Today was my hearing day for my disability case. I have been through 2 denials, and sought the assistance of an attorney after the first. After today, there is a slim chance I'll win, for reasons I'll get into here. It is highly likely, however, that I will lose my case and the ramifications of that are not fun.
Social Security Process
First off, for those of you who have no idea what to expect, here's how the process goes. You apply, either online or in a Social Security office. They base your disability on several factors:
- Do you have a medical issue?
- Is it expected to last more than 12 months?
- Will it result in death?
- and if it does not, then Are you capable of working ANY job, even the most sedentary job you can imagine?
You will then be ordered to see a SS doctor their medical opinion. Frankly, don't let it bother you too much. They see you for all of 5 to 10 minutes and shove you out the door. If you don't get a favorable opinion, it's not the end of the world.
You will be approved or denied based on the evidence you submitted and the doctors' opinions. Most people are denied. You can appeal it, and either be approved or denied again. If you are denied a second time, you can request a hearing.
My recommendation is to get a lawyer at the beginning. They only get paid if you win, they help you with the paperwork, and they get a maximum of $6000 out of your back pay, which you never even see. It's held by the Social Security office and they pay your lawyer.
Overall, the process is simple, if lengthy. But I made some key mistakes that may cost me my benefits. I want others to be aware ahead of time so you can stand a better chance.
Document! Document! Document!
First of all, document everything! I heard it multiple times, and I assumed that when I went to the doctor, what I said was being documented. It turned out, my primary rheumatologist never kept the records indicating my symptoms. I was asked to rate my pain, I stated the symptoms I was dealing with, but never verified they were in my records. Turns they were not. So I walked into my hearing with no medical evidence of the severity of my symptoms. So, make sure your doctors are documenting EVERYTHING.
Complain
I know, complaining sounds bad, but in your disability case, it may make the difference. What this does is make sure that it goes into your record how your symptoms are progressing. Using this information, the judge can determine the severity of your symptoms, which you will need to prove to win your case.Never give up!
If you are like me and have difficulty getting health insurance, don't give up. Seek out free clinics, cheap doctors, anything to establish that you are trying to continue your treatment. And even if they cannot do anything for your fibro but refill your existing meds, continue to mention your fibro, your symptoms, and how they affect you. I was able to find a free clinic, but I didn't bother with anything but general health and getting my pain meds refilled because I knew they could not do any more than that. I didn't see the need to complain, and that was a big mistake on my part because they were the ones that ACTUALLY kept records. The fact you are attempting to continue treatment in some way will prove beneficial, otherwise the judge will wonder why, if your pain is so bad, why weren't you seeking treatment.
Timing is important!
If you are filing for SSDI (which you pay into as you work) you have a final day that you can win your case. They call this the "Date Last Insured". This is your deadline to win your case. If you do not win your case by that date, you can only apply for SSI (which is based on household income).
Ramifications of losing and the option to withdraw
The last thing you should be aware of is that if the judge at your hearing denies your appeal, this is your last chance. You lose your case, period. All evidence provided can no longer be used. You may refile, but you can only date it back to the day following your hearing date. You do have the option to withdraw if your case is weak. What this does is it preserves everything you've submitted and you can reopen your case and if you win after reopening, you will get back pay to your original onset date. You still have to win by your "Date Last Insured".
One more thing to note, which was the deciding factor for me, is that should you withdraw, you must reopen your case within 1 year of your last denial. For me that date had already past. You can, however, have an attorney get involved and they can file the appropriate motions to reopen the case. Basically, after the year, you'll NEED an attorney.
After the preliminaries (date, case number, my name and information, etc, etc), my lawyer proceeded to ask me a series of questions. Some of the most important were how long I could sit, stand, and walk. What was my average day like? Why did I feel I was incapable of working? After all the questions, my lawyer asked me if there was anything I wanted to address or say to the judge.
My response was this: I worked hard all my life, even as a child. I would babysit, or go work at the family business doing filing or answering phones. I kept up a good work ethic and the day I realized I couldn't work was the hardest thing. Deciding to go on disability was the most difficult decision of my life and one I did not take lightly. I said if I could work, I would love to, but the combination of the pain making me unable to sit for more than 2 hours, the cognitive issues that had me asking how to do a job I knew how to do, the insomnia keeping me at my worst, the migraines hitting out of nowhere, and the other symptoms that interfered with my day made it impossible for me to be a reliable employee.
Once all that was done, my judge basically looked at my lawyer, and said, "I believe the testimony, but the medical evidence is not supportive of this." I was permitted to address the judge and mentioned that I was upset and disappointed that, although I had indicated my issues with fibromyalgia and my doctor had even approved temporary state disability for me, that none of that was in my medical records. I explained that I had been addressing my complaints to the only rheumatologist I had seen regularly. I also explained that I was uninsured for much of the time and was unable to provide this information to anyone, but that I was currently seeking a care team to continue my treatment.
My lawyer mentioned they were still playing phone tag for some records and the judge agreed to withhold his decision until my lawyer could provide those.
If I had any advice to offer, it would be to stress the things that are difficult for you that should not be. For example, in explaining my average day, I stressed that I woke up every morning, stiff and in pain. Took meds, ate breakfast and rested for a little bit. Said that I would do chores, like dishes or laundry for a few minutes, then lie down for anywhere from an hour to 3 hours. I told the judge that at night, when I cuddled with my husband, and laid my head on his chest, I could only do so for a few minutes before my neck hurt so bad I couldn't bear it any longer. I even, embarrassingly, mentioned, that I often went 2 weeks to a month without shaving because I couldn't physically handle it.
Also, be yourself. Don't feel like you have to hide anything or make things seem better or worse than they are (lying under oath is a crime, after all). But make sure you accurately explain everything to the best of your ability. Be as genuine as possible. And don't let the stress get to you. You may just need to take a second, compose, and straighten out your thoughts. If the fog gets in the way, don't be afraid to say so! In fact, they asked me about my hobbies and I literally said, "I know I have more, but I can't remember them."
The hearing itself
Despite the risks, I decided to go forward with the hearing. With all the factors involved, I felt I had little to lose by trying, even though the odds were against me. In the hearing itself, there are very few people: the judge, stenographer, you, your lawyer (if you have one) and possibly a vocational assessor. The vocational assessor will help the judge figure out if there is any job they believe you are capable of. Aside from swearing the oath, mine said nothing while I was there. I believe after I left, she spoke with the judge.After the preliminaries (date, case number, my name and information, etc, etc), my lawyer proceeded to ask me a series of questions. Some of the most important were how long I could sit, stand, and walk. What was my average day like? Why did I feel I was incapable of working? After all the questions, my lawyer asked me if there was anything I wanted to address or say to the judge.
My response was this: I worked hard all my life, even as a child. I would babysit, or go work at the family business doing filing or answering phones. I kept up a good work ethic and the day I realized I couldn't work was the hardest thing. Deciding to go on disability was the most difficult decision of my life and one I did not take lightly. I said if I could work, I would love to, but the combination of the pain making me unable to sit for more than 2 hours, the cognitive issues that had me asking how to do a job I knew how to do, the insomnia keeping me at my worst, the migraines hitting out of nowhere, and the other symptoms that interfered with my day made it impossible for me to be a reliable employee.
Once all that was done, my judge basically looked at my lawyer, and said, "I believe the testimony, but the medical evidence is not supportive of this." I was permitted to address the judge and mentioned that I was upset and disappointed that, although I had indicated my issues with fibromyalgia and my doctor had even approved temporary state disability for me, that none of that was in my medical records. I explained that I had been addressing my complaints to the only rheumatologist I had seen regularly. I also explained that I was uninsured for much of the time and was unable to provide this information to anyone, but that I was currently seeking a care team to continue my treatment.
My lawyer mentioned they were still playing phone tag for some records and the judge agreed to withhold his decision until my lawyer could provide those.
If I had any advice to offer, it would be to stress the things that are difficult for you that should not be. For example, in explaining my average day, I stressed that I woke up every morning, stiff and in pain. Took meds, ate breakfast and rested for a little bit. Said that I would do chores, like dishes or laundry for a few minutes, then lie down for anywhere from an hour to 3 hours. I told the judge that at night, when I cuddled with my husband, and laid my head on his chest, I could only do so for a few minutes before my neck hurt so bad I couldn't bear it any longer. I even, embarrassingly, mentioned, that I often went 2 weeks to a month without shaving because I couldn't physically handle it.
Also, be yourself. Don't feel like you have to hide anything or make things seem better or worse than they are (lying under oath is a crime, after all). But make sure you accurately explain everything to the best of your ability. Be as genuine as possible. And don't let the stress get to you. You may just need to take a second, compose, and straighten out your thoughts. If the fog gets in the way, don't be afraid to say so! In fact, they asked me about my hobbies and I literally said, "I know I have more, but I can't remember them."
Fibro cases are notoriously difficult and lengthy. They can be won, and hopefully my mistakes will help make it easier when you file for yours.
