No one knows your pain better than you. And if you seek relief through Social Security Disability Insurance it may be quite a “pain in the back.” Be assured, back problems are the most common of all petitions to the Social Security Administration (SSA). Social Security Disability benefits may be available for chronic back pain but it will not be easy to prove. Evidence of pain and other symptoms, severity of impairment, and your credibility will all be considered.

Objective Signs of Chronic Back Pain

Benefits primarily go to those who have “medically determinable” back impairment; applications for moderate or intermittent back pain will not be granted. Success on your application for disability benefits are most likely to succeed when there is medical evidence supporting spinal disorders such as:

• Spinal stenosis
• Nerve root compression
• A chronic and untreatable herniated disc
• Arachnoiditis

Accordingly, the back injury must meet or “equal” those listed in the Social Security regulations “Listing of Impairments” found in The Social Security Bluebook Section 1.04 for Disorders of the Spine. In order to be eligible for Social Security disability benefits you must meet any of the three parts: A, B, and C listed in this section.

The Social Security Administration (SSA) will consider medical evidence of abnormalities on X-rays, CT scans, or MRIs of the spine. But objective abnormalities on these exams, standing alone, are not conclusive. At times, an individual may experience no or minimal symptoms, but an X-ray could reveal significant degenerative abnormalities. Contra, an individual whose X-ray revealed minimal or moderate objective abnormalities could experience severe and debilitating pain when bending over, standing for a length of time or walking long distance.

Thus, since objective evidence alone is insufficient, the SSA may also consider your behavior in seeking relief from the alleged symptoms, the nature and frequency of your visits to your treating physicians, responses to treatment, and activities performed and limited by pain.

Functional Limitations

A functional limitation is something you cannot do because of your back pain or injury.   The question of disability depends on how much the chronic pain experienced interferes with the ability to perform everyday activities, such as walking, bending, lifting, or twisting. Most acute lower back pain is a result of a strain of ligaments and other soft-tissue supportive structures of the spine which will recover in less than one year even with no treatment. The SSA scrutinizes for chronic pain.

Some examples of limitations related to back problems that the SSA considers:

• Being unable to bend or stoop to pick something up
• Inability to walk more than a block without taking a break
• Not being able to lift or carry more than ten pounds occasionally
• Inability to sit or stand for at least two hours in a day
• Requirement that you be allowed to get up and move around or to change positions whenever you need to
• Need to keep at least one of your legs elevated throughout the workday
• Need to lay down throughout the day, and
• Inability to sit for at least six hours in a workday.

Most claimants with back problems do not qualify for Social Security disability benefits under the social security listing 1.04 and require a residual functional capacity (RFC) assessment. Functional limitations are used to determine your residual functional capacity (RFC). Although SSA doctors will prepare an RFC assessment form that considers functional limitations, it is still an essential part of your claim to have your treating doctor, a back specialist, also fill out an RFC form.

Claimants Credibility

Your credibility matters. Since pain is subjective and hard for doctors to scientifically measure, it may be helpful to record your pain, discomfort, and functioning capacity in a journal. Your credibility compares the medical evidence in your file with statements of treating physicians as well as statements made by you to others (particularly employers and doctors) regarding symptoms impacting the ability to work, attempts to work, and how well you responded to treatments.

Your file should be consistent. The SSA will be looking for statements or behaviors that are not consistent with the record. If you tell the SSA that you cannot bend or stoop to pick something up, yet the record indicates that you continued to perform gardening and routine yardwork tasks, your credibility will be damaged.

Another factor in determining your credibility is the efforts taken to alleviate pain symptoms. The SSA is more persuaded by records that indicate a long-term effort at finding successful treatment to relieve the back pain. A claimant who has tried alternative treatments or different medications with varying dosages is more persuasive.

If you are seeking to obtain Social Security Disability benefits for chronic back pain, consult our knowledgeable and experienced representatives with Adams & Associates Disability, Inc. by calling (888) 551-1190.

 

The financial burden on families with an autistic child or an adult with autism can be difficult and the Social Security Administration (SSA) offers disability benefits to help such families with their medical and living costs.  Autism Spectrum Disorder (ASD) is a mental disorder which includes autism, Asperger Syndrome (AS), and Pervasive Developmental Disorder-not otherwise specified (PDD-NOS) that affects how the brain processes information.  These disorders are characterized, in varying degrees, by difficulties in social interaction, verbal and nonverbal communication and repetitive behaviors.

Symptoms and Diagnosis

Autism is a mental disorder specifically enumerated in the SSA’s Blue Book.  Symptoms of autism may be evident at birth but is usually recognized by age three. The inability to interact with others or repetitive behaviors such as rocking or hand flapping are possible signs of autism.  An infant with autism will not respond to social stimulation with healthy behaviors such as babbling, laughing, smiling, or making eye contact. Notably, many autistic individuals do not develop speech and communication enough to meet the needs of daily life.

Children with autism may cope with their condition to different degrees with the help of early intervention, but most are unable to live independently as adults.   Sometimes ASD is diagnosed later in life, often in relation to learning, social or emotional difficulties.

According to medical articles, diagnosis of autism currently depends upon the patient showing at least six symptoms. Two of the symptoms must be linked to social interaction impairment, while one must be a communication impairment, and another one must be a restricted or repetitive behavior impairment. These behaviors affect the ability to function normally.

Individuals with autism may display:

• Restrictive behavior – purposeless movement such as rocking, head rolling, hand flapping, and other movements
• Compulsive behavior – rearranging objects and needing to control the physical environment
• Ritual behavior – needing to do things the same way and at the same time every day and resisting change in the environment
• Limited activity, focus, and interest
• Self-injury – biting oneself, pulling hair, and other self-injury activities

Although none of these symptoms are specific to autism, these behaviors are often present, severe, and reoccurring and affect one’s ability to work.

While there is no medical test that can diagnose autism, there are autism-specific behavior evaluations by trained physicians and psychologists that help recognize symptoms.    ASD can be associated with intellectual disability, difficulties in motor coordination and attention and physical health issues such as sleep and gastrointestinal disturbances.  Others with ASD may excel in visual skills, music, math and art.

Causes of ASD

There is no known single cause of ASD.  Scientific theories regarding the cause of autism range from the abnormal formation of brain synapses to genetic abnormality. Other possible causes may include problems during pregnancy or environmental factors, such as exposure to heavy metals or pesticides.

Meeting the definition of “Disabled”

In order to receive Social Security Disability benefits the first thing to consider is whether you meet the SSA’s definition of “disabled.” This is different for children and adults:

Children under the age of 18 must:

• Not be working a job that is considered to be ‘substantial work’;
• Have a medical condition which very seriously limits their activities; and
• The condition is expected to last at least one year.

In contrast, adults must show:

• They can’t do the type work that they did before;
• They can’t do other types of work because of their medical condition; and
• The condition will last for at least one year.

Once these conditions have been met, the next step is applying another set of rules just about autism found in the SSA’s Impairment Listing Manual, or “Blue Book” which has separate sections for adults and children.

Proving Childhood Autism

Childhood autism is found as a listing under Section 112.10 of the Blue Book. To meet the listing, you will need to show that the child’s social and communication skills and other activities are delayed for their age.  To qualify a child for disability benefits the requirements of both Paragraphs A and B must be satisfied.

The required level of severity for autistic disorders is met when the following requirements are satisfied. A doctor must have found the child has:

• Deficits in reciprocal social interaction,
• Deficits in communication and imagination, and
• A restricted repertoire of activities and interests (not needed for Asperger’s syndrome).

And these deficiencies must cause serious limitations in at least two of the following:

• Communicative/cognitive functioning
• Social functioning
• Personal functioning
• Sustaining concentration, persistence, or pace

OR the child displays marked age appropriate impairment in two of the following areas:

• Cognitive/communicative function – measured by standardized and special tests
• Social functioning – ability to form and keep relationships, cooperate with others and groups, and respond appropriately to authority figures
• Personal functioning – ability to develop self-care such as feeding oneself, personal hygiene, dressing, grooming, and toileting
• Maintaining concentration, persistence, or pace – ability to focus on a task and stick with it

Gather all the information you can for your claim to prove these conditions are met. Try to obtain doctor’s notes, results from medical tests, and information about any therapies.  Statements from teachers and other professionals who work with your child are helpful.  The more details you can provide in the application about your child’s autism the better chance you will have of being approved.

After you have gathered the necessary information you may begin your application.  When applying for social security benefits for a child with ASD, you will have to complete that application during an in-person interview at the SSA office before deciding whether or not to award benefits.  These benefits are helpful when it comes to paying for therapies and other treatments, or simply affording daily expenses that become difficult when families are unable to work.

Proving Adult Autism

In Blue Book Section 12.10, besides showing the signs of autism, adults also have to show they have trouble with concentration, social interactions, or daily activities.

Despite Blue Book Section 112 listing the disability requirements for childhood autism, the SSA does not have a specific listing for a diagnosis of adult Autism (AS or PDD-NOS).  Thus, since there are no specific criteria to disability approval, it is difficult to prove total disability and successfully obtain disability benefits based on AS or PDD-NOS diagnosis.  In such cases, it is critical to:

• Demonstrate the inability to function well enough to meet the SSA’s threshold for gainful employment as a result of autism, and
• Presenting medical evidence of its severity

Before you file your application for disability with the SSA gather the necessary medical information to support your claim.  Again, try to get doctor’s notes, results from medical tests, and information about any therapies.  The key is collecting the most information to show you case matches the autism requirements.

If you are seeking to obtain Social Security Disability benefits for Autism Spectrum Disorder, consult our knowledgeable and experienced representatives with Adams & Associates Disability, Inc. by calling (888) 551-1190.

 

At one time a diagnosis of HIV/AIDS was associated with finality. However, with today’s medical advances, a person with HIV/AIDS can live a long life with the proper medical care. However, despite medical abilities, HIV/AIDS and necessary treatment can be debilitating.

If you have HIV/AIDS, you may qualify for HIV / AIDS Social Security disability benefits. If you are unable to work or your activities of daily living are severely limited because of your condition, you should apply for benefits. Our knowledgeable Georgia HIV/AIDS Social Security Disability representatives at Adams & Associates Disability, Inc. are ready to help you start the application process.

What Is HIV/AIDS?

HIV (human immunodeficiency virus) can become AIDS (acquired immunodeficiency syndrome) if left untreated. HIV is a virus just like the flu; however, the human body cannot completely get rid of HIV. Once you get the virus that causes human immunodeficiency, you have it for life.

The virus that causes HIV attacks T cells in the immune system, which helps fight infections. If HIV is untreated, it can reduce the number of T cells to the point that a person is more likely to get infections, including infection-related cancer. When a person develops significant infections or cancer due to HIV, they develop AIDS, which is a final stage of HIV.

Although no cure exists for HIV, there are effective medical treatments that can prevent the progression to AIDS and the development of infections and cancer. Antiretroviral therapy (ART) may be used to increase the lifespan of someone living with HIV. The medication can even lower the chances of transmitting the virus to other people. A person who receives proper medical treatment can live as long as someone without HIV.

For more information about HIV/AIDS and treatments, visit Aids.gov.

Debilitating Symptoms And Side Effects

Although modern medicine can effectively treat HIV/AIDS, the disease can still have devastating effects on the body. ART medications and treatment for severe infections and cancer can also have a negative impact on a person’s health.

Symptoms of HIV include:

• Fever
• Chills
• Rash
• Night sweats
• Muscle aches
• Sore throat
• Fatigue
• Swollen lymph nodes
• Mouth ulcers

Recurring infections and cancer can also be symptoms of HIV; however, if untreated they can result in the development of AIDS. ART medications can greatly decrease the symptoms of HIV, but they also have side effects that can be debilitating, including:

• Bleeding
• Anemia
• Blood loss
• Heart disease
• High blood sugar and diabetes
• Lactic acidosis
• Kidney, liver, or pancreas damage
• Severe nausea and vomiting
• Chronic diarrhea
• Numbness and tingling
• Extreme fatigue

Although the side effects can be significant, the medications can prevent the advancement of HIV, recurrent infections, and cancer development.

When Is HIV/AIDS A Disability?

The Social Security Administration (SSA) details factors that make HIV severe enough to be a disability on its Adult Listing of Impairments, Category 14.08 Human Immunodeficiency Virus (HIV) Infection.

Proof of disability requires positive diagnosis of HIV/AIDS. This can be proven with verifiable medical tests, including laboratory blood work, and physician notes. Physician notes should document the onset of the disease and extent of impairments that you experience.

You must also show that you experience any of the following associated with HIV/AIDS:

• Bacterial infections – You may experience multiple or recurrent bacterial infections, including but not limited to, mycobacterial infections, nocardiosis, and non-typhoid salmonella.

• Fungal infections – You may have aspergillosis, candidiasis, coccidioidomycosis, cryptococcosis, histoplasmosis, mucormycosis, or pneumonia.

• Protozoan or helminthic infections – These include cryptosporidiosis, isosporiasis, microsporidiosis, strongyloidiasis, and toxoplasmosis.

• Viral infections – You may have cytomegalovirus, herpes simplex virus, herpes zoster, or progressive multifocal leukoencephalopathy.

• Malignant neoplasms – This may include carcinomas, sarcomas, lymphomas, and squamous cell carcinomas.

• Conditions of the skin or mucous membranes – You may have extensive fungus or ulcers that do not respond to treatment.

• HIV encephalopathy – This may be characterized by cognitive or motor dysfunction that limits function and is progressive.

• HIV wasting syndrome – This may be characterized by involuntary weight loss, chronic diarrhea, and chronic weakness.

• Diarrhea – You may have digestive disturbances that last one month or longer and is resistant to treatment, requires intravenous hydration, intravenous alimentation, or tube feeding.

• One or more infections – These may include sepsis, meningitis, pneumonia, septic arthritis, endocarditis, or sinusitis that is resistant to treatment or requires hospitalization or intravenous treatment.

• Repeated infections – These may limit activities of daily living, the ability to maintain social functioning, and the ability to complete tasks in a timely manner due to deficiencies in concentration, persistence, or pace.

This list is not exhaustive, and the Adult Listing includes many more details regarding requirements for qualification of disability.

Filing for HIV / AIDS Social Security Disability Claim

You may apply online, in person, via telephone, or by mail through the Social Security Administration. You must include significant medical documentation with your initial application in order to be approved right away. Experienced Georgia HIV/AIDS Social Security disability representatives with Adams & Associates Disability, Inc. can help you gather the appropriate information and submit a successful claim or help make an effective appeal if your initial application was denied. Call 1 (888) 551-1190 to schedule an appointment.

Proving Medically Determinable Impairment

The Social Security Administration (SSA) has set guidelines that establish eligibility for Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). Importantly, you must be disabled due to a “medically determinable impairment” in order to qualify for disability benefits. That means you must have a condition that can be proven with verifiable medical evidence.

It can be difficult to prove that an impairment is severe enough that you qualify for Social Security benefits. The experienced Clayton Social Security disability representatives at Adams & Associates Disability, Inc. can help you understand the application process and gather information necessary to proving your claim.

Defining An “Impairment”

In order to understand what a medically determinable impairment is, you must first know what qualifies as an “impairment.” An impairment is a physical or mental condition that results from abnormalities of an anatomical, physiological, or psychological nature. That condition must cause functional limitations of daily activities that prevent you from working.

The SSA maintains a listing of impairments and medically determinable requirements for both Adults and Children. If you can show that you have an impairment through the methods described on that listing, then you may qualify for benefits if your impairment is so severe that it prevents you from working, or, for children, causes marked or severe functional limitations.

Medically determinable impairments on the Adult Listings (Part A) include the following:

• Musculoskeletal System – major dysfunction of joints, reconstructive surgery or surgical arthrodesis, disorders of the spine, amputation, fracture of certain bones, soft tissue injuries

• Special Sense and Speech – loss of visual efficiency, disturbance of labyrinthine-vestibular function, loss of speech, hearing loss with or without cochlear implant

• Respiratory System – chronic pulmonary insufficiency, asthma, cystic fibrosis, pneumoconiosis, bronchiectasis, lung infections, pulmonary vascular hypertension, sleep-related breathing disorders, lung transplant

• Cardiovascular System – chronic heart failure, ischemic heart disease, recurrent arrhythmias, congenital heart disease, heart transplant, aneurysm of aorta or major branches, chronic venous insufficiency, peripheral arterial disease

• Digestive System – gastrointestinal hemorrhaging requiring blood transfusion, chronic liver disease, inflammatory bowel disease (IBD), short bowel syndrome (SBS), weight loss due to any digestive disorder, liver transplant

• Genitourinary Disorders – chronic kidney disease, nephrotic syndrome, complications of chronic kidney disease

• Hematological Disorders – hemolytic anemias (sickle cell disease, thalassemia, etc.), disorders of thrombosis and hemostasis, bone marrow failure, hematological disorders treated by bone marrow or stem cell transplantation, repeated complications of hematological disorders

• Skin Disorders – ichthyosis, bullous disease, chronic infections of the skin or mucous membranes, dermatitis, hidradenitis suppurativa, genetic photosensitivity disorders, burns

• Endocrine Disorders – disorders of the pituitary, thyroid, parathyroid, and adrenal glands, diabetes mellitus, pancreatic disorders

• Congenital Disorders – non-mosaic down syndrome, mosaic down syndrome, any other catastrophic congenital disorders

• Neurological – convulsive or nonconvulsive epilepsy, central nervous system vascular accident, brain tumors, Parkinson’s disease, cerebral palsy, spinal cord or nerve root lesions, multiple sclerosis, amyotrophic lateral sclerosis, anterior poliomyelitis, myasthenia gravis, muscular dystrophy, peripheral neuropathies, subacute combined cord degeneration, other degenerative diseases, cerebral trauma, syringomyelia

• Mental Disorders – organic mental disorders, schizophrenia and other paranoid and psychotic disorders, affective disorders, intellectual disability, anxiety-related disorders, somatoform disorders, personality disorders, substance addiction disorders, autistic disorder

• Cancer – any type of cancer, including sarcomas, lymphomas, leukemias, melanomas, and carcinomas, even if the primary site is unknown

• Immune System Disorders – lupus, vasculitis, sclerosis, HIV/AIDS, connective tissue disease, inflammatory arthritis, Sjogren’s syndrome

Childhood Listings (Part B) include many of the above, but also include a category for infant issues like low birth weight and failure to thrive.

If you have a condition that is not listed on the Adult or Child Listings, your condition may still qualify as a medically determinable impairment. If your doctor told you that you have a condition that prevents you from working, you may still apply for benefits and use the listing that most closely matches your condition to describe your limitations.

How To Prove You Have An Impairment

You must do more than report to the SSA that you have a condition that is as severe as one described in the Child or Adult Listings. You must prove that it is medically determinable. That means you must provide evidence of your impairment through reliable medical opinions and verifiable medical tests.

Reliable medical opinions must from medically licensed service providers. Most doctors, psychologists, and psychiatrists have the appropriate medical licenses to provide opinions to the SSA. However, massage therapists, chiropractors, acupuncturists, yoga instructors, physical trainers, and sports medicine caregiver do not usually have the training and education to obtain a medical license. Thus, their records and notes hold little weight with the SSA. The best source of information about your impairment is a licensed physician with a specialist certification, such as a podiatrist or optometrist.

Opinions and records provided by licensed physicians must contain verifiable medical evidence from tests and evaluations. A description of your symptoms as told by you is not enough. Acceptable tests include clinical and laboratory tests, such as MRIs, CAT scans, blood screens, and biopsies. Evaluations, such as mental exams performed by licensed psychologists or psychiatrists, are also acceptable.

In addition to providing the appropriate type of medical evidence from an acceptable provider, you must also include medical evidence from the onset of your disability through the current date. The SSA will want to see medical documentation of all treatments and prescriptions over time to show that you are unable to work on a sustained basis. You must show that your condition is ongoing and severe.

A Social Security Disability Representative Can Help

The SSA will deny your claim for benefits if you do not prove that you have a medically determinable impairment that is severe enough to prevent you from working and is expected to last at least one year or result in death. You can improve your chances of approval by providing the necessary medical documentation from an acceptable licensed provider to show that your impairment is disabling.

A knowledgeable Clayton Social Security disability representative can help you gather the appropriate information and submit it to the SSA. Contact Adams & Associates Disability, Inc. today at (888) 551-1190.