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How To Reduce or
Eliminate Drug Cost

 April 5, 2008

By  Brian

This story from Jo is a real life experience that can prevent your social security disability application from being lost, and avoid months if not years of delay! Thanks for the contribution Jo

—-story starts here——-

I live in the most heavily populated, fastest growing state east of the Mississippi. Since my claim is based on traumatic orthopedic injuries, my onset date is clear. I first applied for Benefits in early 2003. At that time, my orthopedic injuries were making it almost impossible for me to work; I just could not do the 100 miles of daily driving required for my job, I had very limited range of motion in my arms and wrists, and, to be blunt, I just plain hurt.

So I gathered my records and turned them over to the SSA only to be told that I first had to liquidate and old, quite small pension. I did so, losing 40% of it to taxes and penalties. I was then told I also had to spend down my state pension since I was not vested in it yet. I did this as well. I made copies of what records I had and made a very foolish mistake: I assumed that SSDI/SSI, in fact, that all of the SSA worked for us, the disabled.

Orthopedic injuries are common where I live. I was naive and trusting. As time dragged by, I grew more and more concerned. I found The Disability Digest and got a heavy dose of reality. By my calculations, I should have already been denied once and be stuck in the Reconsideration process. With a sinking feeling, I called my local office. They had “no records” on me at all. Nothing. That was one of my mistakes. Make sure you keep a copy of everything.

Fortunately, I had kept all my mail from the SSA. I thought I could prove that I had filed in early 2003. According to the very pleasant intake interviewer, my mail was not enough to prove I had applied. This woman very patiently explained that this particular office is overrun with orthopedic cases – so many, in fact, most are reviewed by outsiders.

This makes no sense to me. My area does have lots of orthopedic cases – the number of working farms and factories make orthopedic injuries common: in a town of 20,000 people, we have over 20 orthopedic specialists. Why would the SSA need to send out my file?

And then I got it. By “losing” my file and claiming it had never existed, the SSA could invoke its policy of only providing back benefits for the previous 18 months. That saves the SSA money. But even more important, by denying I had ever filed, the SSA could make much of the long wait just disappear. And with a backlog of 750K cases, something has to be done. As the outside auditors found out, the intake interviewers and first Adjudicators are simply overwhelmed. One (former) SSA employee said he and his co-workers just boxed hundreds of applications, slapped a “settled” sticker on them and let them be hauled away to an unknown place. It sounds about as convincing as my dog ate my homework.

I thought I had done a creditable job of self- representation. I had full reports from all the major figures, surgeons, physical therapy records, my family doctor and a psychologist. But using the Disability Digest’s Mini-Course and Jonathan Goldberg’s book, I found at least two major mistakes I had made. In the Daily Activities report (which the interviewer had to fill in as both my arms were in casts) I said I could drive. I lost my case right there. Though it was clear I could not actually drive, my answer immediately meant I could work. I also ruined my chances by saying I could sweep a floor. Dealing with the SSA is like nothing else I have ever experienced. If you have the patience of Job, the watchful eye of a hawk, and are up for it physically, you can win, with help, on your own. I did not interview a representative last time. Big, big mistake.

It took me almost 3 years to get any answer to anything about my case. Without the guidance of The Disability Digest, I probably still would not know that I had a creek and no paddle. What I learned shocked me. Thousands, perhaps hundreds of thousands of applications might be lost. “Lost” translated into SSA-speak means applications hidden away, not really lost. One estimate is that as many as 300K applications are “lost” every year.

I can’t face the stress of doing all of that again. Even my chief orthopedic surgeon is outraged for me. He told me to have my lawyer write to him and tell him what to say and he would follow all instructions. My doctor, in other words, got so angry with the SSA that he is determined I will win at the listing stage. I want my life back and now know that no matter how trite a legal issue might be, there is truth to the old saying that only a fool represents his or herself.

Fain, aka Jo


Understanding Continuing Disability Reviews: Key Updates and Guidance


Welcome to our latest blog post where we delve into the critical topic of Continuing Disability Reviews (CDRs), which are essential for individuals receiving disability benefits. The focus today is on recent statistics and personal anecdotes that highlight the ongoing importance of staying informed about CDRs.

What is a Continuing Disability Review?
A Continuing Disability Review is a routine process for individuals who have been approved for disability benefits. The Social Security Administration (SSA) conducts these reviews to determine if the health of a beneficiary has improved to the point where they can return to work, and thus no longer qualify for benefits.

Recent Case and Discussion
Recently, a case surfaced involving a person who had been receiving Social Security Disability Insurance (SSDI) for end-stage kidney failure since they were 20. Despite their condition remaining unchanged, they received a notification of health improvement at age 50 and were at risk of losing their benefits. This situation underscores the unpredictability and significance of understanding the CDR process.

How CDRs Work
During a CDR, beneficiaries might be asked to complete a short or long form detailing their current health status. The forms are then reviewed, and if further information is needed, a full medical review may be initiated. It's crucial for recipients to respond promptly to any communications from the SSA to avoid complications or cessation of benefits.

Statistics and Trends
In 2022, approximately 1.5 million of the estimated 9 million disability recipients underwent CDRs. Of these, about 125,000 had their benefits terminated. These statistics reflect a consistent review rate, with an apparent annual increase in the number of reviews conducted, emphasizing the necessity for beneficiaries to stay vigilant.

Key Takeaways
Stay Informed: Always keep your contact information up to date and pay close attention to all correspondence from the SSA. Missing a notification or failing to respond can lead to benefit termination.
Understand the Review Frequency: Depending on the expectation of medical improvement, reviews may occur more frequently. Typically, conditions considered likely to improve are reviewed sooner and more often.

Prepare Adequately: If a review is scheduled, ensure all medical documentation is current and complete. Understanding the review process and preparing accordingly can significantly affect the outcome.

Seek Expert Advice: Engaging with professionals who specialize in disability rights and CDRs can provide crucial support and guidance. For instance, next week, we will feature an in-depth discussion with Attorney James Mitchell Brown, a veteran in the field of social security disability.

Conclusion
Continuing Disability Reviews are a standard part of the disability benefits process, but they can be daunting. By staying informed, prepared, and proactive, beneficiaries can navigate these reviews successfully. Remember, the goal is not only to retain benefits but also to ensure that the support aligns correctly with the individual’s current health needs.

Stay tuned for more updates and expert insights in our upcoming posts, and don't hesitate to reach out with your questions or for further information.

Brian


My name is Brian Therrien, and I'm a professional researcher. So when a number of my friends went through unexpected downturns in their life and required disability assistance, I left no stone unturned to try and help them.

At first, I was concerned with how to qualify for disability, ... but as I learned more about the system, I realized that people also really needed help with getting approved, maximizing their benefits, and most importantly, supplementing their income without losing their benefits when they were ready to transition back to the work force.

That's why when you subscribe to my FREE disability newsletter you'll get concrete help with ALL the issues you'll encounter in the disability system

Brian Therrien

related posts:


The FREE Local Resource That 87% of People Don’t Know About (That Could Make or Break Your Disability Benefits)


The Spoon Theory: A Real-Life Guide to Managing Energy with Chronic Illness


What To Do If SSA Surveillance Leads to a Mistake — And You’re Blamed for It

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