Appeal for disability denied -- what to do next?!

[KathyB]

Hi all,

Original request for Virginia Retirement Disability -- denied. Appeal -- denied. It seems they still feel lowering my dose of prednisone to 5 mg is showing improvement. I'm not permanently disabled nor am I incapacitated and should be able to perform my job. Also, having low immunoglobulin levels is not a basis for disability. These are all excerpts were told to me by my rep as the "findings" of the medical review board. So far, I've received no report or findings from Social Security.

So now I have to either accept it or appeal again, this time by hiring a lawyer and hearing with an independent fact finder (atty specializing in disability cases). I can add new evidence before the hearing. In addition, witnesses are welcome to "testify" on my behalf. I offered to have a medical exam with one of their "independent" physicians, but the VRS didn't make the request.

I desperately need help and advice!

KB

[Dirty Don]

I think hiring a 'disabilities' lawyer is the best choice, weighing the legal costs against the winning of your disability payments, of course. I forget what thread or who on here, but someone did hire legal advice and won eventually. For some reason, the governments don't recognize AIs as something that is debilitating...perhaps it's the severity, not sure, perhaps just stupidity or cheap! When pushed to the wall, most agencies, with good evidence, will give in. They have to, they don't want to be sued either! Good luck!

[drz]

Hi all,

Original request for Virginia Retirement Disability -- denied. Appeal -- denied. It seems they still feel lowering my dose of prednisone to 5 mg is showing improvement. I'm not permanently disabled nor am I incapacitated and should be able to perform my job. Also, having low immunoglobulin levels is not a basis for disability. These are all excerpts were told to me by my rep as the "findings" of the medical review board. So far, I've received no report or findings from Social Security.

So now I have to either accept it or appeal again, this time by hiring a lawyer and hearing with an independent fact finder (atty specializing in disability cases). I can add new evidence before the hearing. In addition, witnesses are welcome to "testify" on my behalf. I offered to have a medical exam with one of their "independent" physicians, but the VRS didn't make the request.

I desperately need help and advice!

KB

First get a consult with an expert in this field. Often these are free. The main purpose is to find out what they will charge if they win an appeal. Lose an appeal? Often they take your benefits for first year and maybe a portion of later payments. Some take just a portion of back pay you receive and don't charge if they don't get you any money? Also call the number to get info about how to appeal and ask about procedures to appeal and try gain any other info you can. You probably have to wait till you get written denial for this. Some times they can give you some advice or help on how to best proceed. Seek advice and info from the hospital social worker or whoever helps indigent patients get funds for medical care since they may have some experience in this area? Usually the best supporting info for your case comes from your treating doctors who know your history and current condition. Inquire about where, how, and cost to get a professional vocational assessment. Often government rehab programs have these available free. They can test and document your strengths and limitations for regular work. The biggest problem is usually how disability is defined as it applies to your situation. Some are so narrow that if you can sell pencils on the street, stuff envelopes, or talk on a phone you won't qualify. The most generous ones define disability as inability to do your regular work adequately for regular hours and earn your normal salary. How much damage and limitations you have from Wegs is key to gaining disability, not current meds. Gather how much documentation you have and any supporting evidence such as, do you have a handicapped parking permit, other medical equipment, a doctors note to avoid contact with sick people etc.? Start building a file so any doctor or attorney or rehab person can readily assess your current status and ability to function. Remember it often take more than one try to gain what you are entitled to receive and it can be a long drawn out process. Can you gear up for long haul of doing an appeal? Or do you just want to delegate the work out to a specialist and give them a large part of your benefits? The answer to this question will help you decide what to do.

[Lightwarrior]

I agree with Don and drz. APPEAL, for some reason in my experience when I was a community organizer no one ever won on the first try. Most usually it was the third or fourth appeal.

I don't know about your income but if you are at or below the federal poverty level you may qualify for free legal aid. I know there is usually a back log but you might check in your area. If you know anyone because of the work you did now is the time to start pulling in favors and asking for help. GOOD LUCK

[annekat]

Their reasoning about the prednisone dose is ridiculous. I guess they don't realize that tapering prednisone at that stage can cause flares and increase your symptoms, that your adrenal function is still compromised or in question, and that it is normal to attempt a taper even if you are still sick. You and no one else knows how you feel physically, how fatigued you get, etc., and that should be backed up by your doctors. Other than that, I have nothing to add to what others have said, except to repeat, GOOD LUCK!

[Sangye]

Kathy, I agree with all of the above-- great suggestions everyone! Also, your documentation from your docs should be specific about your functioning abilities. For example, how long can you stand, sit or lift without pain or fatigue, etc....

[KathyB]

Thanks, everyone! I found online the Doctor's Residual Function Capacity Form used by SS to document info like: symptoms, findings, treatment, prognosis, length of impairment, prevention of the patient standing, sitting, need to lay down during the day, % of function for different physical tasks, range of motion issues, pain, their opinion about my ability to work, long-term work implications, etc. I suppose this could be a part of his deposition. I'd like to follow the info needed by SS since I'll probably need it as well!

I finally realize what is bugging me the most -- I've worked in Virginia for 19 years all the time contributing to the retirement system and working hard to improve my "lot in life" with continued education and promotions, always giving back to my community and state. So I paid into the system to protect me in case I became ill and needed their support. Now here I am, needing them and the road blocks have sprung up. What the heck!

I'm staying positive and ready to take this forward...something I've learned first-hand since WG!

KB

P.S. If you come across any links to info or resources, please let me know. Thx again!

[annekat]

Kathy, I don't remember if you are still working at all or have stopped due to your incapacity. If the latter is the case, it seems your supervisors and co-workers should be able to bear witness to the effect Wegs has on your ability to work! I know it is not that simple; obviously the system doesn't want to pay out and is resisting tooth and nail. In any case you are doing all the right things, and it is wise to get your ducks in a row for SS disability as well. Perhaps you will have more luck there; I hope so.

[KathyB]

Hey, Anne. I officially retired effective July 1. Wasn't in the office even one whole day since August 17, 2011 and took 79 days of sick leave. The rest of the time, my employer permitted me to work from home (emails, etc). I relied heavily on the good nature and dedication of my staff to get through my annual contract (ended June 30). I like to feel I trained them well to operate on my behalf!! I submitted my letter of intent to retire at the end of February but they didn't approve it until May! They all wanted to believe (and remained hopeful) I would return. Once I meet with an attorney, I'll put together a list of my colleagues who have witnessed my illness first-hand. They used to come over to my house for impromptu meetings when I felt up to it. They were so wonderful! Thanks for the encouragement!

Wouldn't it be crazy if my SS came through on the first try?!

KB.

[annekat]

Kathy, since you haven't been working at all since July because of your illness, I'd think you'd have a pretty good chance with SS, though you might have to wait maybe 3 more months since I seem to remember they want you to be not working for 6 months. Probably worth the wait! It seems that you have PLENTY of evidence on your side.