Denied Disability on Reconsideration - Eventual Next Stop Hearing

[stumblnrose]

I was denied on reconsideration. They told me I could work as a waiter. I quit waiting tables 15 years ago because it was ruining my body. After my bout with Toxic Epidermal Necrolysis I have arthritic joints, cannot carry heavy things and can remain on my feet maybe one hour. I have state supported benefits (GAU in WA state) but was denied an appeal for psychological benefits. I was in a coma four months and suffered PTSD, my mother died, my wife abandoned me and I have severe anxiety attacks. The psychiatrist who interviewed me told me I had never seen a certain caseworker I saw for 2 months and that I better get my story straight. When I asked her why I sometimes slept 16 hrs a day she laughed at me. I complained about her and spoke to her supervisor who seemed aware of her tactics. The shrink lady kept saying "Are U suicidal"? and i said sometimes. she said that is not an answer, either I am suicidal and needed to go to the hospital right away or I am not suicidal. I would probably have gone but my puppy was in my car outside.

I miss being in a methadone-laden coma. That was heaven. Being sick in this system is a living hell and I have no support. My attorney too for medical malpractice is an arrogant pig who totally mismanaged my case. I am getting pennies on the dollar. Every time I questioned him he told me to keep quiet and listen to him. Knowing what I do now I could have handled the case better than this highly touted schmuck.

[bkkyosemite]

1. I was denied 3 times and had an Administrative Law Judge fully approve me in 7 days

Get another Attorney now!!! Make sure you have all documentation from doctors and people you know who have seen your inability to work especially those who you worked with.

[KT2000]

2. Keep going

it usually takes three tries.
Another lawyer might help as well.
It is a horrible system that wears people down but you must keep going.
Best to you.

[stumblnrose]

3. My SSDI atty is not my MedMal atty

nt

[happyslug]

5. If your SSI attorney has experience is SSA stay with him

Below I mentioned Legal Services, but that if you did not already have an attorney.

[happyslug]

4. File an appeal for an ALJ Hearing, then contact legal aid for representation

Legal aid provided free legal help to people seeking SSI, many states pay Legal Services to represent you in your request for SSI. Generally they know SSI disability law better then most people and will do a good job representing you in your quest for SSI.

Do NOT wait to see the Legal Aid Attorney, file the appeal with SSA as soon as possible. When it comes to the reason why you want to hearing just write down you are still disabled. Legal Services may have trouble getting you in within the 60 day appeal period so do NOT wait to file the appeal till you see the Legal Aid Attorney.

At the hearing, there may be an Vocational Expert will be present (In almost all ALJ hearings regarding adults in the Pennsylvania that is the case, I do not know what they do in your home state even through SSI is a Federal Program, the rules regarding SSI do vary depending on what the Federal Court of Appeals that covers your state has ruled on what is required in a SSI hearing).

Legal services can NOT handle your mal-practice suit, you have to go with a private attorney for that.

In my experience, when it comes to past relevant work like your past job as a waiter, an ALJ will ask questions of the Vocational Expert in the hearing. Your lawyer should listen to the questions (and most will) and if the right questions are not asked, asked the questions themselves.

Now you did NOT mention your age, age is an important issue under SSI disability. If you are below age 50, you must show you can NOT do Sedentary work, which is work that requires you to be on your feet no more then two hours a day (Through this can be in 10-15 minutes intervals) and lift no more then 10 pounds. Further more the Vocational Expert will testify that you have to be able to perform within 90% of the average worker, work for two hours take a 15 minute break, work another two hours, take a 30 minute lunch break, work two hours and take an 15 minute afternoon break, then work two hours and go home. If you can NOT do that level of work (And that has to be decided by the ALJ not the Vocational Expert) you are unemployable.

Other things that make you unemployable is missing work do to your problems more the two days a month (Which can include the days you miss work do to having to go see a Doctor or other medical provider) or miss work more then one day a month every month for some other MEDICAL reason (i.e. NOT wanting to work is NOT enough, you must show it is do to Medical Reasons). Now, Psychological factors can be Medical Reasons, i.e. you do not want to go to work but the reason you do not want to go to work is not laziness but some psychological reasons, then that also precludes from working and thus you are disabled for SSI purposes.

Notice, the key is the testimony of the Vocational Expert based on what the Medical providers say your restrictions are. SSA does NOT believe your Doctor has the training to determine whether you can work or not (The Vocational Experts have PhD in work related fields and thus in the best position to say what a person with your medical restrictions can do in the terms of Jobs that exist in substantial numbers in the National Economy). Now the Vocational Experts will NOT testify what you can do, but only someone with your education, work background and restrictions as set by Medical Providers (and if the providers disagree then it is up to the ALJ which medical provider to go with) can do. It does not sound like much of a difference but all the Vocational Expert is testifying to is the question put to him by the ALJ or your lawyer, so listen to the question being asked.

Now, my experience has been when an issue involved what jobs you can do, the case almost always go to an ALJ whose decision will be based on what your Medical providers say your restrictions are what the Vocation Expert testify what a person with those restrictions can do when in comes to Jobs that exist in substantial numbers in the National Economy. Thus file the appeal for an ALJ hearing, that is the best place to get awarded SSI benefits for a person with your restrictions.

Here is a paper where I simplify the Social Security Disability Test. Read it for your education as to what is being disabled is for SSA.

http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=250x353#376

[pengillian101]

6. Great information!

Very helpful for lots of folks, I'm sure. Thanks for posting it.

[musical_soul]

7. Just wanted to say....

Just wanted to say that I'm sorry for you going through what you're going through. I hope you find a really good lawyer who can maybe help you with Disability and Social Services junk (although different lawyers specialize in different stuff).

[pengillian101]

8. stumblnrose - this is for you and I ALSO send along my best wishes to you.

musical_soul (367 posts)
Sat Jul-11-09 01:08 PM

Response to Reply #6
7. Just wanted to say....

Just wanted to say that I'm sorry for you going through what you're going through. I hope you find a really good lawyer who can maybe help you with Disability and Social Services junk (although different lawyers specialize in different stuff).

[Tam3]

9. Make sure you keep on top of lawyers

Sorry you are going through this, my case went all the way to the ALJ, so I was scheduled for a hearing Nov. 3rd, finally from recon stage it was 2 1/2 year wait. My lawyer calls me 5 days before the hearing and tells me they don't have my last 2 1/2 year medical files. Shouldn't he have know that SS doesn't ask for updated files beyond the first ones they get at the application stage? I didn't know, she I had to go and get them, which the clinic has another company that takes care of the files so I wouldn't get them on time. My lawyer has me call him and tell him I am sick so he can reschedule. Next hearing is Feb 4th, we get there and not only has the SS medical expert not read those updated files which him, and the judge all got a month before this hearing, but he hasn't gotten himself the updated SS Blue Book, which had important information about my Lupus. The judge also states her staff didn't tell her they had new medical files on me, so we have an sort of hearing, but she was not happy with the way things were going, and she pretty much was telling the SS Dr. that I am disabled, so she is going to read the updated info and either approve me or have another hearing. I get another hearing on June 1st, 4 months later. Again we get there, and wait 2 hours because they slipped in another hearing and the Dr ended up having to leave; meanwhile I am in agony. The judge calls my lawyer back, and spent 20 minutes, first arguing that not to reschedule me yet again, then I guess they went over some of the facts of my case, Finally they call me back. the judge said the Dr had to go, but we are going to have this hearing. She tries to get the vocational person on the phone who is on vacation and is conferencing by phone, but she can't. We go head with the hearing. We agree to take off one year from my onset date, which is fine. The judge is satisfied that she has enough information so she doesn't call the vocational Dr and doesn't need the Dr's opinion. The lawyer said it looks good, and if I don't get approved we have the perfect reason to ask the appeals council to over turn the judge due to her not getting the vocation or Dr's opinion. Day before yesterday I finally got the answer we had been fighting for, fully approved.

The moral of the story is you have to be on top of your case, make sure you have everything, and if you don't ask your lawyer, he is getting paid to handle your case. Know that you have a long wait for the hearing, and SS won't ask for updated files, you need to make sure they get them well ahead of your hearing.