Re; Disability denial

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Mike, everybody's advice is generally good. Your disability denial letter should have a "personalized" notice which explains precisely why your claim was denied. Sometimes these are fairly well written, often they aren't. You can sometimes get clues as to why your claim was denied if the personalized notice part of the denial letter was fairly detailed. You should file your appeal immediately - get the ball rolling - also there's a time limit for filing so don't put it off. You can hire an attorney or non-attorney later. The appeals process used to involve three levels - reconsideration, hearing before an administrative law judge (ALJ), and federal court. If you live in a state where Social Security has eliminated the "reconsideration" step, you will be filing to have your case heard before an ALJ. At this stage a lawyer or non-lawyer can be used to help represent your

case. At the federal court level, only an attorney can represent you. Some non-lawyer representatives do a good job because they worked for Social Security and know a lot about the process and regulations. The representative is hired on a contingency basis, so if you lose, you don't pay, although there may be a clause in the contract for payment of "expenses" like getting medical records. You can request all medical records yourself, so be careful about agreeing to pay for "expenses". As far as knowing how sick you need to be to get on disability, you should know that the link to the Soc Sec Disability "Blue Book" in ' post is for the Listing Of Impairments. However, there are several ways to get on Soc Sec disability. One is if you meet "listed" requirements. These are hard-core cases - you are presumed disabled just by having the medical condition. The HIV listings generally require the

presense of opportunistic infections, cancers etc. However, you don't have to meet a listing to be approved. The process of deciding your claim is supposed to go like this - it's called "sequential evaluation" Step 1: Is the claimant engaging in significant gainful activity (in other words, working too much to be considered disabled)? Yes - deny claim, No - go to step 2. . 2. Does the claimant have a severe impairment? (anything more than slight is severe). (If no, deny claim. If yes, go to step 3) 3. Does the claimant's impairment "meet or "equal" the severity of an impairment in the Listing of Impairments? (If yes, approve claim. If no, go to step 4) 4. Does the claimant's impairment prevent them from performing "past relevant work" ?( Past relevant work means jobs done within the past fifteen years at a significant level). If

no, deny claim. If yes, go to step 5. 5. Does the claimant's impairment prevent them from performing "other" work considering the claimant's age, education, and past work experience, and availability of other work in the national economy? (If no, deny claim. If yes, approve claim.) Note: In deciding steps 4 and 5, the decision maker relies heavily on a two forms called "Residual Functional Capacity Assessment (RFC)" - one physical, one mental (if mental issues are involved). These previously were filled out only by staff physicians or psychologists. Now, they are often completed by disability "specialists" who have no advanced medical training. In my view, this has been a huge mistake resulting in many errors. You can request to see these forms, which are on the left side of your disability file. Copy them, and see what things they say you're supposed to be able to do, and whether the forms

were signed by a physician. In summary, even if you don't have a medical (physical or mental) condition which is among the listed impairments, you can still get approved. However, this process clearly gets more complicated and subjective as one moves down those five steps. Factoring in past jobs, work experience, RFC etc can be judgemental. As others have said, you need to document ANYTHING that interferes with work-related activity. This means telling your doctor clearly about symptoms and problems that are affecting any physical or mental capacities that could be interfere with going to a regular job. You mention several mental issues, so you hopefully have sought treatment and have told your therapist about all problems you're having. If your combined medical impairments prevent you from doing past work and "other" work, given your age, education, and past work experience, you

can be found disabled. You can see why people hire attorneys or informed representatives to assist them in the appeals process. I used to work as a federal QA reviewer of Soc Sec disability claims in the Chicago and KC regions. Tom in MO Date: Tue, 18 Apr 2006 15:33:20 -0700 (PDT) Subject: RE: Disability DenialHere's what Social Security has to say....... http://www.socialsecurity.gov/disability/professionals/bluebook/14.00-Immune-Adult.htm#14.08%20Human%20Immunodeficiency%20Virus%20(HIV)%20infection wrote: v\:* {behavior:url(#default#VML);} o\:* {behavior:url(#default#VML);} w\:* {behavior:url(#default#VML);} .shape {behavior:url(#default#VML);} st1\:*{behavior:url(#default#ieooui) } You don’t need an ‘AIDS defining condition’, or OI. You COULD qualify with a constellation of problems which disable you from the activities of daily living – a set of things which add up to disability.

Key, is what is in your med records, what a med expert would testify too. And yeah, document, document, document. IF relying on the ‘constellation’ approach, which evidently is what you are doing, denial is more often first time ‘round. Get a lawyer to appeal it NOW. Their pay is capped. I believe the next stage may be only an administrative law judge-hearing, rather than a full up Court: that is, less time, formality, and expense.

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