Multiple Sclerosis Patient Seeks Strategy to Win SSDI Case Early
Posted Mar 19 2011 7:14pm
Here is a question I received from a multiple sclerosis patient who is preparing to apply for Social Security disability and is hoping to win her case early.
First, I want to thank you for putting valuable information about the SSDI process online. I was diagnosed with MS in 1993. I recently left work on an early disability retirement after a 24 year career with the State of ABC. My question is this – if I have MS and my medical records document cognitive dysfunction, isn't it feasible that I would be approved with my initial application to SS? Although I did very well in the beginning of the journey, as I have gotten older, (I'm only 44), my disease has started progressing over the last few years. Will the fact that I have taken an early disability retirement from the state weigh favorably towards my case?
Here are my thoughts: the first question I would ask is "are you insured for Title II Social Security disability?" In some states, employees do not contribute into the Social Security system- instead, they contribute to a state disability program. For example, I sometimes get calls from teachers who may have worked for years, but who are not insured for Title II disability because their school system opted out of Social Security. If you cannot tell from looking at an old paystub, I would advise you to contact your human resources office to confirm that you have been making payments into the Social Security system. You can also call Social Security at 800-772-1213 to inquire as to whether you have been earning credits. You can also request an earnings and benefit statement (Form 7004) from Social Security directly.
If you are not insured for Title II SSDI, then you might still be eligible for SSI, but that will depend on household income and the value of assets that you own.
Assuming you are eligible for Title II disability, your best chance at an early approval would be to request help from your treating doctor to show that you meet or equal the multiple sclerosis listing, which is found at Listing 11.09 . When you read this listing, it does refer to cognitive issues by referring to Listing 12.02 which describes "organic mental disorders."
I would print out the entire Multiple Sclerosis listing and the listings referenced in 11.09 and take the printout to your doctor's office. If your doctor or someone in his office is willing to write a narrative report describing your symptoms, course of treatment and state that your symptoms meet or equal what is contained in the listing, you greatly improve your chances at an early decision. Your doctor should track the language of the listing as closely as possible, using the language of the listing wherever possible. Further, since the disabling symptom you describe has to do with cognitive dysfunction, you may need to have a psychiatrist or a neuropsychologist evaluate you and write a narrative report that tracks Listing 12.02.
I take a similar approach when I am representing an MS client – although instead of a narrative report, I create a checklist for the doctor to complete and submit that to the Social Security judge along with copies of all medical records. Often times, by the way, Social Security will provide the neuropsychological exam as a "consultative evaluation" that they pay for, however, if you can provide your own, you obviously have more control of the process.
As far as whether your decision to take an early disability retirement will help, that is hard to say. If you were required to meet certain criteria before you were allowed to take a disability retirement, then, yes, your status as a disability retiree might help a little, especially if there are medical reports and forms associated with this determination. I would definitely submit those reports to the adjudicator, and I would write the adjudicator to advocate for an early approval based on the 11.09 and 12.02 listings. I still think that an early favorable decision at the administrative level will turn on whether the adjudicator believes that you meet or equal a listing, so that is where I would focus my energy.
If you are not approved at the initial or reconsideration stages, please do not get discouraged as many deserving cases are turned down for what seem to be arbitrary reasons.