A hand affected by rheumatoid arthritis (Photo credit: Wikipedia)

• Fractures
• Carpal Tunnel Syndrome
• Rheumatoid arthritis
• Nerve damage (hand neuropathy)
• Broken fingers

Common symptoms of a severe hand condition can include swelling, severe pain, loss of motor function, hand deformity, rashes, bruises, and decreased mobility.

Proving you are disabled with severe hand disorders

Whether you have applied for Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI) to win benefits for a severe hand condition you will either have to prove that your condition is so severe it meets or equals a listing in the SSA Listing of Impairments or through a medical vocational allowance, which is a process used by the SSA to determine whether you have enough residual capacity to work considering your age, work history, medical condition and education.

Meeting a listing in the SSA Listing of Impairments for Hand Disorders

Severe hand disorders will be evaluated under listing 1.00 Musculoskeletal System, section 1.02 Major Dysfunction of a joint due to any cause. Under this section the SSA will be evaluating if your condition is “characterized by gross anatomical deformity (e.g., subluxation, contracture, bony or fibrous ankylosis, instability) and chronic joint pain and stiffness with signs of limitation of motion or other abnormal motion of the affected joint(s), and findings on appropriate medically acceptable imaging of joint space narrowing, bony destruction, or ankylosis of the affected joint(s).”

The SSA will determine if the disorder includes the “involvement of one major peripheral joint in each upper extremity (i.e., shoulder, elbow, or wrist-hand), resulting in inability to perform fine and gross movements effectively.”

Meeting the listing for this condition is very difficult. Arguably the claimant would have had to have a severe injury or a disease which has affected both hands and is expected to last for at least 12 continuous months.

Proving disability through a medical vocational allowance

What is more likely than meeting a listing for a hand disease or condition is proving that you are disabled through a medical vocational allowance. Older claimants who suffer from pain, numbness, muscle weakness, the inability to write or type, or to perform other fine manipulations may be able to win SSI or SSDI through a medical vocational allowance, especially if they have been limited to light or sedentary work. Why, because it will be difficult to complete sedentary work if the claimant does not have use of their hands.

What medical evidence do I need to win SSDI or SSI?

The most important thing for you to do is to get clear medical evidence of the limitations you have using your hands. Unfortunately, most doctors to do not clearly list limitations in their medical notes and may not normally perform the right testing to document your limitations. It may be necessary to request that you are sent to a vocational rehabilitation center for additional testing to get the evidence you need to prove your SSI or SSDI claim.

Disability lawyers also can have the claimant perform a variety of demonstrations at the hearing in front of the judge to illustrate the claimant’s physical limitations to write, and assemble small objects. Limitations in daily living can also be relevant, for example, if the claimant has to have help shaving, dressing, eating or brushing their teeth.

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Cystitis glandularis at trigone (Photo credit: Wikipedia)

The cause of cystitis can vary, but it is frequently caused by a bladder infection causing symptoms such as frequent urination or the feeling the claimant always needs to urinate. This feeling is generated from the inflammation of both the urethra, which is the tube that eliminates urine from the body, or from the bladder.

Claimants can suffer from other symptoms of cystitis including:

1. Bloody urine
2. Painful urination
3. Cloudy urine
4. Fever
5. Abdominal pain

Cystitis is most common in women but can also affect men. The good news is this condition is generally treatable, although failure to properly treat it can lead to severe conditions such as kidney infection, kidney failure, inability to urinate, very high fever, disorientation, or severe pain. Death can result if the condition progresses to sepsis.

Winning SSI or SSDI for Cystitis

The Social Security Administration has two methods they use to determine if a claimant has a severe mental or physical health condition which is so severe they cannot work: determine if the claimant’s condition is listed in the SSA Listing of Impairments (also known as the Blue Book) or through a medical vocational allowance.

Although the SSA does not currently have a listing in their Blue Book for this condition they have published information about how they will evaluate this condition (Policy Interpretation ruling, titles 2 and titles 16: Evaluation of Interstitial Cystitis). Generally the SSA will evaluate the claimant’s condition and any other additional conditions, such as depression, to determine if it is as severe as another condition which does have a listing. If it is, then the SSA will award SSDI or SSI to the claimant, assuming they meet the nonmedical requirements of one of the programs.

Winning SSDI and SSI for Cystitis through a Medical Vocational Allowance

The SSA can also award disability for cystitis through a medical vocational allowance. Basically the SSA will determine whether the claimant’s condition is severe enough to limit their ability to work. According to the SSA evaluation of this condition they will evaluate the claimant’s “urinary frequency and pain and their exertional limitations for functions such as sitting, standing, walking, lifting, carrying, pushing, and pulling. It also may affect the claimant’s ability to do postural functions, such as climbing, balancing, stooping, and crouching. The ability to tolerate extreme heat, humidity, or hazards also may be affected.”

The SSA also acknowledges that severe pelvic pain can affect a claimant’s ability to focus or sustain tasks, and frequent urination could interrupt nightly sleep patterns which lowers the claimant’s ability to sustain concentration throughout the day. Social interaction and functioning can also be limited if the claimant must confine themselves to their home.

Hiring a Disability Lawyer

Because cystitis does not have a listing in the SSA Listing of impairments it will be more difficult to win SSI or SSDI. Remember, the condition must be considered severe and be expected to last for at least 12 continuous months to qualify for SSDI or SSI. The SSA will also expect that the claimant has been getting adequate medical treatment and has followed the doctors’ prescribed treatment plan for their condition.

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The pancreas, which is located in the abdomen, is part of the digestive system. It generates both enzymes and hormones which can assist with the digestion of food. Additionally, the enzymes which are generated by the pancreas are released into the small intestines and can further digest food particles that are no longer in the stomach.

Micrograph of pancreatic ductal adenocarcinoma (the most common type of pancreatic cancer). H&E stain. (Photo credit: Wikipedia)

Cancerous cells which begin to form and grow in the tissues of a claimant’s pancreas will cause pancreatic cancer. Unfortunately, most claimants who are diagnosed with this condition may not be aware of it until it has progressed. Common symptoms can include:

1. Pain in the back
2. Pain in the middle abdomen
3. Loss of appetite
4. Severe fatigue
5. Depression
6. Jaundice

Claimants of any age can be diagnosed with this condition, but there are several factors which can increase the rate of incidence including pancreatitis, diabetes, smoking and heredity.

Winning SSI or SSDI for pancreatic cancer through the compassionate allowance initiative

In 2008, the Social Security Administration developed the Compassionate Allowance Initiative to expedite the disability approval process for claimants who had certain severe debilitating health conditions. The goal of this new program was to help very sick applicants avoid the months and years of struggle to win SSI or SSDI benefits.

The Compassionate Allowances program started with 50 medical conditions but has been expanded throughout the years. This program includes pancreatic cancer so claimants who have this condition and the appropriate corresponding symptoms can expect to have their SSI or SSDI claim immediately approved.

It is expected, however, that the claimant has sought the appropriate medical treatment and has medical evidence to support the claim that they can no longer work.

Denied SSI or SSDI for pancreatic cancer

If you have been denied SSI or SSDI benefits but you have a severe case of pancreatic cancer it is most likely because you either do not have sufficient medical evidence to prove that you are disabled and unable to work or you do not meet the nonmedical requirements of Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI).

For instance, claimants who have not worked and earned enough work credits close enough to their date of disability will not be awarded SSDI benefits. This can be confusing, especially for the claimant who worked for years and then stopped working for several years before they applied for SSDI. Many claimants assume that their credits have accumulated and can be used any time, but this is not the case. If you have not worked in several years you need to contact the SSA and talk to them about your date last insured (DLI) and find out what is the last day you can qualify for SSDI benefits.

Claimants who have not worked enough will not qualify for SSDI, regardless of the severity of their pancreatic cancer. Their only option is to apply for SSI benefits, which are benefits offered to the aged, disabled or blind who have not worked and who have very limited income and resources.

Keep in mind if your resources or income is too high for SSI you also will not be awarded SSI for pancreatic cancer, regardless of the severity of your condition.

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If you have been denied in the past and nothing has changed than it is unlikely that you will now have your SSDI or SSI case approved. If, however, you were denied disability benefits and you were able to “fix” whatever was wrong with your case than applying again a second or third time may increase your chances to receive SSI or SSDI.

Let’s review a few different scenarios to clarify exactly what I am talking about.

Denied SSDI because of lack of work credits

The Social Security Administration makes their disability determination based on a claimant’s medical records, but if the claimant does not meet the basic nonmedical requirements of the SSDI program than the SSA will never pull the claimant’s medical records; they will be denied automatically.

So if you were denied because you did not have enough work credits for SSDI and you simply keep applying over and over again without returning to work to accumulate more credits, you will continue to be denied indefinitely. The SSA does not “hold against you” the fact that you have applied before, but they do not change their disability decision.

Denied SSD for Refusing proper medical treatment

What if you are not going to the doctor or you have not been following your doctor’s treatment plan?  Many claimants want to know if they can be denied SSDI or SSI benefits if they refuse to follow their doctor’s treatment plan or if they are not seeing a doctor. Yes, the Social Security Administration can deny benefits if you are not following your doctor’s orders. Why? Because the SSA can argue that your refusal to follow the prescribed treatment plan eliminates your chances of restoration to a level that would allow you to perform substantial gainful activity.

Now, let’s assume that you applied and were denied for the reason listed above but before you applied for SSI or SSDI a second time you went and saw all the proper doctors and specialists and began to take the right medications or therapy treatments. Now, after some time if you continue to be unable to work or perform substantial gainful activity it may be possible to prove, with your new medical evidence, that you are disabled and the SSA may approve your case the second time you apply.

Denied for SSI because your resources and income are too high

What if you applied for SSI but you were denied benefits because your income or resource level was too high? Applying again and again when nothing has changed will result in continual denials. But what if your resource and income level decreases under the allowable limit for SSI? In this case, assuming you meet all the other criteria for SSI benefits, the SSA may approve your claim the second time you apply.

In Conclusion

The answer to the question does the SSA “hold is against me” if I apply again and again is not really the right question to ask. Claimants should make sure they understand why they were denied SSI or SSDI benefits and fix the issue BEFORE applying again and again.

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assistance of disability payments. Medical costs have skyrocketed and finding affordable healthcare is challenging, even for employees who are able to work and receive insurance through their employer.

But what if you are unable to work? What are your options for insurance and medical care? The Federal Government offers two medical insurance programs to qualifying applicants- Medicare and Medicaid.

What is Medicare and can I get it?

According to the Social Security Administration (SSA), “Medicare is our country’s health insurance program for people age 65 or older. Certain people younger than age 65 can qualify for Medicare, too, including those who have disabilities and those who have permanent kidney failure. The program helps with the cost of health care, but it does not cover all medical expenses or the cost of most long-term care.”

So can SSDI or SSI applicants get Medicare if they are approved for disability benefits? SSDI recipients can, but they will have to wait 24 months from the date of their disability. SSI recipients will not, however, receive Medicare, but they will receive Medicaid, in most states, at the time of their approval.

What happens if you are denied SSDI benefits and you are under the age of 65? Do you qualify for Medicare? Unfortunately, the answer is no. There may be other private insurance options or you can attempt to pay cash for medical care, but Medicare is not an option.

What is Medicaid and can I get it?

Medicaid was created under Title XIX of the Social Security Act in 1963. Its main objective is to help low-income families and children have access to affordable health care. Many states also provide Medicaid to low-income pregnant women and children under the age of one.

States administer their own Medicaid programs, although the funding comes from state and federal government programs. Eligibility guidelines are also determined by the state.

Supplemental Security Income (SSI) recipients may, in many states, get Medicaid automatically when they are awarded SSI benefits. Some states require SSI recipients to file a separate Medicaid application form, and the remaining states do not automatically award Medicaid to SSI recipients unless they meet other criteria.

What if I am denied SSI or SSDI, am I still eligible for Medicare or Medicaid?

As mentioned above, SSDI applicants who are denied SSDI benefits will not be awarded Medicare because they are not 65 years or older nor disabled. SSI applicants who are denied SSI benefits may still qualify for Medicaid but it will depend on the requirements determined by their state.

What are my options if I cannot get Medicaid or Medicare?

On our disability forum many disability claimants ask, “How do I get medical care if I cannot afford insurance?” This is probably one of the toughest questions to answer because there is not a good answer.

Some doctors will take cash payments for basic medical services, but if a claimant is out of work they may not have any money. Without good medical care it is tough to prove a claimant is disabled. Unfortunately, the system is broken.

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• Headaches
• Nausea
• Vomiting
• Sounds pulsating within the skull
• Ringing in the eyes
• Dizziness
• Blurred vision
• Brief episodes of blindness
• Loss of peripheral vision
• Seeing flashes of light
• Neck and back pain
• Double vision

SSDI or SSI claimants with this condition should seek medical treatment to rule out other potential conditions. One of the main problems which should be monitored is changes in vision which can be detected with frequent eye examinations.

Risk factors associated with pseudotumor cerebri include obesity, which can increase the risk factor by as much as 20 times, especially in women under the age of 44. Medications can also increase the risk including growth hormones, oral contraceptives, Tetracycline and excess vitamin A. Additional health problems can also increase the risk including lupus, Lyme disease, mononucleosis and kidney disease. Treatments can include dieting, steroids, surgery, and shunting to remove the excess of fluid.

Winning SSDI or SSI benefits for pseudotumor cerebri

To win SSDI or SSI benefits the claimant’s condition will first be evaluated and determine if it meets or equals a listing in the SSA Listing of Impairments. Pseudotumor cerebri is not specifically identified in the SSA Listing of Impairments but claimants can have symptoms that would meet or exceed an existing listing.

For example, if you have severe vision loss it would be possible to meet a listing for vision loss which is evaluated under 2.00 Special Senses and Speech, Section 2.02 Loss of Visual Acuity, 2.03 Contraction of the visual fields in the better eye or 2.04 Loss of visual efficiency.

Claimants who are attempting to meet or exceed a listing should be seeing the appropriate medical specialist to get the appropriate vision tests. The SSA must find evidence within the claimant’s medical files to make a disability determination.

Winning SSDI or SSI benefits through a medical vocational allowance

Most claimants will not meet or equal a listing for pseudotumor cerebri and will instead have to prove through a medical vocational allowance that they do not have the residual capacity to work.

If you are attempting to win benefits for pseudotumor cerebri through a medical vocational allowance you may need to talk to a disability lawyer who can review your medical files and determine if you have enough medical evidence to prove your case.

The Social Security Administration will be looking for medical evidence to prove that you are no longer able to perform work activities. Failure to seek proper medical care or to follow the doctors prescribed treatment plan of your condition can limit your ability to be awarded Social Security Disability Insurance or Supplemental Security Income benefits.

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Is Multiple Personality Disorder Real?

There are skeptics who question whether multiple personality disorder is real but experts agree that multiple personality disorder does exist. Highly trained experts who study this condition have identified several general symptoms associated with this condition including:

1. The presence of two or more distinct personalities controlling the individual’s actions or behaviors.
2. The inability to remember personal information
3. Distinct memory variations between the personalities
4. Identities which can have different ages or be of a different race or sex
5. Identities which have specific thoughts and behaviors

Claimants with this condition may also experience a variety of other mental health conditions or symptoms including mood swings, severe depression, eating disorders, compulsions, anxiety, panic attacks, phobias, sleep disorders and suicidal tendencies.

These symptoms combined with the dissociative disorder can increase the chances that the claimant will not be able to maintain full-time employment.

Winning SSDI or SSI for Dissociative Personality Disorder

The Social Security Administration (SSA) has two methods they use to determine if a claimant is disabled, unable to work and qualifies for SSDI or SSI benefits. First, the SSA will evaluate their condition and determine if it meets or equals a listing in the SSA Listing of Impairments. Next, the SSA will determine if they can continue to work through a process called a medical vocational allowance.

As with all conditions, the SSA expects the claimant to have good medical records documenting their condition and to be consistently seeing a doctor and following their prescribed treatment plan.

Meeting a Listing for a Mental Health Disorder

To win benefits for dissociative personality disorder you must prove that your condition meets or exceeds a listing under 12.00 Mental Disorders. This listing includes a section for organic mental disorders, schizophrenic, paranoia and other psychotic disorders, affective disorders, mental retardation, anxiety-related disorders, personality disorders, somatoform disorders, substance abuse disorders, autistic disorders and other pervasive developmental disorders.

Claimants who cannot prove that their condition and resulting symptoms are as severe as the conditions and symptoms listed will have to win SSI or SSDI through a medical vocational allowance.

Winning SSDI or SSI through a medical vocational allowance

To consider whether or not a claimant is disabled through a medical vocational allowance the SSA will determine if the claimant, based on their age, education, work history, and health condition still has the residual functional capacity to work.

A claimant’s medical records should clearly state any behaviors which would interfere with their ability to perform substantial gainful activity. For instance, does the claimant have persistent disturbances in their affect or mood, a pathological dependence, oddities of through, hostility, paranoia, damaging behavior or unstable personal relationships? If so, the claimant may be able to gather enough medical evidence to prove that they would have severe restrictions in their activities of daily living, severe difficulties functioning socially or difficulty maintaining their persistence, pace and concentration in a work setting.

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If you do not meet the basic nonmedical requirements of SSDI- you do not have enough work credits, your condition will not last 12 continuous months, your condition is not severe, or you are working too much – the disability lawyers knows they will lose your case and they will be wasting their time.

But what if you meet the nonmedical requirements and you have hired the disability lawyer to argue your case at the administrative hearing level but you were denied SSDI or SSI benefits and your lawyer refuses to appeal it to the Appeals Council? Why would your disability lawyer refuse to finish the fight and give you another a chance to win SSI or SSDI benefits?

This is a great question, and to answer it you must understand how the Appeals Council operates and the difference between it and the Administrative Hearing.

What happens at the Administrative Hearing?

By most accounts the Social Security Administrative Hearing is generally your best chance to win SSI or SSDI disability benefits. Why? The administrative hearing is your chance to share your story with an objective administrative law  judge who has the authority to award Social Security Disability Insurance or Supplemental Security Income benefits.

The Administrative Judge can see how you function, review your medical records and make a judgment on the reliability or your testimony. Although Administrative Judges approval records vary greatly throughout the United States, in most parts of the state some judges have an extremely high approval rate.

So what if you are denied at the Social Security Disability hearing? What is your next step?

Why won’t my lawyer take my case to the Administrative Council

Keep in mind, the Appeal Council operates more like the Supreme Court than the Administrative Law Judge. Their primary objective is to do one of three things: decide if the decision from the judge was accurate (and if so they will refuse to review the case), review the case themselves or remand the case back to the administrative law  judge for a second review.

If they do decide to review the case themselves they are looking for very specific criteria:

1. Whether or not the Administrative Law Judge may an error of law.
2. Whether the Administrative Law Judge’s actions, findings or conclusions cannot be supported by substantial evidence.
3. Whether there is a broad police of procedural issue which might affect the public or general interest.

So, before your lawyer will decide whether or not they will appeal your case they will review the judge’s decision and determine if they believe the judge made an error in law. This is the most in the case being sent back to the administrative law judge.

If your disability lawyer does not believe they can prove there was an error in law they are unlikely to press on with the fight.

Other reasons a disability lawyer will not appeal a case to the Appeals Council

The most common reason I believe that a disability lawyer will not appeal a case past the hearing level is the extended time it will take for an Appeal’s Council review- an average of 345 days- and the unlikelihood that the Appeals Council will make a favorable decision, which is extremely low.

Most disability lawyers will simply recommend that disability applicants begin the process again with a new application.

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According to an article  in the Washington Post, Social Security Administration officials claim that not only do such judicial searches compromise an individual’s private information it also detracts from the Administrative Law  judges primary responsibility of reviewing the claimant’s medical records and making the disability decision.

Proponents of the judge’s searches disagree. Senator Tom Coburn of Oklahoma believes that online searches are a great tool for judges whose responsibility should include detecting fraudulent claims.

In a letter Senator Coburn wrote to the Social Security Administration (SSA) commissioner he stated, “If an individual claims to be disabled, and then publicly posts a picture participating in a sport or physical activity on a social media website, such information should be used by [adjudicators] to determine if the claimant was truly disabled.”

If SSA Administrative Law Judges are not allowed to investigate potential fraud who is looking out for the public’s welfare? According to the SSA, this is the job of the Social Security Administration fraud investigators who are trained to detect such illegal activities. According to Kia Green who works for the Social Security Administration, the Office of Inspector General has trained investigators who have the proper tools and resources to detect fraud within the disability system.

Coburn and others disagree claiming that Administrative Law Judges should be a first line of defense for detecting fraud and making good disability decisions on behalf of the U.S. public. Many Administrative Law judges agree claiming that with their knowledge and experience they can review public online information and decide the validity of the information for their SSI or SSDI case.

The new policy was implemented in March, but there is evidence that judges have used online information to deny claimants in the past. For instance, some claimants have posted pictures on Facebook showing themselves engaged in difficult physical activities, which has led to the question of whether or not they are severely disabled.

It is not clear how the new policy will affect the judge’s decision making, but SSI and SSDI claimants should know that anything they post online may be considered public information and may be accessed by an investigator in the Office of the Inspector General who is looking for disability fraud.

Social Security Administration (SSA) disability fraud can lead to serious charges and could result in mandatory repayment of fraudulent disability benefits and prison. Consider Ronnie George and Nancy Stone of Kent, Washington, after defrauding the government of hundreds of thousands of dollars in disability benefits George was ordered to pay $315,318 in restitution and Stone was found to be jointly responsible for $275,965 of the restitution.

This case is one of many disability fraud cases that are currently being investigated by U.S. District Courts throughout the United States.

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Causes of Adult Stills Disease

Medical doctors continue to debate the causes of this condition. Some experts in the medical community believe that Adult Stills Disease is an autoimmune disorder, while others claim that it may be caused by an infection (including viral or bacterial).

There is not cure for this condition.Claimants who experience any of the conditions listed above should seek medical treatment to rule out other conditions such as lymphoma, rheumatoid arthritis, mononucleosis or other severe infections.

Who is most likely to have Adult Stills Disease?

Adult Stills Disease is most commonly found in individuals ages 15 to 25 and ages 36 to 46 years of age. The disorder does not seem to be hereditary, and males and females have this condition at an equal rate.

Winning SSDI or SSI for Adult Stills Disease

The SSA has two methods for determining if a condition is disabling  and if a claimant should receive SSI or SSDI: determining the condition meets or exceeds a listing in their SSA Listing of Impairments (also known as the Blue Book this list outlines conditions and symptoms which the SSA considers automatically disabling) or through a medical vocational allowance.

Meeting a Disability Listing for Adult Stills Disease and winning SSDI or SSI

Although the SSA does not have a listing for adult stills disease, this does not mean that a claimant could not prove that their condition “meets or exceeds” another listing. For instance, Adults Stills Disease can cause severe chronic inflammation to a claimant’s organs and joints.

If you have severe destruction in your joints, inflammation in your heart or excessive fluid in your lungs it may be possible to prove that your symptoms are as severe as a listing in the SSA Blue Book for conditions which affect these organs.

What will I need to prove my condition is disabling and win SSI or SSDI benefits?

Keep in mind the SSA will expect you to have proof of your symptoms. This means you will need to have your doctor perform a number of diagnostic tests including a physical examination, blood tests and imaging tests such as CT scan, ultrasound or echocardiogram to rule out other conditions and to make an accurate diagnosis of your condition. Liver function tests can also be done to determine if your condition has caused liver damage.

Winning SSDI or SSI through a medical vocational allowance for Adults Stills Disease

Claimants who cannot prove that their condition meets or exceeds a listing will need medical evidence which proves they do not have the residual capacity to work. Information such as when you condition developed, what symptoms you have, whether your symptoms are continuous, the treatments you have received and the limitations caused by your condition should clearly be stated in you medical records. Claimants whose condition does not meet a listing generally will benefit from assistance from a disability lawyer.

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