Category Archives: Legal Issues

Chronic Pain and Social Security Disability Benefits (Guest Post)

Empty wheelchair in snowNote from Annie: Today’s post is a guest post from Molly Clarke, and I think it’ll offer some answers to questions a lot of Dolls have about Social Security Disability – enjoy!

Chronic Pain and Social Security Disability Benefits

When most people think of Social Security Disability (SSD) benefits, they imagine someone unable to work because of a serious physical disability – loss of motion, inability to walk, or life-threatening diseases.  However, many individuals who need disability benefits have conditions that aren’t necessarily visible to outsiders.

A common reason why people apply for disability benefits is because they suffer from chronic pain. If you can no longer work due to chronic pain, you may be eligible for SSD benefits. The following article will give you a brief overview of the benefits available to you and will provide you with the information needed to begin the process.

Disability Benefit Programs

The two different disability benefit programs—SSDI and SSI—are governed by the Social Security Administration. Each of these programs is very different and has separate eligibility requirements.

SSDI—Social Security Disability Insurance—is funded by taxes that workers pay into the system. Therefore, eligibility for SSDI is determined by an applicant’s work history and the amount of Social Security taxes he or she has paid. Learn more about qualifying for SSDI here.

SSI, the second program that offers disability benefits, stands for Supplemental Security Income. SSI is offered to elderly and disabled individuals who earn very little income. SSI is a needs-based program and the SSA uses very strict financial regulations to determine an applicant’s eligibility. SSI has no work history or tax related requirements. For this reason, SSI is the best option for children or young adults who haven’t had the opportunity to pay into the system. Learn more about qualifying for SSI here.

Social Security Disability Blue Book Requirements

In addition to meeting the previously mentioned technical requirements, SSD applicants must also meet very specific medical criteria. These medical criteria can be found in the SSA’s blue book—the official guide of potentially disabling conditions. The blue book lists many different disabilities and impairments. Under each listing are the specific medical requirements that an applicant must meet in order to qualify.

Unfortunately, chronic pain is not listed in the blue book. To qualify for disability benefits with chronic pain you must have a documented, “medically determinable” condition. Essentially this means that you must qualify based on the condition or illness that causes your chronic pain, rather than the symptom itself. Because chronic pain can be caused by a number of conditions, it is suggested that you go through the blue book listings and search for the condition that best matches your symptoms. This may include the following listings: neurological disorders, somatoform disorders, inflammatory bowel disease, back injury, chronic renal disease or inflammatory arthritis.

You can find all blue book listings on the SSA’s website, here.

If your chronic pain is not caused by a listed impairment, you do have other options. If you can prove, using medical evidence that your symptoms make it impossible for you to maintain employment, you may be able to qualify under something called a Medical Vocational Allowance. To determine whether or not you qualify under a Medical Vocational Allowance the SSA will evaluate you to determine the location, frequency, intensity and duration of your pain, and how it affects your day-to-day life.

Social Security Compassionate Allowances

The processing time for an initial SSD application is often several months. The SSA realizes that individuals with severely disabling conditions may not be able to wait that long to receive benefits. For this reason, they allow people with inherently disabling conditions to qualify for benefits in as little as ten days. This is known as a compassionate allowance. View all conditions that qualify for compassionate allowance processing here.

Preparing for the Process

Prior to submitting your application for SSD benefits, it is important that you are thoroughly prepared. This includes collecting the necessary medical documentation to support your claim. Your application should include records of the following:

  • Your diagnosis
  • Hospitalizations and other medical appointments
  • Treatments and your response to them
  • Any lab tests or diagnostic images
  • Written statements from your doctors

Once you collect this information, it is also important to collect documentation of your finances and employment history. When you are ready to begin the process, you can complete your application online or in person at your local Social Security office.

It is important that you realize how difficult the application process may be. In fact, many initial applications are denied. If this happens to you, it is important that you don’t give up. You are allowed to appeal this decision. Once you are awarded benefits, you will be able to focus on your health and wellbeing rather than stressing about your finances.

About the Guest Author:
Molly Clarke is the Social Media Coordinator for Social Security Disability Help and contributes regularly to the Social Security Disability Help blog. You can reach her via email at mac@ssd-help.org.

Photo credit: Kid Vincent via photopin cc

Did a UK Woman Commit Insurance Fraud By Claiming Fibromyalgia?

I have a Google news alert for “fibromyalgia or chronic disease or chronic pain” (and some other search terms related to this blog’s purpose), and that’s the only way I would have ever found the following snippet from a site called No Claim Discount. This seems to be a news site in the UK for the insurance industry.

Joanne Kirk of Preston, is suffering from, what has been deemed as, a landmark judgement against her for insurance fraud. Initially attempting to claim £800,000 in compensation after a rear-end shunt in 2001 the claim was finally settled for £25,000. Of course, such a case will involve a level of investigation and it seems Ms Kirk had no inkling that insurance fraud investigators might be filming her driving, walking and carrying shopping despite her claiming she had developed fibromyalgia, a condition which causes chronic pain in muscles and ligaments. She originally stated she required crutches or a wheelchair to get around and could only walk a few steps without the assistance of another person.

Unlike most insurance fraud convictions which see defendants given no more than a slap on the wrists, Joanne Kirk was fined £2,500 and ordered to play the insurance company’s legal costs. The tables were certainly turned as her legal protection insurance was revoked leaving her with the cost of the entire bill – somewhere in the region of £125,000.

Realizing that:

  • We don’t know the full story from this blurb, much less have any of the details from the trial itself;
  • We don’t have Joanne’s side of the story; and
  • This piece, if not the site as a whole, is obviously biased in favor of the insurance industry (it’s titled in an entertainingly sexist way “Women, Their Handbags, and Faking It For Money”)

… we just don’t get enough information from this piece to draw any kind of conclusions. But I can tell you my first reaction upon reading that Joanne was filmed walking and shopping after claiming fibro: So what?

Is this just a case of not understanding fibromyalgia? That’s certainly a possibility. In my own experience, I frequently have days that are much better than others, in which tasks like shopping and going to the park with my child are an absolute breeze. I also have days in which I can’t get out of bed, and days that fall anywhere in the middle.

Of course, the piece also states that Joanne had told someone involved in the case that she could only get around with the aid of crutches or a wheelchair. Still, I have to wonder if what she actually said was something more along the lines of “when I have a flareup, I need crutches or a wheelchair.”

The truth is that we don’t know — we just don’t have enough information here. The only conclusion I can draw is that whoever wrote this article is a bit sexist, or at least felt comfortable pretending to be for the sake of being entertaining, and that s/he has a lot of disdain for Joanne, if not fibromites as a whole.

I’m also concerned that, even assuming Joanna did commit willful fraud here, this story will just give more ammunition to the unbelievers.

At a minimum, it’s a good object lesson in dealing with legal issues concerning your chronic disease:

  1. Be precise with your language. Don’t make sweeping generalizations. Be exact, and consider thoughtfully how your words might be misconstrued.
  2. Keep a diary of your symptoms. This is probably the best advice any chronic pain patient can take, no matter what the purpose. It helps in so many ways, and I hope to write about that in much more detail later on. But for legal purposes, a diary or log that’s kept contemporaneously with (at the same time as) your symptoms is invaluable evidence.
  3. NEVER EXAGGERATE.  No matter what. Just don’t do it.
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