- The Americans with Disabilities Act (ADA)
- Five Areas of the ADA
- The ADA General Rule—Statute 42 U.S.C. §12112(a) Qualified Individual, Essential Function, Reasonable Accomodation
- United States Department of Labor (USDOL)—Equal Employment Opportunity, Undo Hardship
- The Equal Employment Opportunity Commission (EEOC)
- Patient Rights
- Miscellaneous Programs and Help, such as Workers’ Compensation, COBRA, Private Disability Insurance, Employee Assistance Programs (EAPs), ERISA, FMLA, Vocational Rehabilitation, and Temporary Assistance Programs
- Confidentiality and HIPAA
Among other tools in chapter seven are:
Interaction Worksheet for Important Calls and Meetings [with the SSA]
Table for Determining Disability Status for Those Limited to Sedentary Work
Table for Determining Disability Status for Those Capable of Light Physical Work
- • Medication Log
- • Symptom Inventory Survey
- • Anatomical Diagram of Pain
- • Health History Log
- · Treating Health Care Provider Log
- · Chronological Health Record
I was shocked when I got a copy of my medical record from one of my specialists of 25 years. Unbeknownst to me, he consistently documented no changes in my medical record. I copied the “Residual Functional Capacity Assessment” (below) and reviewed it with him. He filled it out signed it and put it in my medical record. He knew all the things they were asking, but many times physicians are not savvy, instead they run the other way when asked for their input. Reviewing your functional status is not only good for your medical record; it should be a periodic review for your physician, so he/she understands how pain and illness affects you. This is an easy tool to help everyone involved.
The Social Security Administration's (SSA) wants to see how illness affects your ability to function and they want objective measurable criteria.
Have you noticed a steady decline in the way you form words, transpose numbers, letters and words or have difficulty putting an intelligent sentence together? It can be frustrating and life altering. The work that once took us an hour now takes us all day, possibly days and needs to be broken down in small manageable increments. If you notice you consistently have to set a timer to remind yourself of something in 3 minutes, or leave items out as triggers to your brain to complete a simple task you used to take for granted, be sure you bring this up. A neurocognitive exam is in order. The exam will document attention, memory, recall, response to repetitive behavior, and how the results relate to others of your age, experience, and education. It should be administered by a forensic neuropsychologist. A forensic neuropsychologist is known by the court and they have tremendous credibility. It will be bitter sweet, seeing the results in black and white validates your decline, but it is also reassuring to know you are not off your rocker.
Rule #6 - Brainfog? Get a neurocognitive exam.
- What is your cognitive-neuro score?
- Does altered sleep interfere with your ability to cope, if so, how?
- How long does it take you to prepare simple tasks?
- Do you have to have medical equipment to carry on each day?
- Are there days when you can’t drive and why?
- Are you able to lift, carry, stand, use your arms for long periods, if not, why?
- Are your symptoms affecting your relationships and how?
- Do you have other conditions that affect your pain and function?
- What adjustments have you made to accommodate your personal needs?
These are an example of what the SSA is looking for, there are more in the book, but the idea is to get you thinking about how your illness and pain are affecting you. Write down each thing as you notice it. We evolve into this new person because we must, don’t lose sight of how your life is affected. I mostly talk about how to cope, and say putting such focus on these things is unhealthy, but this is the time you must focus. As I said before, the process is itself is difficult.
SSDI and Their Expert Witness
The SSAs own doctors said I should not do anything that requires repetitive long term motion of my upper extremities and hands, (boy do I ever know that) and that I should not stand or sit for prolonged periods. This was THEIR doctor. Yet in my denial letter they suggested I get a job as a "doll maker." Obviously the system is overloaded. Don't stop, file an appeal.
Rule #7 - Don’t give up.
The Administrative Law Judge (ALJ) may ask for expert testimony from an independent source. Most of these experts do not have direct experience with invisible illnesses. Most of us go months or years without a diagnosis and have difficulty finding THE doctor that knows how to diagnose our condition, so you can imagine what the ALJ’s “expert witness” knows about how our illnesses affect our lives, let alone our ability to stick to the regimented schedule of work duties. The laws protect us somewhat because the ALJ should give more weight to the opinion of the claimant’s treating doctor than to the opinion of one of their doctors. However, the judge’s expert witnesses have more impact on the ALJ’s decision when the claimant’s physician has not adequately addressed and documented key issues in your medical record.
Cooper, C and Miller, J. Integrative Therapies for Fibromyalgia,Chronic Fatigue Syndrome, and Myofascial Pain: The Mind-Body Connection. Vermont: Healing Arts Press. 2010.
SSA - Your Ticket To Work
Social Security Application
Social Security Blue Book
Listing of Impairments - Adult Listings (Part A)
Listing Of Impairments - Childhood Listings (Part B)
The SSA Physical Residual Functional Capacity Assessment
Fibromyalgia Residual Function Questionnaire