It is not mandatory that you be on some kind of medication to apply for Social Security disability. Nor are the Social Security Disability Rules definitions based on the medications that you are prescribed. But with that being said, if your condition could be better controlled with a certain type of medication and you’re not taking it, then the examiner might see that as a sign that your condition might not be disabling.

Furthermore, the disability examiner might feel that either you are not seeking care for your disability and that is why you are not on medication; or that your doctor feels that your condition(s) are not severe enough to need medication. So once you are given a medication for your condition, you should take it as prescribed. By showing Social Security Disability that you are working with your doctor to try to control you condition(s) and that you are being compliant with what is being asked of you pertaining to your doctor’s medical directions.

You and your doctor need to work together to prove to Social Security that even though you are taking the medication(s) as you are supposed to, the debilitating condition(s) that keep you from working are still affecting your daily life. The best way is to stay compliant with your medication(s). If you go off and on the medication(s) it could be construed that this might be why you are unable to work.

Unfortunately you might be one of the people that are either uninsured or cannot afford the treatment(s) they need. If you fall into either of these groups, you will have a harder time proving that you are disabled. If this is your situation, check into free clinics, county assistance, and any other professional opportunities available to you to get the care you need. Final thought! Once compliant with your medication(s) and treatment(s) do everything in you can to stay that way. It is in your best interest medically and it will assist you in having the credibility needed for your Social Security Disability Claim.

The Social Security Administration periodically checks up on Social Security Disability Insurance (SSDI) beneficiaries and Supplemental Security Income (SSI) beneficiaries to assure that the individuals continue to be disabled. This process is called continuing disability review (CDR).

These reviews will happen at various times. The frequency of these reviews depends upon the medical condition and age of the recipient. A review can happen at 6-18 months for conditions that are expected to improve. If there is a possibility for improvement, then a review will be triggered at three years. For those conditions where improvement is not expected, a review happens anywhere from 5-7 years. It is noteworthy that reviews are more frequent for those beneficiaries under the age of 50. This is because the standard to be found disabled is higher for those under 50.

CDR can be triggered by certain events. These include returning to work, reporting an improvement, medical evidence showing improvement, a third party reporting failure to follow treatment, or a new treatment becoming available for your medical condition.

These reviews entail SSA obtaining the medical records from the year prior to the CDR notice. Thus, it is important to continue going to the doctor even after being found disabled. If these records are insufficient, SSA can send the individual to a consultative exam. Your disability benefits will continue as long as the condition remains the same. Improvements are evaluated to determine whether the individual is capable of working. The benefits will cease if it is determine that you can work.

Under the Supplemental Security Income (SSI) program, the Social Security Administration (SSA) can provide payments to children who are disabled. This child will usually also be eligible for Medicaid, food stamps, and other services.

There are two areas that must be met to receive SSI. The first is the financial criteria based on income and resources of the child and their family. The Second is the medical requirement finding them disabled under the rules of the SSA.

When a child is eligible for SSI, SSA will usually make the cash payments to a responsible person or organization. This is known as a representative payee. Usually, the child’s parent or another relative will be appointed as the representative payee. The payee’s responsibility is to provide food, clothing, shelter, medical care, and personal care items for the disabled child.

Under SSA law, a child is considered to be disabled if they have a medically determinable impairment that results in marked and severe functional limitations and has lasted or is expected to last 12 months in duration. The medical impairments must be shown with medical evidence consisting of symptoms, signs, and lab findings.

For more information, please contact one of the attorneys at Hoglund, Chwialkowski & Mrozik.

Undifferentiated connective tissue disease can be difficult to diagnosis. It is a systemic autoimmune disease. What this means is that a person with this disease, their immune system does not behave as it should. Instead of fighting infections like viruses, a person with undifferentiated connective tissue disease’s immune system attacks its own body.

Someone with undifferentiated connective tissue disease would see a rheumatologist. As the phrase “connective tissue disease” implies, these are diseases that might involve the muscles, joints, skin, heart, lungs, and eyes just to name a few.  A person who has features of connective tissue disease but, does not fulfill the diagnostic benchmarks for any one disease; would be considered to have undifferentiated connective tissue disease. This disease may progress into one specific connective tissue disease over time.

Some of the symptoms of this disease are fatigue, swelling of the lymph nodes, muscle weakness, shortness of breath, heartburn, cough, chest pain, and joint pain. This is not a complete list of the possible symptoms that are attributed to this disease. To diagnosis this disease, as mentioned above a rheumatologist is required. This type of doctor is a specialist in this area.

It takes many factors to diagnosis undifferentiated connective tissue disease. A complete history and examination are vital. Also things like labs, x-rays, CT scans. There is no one blood test to confirm this disease. There is also no cure for this disease. The best course of action is early identification and treatment. Since, before a treatment can be recommended, the extent of the damage to the organ(s) is needed. Persons with this type of disease are usually put on anti-inflammatories and an immunosuppressant.

To prove a case of disability to the Social Security Administration you will have to have medical evidence that shows which organs are being affected and how they are being affected. Along with to what degree. The list of symptoms that you are experiencing and how your life might be being affected by your disease. Like how the disease affects your daily activities. Or does it affect your concentration and how it does this.

This article gives a basic outline of Undifferentiated Connective Tissue Disease. Who you should see if you feel you might suffer from it and what types of tests one might have to take to be diagnosed. Along with what Social Security Disability will want to see in your evidence to possibly deem you disabled and approve your claim.

In order for a child to be found disabled, they must either meet or functionally equal a “listing” (a list of impairments that the Social Security Administration (“SSA”) has said will result in a finding of disability if the impairment is severe enough). Thus, if a child has an impairment that is on the list, and it is as severe as required by SSA, that child “meets” the listing. However, if the impairment does not meet the specific criteria in the listing, the child can still be found disabled if the impairment “functionally equals” a listing. This is done by showing that the child is either “marked” in 2 of the 6 domains, or “extreme” in 1 of the 6. SSA has defined being marked or extreme in a domain as having impairment or impairments that interferes seriously with your ability to independently initiate, sustain, or complete activities. Obviously to prove an extreme limitation, you would have to prove it interferes more substantially than a marked limitation, although the definition is more involved than this.

The 6 domains are: “acquiring and using information; attending and completing tasks; interacting and relating with others; moving about and manipulating objects; caring for yourself; and health and physical well-being. This article deals with the third domain: “health and physical well-being.”

So, how does one prove that a child is marked or extreme in this domain? Social Security Ruling (“SSR”) 09-8p gives us some guidance. This domain considers “. . . the cumulative physical effects of physical and mental impairments and their associated treatments on a child’s health and functioning. Unlike the other five domains of functional equivalence (which address a child’s abilities), this domain does not address typical development and functioning. Rather, the “Health and physical well-being” domain addresses how such things as recurrent illness, the side effects of medication, and the need for ongoing treatment affect a child’s body; that is, the child’s health and sense of physical well-being.”

The first point to note from this, is that the SSA will take into account effects from both the impairment itself or from treatment. Thus, if a child feels dizzy because it is a symptom of his or her impairment, or because it is a side effect of medication, it will be considered.

This ruling also explicitly notes that symptoms can fluctuate, and they will consider “…the frequency and duration of exacerbations, as well as the extent to which they affect a child’s ability to function physically.”

Some examples of limitations given in this ruling are whether the child:

• Has generalized symptoms caused by an impairment(s) (for example, tiredness due to depression).
• Has somatic complaints related to an impairment(s) (for example, epilepsy).
• Has chronic medication side effects (for example, dizziness).
• Needs frequent treatment or therapy (for example, multiple surgeries or chemotherapy).
• Experiences periodic exacerbations (for example, pain crises in sickle cell anemia).
• Needs intensive medical care as a result of being medically fragile

If a child has a severe impairment(s) that does not meet or medically equal any listing, the Social Security Administration (SSA) will then look to see if the child functionally equals the listings.  To functionally equal the listing, the child’s impairments must result in marked limitations in two domains, or extreme limitation in one domain.

The second domain used by SSA is called 2. Attending and completing tasks.  In this domain, SSA considers how well the child is able to focus and maintain attention, and how well the child starts, follows through, and finishes their activities.  With this, pace at which the activities are performed is also considered.

Attention involves how the child regulates their level of alertness and maintains concentration.  SSA will look at a child’s ability to filter out distractions and stay focused on activity or a task.  This would include focusing long enough to initiate and complete an activity or task, and change focus once the task is completed.

Adequate attention is also needed to maintain physical and mental effort and concentration on an activity or task.  Adequate attention allows the child to think and reflect before starting or stopping an activity.  SSA will consider all of the relevant information in the case record when deciding whether the child’s medically determinable impairment(s) result in marked or extreme limitations in this domain.

If a child has a severe impairment(s) that does not meet or medically equal any listing, the Social Security Administration (SSA) will then look to see if the child functionally equals the listings.  To functionally equal the listing, the child’s impairments must result in marked limitations in two domains, or extreme limitation in one domain.

The first domain used by SSA is called 1. Acquiring and using information.  In this domain SSA considers how well the child acquires or learn information, and how well you use the information the child has learned.  Children learn through life experiences growing up.  Using the concepts they have acquired through play and experiences, they should be able to learn to read, write, do math, and understand and use new information.

Thinking is the application or use of information that the child has learned.  This includes perceiving relationships, reasons, and making logical choices.  The child must also be able to use language to think about the world and understand others.  SSA will consider all of the relevant information in the case record when deciding whether the child’s medically determinable impairment(s) result in marked or extreme limitations in this domain.

For more information, please contact one of the attorneys at Hoglund, Chwialkowski & Mrozik.

An administrative hearing is held if the claimant is denied Social Security Disability benefits at the Initial and Reconsideration levels.  The hearing is held at a local Office of Disability Adjudication and Review (ODAR) and is presided over by an Administrative Law Judge (ALJ).  The hearing is statistically the best opportunity to get approved for disability benefits.

Many claimants wonder, “Do I have speak to the judge myself, or will my attorney do all the talking?”

The answer is that you should fully expect to talk to the ALJ.  One of the reasons the hearing is the best opportunity to get approved is because the ALJ has an opportunity to meet you and get your perspective before making a decision on your case.  At previous administrative levels, the adjudicators never meet the claimant.  At the hearing, the claimant is face to face with the person making the decision, giving them the opportunity to ask any questions they have about the case.

Do not worry.  You will not be asked to present legal theories or define complicated medical terms.  That is for your attorney to deal with.  The ALJ will most likely ask you questions about your day to day activities, trying to get an understanding on how your medical impairments limit your daily life.  He/She might also ask you to describe your symptoms and how they affect your physical and mental abilities.  Your answers will help the ALJ make a more accurate decision.  Your attorney will also have a chance to ask you questions that he/she wants emphasize regarding your disabilities.

The best advice to give to a claimant is simple: be honest.  The ALJ will get your testimony at the hearing and then review your medical records in light of the new testimony.  If what you say at the hearing makes sense with what is in the medical records, your testimony can go a long way toward a favorable decision.

The Social Security Administration established the Compassionate Allowances program in an attempt to expedite cases where individuals have medical conditions that are very severe and would qualify under one of the listings. However, not all diseases are met under a specific listing, but still may be approved under the CAL.

Sandhoff disease is a rare inherited disorder that progressively destroys nerve cells (neurons) in the brain and spinal cord.[1] There is no cure for Sandhoff disease.  Treatment includes supportive care for symptoms, such as medications to control seizures and nutritional and respiratory support.[2] Onset of this disease can occur at any age. Adult/Late-onset Sandhoff disease typically presents in adolescence or adulthood, and symptoms may include: Progressive muscle weakness, clumsiness and gait disturbances, speech and swallowing difficulties, urinary incontinence, and psychosis.[3]

Sandhoff disease may be evaluated under Listing 110.08B under catastrophic congenital abnormality or disease. SSA suggests genetic testing for a mutation in the HEXB gene, and a clinical description of the physical and developmental features for approval.[4] If definitive genetic testing is not available, the results of other laboratory studies such as enzyme assays, molecular cell analysis, and tissue biopsy can be substituted.[5]

[1] https://ghr.nlm.nih.gov/condition/sandhoff-disease

[2] Bley AE, et al. Natural History of Infantile GM2 Gangliosidosis. Pediatrics 2011;128;e1233

[3] Delnooz, CCS et al. New cases of adult-onset Sandhoff disease with a cerebellar or lower motor neuron phenotype. J Neurol Neurosurg Psychiatry. 2010; 81:968-972

[4] https://secure.ssa.gov/apps10/poms.nsf/lnx/0423022295

[5] Id.