Question 11

Question: I am a 37-year-old man working with Vocational Rehabilitation (VR), mental health, and a local community employment agency that helps people with disabilities find jobs. I also attend a psychiatric day treatment program every day. Medicaid covers most of my health-related costs. I applied for SSI last year and listed my disability as “depression.” Social Security denied my application. I’ve tried several different work experiences through VR, but each time they’ve ended badly. Sometimes I’ve gotten angry and yelled at customers and co-workers; sometimes I’ve gotten angry at myself and tried to hurt myself. People have told me I should reapply for SSI, but I don’t see the point since they’ve already said I’m not “disabled.” Should I go ahead and reapply anyway?

Answer: This is a tough situation to be in! I encourage you to apply for SSI again, because it certainly sounds like you may be eligible. However, this time, I also encourage you to have someone help you. I'm suggesting the help because it is hard for everyone to put on paper the things that Social Security needs to know about your disability. It is especially hard when you have to focus on the things you have trouble doing, the things you need help with, and the things that might be labeled as your "deficits." I advise people to be prepared for how hard it can be to focus on these things, and to build in some support for yourself. That support may be having someone partner with you to fill out the forms; it might mean going home and taking a hot bath, eating a big piece of chocolate, or getting a hug; or that support might be having someone you trust fill out the disability part of the paperwork for you.

Most of the time you, like other people with disabilities and those of us who provide assistance to you, rightly focus on what you CAN do, what your STRENGTHS are. And that's how it should be....except when we are dealing with Social Security. Social Security's forms ask for lots of positive information about you, but they don't ask the right questions to hear the WHOLE truth, including the information they need to grant you SSI or SSDI. Therefore it is essential that you, or people who are helping you, get that information to SSI/SSDI.

Here is more information about filling out the forms, and the things you can do to have the best chance at getting benefits.

The disability part of an application for SSI or SSDI is written to elicit answers about what you can do. Therefore, it is very important when filling out this form to qualify items that need qualification. For instance, if you can walk, but only for a few steps at a time, or only if you rest five minutes after each ten minutes of walking, don’t write “yes, I can walk” and stop there. Describe all the limits that apply when you walk or attempt to walk. If you get very short of breath, or experience pain, describe it fully. Don’t feel limited by the space provided with each question. You can always attach additional sheets if needed to fully answer the questions. SSA has put out a “Disability Report Form Guide” on its website, located at www.ssa.gov/disability/3368, which answers common questions and gives some guidance for completing the Disability Report Form. The SSA website also now has a Disability Application Toolkit to help people gather needed information.

Application Do’s:

• If you can’t get to the Social Security Office to apply right away, call the SSA “800” number, 1-800-772-1213, to establish what Social Security calls “protective filing.” When you do a “protective filing,” Social Security will treat the day you call as the day you file your application. This can be important because SSI benefits are payable as of the first of the month after the date you file your application (e.g., whether you apply on the 2nd, 17th or 23rd of April, benefits can only begin as of May 1.) However, you are eligible for Medicaid as of the date you file, but you must apply with your state Medicaid agency if you need/want Medicaid coverage for the partial month before your SSI benefits begin.
  
• List all disabilities/impairments/conditions that pertain to you. This includes listing pain and the ability/inability to read and/or write and/or speak. Don’t try to decide whether certain conditions are “disabling” enough. List anything that interferes in any way with typical functioning.
  
• When the application asks when you became disabled, list your date of birth if you were born with one or all of your disabilities. For acquired disabilities/medical conditions, list the earliest date you can remember having symptoms, even if a formal diagnosis wasn’t made until sometime later.
  
• Fully describe any pain you have, where it occurs, how long it lasts, how often you experience it, what you have tried to relieve the pain and whether it worked or not, what medications you currently take, and any medication side effects.
  
• When you list medications you take for any condition, always describe any side effects that occur if the side effects cause problems in your functioning in any way. Common side effects of medications that could impede your functioning might include drowsiness, lethargy, nausea, etc.
  
• Try to gather copies of all your medical records yourself, so you know exactly what information is going to Social Security, and what your healthcare providers have said about you. It’s amazing how much misinformation may have made its way into your medical (or school or other) records. Reading copies of the records yourself allows you to correct any misinformation and tell your doctor about any signs, symptoms, or problems not currently listed in records. Reading your records also allows you to see where the gaps are in the information about your disability so you can take action to fill those gaps.
  
• Follow up with doctors and schools and others to make sure they have responded to Social Security Releases of Information requesting records. If treating sources are reluctant to release your records to you, an advocate or organization assisting you can send a release for the records and often get them more quickly.
  
• Periodically check with the Disability Determination Services disability examiner to see if records have arrived and whether anything else can be provided, or is needed. Please note that in many states all medical records are now transmitted to SSA electronically. Soon all medical records in every state will be sent to SSA electronically as email attachments.
  
• Ask family members, friends, teachers, social workers, VR counselors, neighbors, your pastor, former co-workers and any other people you are comfortable asking to write statements to SSA that describe their observations of your functional difficulties, and any help they provide. These statements don’t need to make any diagnosis, and shouldn’t contain conclusions about your eligibility for benefits. They should focus on what you need help with, any pain and its effects that they have observed, and all the functional limits they have witnessed first hand. Ask these people to describe what it’s like on your worst days so SSA can get a complete picture of how your disability (disabilities) impacts your ability to function from day-to-day. These statements can be sent directly to SSA, if people are more comfortable, but should always contain your name and Social Security number at the top. These statements can make all the difference in your case, so don’t hesitate to solicit them from people you trust. If others are unsure about what to write, or how to say things, it can be helpful to have an advocate work with them, or to provide them copies of the medical listings so they can note the “signs and symptoms” they have observed.
  
• If you are an advocate assisting someone to apply, get copies of the disability application to fill out with the person ahead of time. Applicants will be less nervous, you can frame information emphasizing how someone meets/equals the listings, and you can secure releases to send for copies of all medical and other records that will support the person’s application. If a doctor is slow to respond or is altogether unresponsive to SSA, ask the person for a signed Release of Information to view the doctor’s records, and make an appointment to personally view the records. Using the SSA medical listings as a guide, write a letter to SSA reporting the pertinent information, findings and documentation from the doctor’s records. Then ask the doctor to read it for accuracy, make any corrections needed, and sign it so it can be sent to SSA. Many doctors are happy to cooperate because of the time and energy you are saving them and their staff.
  
• Descriptions of your limits on the application, and statements from family, friends, and medical sources should all talk about your limits as they relate to “typical” work-like activities. Examples may include to what extent you experience difficulty in:

  • concentrating
  • remembering
  • following directions
  • picking objects up
  • bending
  • lifting
  • carrying
  • getting along with others
  • telling time
  • handling stress
  • sitting
  • standing
  • reading
  • communicating
  • moving
  • hearing
  • seeing
  • manipulating objects
  • understanding
  • following a schedule

Along with functional limits, these statements should also discuss how slowly you may do things, if you need frequent written or spoken reminders, or hands-on assistance to accomplish a task, how you get along with others, and how you respond to supervision. If you experience pain, seizures, stiffness, intermittent memory problems, etc., these statements should also describe what triggers these things to occur (e.g., stress, too little sleep, too much medication). If your disability is epilepsy, having statements from others is essential because you aren’t able to observe your own seizures. The information from persons who have observed your seizures should include what they look like, how long they last, how long recovery from the seizure takes, how frequent the seizures are, and anything else they have observed.

I hope this information will be helpful. Good luck, both with your application and in finding a good job match that will allow your strengths to shine through while also accommodating your disability.

Response provided by Marsha Katz

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