POLIO TIPS AND TECHNIQUES |
By Dr. Richard L. Bruno
I have been getting lots of e-mails from readers asking about filing for Social Security Disability Income. Many have asked two key questions: Do you need a lawyer, and what can you do to get the best outcome from the process?
First, you don’t need a lawyer to apply or even if you’re appealing a denial.
Second, the Social Security Ruling for post-polio syndrome (PPS) is your road map to getting SSDI. (To take a look at it, click on Social Security Disability at PostPolioInfo.com.)
Following are key points that I believe will lead you to a successful outcome, which you are entitled to if your post-polio disables you from seeking or holding gainful employment:
Ask the Social Security Administration office to mail the SSDI application form (SSA-3368-BK) or look at it on line (SSA.gov). Never go to the SSA offi ce to fill out or drop off the application.
SSA will do a phone interview to collect general information. Get the name, phone number and location of everyone you talk to at SSA, especially the adjudicator on your case.
Before the phone interview, briefly and clearly list the job-related duties you can’t do and why you can’t do them, (e.g., fatigue stops me from concentrating or staying awake while working on the computer).
Remember that the answer to the question “illnesses, injuries or conditions that limit your ability to work” is the only information SSA needs to determine disability. The “kitchen sink” approach—listing every illness you’ve had and every doctor you’ve seen—is what gets most people denied. If you have conditions that do not disable you (osteoporosis, arthritis, successfully treated sleep apnea—even cancer or a heart attack), SSA doesn’t want to know about them or the medications you take for them, hospitals where you were treated, tests you’ve had or doctors you’ve seen. Limit answers to polio-related symptoms and explain how they make you unable to work.
For determining post-polio eligibility, fatigue is the key! The ruling explains that polio survivors are typically disabled by fatigue. Describe “tiredness” as “mental fatigue” and “muscle weakness” as “muscle fatigue.” Explain that you “don’t have the endurance” to complete activities at work or chores and social activities at home.
Don’t mention pain unless it is the overwhelming reason for your disability and you can see its cause on an MRI or X-ray. Answering “yes” to having pain results in more paperwork and it’s nearly impossible to get SSDI for pain. Don’t mention depression or anxiety or the medications you take for them unless these symptoms prevent you from working.
At the end of the application is the “Remarks” section where you briefly summarize your polio history and again describe your work disability as it is caused by specific PPS symptoms. Also mention long- standing polio effects that have never prevented your working. Some people who have always used a leg brace but are now disabled by fatigue have been denied because SSA said, “Your leg has always been paralyzed and should not affect your working at a desk job.” Say, “The fact that I have always used a long leg brace has nothing to do with my being disabled by post-polio fatigue today.”
Your doctor must write a letter describing your PPS symptoms, how they disable you and saying that working, even in a sedentary desk job, is “medically contraindicated.” Your doctor should not just send in scribbled notes or even a typed history and physical. Remember that the Ruling says an EMG, repetitive physical testing to document fatigue and neuropsychological testing are not required to determine disability. Also, “Consultative Examinations”—being required to go to a doctor appointed by SSA—are only to be used if your physician cannot answer questions about your disability.
Fax a letter to the Washington office of your Congressperson and Senators asking them to write the SSA representatives reviewing your case to use the PPS Ruling to make the decision about your disability (a sample letter can be viewed at PostPolioInfo.com).
Mistakes happen and you may get denied. Find out the reason for the denial and appeal immediately, asking your doctor and Congresspeople to write to support your appeal. You have a right to two local appeals and then a hearing before an Administrative Law Judge, where about 90% of denials are overturned. If an error of fact has been made by SSA or they haven’t reviewed all of your records, you or your Congressperson can ask for an “on the record administrative review,” where SSA officials pull your file and correct the mistakes, making an appeal or hearing unnecessary.
Remember, when you’re applying for SSDI, you’re following a well- worn path others have blazed. Your key to success is to follow the Ruling.
Dr. Richard L. Bruno is chairperson of the International Post-Polio Task Force and director of The Post-Polio Institute and International Centre for Post-Polio Education and Research at Englewood (NJ) Hospital and Medical Center. His new e-Book, How to STOP Being Vampire Bait: Your Personal Stress Annihilation Program, is available through PostPolioInfo@aol.com.
