Monthly Archives: October 2011

Pancreatitis and Social Security Disability Benefits

The pancreas is a large gland behind the stomach and close to the duodenum, which is the first part of the small intestine. If this gland becomes inflamed it can cause pancreatitis.

What does the pancreas do? It secretes enzymes into the duodenum, through the pancreatic duct, which combine with bile to help digest food. Hormones, including glucagon and insulin, are also released by the pancreas into the bloodstream. Pancreatic hormones can also help the body control the glucose it absorbs from food.

Pancreatitis may cause the digestive enzymes which are used to digest food to become active before they reach the small intestines. If this occurs, the enzymes can damage the tissues that create them.

Symptoms of pancreatitis can include fever, bleeding, infection, tissue damage, and vomiting. Individuals may have either an acute condition, which appears and leaves suddenly, or a chronic condition, which slowly destroys the pancreas. Either condition can be extremely serious and sometimes fatal.

Treatment for pancreatitis should be immediate, especially if there is bleeding, which can lead to damage to an individual’s lungs, heart and kidneys.

Diagnosing Pancreatits

A physical exam or blood test can generally identify pancreatitis. Doctors will also generally order a CT or CAT scan if the patient has severe abdominal pain. Blood tests can reveal high levels of lipase or amylase, and CT Scans can reveal gallstones or inflammation.

Winning Social Security Disability Benefits for Pancreatits

Claimants can win disability benefits either by meeting a listing on the Social Security Administration Listing of Impairments (also known as the Blue Book) or through a medical vocational allowance.

Meeting a Listing on the SSA Blue Book

Although pancreatitis can be a very serious or painful condition, the SSA does not currently have listing in the SSA Blue Book to evaluate this condition. This does not mean, however, that a claimant could not make an argument that a severe case of chronic pancreatitis could not be as severe as a listed condition, especially if it has led to damage of organs (heart, lungs or kidneys).

If you believe your condition is as serious as a condition listed in the Blue Book, contact a disability lawyer and work with them to develop your disability claim.

Getting disability for Pancreatitis through a Medical Vocational Allowance

Most claimants who win Social Security Disability benefits do so through a medical vocational allowance. Using this disability determination method the Social Security Administration focuses less on the claimant’s diagnosis and more on their resulting limitations.

For instance, the SSA will evaluate, given the claimant’s age, educational level, work history, and residual capacity to work whether they can perform substantial gainful activity.

So how do you prove you cannot perform substantial activity? Make sure your medical records clearly outline your work limitations. For instance, do your medical records clearly document the following?

• How long you can walk, sit or stand?
• Do you have to take frequent breaks?
• How much weight can you lift or carry?
• How frequently do you have to go to the restroom?
• Do you have difficulty completing a work day? Work week?
• Can you reach overhead?
• How much weight can you push or pull?
• Does your medical interfere with your ability to work?
• Can you drive?
• Have you lost a significant amount of work?
• How often do you have to go to the doctor?

These are just a few questions, but the more limitations you have to perform work functions, the more likely the SSA will determine that you do not have the residual capacity to work.

When does the SSA schedule my SSD evaluation?

Many Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) claimants want to know if or when the Social Security Administration will send them to a doctor or to an “evaluation” to determine if they are disabled.

It is important to understand there is no “evaluation” exam to determine disability for all claimants. The Social Security Administration (SSA) instead focuses on a claimant’s medical records from qualifying medical sources to make their disability determination for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI).

Qualifying medical sources include:

• Licensed physicians (medical or osteopathic doctors)
• Licensed or certified psychologists.
• Licensed optometrists
• Licensed podiatrists
• Qualified speech-language pathologists
• Medical Reports

Medical reports can include the medical history of a claimant, clinical findings (such as the results of physical or mental status examinations), laboratory findings (such as blood pressure, x-rays), diagnosis (statement of disease or injury based on its signs and symptoms), treatment prescribed with response, and prognosis and statements about what the claimant can still do despite their impairment.

When does the SSA send a claimant to an evaluation?

Claimants are sent to a consultative examiner (C.E.) only if the SSA does not have enough information to make a disability determination, the treating physician is not a specialist for the claimant’s medical condition or the claimant’s treating sources have failed to send the claimant’s medical records.

What does a C.E. do? They simply perform a cursory medical review of the claimant’s mental or physical health status and offer a professional opinion to the Social Security Administration about the claimant’s mental or physical limitations. The C.E. does not offer an opinion about whether the claimant is disabled or have the authority to approve benefits.

Does the Consultative Examiner help my disability claim?

Some claimants will benefit from the Consultative examination, especially those who have disabilities that are easily diagnosed and obvious to an observer in a short examination. Others, who have conditions which are not so readily apparent, may not benefit for a C.E. exam.

Remember, a C.E. is not employed by the Federal Government and they are supposed to provide “objective” information to the SSA, but unfortunately, a one time, cursory exam cannot possibly replace medical documentation provided by a physician who has an ongoing relationship with a claimant.

Consultation examiners are not a very good substitute for thorough, comprehensive treatment from a doctor. In fact, according to Social Security Administration, they must consider the claimant’s treating physician as the primary source of information about their mental or physical health condition.

So when is the SSA going to send you to a disability examination? Hopefully, they do not have to. If they do send you to an exam it is because they do not have enough information to find you disabled.

Hiring a Disability Lawyer

If you would like a Social Security Disability attorney to review your Supplemental Security Income or Social Security Disability claim, fill out the FREE evaluation form and a disability advocate will call you to review your claim or you can call our office at 1-800-641-3759 to talk to someone now.

Can I get Social Security Disability benefits for Gastroparesis?

Gastroparesis is a condition in which the muscles which propel food through an individual’s digestive tract do not function properly, interfering with digestion.

Specifically, the vagus nerve, which is responsible for moving food through the stomach and digestive tract, is damaged. Gastroparesis causes a variety of symptoms including heartburn, vomiting, nausea, abdominal bloating, uneven blood sugar levels, weight loss, lack of appetite, spasms in the stomach, and malnutrition.

Gastroparesis can cause a wide variety of symptoms, ranging from the mild to severe. Frequency of symptoms can also vary, and doctors may have a difficult time diagnosing this condition.

Controlling Gastroparesis

There are a variety of treatment options such as avoiding certain high fiber, fatty or carbonated foods and beverages. Dieticians can also help individuals outline an eating plan which can include eating smaller meals, drinking more water and moderate exercise.

Winning SSA Disability Benefits for Gastroparesis

Claimants may win Social Security Disability benefits either by “meeting a listing,” which means they have a condition which is listed on the Social Security Administration’s Listing of Impairments (also called Blue Book) or through a medical vocational allowance.

Gastroparesis is not specifically listed in the SSA Blue Book, although because this condition can cause an imbalance in blood sugar levels certain claimants may qualify under Section 9.00 Endocrine Disorders if they can prove that have chronic hyperglycemia.

• Section 9.00 Endocrine Disorders – Chronic hyperglycemia

Chronic hyperglycemia, which is longstanding abnormally high levels of blood glucose, leads to long-term diabetic complications by disrupting nerve and blood vessel functioning. This disruption can have many different effects in other body systems. For example, we evaluate diabetic peripheral neurovascular disease that leads to gangrene and subsequent amputation of an extremity under 1.00; diabetic retinopathy under 2.00; coronary artery disease and peripheral vascular disease under 4.00; diabetic gastroparesis that results in abnormal gastrointestinal motility under 5.00; diabetic nephropathy under 6.00; poorly healing bacterial and fungal skin infections under 8.00; diabetic

Additionally, individuals with severe weight loss may also qualify under Section 5.08 Weight Loss to due to any digestive disorder.

• Section 5.08 Weight loss due to any digestive disorder

To win under this listing the claimant will have to prove that despite continuing treatment as prescribed, they have a BMI of less than 17.50 (calculated on at least two evaluations at least 60 days apart) within a consecutive 6-month period.

Cases have been won by arguing that a claimant’s disability equaled these listing because the either the blood sugar levels resulted in an abnormal gastrointestinal motility or the nutritional malabsorption from gastroparesis resulted in severe symptoms which caused extreme weight loss.

Winning Disability for Gastroparesis through a Medical Vocational Allowance

If a claimant cannot prove that their condition meets or exceeds one of the listing above they will have to win benefits through a medical vocational allowance. Using the medical vocational allowance process, the SSA evaluates the claimant’s age, work skills, job history, education and residual capacity to work to determine if they can perform substantial gainful activity or if the claimant’s condition is so severe that they are not able to work for at least 12 continuous months.

Fibromyalgia and Social Security Disability Benefits

Fibromyalgia is a chronic condition which can cause stiffness and tenderness of the muscles, tendons, and joints. Some claimants with fibromyalgia also experience chronic fatigue, anxiety and depression. Others have difficulty sleeping.

Unlike other diseases which cause tissue inflammation, fibromyalgia is not associated with any accompanying damage to other organs or deformities. Conditions which do cause body organ damage can include systemic lupus, rheumatoid arthritis and polymyositis.

Researchers are still unclear of the exact cause of fibromyalgia, but it is most prevalent in women (over 80%) between the ages of 35 and 55. It is estimated that over 4% of the U.S. population has fibromyalgia.

Does the SSA consider Fibromyalgia disabling?

The Social Security Administration uses two different methods to determine if a claimant is disabled: meeting a listing on the SSA Listing of Impairments or through a medical vocational allowance.

The SSA maintains a listing of impairments which they consider automatically disabling. This list can be found by at and is informally known as the SSA “Blue Book.” At this time, the SSA does not have a listing for Fibromyalgia.

Proving Fibromyalgia is disabling through a medical vocational allowance

Claimants who cannot meet a listing or if there is not listing, will have to prove that their fibromyalgia is so severe that they cannot work. The problem is that many claimants who have this condition can work if they adequately control their stress and pain and their boss is willing to make a few modifications.

In fact, the U.S. Department of Labor’s Job Accommodation Network has offered several suggestions for employers to consider if an employee has this condition: provide written job instructions when possible, allow flexible work hours, allow a self-paced workload, allow periodic rest periods to reorient, minimize distractions, reduce job stress, remind the employee of important deadlines and meetings, develop strategies to deal with work problems before they arise and reduce or eliminate physical exertion and workplace stress.

Given the high rate of unemployment and the excessive pool of job candidates willing to work, the amount of “modifications” an employer may be willing to make for an employee may be limited.

Hiring a Disability Lawyer

So what’s the bottom line? Most fibromyalgia claims are won if the claimant has this condition in conjunction with other diagnosis.

For instance, claimants who have rheumatoid arthritis and fibromyalgia or fibromyalgia and degenerative disc disease will have a better chance of winning SSDI or SSI benefits. Why? Because as the SSA is evaluating their condition they will accept that fibromyalgia could be a plausible explanation for the symptoms of other more proven and easily diagnosed conditions. This can be especially true if fibromyalgia is diagnosed by an Orthopedist or Rheumatologist.

Whether you have fibromyalgia by itself or in conjunction with another condition, the best way to win benefits for this condition is to hire a disability lawyer and begin to gather evidence of functional limitations for work. For instance, find medical evidence that proves the following:

• Your symptoms are so severe that you have difficulty performing daily activities
• The location, duration, intensity and frequency of pain does not allow you to work
• Side effects of any medication being taken, as well as the type of medication and the dosage taken makes it dangerous for you to work
• You have followed all of the medical recommendations suggested by your doctors but you continue to have severe pain or limitations to work
• You have an inability to due basic work activities: lift weight, push or pull objects, stand, sit or walk for extended periods of time

Asthma and Social Security Disability Benefits

Asthma is a chronic disease that affects an individual’s airways causing wheezing, coughing, chest tightness and trouble breathing.

Asthma affects the tubes that carry air to the lungs and can cause them to be swollen or sore. With this inflammation, an individual’s airways can become increasingly sensitive to irritations and increase the chances that they will have an allergic reaction.

In extreme situations individuals can die from a severe asthmatic attack if their airways narrow to the point that their vital organs do not get sufficient oxygen.

Asthma is not curable but generally can be controlled with medication and managing other stressors or conditions which can increase attacks such as stress, cold, allergies, and exercise.

Can I qualify for Social Security Disability Insurance or Supplemental Security Income with asthma?

The Social Security Administration has created a list of impairments they consider so severe that claimants with these conditions are assumed to be unable to work. This list is called the Listing of Impairments or SSA Bluebook. Claimants, whose condition “meets or exceeds” a condition on this list, will be considered disabled.

Asthma is evaluated under 3.03A and 3.03B using the criteria established for chronic obstructive pulmonary disease (Chronic Pulmonary Insufficiency).

Under 3.03A the SSA will evaluate chronic pulmonary insufficiency which indicates that a claimant can be disabled if they have a speficic FEV1 (forced expiratory volume in one second). The SSA has established specific limits which must be met and the assumption is that the more severe the lung disease the lower the FEV1 score.

Claimants may also qualify for disability if they meet 3.03B. This criterion outlines the number of “attacks” that the claimant must have, in spite of prescribed treatment and requiring physician intervention.

The SSA specifies that the asthmatic attacks must occur at least once every 2 months or at least six times a year. Each in-patient hospitalization for longer than 24 hours for control of asthma counts as two attacks, and an evaluation period of at least 12 consecutive months must be used to determine the frequency of attacks.

How does the SSA define attack? An attack is not a minute long coughing spell. An attack, according to the SSA, is a prolonged episode that requires emergency treatment and generally a trip to the emergency room. If you are able to control the symptoms at home with a nebulizer or your personal inhaler, the SSA will not consider this an “attack.”

To win disability benefits under 3.03B the claimant will need very good medical records documenting the medical invention which was needed for each emergency asthmatic episode.

Hiring a disability lawyer

What if the claimant’s condition does not meet or exceed a listing? The Social Security Administration does have another process they use to determine if a claimant’s condition is so severe they cannot work. This approval method is called a medical vocational allowance.

Under the medical vocational allowance the SSA will evaluate if the claimant has enough residual capacity to work given their age, educational level, work skills and health condition. Claimants who do not meet the listing for asthma may need to talk to a disability lawyer to develop a strong case with recent medical evidence to prove they cannot work.