Tell Us About Yourself...

[ClaimsESP]

Welcome!

If you are new here, please take a moment to tell us a little, or a lot, about yourself.

Share whatever you are comfortable with sharing, and leave off the rest.

Thanks --

[rpursley]

I am a volunteer with the National Multiple Sclerosis Society who helps people with MS apply for SSDI. I have been doing so since 1997 and done much research on my own, but the 9 Step book has filled in some major gaps in my knowledge. Until now, I have never had access to any information from "the inside." I had only guesses about procedures based on experience with clients. This resource is a treasure!

[Loretta Crosby]

Hi rpursley and welcome to the Social Security Disability ESP Forum!

I know that with your 12 years of experience helping people apply for SSDI that you will be able to assist others with questions they may have about the process, so I encourage you to participate in the forum discussions and offer insights when you can.

Again, welcome, welcome, welcome. We're glad to have you join our Disability ESP family...

Oh...and thanks too for your kind words about the 9 Steps to Getting Disability guide. I'm hoping this "treasure"--as you so graciously described it--will help others to have a better understanding of the disability process and how to successfully engage it.   

[juligoss]

My name is Ruby. I have had Crohn's disease for 25 years, I was declared disabled 25 years ago when I was bedridden, hooked up to TPN's and had a visiting nurse come to my house daily. At that time I also had a husband who was stuck raising 4 very small children as I discovered I had Crohn's with my 1st child at age 20. I have 4 more children after that. With each pregnancy my disease would go into remission but eventually come back after with a vengeance!. I went through several surguries/peritonitis/lost 97% of my small bowel/developed sepsis several times. I collected 240.00/month at that time from social security. The main thing I guess, is my children were growing up without me. I looked at my situation and made the decision to discontinue all the "poison" drugs the Dr.s had me on and only take what made my life comfortable. I switched Dr.s who agreed to let me try it "my" way. # to 4 years later, I was actually in somewhat of a remission only having to take 1/2 of a vicodin 2 times a day for short bowel syndrome (as it slows things down) and vitamin supplements in liquid form. I then decided when my husband lost his job to make an effort to work again! I found at times it was such a stress reliever to use my brain and skills outside the home and I was doing pretty well. I would have frequent flare ups and hospitalizations but I got through them because I had to as my husband was back in school and someone had to work and carry health insurance. This was ok for some years...about 2 years ago I began to feel weak and unable to work as much as I used to and began cutting back my hours. I knew something was wrong as my children were now grown I has little to do at home why was I drained? I grew weaker and weaker until this Feb I developed a high fever and collapsed and was hopitalised for 2 weeks when they found out I had severe Periph. Neuorapathy in both lower extremeties, what little I had left of my small intestine was no longer working so I had developed severe malnutrition/severe chronic anemia and my weigh had gone from 122 to 88 pounds. My Mds all agreed at age 51 it was time for me to retire early. They wanted me on immunosuppressant drugs/daily injections of vitamin complex/iv's I had to go to the hospital for weekly of bllood components as my digestive tract was no longer absorbing anything I was consuming and I now had permanent nerve/muscle/brain damage due to effects over the years of malnutrition from short bowel syndrome. I applied for SSD and they were quick to determine a positive decision I was told and I should "watch my bank acct". I heard/saw nothing for weeks. I called a group called "ALLSUP" in and they checked into things and said "yes, they said they would be making a decision today and it looked favorable as the same Dr. who looked at my case 25 years ago looked at my new case and said I was never "not disabled"that I had made an attempt to work for a long period and now I was unable to as my disease had progressed. I waited 3 more weeks and Allsup called them only to find out my case was "randomly" pulled my quality assurance for review. Now I am told the SSA office is scrambling for more records. How likely are they to overturn a positive decision in this type of case with a previous decision from 25 years ago?

[Loretta Crosby]

Hi Ruby,

Thanks for sharing a little about yourself and your claim.

Regarding your question about how often Quality Review overturns an "allowance", it all depends.  Sometimes it appeared to me that more "allowance" cases than "denials" were pulled by quality review even though the sample of cases selected is supposed to be random. Still, let me try to answer your question.

The disability decision is based on your current condition, though the historical data you provided is good background information and helps to paint the picture of just how long you have struggled with your chronic illness. Your weight could be a major contributing factor to a favorable determination of disability, but since I don't know how tall you are it would be difficult to say how that component actually impacts your claim. Quality Review, Assurance or Control--I don't recall what it is called now--may have asked the claims examiner to provide more updated medical records in support of your claim and that's why he/she is seeking the additional medical records.

I could be wrong, but it seems Quality Review may be trying to get the claims examiner to dot all the "i"s and cross all the "t"s with your claim to ensure that everything is documented. That is what they do, and they too have to justify their existence by finding policy and procedural errors in cases that must be corrected before they allow it to move forward. Let's hope that this is the case with your claim and that you will soon be given the full stamp of approval.

Let us know how it goes....and good luck to you.