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Derek1987

SSDI sending me for evaluation. Advice please

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So I have a SSDI case pending. First application.  After they got all my doctor records, they are saying  that's not enough to approve my claim. 

They are sending me out for a mental and anxiety evaluation. I have hyper pots and elevated adrenaline in my body. So it seems like they don't care about the fainting issues, heart palpitations and all of the other suffering that goes on with this disease. Looks like they are focusing on the anxiety side of things.

My psychiatrist even has a letter in my doctor records mentioning the sympathetic  and parasympathetic nervous system dysfunction causing high anxiety, rapid heart rate, fainting etc and says I am permanently disabled.  

Has anyone ever gone through this? How can I prove to them my anxiety is horrible.  I mean it really is. I had an autonomic nervous system test done showing my adrenaline is way above normal. A normal person is a 1. Mine was an 11. I wonder if I can take those records and explain to him what it means. I know a regular doctor won't understand the graph. Only my cardiologist and neurologist understood it.

On the letter it states " the medical evaluator may not do some of the tests we ordered or that other tests are needed". 

Wondering what kind of tests they can do to check my anxiety. I know I am disabled now. They need to know it. I know that the doctor is assuming I am not from the jump. I mean a lot of people  fake disability and it ruins it for others.  My wife for example.  The doctor said she was faking and trying to use the system.  It took her 3 years and a hearing  to be approved. I don't have that kind of time.  Long term disability will only pay me up to 24 months. I wouldn't be able to hold a job in my current condition. 

All advice and wisdom will be appreciated.  Thank you!

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Hi, @Derek1987,

I haven't been through this process but what I do know is that if I had to go through it, I would hire an attorney who specializes in handling SSDI cases.  They will know, among other things, how to obtain proper documentation.  You could meet with the attorney and decide if you're comfortable with hiring them; you could also try doing the first application on your own and if that is rejected, consult with the attorney then.  If I were in your shoes, I would start with the attorney mainly because the anxiety thing is too easy for people to latch onto as a reason to deny the claim, but you may do well without one. However you decide to proceed, good luck!!

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GET AN ATTORNEY.  I promise you the evaluating doctor will know nothing to very little about your disease. An attorney is the best investment. I wasn't put through the examination but did have to go to court, almost. I won in court with a Summary Judgment without a full hearing. I didn't have to go. My attorney did everything from soup to nuts.

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Please get an attorney! They will help you immensely. Social security has a rule that they have to go by your doctor’s opinion first. If they don’t have enough info, they will send you to a consultation with one of their docs, but this person doesn’t necessarily specialize in your problem area. Records are key. You will also need your doctor to complete a functional capacity evaluation. It basically lists how much or how well you can sit, stand, bend, lift etc. and what your limitations are. This is also a key part of their determination. 

When I applied, I also printed off journal articles from Dr. Raj and the Cleveland clinic explaining what POTS is and how it affects our bodies. Just so they could have more info about it. I was approved after my appeal and luckily didn’t have a hearing. My attorney helped so much and I don’t think I would have been able to do it myself.

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I am not familiar with the system in the US, but have just been through the process in the UK. 

I have heard there are some kind of no-win-no-fee representation deals in the US where someone takes on your case for no cost to you upfront, & that these are quite helpful for people applying for disability. 

In terms of making your case, I really think you would be best placing more emphasis on physical symptoms rather than "anxiety", as not only are they generally regarded as more serious, if you are looking at a permanent claim it can be hard to make a prediction that an adult of your age will remain too "anxious" to work for the next several decades. It may be that having your main report come from a psychiatrist has skewed their focus towards the mental health side - have you got good documentation from your cardio/neuro?

I think the main letter that swung it for me was from one cardiologist who stated something like "all the currently known treatments for POTS are only minimally effective". The assessing occupational health doctor also included in her report all the things I had tried, which showed that I had genuinely tried my best to improve my situation. 

Here, a lot of it also rests not on your specific diagnosis but how it affects you, so if you faint or have severe presyncope where you lose your vision & hearing, have to lie down etc, you need to get that across. If you can't stand/sit up for very long, they need to know that, & all the things it makes you unable to do. If it takes you over an hour to get washed & dressed because of blacking out, they need to know that, because they won't see it. 

If you have to physically attend any appointments/assessments, go there in a wheelchair, have someone accompany you, & do not drive yourself there. Ask if you can lie down on the examination couch or put your feet up on a chair whilst you answer the questions, as it helps you think more clearly by getting blood up to your head. 

It isn't milking it, it's just telling/showing it like it is. 

Best of luck,

B xxx

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6 hours ago, bombsh3ll said:

Here, a lot of it also rests not on your specific diagnosis but how it affects you, so if you faint or have severe presyncope where you lose your vision & hearing, have to lie down etc, you need to get that across. If you can't stand/sit up for very long, they need to know that, & all the things it makes you unable to do. If it takes you over an hour to get washed & dressed because of blacking out, they need to know that, because they won't see it. 

@Derek1987 I agree. If you try to get SSDI on grounds of anxiety rather than POTS ( which apparently you do suffer from ) then the syncope will not matter b/c it really is not a symptom of anxiety. So I understand why they would want you to get a second opinion - to determine what the ANXIETY does to you. You no longer are asking for SSDI due o the syncope/ POTS. This is a whole different ball game! 

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32 minutes ago, Pistol said:

@Derek1987 I agree. If you try to get SSDI on grounds of anxiety rather than POTS ( which apparently you do suffer from ) then the syncope will not matter b/c it really is not a symptom of anxiety. So I understand why they would want you to get a second opinion - to determine what the ANXIETY does to you. You no longer are asking for SSDI due o the syncope/ POTS. This is a whole different ball game! 

I put what conditions i suffer with. POTS was at the top. Anxiety was in there. On the back of the questionaire i explained that my POTS is a cause of major anxiety. I explained how the disease works. I told them about the bloodflow to the brain problems, syncope, and all of the other issues its caused me including the anxiety. I included it all together but under the umbrella of autonomic dysfunction. 

My wife was sent for a mental evaulation even though hers was physical pain from various conditions she has. They tried to say her physical pain was from depression. They didnt do an anxiety exam however.  

Im going to be completely honest. And do my best. I just wanted any advice i could get because of how crooked the system is. 90 percent of doctors ive seen either dont care or doubt you.

I did hire an attorney but she wont get anything if i win the first try so i know she isnt interested in helping me right now so i havent even contacted her. She told me to fill out the application and come in to put her as my attorney on paper when i turned it in. Then her assistant was talking about winning at the hearing. And i was like i need to be approved before that. So im doing everything i can on my own to be approved. 

 

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I was approved on a physical ailment but still had to take a psychological exam. I think it is standard. 

I think a good question to ask is who got approved on the first attempt with no appeals.

I didn't. 

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I know I am in the UK & things are possibly different, but I got approved first time (I expected a fight because that seems to be what most people experience) & I based my case purely on physical symptoms & limitations. 

Yes, dysautonomia can both mimic anxiety in terms of some physical symptoms like a pounding heart, shaking etc, & be a cause of secondary anxiety due to having a horrible physical illness with no effective treatment, but that doesn't make your main problem anxiety. 

Did you have a diagnosed anxiety disorder prior to becoming ill at all? 

I would try and get the focus back on your physical symptoms because that is what will likely justify declaring you permanently disabled, whereas anxiety/depression can improve or go away, & has many proven effective therapies. 

B xxx

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PS have you ever seen or do you have the opportunity to see an autonomic specialist? It may be worth trying to do that if you can to get their report as a regular neurologist/cardiologist may not have sufficient condition-specific expertise to be able to comment on your long term prognosis. A number of the doctors I had seen that I got reports from could not give a definitive answer as to whether I had any scope for improvement as it was beyond their expertise, & I thought this was going to be a real problem for me. 

They were all agreeing that I was unable to work right now but only a couple were willing to commit to saying it was unlikely I would ever be able to. 

B xxx

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8 hours ago, bombsh3ll said:

have you ever seen or do you have the opportunity to see an autonomic specialist? It may be worth trying to do that if you can to get their report as a regular neurologist/cardiologist may not have sufficient condition-specific expertise to be able to comment on your long term prognosis.

@Derek1987 I also believe that it would be beneficial to you to see an autonomic specialist at this time. If you apply for SSDI based on anxiety your psychiatrists eval may be enough but you will be assessed on that diagnosis. If you want them to consider the syncope/ dysautonomia as a reason for disability you should see a specialist ( I understand that you say the physician that is seeing you for your dysautonomia symptoms is a specialist but if the treatment is not working I personally would seek a second opinion ).  

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1 hour ago, Pistol said:

@Derek1987 I also believe that it would be beneficial to you to see an autonomic specialist at this time. If you apply for SSDI based on anxiety your psychiatrists eval may be enough but you will be assessed on that diagnosis. If you want them to consider the syncope/ dysautonomia as a reason for disability you should see a specialist ( I understand that you say the physician that is seeing you for your dysautonomia symptoms is a specialist but if the treatment is not working I personally would seek a second opinion ).  

Yeah i see an autonomic specialist and im still the same. This is her bio if you are interested.

https://semmes-murphey.2dimes.com/debbie-turner

I was offered to go to vanderbilt initially but in my ignorance i was like well if i have a specialist here in my city, ill just see her. But now im officially iust waiting to go to vanderbilt after my recent referral.

If i get denied, thats when i know my attorney will really start to help me. Like i said, i did explain i have autonomic dysfunction and it causes this, this and this. 

Social security might of zoned in on anxiety because they feel my autonomic dysfunction doesnt meet the criteria of disability. Who knows but thats where my attorney can help me.  Either way, ill win eventually unless i get better.

I hope i can talk to my examiner and be like my anxiety isnt just mental, its physical. My test results prove it.  And describe what autonomic dysfunction is. If i can explain my condition, that will help me out. If not, idk.  We will see what happens.

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@Derek1987 - I had to pply for SSDI b/c after I had to stop working I had Longterm disability insurance and they required me to apply ( so they did not have to pay for the rest of my life … ) and they supplied an attorney. Still - it took 2 years and 2 denials and I had to tell the ALJ personally what it is like before I got approved. Don't be disappointed if you get denied the first time around - that is common. With me they focused on seizures, which were caused by POTS. They seem to just go by a symptom since I do not believe POTS is understood by them. But I was told that it is a Diagnosis that they recognize. 

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