Social Security Disability and my Dad

[RiverRunning]

My parents are awful people. Well, sort of. My dad is 59 and has a host of medical problems: chronic cellulitis, for one. He has to get creams to apply to his legs to keep the outbreaks at bay. He's about 200 pounds overweight.

 

His knees need to be replaced - apparently all of the cartilage is gone, so he has a very hard time getting around. He has kidney failure and, arguably, heart failure (apparently his heart failure isn't that awful - he's slipped in and out of it. Every time he goes for tests, he's in it...then he's not...then he is). He also has depression and is taking Zoloft.

 

He has high blood pressure, for which he's taking medication. He has arthritis in his knees (which is genetic - he has a Baker's cyst on the back of one of his knees).

 

My dad has always worked in manual labor. For the past 25 years, he has worked in an auto factory. He stands in a fixed position lifting heavy machinery all night. However, they moved him to other positions that require more walking.

 

For the last 6 months, whenever they don't need all of their workers, he has volunteered to come home because he can't take the pain (he has pain medications, which he says do not help) in his legs and knees. He has no education beyond high school and has never done any work besides manual labor.

 

My question is this: how can I improve his chances of applying for medical disability? After a night of work, he'll often call off the next day because he says he can't do it again. We've kept track of his work record, hopefully to demonstrate that his medical conditions are interfering with his work. So far as I'm aware, he doesn't need to be COMPLETELY out of work to apply - although that would help his case all the more.

 

Is there anything I should be paying attention to, etc.? My mom just wants to pretend nothing's wrong, or worse yet, scream and yell at the poor guy in an attempt to shame him into working full-time again. That's not going to happen.

 

I'm trying to do as much as I can to keep my parents from losing their house. Any advice others can give on the social security disability process would really, really help.

 

I've already told my mom that she should have my dad talk to his doctor about his conditions and the possibility of going out on disability - the doctor could really help his application.

[lemontwist]

Hi!

I'm an adjudicator- fancy word for someone who determines medical disability for SSA.

 

Considering what you've mentioned, he would probably be allowed quite easily. (59, unskilled work history, 12th grade education)

 

Some recommendations-

Get the process started ASAP. And DO NOT hire an attorney- I can't stress that enough. They will only hurt/slow down the claim. (Think about it... the attorney gets a percentage of "back pay". The longer the process takes, the bigger their cut.) When there is an attorney on the claim, I MUST go through the attorney for any information I need- be it, medical updates, to clarify a treating source, or to get a better description of their past work. Many times, attorneys have not provided me the information I need, and since I can't contact the claimant, I have to deny them for failure to cooperate (even though the claimant may have no idea). THEN when the case gets appealed to the ALJ (hearing) level, THEN the attorney will provide the info to allow them. By this time, an additional year has been added to the case, and the attorney gets more money. This situation is so frustrating to me, and it happens more then you would think. The claimant could have easily been allowed at the initial level without any representation, but because of their attorney, they are forced to wait and pay out more of their money. ARGH!

 

Also, if you want to speed up the claim.... make sure to write down the exact name, address, phone, and fax of any doctor/hopsital/clinic he has has seen within the last year. One of the hardest and most time-consuming parts of my job is trying to get all the darn medical records. You don't have to go and pay for them yourself, but it would DEFINITELY speed up the claim if you can bring them to the interview with SSA. They can scan them in and cut down 1-2 months of processing time. His knees are going to be a biggie.. so if he's had an XR/MRI within the past year or two, see if you can get a copy of the report (not the actual image) and send it in. Letting his doctors know that he's thinking about applying is advised- but just know they don't make or break a case.

 

In order to be eligible to file for Disability, he can't be making over $1,000/month. The SSA office will refer to it as "SGA". Your local SSA office should be able to help you with all that. Even if he's making a bit more than SGA, I would still encourage him to apply. If there have been significant breaks/inconsistent earnings he may still be eligible.

 

And and "everyone gets denied the first time" is a total myth! I allow people everyday at the initial level.

 

Hope that helps!!

[RiverRunning]

This is seriously the most helpful thing I've encountered on Loveshack. Thank you -so- much for creating an account and answering my question. It was ridiculously helpful. I owe you...well, more money than I have.

[lemontwist]

Glad I could help!

I peruse the forums occasionally but never had much of a reason to post. The title caught my attention... and I feel for people in his situation. (Versus the 25 year old with no work history, claiming headaches and a hangnail... ).

Best of luck, I'd be happy to answer more questions!

[lemontwist]

Oh and one more thing...

After applying, he should receive a Work History Form (SSA-3369) to complete about his job duties for the last 15 years. (Or, occasionally they will get this info at the interview).

Help him with this and be as thorough as possible (especially with weights). Do not underestimate weights he lifted... this could make or break his claim. Not saying you should lie about it either, of course. But just really be descriptive as you can. Make sure he names ALL the tools and ALL the duties he performed, and don't underestimate the weights he lifted.

 

I had a claimant whose job was to spray shotcrete for underground pools. He described the job as not routinely lifting any weight, however, a hose full of shotcrete is no joke (40-50#s) and he was holding(lifting) that continuously. That difference can be the deciding factor between an allowance vs. sending them back to past work.

[RiverRunning]

Of course this would be the one time I had a LONG reply to you and it gets eaten...fail me.

 

I am curious. Most of his conditions have been diagnosed within the last 5 years. I want to say he had the Baker's cyst/arthritis/cartilage-less knees issue first explored about 3 years ago. I want to say he had x-rays and the like 2 - 3 years ago. Will this hurt his claim since it's been so long? Should he go and have them looked at again, or is that a moot point (are the 'old' records good enough)?

 

He has routinely been to his doctor's office and mentioned his knees, even gotten stronger pain medication to help with them.

 

Until about a year ago, he worked doing demould for a car seat company. I'm going to estimate he continually pulled at least 40 - 50 pounds from molds and carrying them to where they needed to go. The company has since shuffled him around to other positions that require more walking instead, which he says is even more unbearable.

 

I have an uncle who got on SSDi when he was in his early 30s - he had some back problems along with OCD. To this day, I still think he could have held down some kind of job. I think my mom and dad have been so reluctant to apply due to a few misconceptions (like the belief that my dad must be completely without income for 6 months before he could apply for SSDi), and also because they saw that my uncle took 2 - 3 years before he got SSDi.

 

Watching my dad suffer more and more all of these years, meanwhile my uncle barely worked for more than 10 years, bothers me.

 

I hope that this is the end of the working road for my dad. I can't imagine being in such horrible pain. I know the pain has contributed to the depression and to a significant amount of weight gain...

 

Anyway, just rambling at this point. Thank you so much for all of your input.

 

I'm going to try and see if I can convince him to go to an SSA office with me this week. Get the paperwork. I told him to start making a list of his work history/medical history/getting medical records together.

 

My mom is headstrong and will do nothing to help herself - and my dad more or less follows her whims, so I have to take the lead. I'm glad that I was able to tell my mom, "I talked to someone who WORKS doing this stuff." If it's coming from her kid, she's concluded that I'm a complete idiot who knows nothing.

 

Having this discussion has helped me push them a little bit further into doing something and to stop sticking with the status quo, which is obviously not working.

 

But a few more questions: The $1k-ish limit. This wouldn't apply to my mom, right? Would it just apply to my dad (for what it's worth, she's unemployed)? I'm assuming this also doesn't include public assistance (like food stamps)? If he were receiving underemployment or unemployment, does that also count toward the $1k limit - or is it solely reserved for employed income?

 

I'm going to estimate that he's probably earning right around $900 to $1k a month right now.

[lemontwist]

Regarding the knees- no, this will not hurt him at all. Even if it's been more than a year or two, definitely make sure to put down all sources he has seen about his knees (esp if a MRI was done!) as this helps establish duration. If his current medical records aren't detailed or recent enough, he will be sent to a 'consultative exam' and possibly XRs. If his PCP rx's the Zoloft, they will probably send him for a mental status exam (totally routine). BUT if they don't, don't fret- they are probably just assuming he would be allowed under the physical issues solely. The exams are paid for by the state, but he can't miss them or reschedule them repeatedly.

 

Your uncles case is one that probably went to the ALJ level. There is initial level, reconsideration level, then the hearing. Several years ago (2004-2007ish) the average wait between initial to ALJ was easily 2-3 years. They have since hired many more people and streamlined some processes, so now it's down to about a year between filing to the hearing. Though, for your dad I would really expect him to be an allowance at the initial level. (as long as his knees have more than "mild" degenerative changes). It's kind of a running joke with adjudicators that people who get allowed at the ALJ probably shouldn't have been allowed.... a lot of Alj's don't care to go through all the medical records (which is usually 2,000+ pages by that time) so they just take claimant's word for it.

 

Anyone who is under age 50 is going to have a hard time getting disability. Unless they "meet a listing"- Listing of Impairments - Adult Listings (Part A). If they meet a listing, age doesn't matter. If you are 20 and on dialysis for chronic (not acute) kidney failure- allowance.

Why your dad would most likely be allowed is called a "med-voc allowance". This depends on age, impairments, work history and education.

 

Regarding your mom- it would depend on how long she has been unemployed. There are two types of disability... title 2 is the kind you pay into all your life, title 16 or "SSI" is needs-based. If it's been several years since she worked, the sooner she applies, the better. SSDI is like any other insurance- there is a "Date last insured" or DLI. This is typically 5 years after they stop working, but it depends how long and how much they have paid into the system.

And no, unemployment and food stamps do not count into the $1,000 limit.

 

Luckily, you can help both of your parents. You can actually apply for them (online even!) What You Can Do Online

They will still need to cooperate with the process... like signing the medical release, going to exams, etc. But many of my claimants have non-attorney reps/family members who filed for them, so it's not uncommon (and actually, very helpful for my job!).

 

Hope that helps!

[Radu]

Nice to see this kind of detailed help on LS.

[RiverRunning]

Thanks for the link on applying - I did find that yesterday. I know MOST of their details but not all, so I'm waiting for their input. While my mom has some disabilities, she doesn't have any intention of applying herself (it's been more than 30 years since she's done anything other than baby-sit). I was wondering if the $1k limit was more of a household income limit, or if it applied strictly to the person applying for SSDi.

 

I told him to make a list. He's seen heart specialists, kidney specialists, I distinctly remember taking him for the MRi on his knees, hospitals, his regular doctor, etc.

 

So for the initial level - you really believe that it would take less than a year? Not that I'm going, WHERE'S THE MONEY, but they're in a world of financial hurt. My mom is very stubborn and negative and seems to think that if it's going to take too long (i.e., two to three years like my uncle), it's not even worth bothering to apply for.

 

So, any kind of general time-frame you think it might take can only help me out in convincing her. She is getting pushed a little further and further toward it all the time, when previously she's just shut out all of my suggestions about applying.

 

I'm printing out a few copies of the disability forms later. I intend to take some over to them and let them brainstorm, come up with all of the doctors and specialists he's seen over the years, before we send in his actual application.

 

Seriously, lemontwist, if you ever get PM privileges, I am PMing you and sending you money through Paypal or something. The fact that you've taken so much time to answer my myriads of questions has really brightened my entire week and possibly changed the course of my dad's life. He's been sinking fast, and I think that this will give him some hope.

[RiverRunning]

Nice to see this kind of detailed help on LS.

 

I have to admit I expected the thread to kind of just sit here. Who KNEW that a guy who does the stuff would find the thread and respond almost immediately?! That's the kind of luck that's just too good to be true.

[RiverRunning]

It seems like most of his maladies are weight and diet related. Why not help your Pop change his diet and exercise instead of filing for something that will likely result in him getting less exercise? Collecting a disability check isn't going to improve his health.

 

Medical specialists concluded that his knees were the result solely of genetics.

 

A lot of his problems ARE related to his diet. But when your knees get screwed up by the time you're in your 40s (only in the last 5 years did he actually pay to have that done), are you really going to want to get out and walk anymore than you have to? He's been in great amounts of pain for the last 20 years, and especially in the last 5 years.

 

It's impacted his work. My parents are barely scraping by, let alone do they have the money to pay for exercise equipment or for a gym membership (he can barely WALK, my friend).

 

At the very least, not having to stand on his legs for 8 hours every day and not having to worry about how he's going to pay the bills will make it easier for them to buy exercise equipment that he can use, given his problems.

 

This is not a thread for fat-shaming. The intention is to improve his health. He needs to lose 100 pounds before he can get a double knee replacement (again, the knees that several specialists have confirmed have eroded due to a genetic form of arthritis). I'm not arguing that his weight is HELPING his problems, it's incredibly ignorant just to spout off when I've already addressed the genetic nature of it in this thread. And that aside, he didn't start gaining the weight until his knees started going.

 

I have already talked to my dad at length about health, nutrition and starting an exercise program. But as it is, he's so depressed with going to work on the knees that he has that he's mostly shut down and communicates sparingly.

 

I can only solve one problem at a time, and this is a problem.

 

If any other posts are going to focus around, "He's FAT," and blindly ignore that a few are related solely to genetics, or that maybe he GAINED the weight because he can't endure the pain of moving, I'd rather they just not be posted.

Edited July 31, 2012 by RiverRunning

[lemontwist]

I have to admit I expected the thread to kind of just sit here. Who KNEW that a guy who does the stuff would find the thread and respond almost immediately?! That's the kind of luck that's just too good to be true.

 

Haha, I'm actually a lady. Not that anyone would know that, since I haven't made a profile, huh?

 

Your mom may still be eligible for some type of disability. The $1000/month is applicable to pre-tax earnings for both SSDI and SSI. Also, you can still make up to this amount while still being on disability.

 

There is a "household" limit for SSI (not SSDI!!!) that takes into consideration your resources (bank accounts, other dependents on disability, etc.)- but to be honest, I'm not sure what the limit is currently, as I only make the medical decision.... FYI- the SSA office handles all the "technical" issues- that's who you'll be dealing with initially. They run "queries" to determine how much you have paid into the system, and will ask you to provide a variety of documents (pay stubs, bank statements, etc.) to determine what types of disability you are eligible for. Once they have that all sorted out, they send the claim (electronically) to the state agency to make the medical decision (we are usually referred to as Disability Determination Services or Disability Determination Bureau). My job is to request the records, review the records, order exams/labs/etc., make assessments, and get it signed by a staff MD. Once our decision of disabled/not disabled has been made, it gets sent back to the SSA office and they finish up any technical issues. So I am not at the SSA office, and only know the basics of what they do as far as eligibility goes.

 

It's hard to say how long a decision will take for your dad, but absolutely less than a year. My average for an initial case is 37 days. Sometimes I can make the decision in 1 day if medical records are included, sometimes it can go on for 100+ days if it's a complicated case with semi-uncooperative claimants. Then tack on another 30-45 days for the SSA office to do their technical thing. I really don't think it should take any longer than 3-6 months total.

 

Really, the sooner you can get started on it, the better! I know how complicated and daunting the process is.. believe me! But I would really encourage him to try for it.

[lemontwist]

It seems like most of his maladies are weight and diet related. Why not help your Pop change his diet and exercise instead of filing for something that will likely result in him getting less exercise? Collecting a disability check isn't going to improve his health.

 

I used to agree with you.. and still do when it comes to most younger people. However there is a point of no return with some conditions, and they only get worse.

Even if he lost the weight, his knees won't get better. Total Knee replacements are no joke.. especially for someone over 50. Any type of surgery is likely to be high risk for him- especially with the cardiac and pulmonary issues (apnea?) he undoubtedly has. Even with successful surgery, rehabilitation with any weight bearing joint is ROUGH.

 

RiverRunning mentioned their dad having kidney and heart issues... Hypertension can lead to several chronic conditions that you wouldn't necessarily think of- including acute and/or chronic kidney failure, aneurysm/stroke, coronary artery disease, and even vision loss (hypertensive retinopathy). Even if diet is controlled, there can still be end-organ damage. Just as uncontrolled diabetes can lead to extreme neuropathy and poor circulation requiring amputation of an extremity (usually a foot).

 

In these cases, the damage is already done.

 

But yeah, for 85% of the people applying for disability- diet and exercise (and maybe a healthy dose of self awareness) is strongly advised.

Edited July 31, 2012 by lemontwist

[RiverRunning]

I admit I had a bit of a knee-jerk response to it. Part of being around LS is that I've just learned that as soon as someone says, "Gee, you're/that person is fat," the entire thread goes downhill and starts to focus entirely on that one issue. That's part of the reason why I've come down so harshly on it. I wanted to focus on the process of disability, and not, "It's his own fault, drop the weight."

 

From my own research, almost all other exercises besides swimming and riding a recumbent bike are a no-go. I'm hoping that we can eventually meet with someone who can come up with exercise ideas for him.

 

But being entirely realistic here, he's not going to be doing anything that's going to burn high amounts of calories. He might be able to entertain a modest weight loss - 50, maybe even 100 pounds in a year - but in the meantime he'd still be working.

 

Sorry about getting the gender wrong, ms. twist. You rock.

 

I've been searching for some of this stuff for a while, and I admit that navigating some of it can be tricky. I have a hard time filtering out what might be applicable to my dad and what might not be.

 

I think he's going to start calling his medical offices this week and getting records. It's great to hear that this could be done in 3 to 6 months.

 

You know, it's not often on the Internet that you find exactly what you need and that you find someone so cooperative and so willing to provide such detailed, personalized help. It's been a very long time. You've helped change the trajectory of my parents' lives (I really think that they concluded their only other options involved my dad waiting to get fired, really).

 

And mine too - as my pocketbooks would eventually be opened to try and keep them floating as long as possible.

 

Thank you. Problem on its way to getting solved.