Disability process, paperwork, legalities and more

Hello friends,

Just starting to help a friend, age 59, file for disability in the state of California. He worked for approx 1.5 years after his aneurysm, but has been unemployed for over a year now. While he feels he can still perform managerial functions (running a restaurant) the reality is he is unable to perform these tasks due to his injury. Please help to refer any legal advice/professionals so I can steer my friend in the right direction. Or if you have other links of interest, please feel free to send those as well. Thanks to all who respond.

I was just denied after a pipeline for two aneurysms and still have another one on the right. They told me it would take up to a year for a hearing:( I had to go back to work or have no income and lose everything. My life will never be the same and I feel like I am the token disability child at work. I am almost 62 and will have to retire and pay out of pocket for health insurance to the tune of 700 a month (about half of my SS retirement) it is all sad. Someone said to contact your congressperson. I wish I could help more but I am discouraged as well

I'm so sorry to hear. It is such a shame that a brain injury is not taken seriously by the courts, state, federal, etc. Thank you....and I wish you the best.

Martha

I am hoping this conversation will lead to some help. Why is it that an aneurysm survivor w/ disabilities is treated as though nothing is wrong? There must be someone that can give some input. The PED is new and being treated as a stent.

I am still looking for a job. Giving up the idea of disability. Too stressful.

Christine just the stress alone knowing the aneurysms are there is so difficult. Your life changes. Nobody understands. I did have to quit my job. My retirement pays for my medical insurance and a few extra hundred. I cant get SS until I am 67, because I was born in 55. Everyday I meditate to stay strong and positive.

This is a story the same as my wifes. She worked for appox. 1.5 years after her rupture, and discovered she could not work.

It took 2 years for my wife to qualify for dissability. Her first application was denied after about 6 months, and it took over a year to have a hearing for the appeal, and final approval of her disability.

We found through the system that brain aneurysms are not on their standard list of dissabilites, and many of the case workers do not understand what they are. We also found the following issues that came up during her application and appeal. Don't be surprised if your friend is denied during the first round. We chose to try the first request without a lawyer, and after being denied hired a lawyer to handle the appeal. We live in Michigan. Based on the SSI law, the cost of the lawyer was paid for out of back pay that she received from social security. They only get paid if they win the case. This is the law. The lawyer can charge minimal fees for services. Our total out of pocket that was not covered just so you have an idea was $300.00. Each lawyer will be different. They get 25% or maximum of $6000.00 of the back pay.

Where he will be told he went wrong.

Going back to work before applying for dissability. He will be told he should have applied right away and not gone back to work. Quitting his job.

What will happen. Once the application is sent in, they will gather all the information on him from his doctors, and hospitals. They will also schedule an evaluation by a doctor of their choice. In my wife's case, she was sent to clinical physcologist who diagnosed her with depression, after a ten minute interview, and denied her claim saying she could work. He must go to all scheduled evaluations, or it is automatic denial. They are suppose to send him to the best qualified person. This may not be true.

While waiting for the hearing, the lawyer gathered the same information, researched the injury, and had the doctors write letters explaining the injury in detail. The lawyer went over the denial in detail, and discovered a hole in my wife's case. Our GP was recommending that she not work, they saw him as not qualified since he was not a neurologist, while the surgeon was saying she was fully recovered with no issues. He was referring to the surgical clipping, and not the residual after effects. My wife was sent to see a neurophysicologist for a complete evaluation of her abilities. It took seven hours to go through this test, and in the end, he was the one who by his evaluation was able to say she could not work. This was the key piece of information that was needed. Someone who they felt was qualified to make the recommendation. Unfortuantely if he has no insurance, I was told this test can run anywhere from $6000-8000. And of course, after doing all this he may still be denied. Our lawyer said that 60% of the applications are denied the first time, because only 10% of the people appeal. And each state has a different board making the decision for the Federal Government

Keep copies of all correspondence, applications, and such. It will be a thick and heavy file.

Good luck

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Thank you for taking the time to try and give us some advice and your experience with the system.

I have to find a good lawyer. I did go back to work and am having problems; I haven't worked a full week yet. I am done for the semester in two weeks and then I will get an attorney and fight this. It isn't right. I can collect SS early at 62; Denise are you sure you can't collect early? I know you get more at 67 but it all evens out after a while and in some cases you can make out better collecting early. I say it is our money take asap. Anyhow...I'm up at 1 am because of tinnitus and then I have headaches so I am running on about 3 hours sleep a day. Frustrating.

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You are welcome. The system can be very frustrating. I am not a lawyer just a person that went through the system with my wife. Just make sure to keep copies off all your paperwork. And get copies of theirs too if you can. I believe it is truely not about the disability but whether they feel you can be gainfully employed. Gainfully employed is determined from what I understand as not doing the same job you did, but being able to be employed doing anything that brings in a minimum yearly income. That is a term that will you will be hearing alot. And its a process of learining the rules as you go. They are not easy to find in the system. We just went through the whole process again about 2 months ago. Every 3-4 years maximum of 7, they review your files to see if you are still eligible. Refilled out the application, they collected all of the records, then sent a letter stating that they found no medical justification for my wife to collect. Went through another evaluation with one of their recommended clinical psychologists. Took copies of all the past evaluations, made sure the doctor got them, and 3 weeks later they reapproved her disability again. The reason for the denial? She wasn't going to the doctor enough. They feel you should be going a minimum of every 6 months if you are truly disabled. My wife is far enough along that she just has followup visits. We now have to make sure these are scheduled no more that 6 months apart. Keep up the fight, and good luck.

Christine,

A good lawyer can help, they now all the games. I am not a lawyer. It is very frustrating. They want to prove you don't need it, and you are trying to prove you do. Like I said, it took around 2 years of dealing with the system for my wife to be approved.

In one of the many pamphelets we were sent after the approval, and there will be alot, they make a statement about changing from disability to social security. They said that once my wife reaches social security age, she will automatically switched from disability to social security, she has no choice. Guess we will find out in about 12 years. That would be one of the questions I would ask the lawyer.

Good luck and try to keep the faith.

On the outside we all smiles and put on a good face. We take a day trip with friends for a few hours with a few pain pills and laugh and talk about how "life is good". Not everyone knows we spend the next two or three days in bed with neuropathic pain or headaches; we cant walk around being gloom and doom. . and here I go rockin' on. May the peace of all understanding be with you all today.

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Denise, Honestly I had no idea how this would impact my life. I lost my S.O. 11 months prior to my diagnosis. I feel like I have been left swimming alone in a big ocean. The online support group has been huge for me however on a daily basis in upstate new york it is dreary and cold and life at times seems hopeless. I am grateful for my grandkids; they are the reason I go on. I wasn't really asking for much from SS; it would have been a difference of $400.00 a month on my benefit that I am entitled to in Sept anyway. I think they deny everyone once unless they are dying. Then I still remember my SO having a hard time getting paid; had to call every month even after 13 years of cancer and 28 different chemotherapies and 8 major surgeries. Yikes!!

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Denise...PED is a stent...however, that should not be the "thing" determining disability...

I have no expertise but have gone thru a lot...and have done a lot of research...I am having a PowerPoint put together; tho not sure of completion because I am so slow reviewing/documenting appropriately...

I can write stories about pre-PED stents...and coils were/are...marketed/promoted as the minimally invasive procedure/devices... and, I will let that drop for now...

If your neuro-docs have not recommended/provided neuropsych testing, ask them...Results of that can do several things...i.e. be submitted w/your SS Disability application...tho SS may want to do another one...Mine did...i.e.more extensive...but when done I even had back-pay from SS...

Neuropsych tests can vary by the numerous tests available...If you have one done, be sure to get the test results forms...a/w/a the report...there is a results form for each test...

The results of the testing can also direct you/doc for securing the types of therapy(ies) that may help overcome/modify some disabilities for your future...personal and/or to work.

IF SS Disability does another neuropsych test...the scheduling can take up to 6 months...their scheduling can take some time based on the volumes...

Denise...I have no expertise...I am sharing as much data as I got from my experience...

There was apx 18 months between the initial tests and the SS tests; two years after that, I elected to have another test and again two years after that...these f/ups will display the changes...recoveries to declines to "no change"... to help w/continued therapies...

Prayers you keep us updated...and have the best, the right, results...

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Christine...I have no expertise...just covered a lot of my experiences above...to Denise... I attempted to return to work...and, it will make several chapters in my book...

I appreciate you taking the time to make this experience available to me. I have had the tests, and many more. I will be interested in your powerpoint.

Were your tests done by SS Disability?

Where ever...did you get the test results forms or were the results noted specifically enough?

My very initial test/results...I was finally given the forms...on my request...because there was limited to no reference of test results in reality...it was all sort of sloshed over... actually to the point my SS papers note it...and specifically no test results were qualified...

Powerpoint will have images of my brain...w/data...my coordination is mentally taxing.

Do you have CD/DVDs of your procedures...and, of your initial diagnostic one for comparison?

One of these days...I may type some examples of sentences from the report from the facility...and, some sentences from the SS disability report...i.e. ease of reading...

You will be most welcome to my PowerPoint when it gets done...just cannot promise a date...

Hi Martha...I wrote more below...

Has he applied for SS Disability? If he has not, and is not willing to...suggest you connect w/him directly... i.e. he can apply/receive...and, IF he does go back to work, they can stop SS payment...There is a small amount that can be earned while on Disability...cannot remember the amount...

You need his want/commitment b4 the rest can be effective...even getting legal aid...What are his other options...is he getting unemployment; does he still have savings to draw from...etc etc... question to him is...how is he managing his life ...setting the restaurant aside...

Best wishes and hope you keep us updated...you are a grand friend for him...we all so like to know of each success, each step...and which info may help another member.. .

Pat

Daddyfish - thank you for the above info. Very informative and helps us gauge how long the process of SSD will take. My friend received his first rejection letter so we forging ahead with a SS attorney to process the appeal.

Thanks again.

Martha

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Your friend is very lucky to have you. This is well worth the effort.

Good luck.