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moriah

(8,312 posts)
Sat Nov 23, 2013, 10:49 PM Nov 2013

Got first denial letter, onto recon.

My main severe impairments are Bipolar Disorder and asthma. I do have fibromyalgia and nerve damage in my wrists/hands along with arthritis or ligament damage in my thumbs. They never developed the record by sending me into specialists for my pain issues, and I can't afford to see them until January.

I was hospitalized three times in a year, twice for asthma and once for suicidal depression. I got out of the hospital on the 14th of this month, and got my denial letter dated the 18th.

It felt like a slap in the face, because everyone at the hospital said they thought I already had it approved or should be when I told them I wasn't. They said I did not equal any of the listings, but I believe the combination of impairments meets or exceeds the asthma listing -- it wants three hospitalizations in a 12 month period. In that 12 months, two were for asthma and one was for depression. In total I've been in inpatient 4 times in 18 months, two for physical and two for mental.

Am I wrong to feel like this is an incorrect denial? I would give up if I could, but I only made $85 so far for November.

12 replies = new reply since forum marked as read
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Got first denial letter, onto recon. (Original Post) moriah Nov 2013 OP
From what I've heard, they always deny NV Whino Nov 2013 #1
This, I had to go before an ALJ before I was approved. Packerowner740 Nov 2013 #11
Absolutely proceed through Recon. wellstone dem Nov 2013 #2
I retained a lawyer that helped a friend get approved in 7 months. moriah Nov 2013 #7
My doctor told my husband Control-Z Nov 2013 #3
keep going, get a lawyer DonCoquixote Nov 2013 #4
Are you talking about Soc. Sec. disability or SSI? dixiegrrrrl Nov 2013 #5
SSDI, not SSI. moriah Nov 2013 #6
Harder to get when younger. Packerowner740 Nov 2013 #12
No Recon in RSDI cases (correct name for SSDI) happyslug Nov 2013 #8
Huh. Well, they said I could ask for reconsideration in my letter. moriah Nov 2013 #9
It will be treated as a request for a hearing happyslug Nov 2013 #10

wellstone dem

(4,460 posts)
2. Absolutely proceed through Recon.
Sat Nov 23, 2013, 11:07 PM
Nov 2013

Remember that they did not have the info about the most recent hospitalization. Get a copy of the listings and give them to your doctors. One of the challenging things about your case is that you have a psychiatric and a physical impairment. So doctors in those specialties are going to be reluctant to comment on the other disability. But if each will write a letter, not just send in the medical reports that will really help.

Good luck to you. And if you get denied on recon, don't be surprised 95 percent get denied at that stage, but it's a much lower percentage at the hearing stage. If you are denied on recon, you should absolutely get a lawyer.

moriah

(8,312 posts)
7. I retained a lawyer that helped a friend get approved in 7 months.
Sun Nov 24, 2013, 12:21 AM
Nov 2013

I did the recon myself, saying I believed I had a combination of impairments that met the severity of a listed impairment. I had new diagnoses to add, new medications that are causing me side effects, and another hospitalization, though that "repeated episode of decompensation" wants 3 hospitalizations in a year, too.

So the two of them, I think, meet it, and while I hope I don't wind up in the hospital again, I'm going to try to avoid it.

Control-Z

(15,684 posts)
3. My doctor told my husband
Sat Nov 23, 2013, 11:09 PM
Nov 2013

I needed to be on disability. I didn't agree at the time but long story short, he (my doctor) insisted and called a local disability lawyer for me. It sailed through, retroactive something like 3 years.

Yes, the lawyer made money but he deserved it. Everyone I've ever talked to about disability has been denied 3 times applying on their own. Don't give up - and think about using a lawyer who specializes in disability claims.

Good luck!

moriah

(8,312 posts)
6. SSDI, not SSI.
Sun Nov 24, 2013, 12:20 AM
Nov 2013

I worked enough to potentially get a $1700 check, but I'm in my 30s. So the RFC test is harder, the grids put me in a place where it's hard to get a vocational evaluation for RFC.

 

happyslug

(14,779 posts)
8. No Recon in RSDI cases (correct name for SSDI)
Mon Nov 25, 2013, 05:04 PM
Nov 2013

RSDI, Retirement, Survivors, and Disability Income.

Around 2000 Social Security decided to speed up the process, dropping Recon for RSDI income cases.

Since this was an administrative change, it could NOT changed anything passed by Congress, this was the first real change in such regulations first adopted in the early 1960s.

Now, when Congress adopted SSI in 1974, one of things Congress did was adopt the existing Administrative system for SSI. This made the Administrative System part of the law passed by Congress's law as to SSI. Thus SSI still had Reconsideration, but RSDI does not.

You are applying to RSDI, (What you call SSDI), thus has no reconsideration, the next step is a hearing in front of Administrative Law Judge.

Now at Administrative Law Judge (ADJ) a Vocational Expert (VE) will be present and should testify that if you miss more then one day of work for any reason (Or combination of reasons) then he will say they are no jobs that exists in substantial numbers in the National Economy. Your case sounds like the type of case that people win at the ALJ Level, the real key is how many days off work your disabilities make you miss. That I have no information (and want none) on your restrictions, that is between you, your doctor, and your lawyer and sooner or later the ALJ. The issue is how restricted are you by your disabilities. Tell you Lawyer, Your doctor and get them to say that is compatible with your disabilities.

Those are issues in your case. Concentrate on them, Make a list of how you get around, where and when you are going and how you feel afterward. How often you have to cancel doing things do to your restrictions, These will help you address what the ALJ wants.

moriah

(8,312 posts)
9. Huh. Well, they said I could ask for reconsideration in my letter.
Tue Nov 26, 2013, 09:37 AM
Nov 2013

And when I went on the website I appealed the recent denial, as well as talking to my lawyer, so I did what the instructions online told me to. It asked mainly about new symptoms. Since I just got out of the hospital and the new medication has some pretty bad side effects -- I haven't been able to work a full 10 hours in a week for the last three months. This is still in state DDS hands to my knowledge.

I am applying on my own work record, so I'm just grateful that I don't have to draw SSI like my father did, and I'm hopeful that the friend I know who is also about to apply will get it based on her husband's work record (she's a widow of two different men whom she was married to for over 10 years each). She's in her 50s, not old enough though to qualify for straight widows benefits -- not full retirement age or even for Medicare until she's 55.

I've been lucky -- an old friend from years back online is loaning me some money to have in an emergency or if I cannot get more samples of the Abilify before the PAP kicks in so I can stay on it.

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