This page contains posts about Social Security Disability Insurance (SSDI) .
Subject Re: Social Security - disability-related programs
From Margaret
Hello - There are two quite distinct federal disability-related programs in the U.S. People often confuse them.
To qualify for SSI, a person must be both so disabled they can't work and also have very low family income and assets. SSI provides relatively low benefits, but in most states a person who qualifies for SSI will also qualify for Medicaid (the medical program for people with very low incomes).
The other program is Social Security Disability Insurance (SSDI). SSDI is an insurance program that's similar to Social Security Retirement Insurance. To qualify for SSDI, a person have a disability serious enough so they can't work now - but they must also have a history of working in jobs covered by Social Security. The person must have worked long enough to qualify - and their work must be fairly recent, working 5 out of the past 10 years. SSDI benefits are linked to work history. The longer you've worked and the higher your wages, the higher your benefits from SSDI. Also, SSDI has no limit on other income or on assets.
Two years after getting SSDI, a disabled person also qualifies for Medicare -- an outrageously long wait for many people unless they have other medical insurance.
Check the Social Security Administration web site for descriptions of both of these programs. If I remember correctly, the URL is:
http://www.socialsecurity.gov.
Margaret in Michigan
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Subject Re: SS Disability
Sarah wrote:
Is there a fast track for SSI or disability?
has anyone been through this process recently and can give him some > tips on how to get this on the fast track???
From Verleen
I've never heard of a fast track, but my application and approval went smoothly. I applied in July 2001, was quickly approved and began receiving benefits in October 2001. I applied for disability under POMSDI 24580.01 for "The Late Effects of Poliomyelitis". I read all I could find about SSDI and how the SS evaluates a person for disability under this POMS. All these rules and regs are on the internet. I also provided medical documentation along with my application. Do not rely on the SS office intake person to know any of this. You must know it and provide what the SSDI reviewer at another location will be looking for.
The SSDI rules say the best doctor's report would be from a physiatrist, who is knowledgeable about polio. Not all physiatrists are correctly knowledgeable about PPS, nor know anything about how prepare a report for SSDI. It is helpful if the doctor has, or is provided by you, an understanding of the medical data they are looking for, the restrictions in ADL, etc. It is also helpful if you saw the doctor recently before filing. An EMG and nerve conduction studies are helpful to document your condition. The SSDI reviewer will follow a listing criteria for polio (11.11) to determine if you meet or equal the listing. Under this listing they consider fatigue and loss of endurance (tested); weakness; pain (bursitis, tendonitis); and cold intolerance. The doctor should use the code 1380 to record the diagnosis.
If you have been working, then you need to be evaluated under DI 24005.005 to document that you are experiencing new functional problems which are preventing you from continuing to work. In my case, the EMG showed recent weakening in muscles that affected my ability to continue to work.
I found that I had little control over what the SS local office intake person was documenting. I knew he was missing key elements that the reviewer would be looking for. He just did a "form" type of intake. So I wrote a letter that accompanied my application, in which I provided the elements that specifically kept me from working. These included the overwhelming fatigue that caused me to work less than half my work schedule. When I did make it to work, I had trouble concentrating and needed to lay down frequently. I described the pain in my back, shoulders, neck arms, hips, and ankles which often kept me from standing or getting ready for work. I further described how the cold winter months exaccerbated all the above symptoms. I documented my falls at work and inability to safely drive to work.
I should tell you that I saw Drs. Bruno and Zimmerman who campaigned for and wrote the SSDI rules for "The Late Effects of Poliomyelitis". So they knew exactly how to examine me, which appropriate tests to do and how to write the medical report. Verleen
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From Mary
I applied for disability last January and was approved in May. I had polio in 1945 at 11 months of age, and developed PPS in 2000 after a really hard fall. My doctor thought I was approved because I answered each question in great detail. I explained what my job had been, and the physical activity I had always done as part of my jobs. I stated which activities I could no longer do and said that I could not effectively do my job. I supervised the public service section of a state library and did a lot of walking. I specified which activities I was having trouble with.
I was notifed that I had an appointment with a doctor, but then they cancelled it. I think my doctor is one of their examining physicians for PPS, so when they got his records, they did not require the other exam..
I was very surprised when I was approved on the first try. Two of the doctors who had performed surgery on me are dead, so I didn't think there was a chance. I believe it also depended on my doctor's detailed notes on every visit. His reports, along with my history worked for me.
Mary
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From Mark
I went thru this in late 2007. Several useful links to information I referred to are provided below.
Did it on my own, following suggestions in
http://www.post-polio.org/edu/handbk/socsec.html and
http://www.englewoodhospital.com/medservices.cfm?pageid=425&bc=0,8,158,198
Also very useful is the actual ruling/rules for SSDI DI 24580.010 Evaluation of the Postpolio Sequelae
I had my wife take me to the local Social Security office, to have an interview and assistance filling out the application. I brought my work and medical history (up to that point), test results, doctors names, addresses, phone numbers, dates seen, etc, with me and provided a copy of all of that info.
After the application was processed and I received a letter regarding the person assigned to my case, I wrote a letter to my case person regarding PPS and enclosed a copy of the SSDI rules for evaluation of Postpolio Sequelae... just in case I happened to be that person's first such case.
I had been to 15 different Doctors and other health professionals over a span of about 2 years, so with everything that was wrong (with me), there really wasn't an issue regarding a positive disability determination. The challenge was determining (based on medical evidence) when I could no longer work. Had I gone to a Post Polio Clinic sooner, than later, my disability date could have been at least 6 months earlier than it turned out to be.
The whole process took about 2 months.
Good luck,
Mark
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From Scout
The SSDI Program Operations Manual System (POMS) for PPS can be
accessed and printed out via
http://www.skally.net/ppsc/ssdi-poms.html
be careful of some of the web site information, especially the stuff
that suggests you should lie to the SS Administration..
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Subject: Social Security Administration
From: Connie
I wanted to make sure you have seen this ruling by the social security administration effective July 2, 2003. I went to their site and it looks like Post Polio Syndrome people like me are finally going to get their disability much easier. I fought for 4 years to get mine. When I finally got my disability, I had taken much information to the law judge myself, to educate him on PPS. I went to the Social Security Administration's web site to see the information.
http://www.ssa.gov/OP_Home/rulings/di/01/SSR2003-01-di-01.html
Connie
Subject: New on DaWeb
From: Angus
Recently, Gail posted a great post with tips on how to apply for Disability. She has since added a bit more to that, and allowed it to be placed on the net so more people can have access to it:
http://www.skally.net/ppsc/ss.html
The form she mentioned is also included.
THANKS GAIL!
-----Subject: Post-Polio Syndrome and Social Security Disability
Here is an explanation of Social Security's five-step process to determine if a person with Post-Polio Syndrome qualifies for Social Security Disability Income:
STEP ONE simply determines if an individual is "working (engaging in substantial gainful activity)" according to the SSA definition. Earning more than $860 a month as an employee is enough to be disqualified from receiving SocialSecurity disability benefits.
STEP TWO implies that the post-polio syndrome disability must be severe enough to significantly limit one's ability to perform basic work activities needed to do most jobs. For example:
* walking, standing, sitting, lifting, pushing, pulling, reaching, carrying or handling
* seeing, hearing and speaking
* understanding/carrying out and remembering simple instructions
* use of judgment
* responding appropriately to supervision, co-workers and
usual work situations
* dealing with changes in a routine work setting
STEP THREE is Social Security disability adjudication, post-polio sequelae refer to multiple physical and mental disorders that may be demonstrated by polio survivors many years after an acute polio infection. Motor weakness is the most common residual of acute polio infection and is usually manifested by observable weakness, muscle atrophy, and reduced peripheral reflexes. In the absence of contrary evidence, as long as the medical findings support a reasonable medical nexus between the prior polio infection and the present manifestation of any one or combination of the disorders discussed in Social Security Ruling 03-1p (early advanced degenerative arthritis, sleep disorders,respiratory insufficiency and various mental disorders), Social Security will find the claimant has post polio sequelae. Furthermore, the criteria found in medical listing 11.11 (anterior poliomyelitis) are applicable to post polio sequelae. If any of the following are present the claimant will be found to be disabled:
1. Persistent difficulty with swallowing or breathing;
2. Unintelligible speech; and
3. Disorganization of motor function as found in medical
listing 11.04B, i.e., significant and persistent disorganization of
motor function in two extremities, resulting in sustained disturbance
of gross and dexterous movements, or gait and station. The findings
presented by the claimant may meet the preceding or be found to
medically equate the preceding.
STEP FOUR explores the ability of an individual to perform work he has done in the past despite his post-polio syndrome disability. If SSA finds that a person can do his past work, benefits are denied. If the person cannot, then the process proceeds to the fifth and final step.
STEP FIVE looks at age, education, work experience and physical/mental condition to determine what other work, if any, the person can perform. To determine post-polio syndrome disability, SSA enlists vocational rules, which vary according to age.
For example, if a person is: Under age 50 and, as a result of the symptoms of post-polio syndrome, unable to perform what SSA calls sedentary work, then SSA will reach a determination of disabled. Sedentary work requires the ability to lift a maximum of 10 pounds at a time, sit six hours and occasionally walk and stand two hours per eight-hour day.
Age 50 or older and, due to his post-polio syndrome disability, limited to performing sedentary work but has no work-related skills that allow him to do so, SSA will reach a determination of disabled.
Over age 60 and, due to his post-polio syndrome disability, unable to perform any of the jobs he performed in the last 15 years, SSA will likely reach a determination of disabled.
Any age and, because of post-polio syndrome, has a psychological impairment that prevents even simple, unskilled work, SSA will reach a determination of Post-Polio Syndrome disabled.
The peace of the Lord be with you.
carolyn
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