Important SSD Question - Need Advice

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Retired Mom
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Date Joined Feb 2010
Total Posts : 1753
   Posted 6/1/2010 2:06 PM (GMT -7)   
Hi guys,
 
I need your help.  I've had two Dr's call me lately regarding my SSD paperwork.  Apparently they both recently got new requests regarding my SSD application.  My Endocrinologist's office advised that he said he does not treat me for a disabling condition and therefore wanted to send something back saying they need to foward the request to my "back doctor".  At the time, I asked them just to not send a reply because I don't want a "negative" report in my file.  I hope this was correct, but I'm not sure.  He treats me for the Human Growth Hormone Deficiency.  I take shots everyday for the rest of my life.
 
So today I got a call from my psychiatrist's office.  Apparently they got a new request for ALL records from my history up until May 2010.  Last time he sent in only a list of diagnoses and medications on a form he completes as relatively standard.  SSD already sent me to their own psychiatrist and I had a copy of his determination sent to my Dr.  My Dr read me the report and it was "positive" for me receiving SSD....very much so.  So, since that time I've continued seeing my Dr and have made "progress" (which may not be the best for my SSD request) and also I have made some very personal comments that would be added into my notes.  These comments could hurt some people I love who work in government positions (if they are incorrectly used/released).  That being said, if I have ALL of my notes sent, then they could be introduced into court (I think) and I REALLY don't want that information released.  It's all true, but again, it could really hurt people I love and I do not want that at all.  I had to make the decision to allow ALL information to be sent or to have another "summation" sent, which would sort of replicate what was done before.  Again, they had their own Dr do an eval so I'm not sure what benefit I could gain from releasing additional information.
 
Please give me advice on this.  I know I am supposed to give all medical information and that all segments of my medical/psychological being are evaluated to determine SSD, but I'm at a loss regarding this part.  I have already been denied once, so this is the appeal.  Should this one be denied (as it likely will), I will hire an attorney (but I wanted to wait just in case they really followed their own guildelines and approved me this time).   Naturally that would save me some serious money in the long run.  My medical conditions are completely within the guidelines of those which should be "automatically" approved (even though they denied on the first filing).
 
Any advice would be greatly appreciated. 
Retired Mom


finallyreallycrazy
Regular Member


Date Joined Mar 2010
Total Posts : 105
   Posted 6/1/2010 3:06 PM (GMT -7)   
I am in the same boat with you! I have actually been denied twice, but was told by my Social Security Case worker that 90% of the people that end up with their file on the judge's desk or a hearing will get their disability. My only problem is that with so much new stuff going on I keep having to send everything new to the judge, making me wonder if he/she has set it aside. Then I find out that in Oklahoma, the waiting time for a hearing date is usually 3-4 months from the day it lands on the judge's desk......already been one month, and it still isn't even scheduled for hearing. I know the process is long, but I am like you and fit into the paramaters or what they consider disabled. How much longer does one have to wait for someone to decide if they are disabled (something we already know, as well as the local case worker, who keeps telling me that espically with everything that i have going on, it shouldn't take long. Seems to me that their definition of not long came from a dictionary that I have never laid eyes on!!!
New MRI's show I have 3 GOOD vertabrae.  The rest are bulging, compressed, protruding or in one of the three spinal stenosis' in my back.  One stenosis in my neck and two in my lower back.  Fibromyalgia, cfs, degenerative bone disease, osteoporosis, osteoarthritis, HORRIBLE memory problems, panic attacks, depression, and muscle cramps that don't stop.
 
Meds:  Oxycontin 60mg 2x day, Effexor xr 300mg 1xday, Robaxian 3xday, Valium 10mg 4xday, Lortab 10mg 4xday, Phenergan PRN, Folic Acid, B12 and B6
 
 
 
 
 


false_sercurity
Regular Member


Date Joined Mar 2010
Total Posts : 30
   Posted 6/1/2010 6:12 PM (GMT -7)   
Hi guys..i also am in the same boat..i have just been denied as well ..in the process of appealing for the first time but with WCB ..and i have never dealt with such people that twist your words and when you do have serious problem they always try and tell you its caused by something else or soft tissue ...they have a answer for evevythng even if there wrong and im sure SSD is no different..half the time you never no what you should release to them nines times out of ten if there is any way they can use it against you they will..starting to learn that quickly with WCB...i hope you get things settled in your favor...and the best of luck to you wish i could be more help...God Bless

PAlady
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Date Joined Nov 2007
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   Posted 6/1/2010 9:04 PM (GMT -7)   
Retiremom,
I'm not the expert on SSD, so maybe straydog will have an answer when she's feeling up to it, and I'll be curious about it, too, as I listed some doctors who I'm seeing for conditions but they're not the ones disabling me and I'm hoping they don't throw everything off.

In regard to the psychiatrist notes, though, I probably can help with some info. I would speak ASAP with your psychiatrist (at your next session, or before he/she sends records to SSD) and ask if the information about others is in his/her "psychotherapy notes' and ask if these psychotherapy notes could be withheld. Psychotherapy notes are considered a separate part of the record IF they are kept in a separate file. If that is the case, then a special release is required for them to be released. When I did this type of work I never released psychotherapy notes, but in my private business I could do that. When I worked in an outpatient clinic, however, if the record was requested and there was a valid release, then everything was sent because it was all kept in the same chart. This keeping of the notes in a separate file/chart is a legal issue, not something I'm making up. Also, information about other people should NEVER be released unless the therapist or doctor has the written consent of that person(s), so you may need to remind your psychiatrist of this. There is a way for him/her to black out this information with an explanation.

You also have the right to rescind your permission to release records at any time prior to the release of the records, so if you tell your psychiatrist you do not want certain parts of the file released, and give that to him/her in writing, then that request should be honored. I would discuss this issue first and see what your psychiatrist normally does in these situations. Remember your psychiatrist should be in some sense your advocate, and not do anything that would harm you. That's not to say he/she should lie or eliminate some relevant portion of the record, but info. relating to others - even a spouse - can't legally be released without their consent or the psychiatrist could be held liable.

Hope this helps a bit.

PaLady

Retired Mom
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Date Joined Feb 2010
Total Posts : 1753
   Posted 6/1/2010 9:35 PM (GMT -7)   
Thank you so much!
 
PALady,
 
This is the info that I was kind of looking for.  I believe he does have a partitioned file (with psychotherapy notes in a separate section), but I'm not sure of the way they are maintained.  He and I have spoken of this issue before and he does not like to release notes.  I will be seeing him again very soon and will discuss the submission of notes/info with certain information "black marked" should we have to submit it after all.  For now, I think they are going to have to get the summation instead. 
 
I've used a great number of psychological evaluations in court during my career, but never were psychotherapy notes introduced.  These were criminal cases, but your post has sort of sparked a memory where the release of information is concerned. 
 
I see this Dr because he helps me and has helped me through a very rough time in my life.  I have honest, valid, and very candid discussions with him about incidents that caused my PTSD and other areas of concern.  These were things that should not have happened and I don't want them to be known by others.  My friend sees her Psych for the purpose of eventually getting disabiliy....that was discussed upfront and that is all they discuss in the WEEKLY meetings.  He sends everything to SSD and she hears everything he notes (as he dictates with her in the office and it is always about her decline).  After dictation, they discuss why he said what he did and how it related back to her "disability".  It means for a slightly different perspective on sending notes.  SSD sent both of us to be evaluated by their own Dr's for additional information, so I guess I can see why they do that.  
 
Don't get me wrong....she is IMHO disabled (as am I), but we choose to go about the process a little differently.  No judgement here on her part......just consideration of the situation.   
 
This call (these calls) has/have certainly thrown me in to a tail spin right now.  I expected further evaluation, however, the SS department information on disability that they provide on their web site said the first appeal was a re-evaluation of the information on the original application and consideration of  any additional disabliing conditions.  It looks like quite a bit more than that from here.
 
I appreciate the responses!
Retired Mom


straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 13451
   Posted 6/2/2010 11:26 AM (GMT -7)   
Retiredmom I am glad PaLady saw your post and answered you on the notes situation. As far as the Endo's office saying what they did, about not you treating you for a disabling condition thats ok. This happens a lot, because many times a drs name will come up and it has nothing to do with the disability. It really does not count as a negative against you either. I am thinking you said you are in the Reconsideration stage on your claim. I hope you can get approved without having to wait on a hearing on your claim. It can take anywhere from one to two years or longer to get a hearing because of all of the backlog of cases. It is so frustrating for people that are stuck in the SSD limbo game. I do hope you know to only hire an atty that has a "contingency" contract and not to pay any atty any money up front. If they get your benefits awarded at a hearing they get paid out of your past due benefits and there is a cap on what they can charge. They have to file a detailed Fee Petition with SS to actually receive payment. SSD holds out x amount out of the back pay and once the Fee Petition is received & approved by them, then they pay the atty, if his fees are less than what they held out they release the remainder to you. Good luck.
 

crohns disease dx 2002 & small bowel resection, still looking for remission whatever that is, chronic pain 22 yrs, added ulcerative colitis 6-05 to the mix, high blood pressure 28 yrs, aortic heart valve insuffiency, depression, osteoarthritis, osteoporosis lumbar spine, scoliosis lumbar spine, peripheral neuropathy hands & feet, COPD & on oxygen therapy, lupus & psoriasis and psoratic arthritis. Several other health issues just not enough room to list it all. Too many surgeries to list and too many medications to list. Currently on 17 different daily medications. Intrathecal pain pump implanted June 05.


Pete trips again!
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Date Joined Nov 2006
Total Posts : 1899
   Posted 6/2/2010 3:44 PM (GMT -7)   
Hi R~Mom, I to am on my first apeal and this whole SSD biz really sucks! I just got a call from my atty who said she was on the phone w/ the ssd lady handling my case for an hour. She said she was trying to explain to this lady that just because I had the tittle of Purchasing Agent, it didn't mean that I sat at a desk all day (which I didn't and would be imposable for me to too now anyway!) What gets me is I wrote a list of exactly what I did at all of my jobs going back 20 years> TWICE!!! The second time it was over twenty typed pages and my lawyer said she never saw such a detailed description before and that my ssd lady must be an idiot as everything was there in black and white!!! She told me that the lady said it was obvious that I couldn't do any physical labor w/ my condition but should be able to work at a desk. The thing is, in my chosen proffession was in construction> NO ONE just sits at a desk!!! There always is physical work involved to be done!!
Sorry do go off on my own ssd problems when that not what your post is about!
about your problem, I don't think anything you tell your doctors, any doctors can be used in court against someone else> Isn't there some kind of Dr ~ patiant confidential law that prevents it?? I just know what I see on TV so I'm no expert but it seems like it would against the law!
Good luck, I'll put you on my prayer list for sure!!
Hugs>>
Your friend,
Pete

Retired Mom
Veteran Member


Date Joined Feb 2010
Total Posts : 1753
   Posted 6/3/2010 12:05 PM (GMT -7)   
Thank you guys! I appreciate the kind words and the advice. I know this is not a serious medical issue, but it seriously matters to me and my family.

I'm sorry it took so long to post a resonse, but I've had a nasty stomach bug and am just up to posting again.

I appreciate you all!
Retired Mom


straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 13451
   Posted 6/3/2010 7:11 PM (GMT -7)   
Hope you are on the road to recovery. There is a lot of different bugs going around, I don't remember them happening so much at this time of year either.
 

crohns disease dx 2002 & small bowel resection, still looking for remission whatever that is, chronic pain 22 yrs, added ulcerative colitis 6-05 to the mix, high blood pressure 28 yrs, aortic heart valve insuffiency, depression, osteoarthritis, osteoporosis lumbar spine, scoliosis lumbar spine, peripheral neuropathy hands & feet, COPD & on oxygen therapy, lupus & psoriasis and psoratic arthritis. Several other health issues just not enough room to list it all. Too many surgeries to list and too many medications to list. Currently on 17 different daily medications. Intrathecal pain pump implanted June 05.


BobinmidMO
Regular Member


Date Joined Mar 2010
Total Posts : 39
   Posted 6/4/2010 11:19 AM (GMT -7)   
I'll be curious to see if holding back info is the best course of action, but I can't deny my caution in this approach.  In the end, there's nothing that's private, absolutely nothing so I'm betting that SSD will locate everything in the end no matter what.  Thing is, don't assume that one report that's negative will trash your entire case because that's just not necessarily the way it works.
 
SSD isn't denying you filing because of anything against you personally.  They are being more careful than ever before because of all the fraud that's been literally out of hand because of so many people trying to get full disability for some of the craziest reasons in the world.  After these somehow got through, and it was later found out so everyone who's filed since then has paid dearly for it.
 
Determination of benefits is based off of your overall picture and the prognosis of what lies ahead.  As long as your current records show that you've been following through (like you have been) on doctors orders and care and that your situation shows clearly you're unable to work because of health conditions out of your control, you'll will be approved.  It's the cogs of the system that are so painfully slow that drives us half insane at times.
 
If there hadn't been people getting SSD over emotional problems such as "loving my children so much, when they left home to start their adult lives I couldn't handle the empty nest syndrome," (I knew of a sort-of friend who actually pulled this off!) we wouldn't see the horrible mess we're seeing now where everyone is being put under a magnifying glass since we're all assumed to be crooks till proved innocent.  It's these jerks that made the system into a legal hell where lawyers are now commonplace as you prove how badly you're disabled.
 
Stay patient, and you'll get through it.  Best of luck, Bob.
After an accident in  1997 crushed the nerves in my pelvis, halfway down the calf and at the fibular head (knee), my left leg slowly started to turn color from the foot up, along with swelling and temp change.  Within 2 weeks I was diagnosed with RSD.  By 1999 I landed in a wheelchair and started a life taking narcotics all the time. In 2004 I got an Intrathecal morphine pump &5 years ago the RSD spread to my right leg and has done around 80% of the damage it did to my left leg in half the time. 1 1/2 years ago I went septic, and the infection did go body-wide.  After 2 days in the hospital I then had a clot in my lungs.  Both should have killed me, but this time I got lucky.  Meanwhile I've been battling blood clots for the last 4 years.  A year ago my left leg was ampuated above the knee after ging septic.  Guess that about say's it all.  Bob.


Retired Mom
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Date Joined Feb 2010
Total Posts : 1753
   Posted 6/4/2010 12:34 PM (GMT -7)   
Thanks for the info Bob.  I don't want anyone to think I am withholding information....that is far from the truth.  I have discussed personal information with my Dr.  This is the information that I do not want released....not medical concerns.  I simply do not think that my words should (although very true) should be released and I believe that HIPPA laws should prevent that.  I have absolutely no concern about the release of any medical records (just psychtherapy notes/mh notes).    I guess I will deal with whatever when the time comes.  Some things, however, are better left alone and I don't want to open old wounds for others or to create new ones.
 
I'm also not complaining about the disability process (as a whole), although I do find it insane about people who are approved for NOTHING while others who so honestly cannot work are denied. 
 
Thanks again!
 
Best to you.


Retired Mom

Post Edited (retiredmom) : 6/4/2010 5:54:42 PM (GMT-6)


PAlady
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Date Joined Nov 2007
Total Posts : 6795
   Posted 6/4/2010 12:53 PM (GMT -7)   
RetiredMom,
I have to agree with you about trying to keep this info. private. Psychotherapy notes are very different from most other doctor's notes, and are basically designed to be for clinical purposes to help the therapist and the client. Sadly, too many people forget that. And outside organizations - including other doctor's offices (non-psychiatric) most often do not know how to manage such delicate info. Once it's out of the therapist's office, there is nothing the therapist can do to contain the info., because other entities may not be covered by HIPPA protections. Also, these notes then go into the public record unless sealed by court order.

You're not trying to withhold diagnoses or basic info., etc. but the details do NOT need to be released. Is your psychiatrist in a solo practice, or a small private group practice? If so, I'd ask what his/her/their policies are in this regard. Most places will be fine with the summations, etc., including SSD.

Last I knew HIPPA as applied to psychotherapy notes was being interpreted to mean a different FILE, NOT a different section of the chart, which is how most places do it. Sounds like that's also how your psychiatrist does it, which is why it's important to discuss this soon, before things are released. Once they're released, they're gone. If you have an attorney they can petition the court to have these sealed but with SSD I don't know how well that would work considering what a mess it all is, and how many hands will likely see those notes before they get in front of a judge. But also, your psychiatrist should know that he/she is liable for releasing info. about anyone without that person's permission. Fact is, it shouldn't even be recorded except in a general way, but it's tough not to be able to put the puzzle pieces together even if names aren't mentioned if someone has seen you over time. You don't want all the work you've done ruined because sensitive info. got in the wrong hands.

Just call your psychiatrist if you haven't already and leave a message that you do not want psychotherapy notes released, and for this to be considered a verbal authorization that overrides any releases you signed for SSD until you can talk in person.

PaLady

Post Edited (PAlady) : 6/4/2010 5:17:02 PM (GMT-6)


Retired Mom
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Date Joined Feb 2010
Total Posts : 1753
   Posted 6/4/2010 12:59 PM (GMT -7)   
Thanks again PALady,
 
I did only give permission to release the summation and not the notes (or the rest of the file).  I have not signed another release since the first one and it was only for that summation.  I'm going to give them a quick call again (just in case) and make sure things were done right.  Like you, I understand that HIPPA is only as good as the people who follow the guidelines.  You can never take back things that are said or done (once they have been said or done).
 
Great advice as always!
 
Thanks!

Update:  I just called the office and they are going to make sure of what was done/sent and call me back.  Either way, they do not send the psychotherapy notes (no matter what).  Only the progress notes are sent, however, some personal information such as "arguing with child/husband" or something like that could be included.  The files are separated by section, but information is kept in the same physical file. 

Apparently they are as concerned as I am about releasing information to anyone.  I actually remember the first meeting I had with him that we discussed releasing information and he was against it almost completely except under direct court order. 

I'll be waiting on the call for verification, but I feel sure they didn't release anything controversial or detrimental.  I can honestly say that this Dr's office is the most private of any I have ever seen.  There are only two Dr's and there are separate waiting rooms to prevent violation of patient confidentiality.  There is also virtually no wait to see the Dr because they only schedule one patient at a time with about 10 minutes between visits (I guess for making notes). 

 

 


Retired Mom

Post Edited (retiredmom) : 6/4/2010 2:20:27 PM (GMT-6)


PAlady
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Date Joined Nov 2007
Total Posts : 6795
   Posted 6/4/2010 3:59 PM (GMT -7)   
Retiredmom,
Sounds like you have a sound, ethical doctor and the practice is run accordingly. Most mental health professionals cringe at the thought of releasing psychotherapy notes for any number of reasons.

Glad you checked on this. You may want to ask for a copy of what was sent so you can know what's in SSD's hands. Sometimes the therapist wants to review this with you directly so that nothing is misinterpreted or damaging. Even progress notes might contain a few things. In the future if more info. is requested you might ask your doctor if you can review them before they go out. Then you can ask for anything you feel is too sensitive to be blacked out and in most cases that's possible as long as it's not leaving out relevant info. SSD really shouldn't have anything but basic progress notes with symptoms, diagnosis, improvement in symptoms, etc. and how this directly relates to working or not working.

I may edit parts of my earlier post now that you've read it for personal reasons.

Good luck!

PaLady

Retired Mom
Veteran Member


Date Joined Feb 2010
Total Posts : 1753
   Posted 6/4/2010 4:55 PM (GMT -7)   
Thanks again PALady. I have also updated my post to remain a little more private.

I appreciate all the information!
Retired Mom

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