't work. It is torture to stay awake longer than about 2 hours at any time, due to the heart pain. I HAVE to sleep, as that is the ONLY thing that helps it. And keep in mind I'm in Georgia, red state hell, so even if I had no arms or legs, it would still be hell dealing with SS.
Thinkingabout
(30,058 posts)Listed but they do apply for SSI and SSDI.
Kalidurga
(14,177 posts)I can't imagine living in Georgia and being dead broke and suffering from multiple disabilities. Especially ones that make it harder to even seek treatment. Going to the doctors to get documented is time consuming and if you have to sleep a lot it's hard to keep appointments and for some reason missing appointments is a reason for the government to say you aren't as disabled as you are. One of my sisters in Tennessee has Graves disease among many other problems and she had a hella time getting disability, I don't recall how long it too, but it was a long time and in the meantime she had to move from relatives house to relatives house, because she had no money, not even for food. Basically she had to be supported by the family for over a year, but I don't know how much longer than that other than it took longer than that.
As for myself I have a similar situation. I can't stay awake for much longer than four hours at a time. I ache all over and that is everyday. I am exhausted and I have other problems too numerous to mention. The only one I actually care about is the fatigue if I wasn't tired I wouldn't let the aches and pains get in my way of working nor the other problems, I would just deal with those issues as well as I can. Also I can't stand without holding onto something for more than a couple of minutes even if I am in line I hold on to a cart or something otherwise it's very difficult and painful, pacing helps a little.
daleanime
(17,796 posts)just had my SSDI approved a couple of months ago, had like 5 tests from the VA showing what the problem was. The more documentation you have the better. Get your records and check against the requirements. Here's a link, good luck, it's not easy.
https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&ved=0CEMQFjAA&url=http%3A%2F%2Fwww.ssa.gov%2Fdibplan%2Fdqualify.htm&ei=ZrmhVZzIJsqx-QHmkJ7ICA&usg=AFQjCNFtD1GA9IVPg07vXIB5w8TjYDP1RA&sig2=SD-uLMf5y_sxRnSj92F5XQ
840high
(17,196 posts)happyslug
(14,779 posts)And Stress tests can KILL people with bad hearts. Here is 4.00D 2 which is
1. What is chronic heart failure (CHF)?
a. CHF is the inability of the heart to pump enough oxygenated blood to body tissues. This syndrome is characterized by symptoms and signs of pulmonary or systemic congestion (fluid retention) or limited cardiac output. Certain laboratory findings of cardiac functional and structural abnormality support the diagnosis of CHF. There are two main types of CHF:
(i) Predominant systolic dysfunction (the inability of the heart to contract normally and expel sufficient blood), which is characterized by a dilated, poorly contracting left ventricle and reduced ejection fraction (abbreviated EF, it represents the percentage of the blood in the ventricle actually pumped out with each contraction), and
(ii) Predominant diastolic dysfunction (the inability of the heart to relax and fill normally), which is characterized by a thickened ventricular muscle, poor ability of the left ventricle to distend, increased ventricular filling pressure, and a normal or increased EF.
b. CHF is considered in these listings as a single category whether due to atherosclerosis (narrowing of the arteries), cardiomyopathy, hypertension, or rheumatic, congenital, or other heart disease. However, if the CHF is the result of primary pulmonary hypertension secondary to disease of the lung (cor pulmonale), we will evaluate your impairment using 3.09, in the respiratory system listings.
2. What evidence of CHF do we need?
a. Cardiomegaly or ventricular dysfunction must be present and demonstrated by appropriate medically acceptable imaging, such as chest x-ray, echocardiography (M-Mode, 2-dimensional, and Doppler), radionuclide studies, or cardiac catheterization.
(i) Abnormal cardiac imaging showing increased left ventricular end diastolic diameter (LVEDD), decreased EF, increased left atrial chamber size, increased ventricular filling pressures measured at cardiac catheterization, or increased left ventricular wall or septum thickness, provides objective measures of both left ventricular function and structural abnormality in heart failure.
(ii) An LVEDD greater than 6.0 cm or an EF of 30 percent or less measured during a period of stability (that is, not during an episode of acute heart failure) may be associated clinically with systolic failure.
(iii) Left ventricular posterior wall thickness added to septal thickness totaling 2.5 cm or greater with left atrium enlarged to 4.5 cm or greater may be associated clinically with diastolic failure.
(iv) However, these measurements alone do not reflect your functional capacity, which we evaluate by considering all of the relevant evidence. In some situations, we may need to purchase an ETT to help us assess your functional capacity.
(v) Other findings on appropriate medically acceptable imaging may include increased pulmonary vascular markings, pleural effusion, and pulmonary edema. These findings need not be present on each report, since CHF may be controlled by prescribed treatment.
b. To establish that you have chronic heart failure, your medical history and physical examination should describe characteristic symptoms and signs of pulmonary or systemic congestion or of limited cardiac output associated with the abnormal findings on appropriate medically acceptable imaging. When an acute episode of heart failure is triggered by a remediable factor, such as an arrhythmia, dietary sodium overload, or high altitude, cardiac function may be restored and a chronic impairment may not be present.
(i) Symptoms of congestion or of limited cardiac output include easy fatigue, weakness, shortness of breath (dyspnea), cough, or chest discomfort at rest or with activity. Individuals with CHF may also experience shortness of breath on lying flat (orthopnea) or episodes of shortness of breath that wake them from sleep (paroxysmal nocturnal dyspnea). They may also experience cardiac arrhythmias resulting in palpitations, lightheadedness, or fainting.
(ii) Signs of congestion may include hepatomegaly, ascites, increased jugular venous distention or pressure, rales, peripheral edema, or rapid weight gain. However, these signs need not be found on all examinations because fluid retention may be controlled by prescribed treatment.
3. Is it safe for you to have an ETT, if you have CHF? The presence of CHF is not necessarily a contraindication to an ETT, unless you are having an acute episode of heart failure. Measures of cardiac performance are valuable in helping us evaluate your ability to do work-related activities. Exercise testing has been safely used in individuals with CHF; therefore, we may purchase an ETT for evaluation under 4.02B3 if an MC, preferably one experienced in the care of patients with cardiovascular disease, determines that there is no significant risk to you. (See 4.00C6 for when we will consider the purchase of an ETT. See 4.00C7-4.00C8 for what we must do before we purchase an ETT and when we will not purchase one.) ST segment changes from digitalis use in the treatment of CHF do not preclude the purchase of an ETT.
4. How do we evaluate CHF using 4.02?
a. We must have objective evidence, as described in 4.00D2, that you have chronic heart failure.
b. To meet the required level of severity for this listing, your impairment must satisfy the requirements of one of the criteria in A and one of the criteria in B.
c. In 4.02B2, the phrase periods of stabilization means that, for at least 2 weeks between episodes of acute heart failure, there must be objective evidence of clearing of the pulmonary edema or pleural effusions and evidence that you returned to, or you were medically considered able to return to, your prior level of activity.
d. Listing 4.02B3c requires a decrease in systolic blood pressure below the baseline level (taken in the standing position immediately prior to exercise) or below any systolic pressure reading recorded during exercise. This is because, normally, systolic blood pressure and heart rate increase gradually with exercise. Decreases in systolic blood pressure below the baseline level that occur during exercise are often associated with ischemia-induced left ventricular dysfunction resulting in decreased cardiac output. However, a blunted response (that is, failure of the systolic blood pressure to rise 10 mm Hg or more), particularly in the first 3 minutes of exercise, may be drug-related and is not necessarily associated with left ventricular dysfunction. Also, some individuals with increased sympathetic responses because of deconditioning or apprehension may increase their systolic blood pressure and heart rate above their baseline level just before and early into exercise. This can be associated with a drop in systolic pressure in early exercise that is not due to left ventricular dysfunction. Therefore, an early decrease in systolic blood pressure must be interpreted within the total context of the test; that is, the presence or absence of symptoms such as lightheadedness, ischemic changes, or arrhythmias on the ECG.
http://www.ssa.gov/disability/professionals/bluebook/4.00-Cardiovascular-Adult.htm#4_02
AS a general rule, if the medical evidence contains the above findings, you win at the application level. If you do NOT meet the above requirements, that does NOT mean you are NOT DISABLED, but that how the heart problem limits you determine if you are disabled as that is defined by SS.
happyslug
(14,779 posts)Last edited Sun Jul 12, 2015, 11:39 AM - Edit history (2)
SSI is a FEDERAL PROGRAM, as are the various state run (but Federally funded) Office of Vocational Rehabilitation (OVR).
First, SSI. You are claiming heart problems. Heart problems are evaluated under 4.00 of the list of Impairments at Step Three of the five step Sequential Evaluation Program, the Sequential Evaluation Program is the process SSA follows when deciding cases. 4.00 listing are as follows;
http://www.ssa.gov/disability/professionals/bluebook/4.00-Cardiovascular-Adult.htm#4_02
As a general rule if you meet the requirements set forth in 4.00 of the listing of impairments, you would be on SSI today and generally would have won it on your initial application. The listing of Impairments are decided on in Step Three of the five step Sequential Evaluation Program. At Step Three you can WIN, but you can NOT lose. If you do NOT win at Step Three, you go to Step Four (can you return to past work?) and then Step Five '"Are they other jobs in the National Economy you can do'. This is where people whose medical conditions do not meet a listing win or lose they cases, and I suspect that is where you lost your case.
Under Step Five of the Sequential Evaluation, you are under age 50 and to be ruled disabled at Step Five of the Sequential Evaluation Program, you must be incapable of doing even sedentary work. Sedentary work is defined as being on one's feet no more then two hours in an eight hour work day and lifting no more then 10 pounds. Such jobs exist in the national economy in the form of "Small Parts assembler", "Small electric Parts Tester" and "Small Parts bagger" (These are the most common jobs listed by Vocational Experts when I have SSI Hearings, other areas may have different jobs, for the jobs are viewed as 'Representative' not exclusive).
Notice the test for SSI is the "Inability to work in jobs that exist in substantial numbers in the National Economy'. What SSA looks at are full time times that you can do. These jobs must exist, but all of them may be filled, but as long as substantial numbers exist (and that is up to the Administrative Law Judge to decide), you are NOT disabled.
In my area Vocational Experts (VE) will testify that someone who can NOT work 2 hours, take a 15 minute break, work two hours and take a 30 minute break, work two hours take another 15 minute break, work 2 hours and go home, is able to do ANY work that exists in substantial numbers in the National Economy,.
I suspect in your case, the Administrative Law Judge ruled that he gave your testimony no credibility and your claim of restrictions are excessive and not supported by medical evidence. Since the Administrative Law Judge gets to decide such "facts" and as finding of 'facts' MUST be accepted as true on appeal. Thus unless the "facts" are not supported by evidence in the medical record, any appeal of that decision will just uphold the Administrative Law Judge's decision. Given the nature of your illness, no medical record clearly states that your condition FORCES you to sleep every two hours, thus no substantial record exists that says you HAVE TO Sleep every two hours. Thus it is up to the Administrative Law Judge (ALJ) to decide how often you must sleep based on your testimony and the ALJ did not believe you to the extent to claim the problem affects yo. Such finding of the Administrative Law Judge will be upheld on appeal.
Now, that does NOT mean you can NOT RE-APPLY for SSI. New evidence can exists, a new doctor appointment is enough for the Social Security Administration (SSA) to view your case as a new case, but you need to think about getting evidence that supports your position of having to nap every two hours.
Unless you doctor actually see you do sleep as often as you claim , what the Doctor's report as to your sleeping is not a medical finding (On the other hand a Sleep Study would be a Medical Finding and you may want to do one to build up the medical record of excessive sleepiness). Please note what you report to the Doctor and he writes down is just that a report, it is NOT considered Medical Evidence UNLESS the doctor makes some sort of finding based on that report , Most doctors just write down what you tell them, they do NOT then analyze those reports in medical findings. I have seen a lot of Medical Reports indicating problem told to the Doctor by the patient and then the Administrative Law Judge (ALJ) dismissing those reports as simply what the patient told the doctor NOT medical findings of the Doctor,
Please note, SSA does NOT believe your doctor can determine if you can work or not. Doctors can report on how your medical problems restrict you, but NOT if such restrictions prevent you from working. The Social Security Administration (SSA) hires people known as Vocational Exports (VE) who have a background in work placement to testify what jobs someone with a set of restrictions can perform. Vocational Experts (VE) tend to have Phds, but NO medical background.
In Administrative Law Judge (ALJ) hearings, Vocational Experts (VE) will answer questions put to them, but they will NOT say if someone is capable of working or not, just that someone with the set of restrictions in the question put tge tje Vocational Expert can work or not. Actual determination if you can work is up to the Administrative Law Judge ALJ) to decide based on the answers to the
hypothetical question given by the Vocational Expert.
Thus sooner or later we get to the real issue in your case, you need EVIDENCE of excessive sleepiness other then your own testimony. That is where the Office of Vocational Rehabilitation (OVR) comes into play. Apply for their services, see what retraining program they can get you into. I tell my Clients three things can happen if your apply for OVR:
1. The Office of Vocational Rehabilitation (OVR) examine you and determined you are NOT retrainable. While this is NOT binding on SSA, SSA tends to give such reports great weight. This RARELY HAPPENS, in most cases OVR tries to place you in a retraining program.
2. You get into a retraining program and either fail the program OR fail to get a job. SSA views this as a failed Job attempt and is generally a plus point for you. Furthermore, it is a record OF WHY YOU FAILED, and if it is do to excessive sleepiness, OVR will record that. Make sure SSA gets those records, for it will support your statement of having to sleep that often.
3. OVR retrains you to do a job and you get hired, that will pay more then SSI will pay,.
Now, OVR, in my home state anyway (OVR officers are run by your state, but these are FEDERALLY FUNDED PROGRAMS as part of the Social Security Act, so this tends to be nationwide) will evaluate you first. Checking with your doctor, and if you do not have one, send you to one of their own doctors. Once OVR evaluate you, OVR will come up with a list of jobs OVR think you can do with your medical limitations. I have had clients get training in courses from Dog Grooming, auto repair, small engine repair, general office clerk, watch repair to making teeth. Once they have the list, you get to select what you want to be retrained to do.
Thus I would go to OVR and see what they can do for you.
Also see if you have a "Blind and Handicapped" program in your area. These are "Sheltered workshops" often with Government Contracts (The US Army gets a lot of supplies from them, including wire harnesses for electrical devices). They hire people who are disabled and can NOT work full time. The Blind and Handicap agency in my areas does an excellent evaluation of their employees, including if they are NOT working up to Competitive employment (i.e. will report if someone is NOT doing what a normal employee can do). This is another way to get documentation that you can NOT do competitive employment and why.
I suspect in your case the Administrative Law Judge did not believe you when it came to your restrictions. Instead he said the medical evidence supported a finding that you can not be on your feet more then two hours in an eight hour day, but since that does NOT mean two hours are any one time, but over the entire eight hour day, you can do sedentary jobs and such jobs exist in substantial numbers in the National Economy. Nothing can be done about such a decision, but you can make another application.
At the same time, apply to your local OVR office. There do have a web site:
http://gvra.georgia.gov/vocational-rehabilitation-division
There is NO law against applying for SSI again AND applying for OVR services and in your case I would do both.
mackerel
(4,412 posts)You need supportive doctors who will be willing fill-out a residual functional capacity form for you. Everything is empirical evidence so you need to have the medical back up on your side.