Facts about Cushing's Syndrome and Filing for Disability
These selected pages answer some of the most basic, but also some of the most important, questions for individuals who are considering filing a claim for disability benefits.
Facts about the condition
1. Cushing's syndrome is the result of too much of cortisol (a hormone) in the body, either due to the body producing excess amounts or from taking corticosteroid medications to control the symptoms of another condition.
2. Cushing's syndrome causes a fat buildup in the stomach and between the shoulders, an exaggerated round face shape, and stretch marks that look purple or pink.
3. Cushing's syndrome may cause emotional problems such as anxiety, depression and irritability, skin that breaks easily and heals slowly, loss of menstruation in women and erectile dysfunction in men, high blood pressure and sometimes diabetes.
4. Cortisol's purpose in the body is to regulate blood pressure and the cardiovascular system, as well as control stress response, and metabolize proteins, carbohydrates and fats into energy.
5. The body may overproduce cortisol if there is a problem with the pituitary or adrenal glands, or if a tumor forms that produces the hormone.
6. Taking a medication form of cortisol may be necessary to control symptoms related to inflammatory conditions such as arthritis, lupus and asthma. When an individual receives an organ from a donor, these medications are used to keep the body's immune system from rejecting the donor organ. When this medication is taken over an extended period of time, cortisol can build up in the body and cause Cushing's syndrome.
7. The symptoms of Cushing's syndrome can present themselves like other conditions, including polycystic ovary syndrome in women, major depression, an eating disorder or alcoholism. This sometimes makes the condition difficult to diagnose.
8. Cushing's syndrome can potentially cause death, but typically diagnosis and beginning treatment will prevent further problems. If medication is the cause, a doctor can help slowly reduce the amount of corticosteroids used. Surgery and radiation therapy are treatments of choice if a tumor is the cause. There are also prescription medications that limit production of cortisol.
Qualifying for disability benefits with this condition
Whether or not you qualify for disability and, as a result, are approved for disability benefits will depend entirely on the information obtained from your medical records.
This includes whatever statements and treatment notes that may have been obtained from your treating physician (a doctor who has a history of treating your condition and is, therefore, qualified to comment as to your condition and prognosis). It also includes discharge summaries from hospital stays, reports of imaging studies (such as xrays, MRIs, and CT scans) and lab panels (i.e. bloodwork) as well as reports from physical therapy.
In many disability claims, it may also include the results of a report issued by an independent physician who examines you at the request of the Social Security Administration.
Qualifying for SSD or SSI benefits will also depend on the information obtained from your vocational, or work, history if you are an adult, or academic records if you are a minor-age child. In the case of adults, your work history information will allow a disability examiner (examiners make decisions at the initial claim and reconsideration appeal levels, but not at the hearing level where a judges decides the outcome of the case) to A) classify your past work, B) determine the physical and mental demands of your past work, C) decide if you can go back to a past job, and D) whether or not you have the ability to switch to some type of other work.
The important thing to keep in mind is that the social security administration does not award benefits based on simply having a condition, but, instead, will base an approval or denial on the extent to which a condition causes functional limitations. Functional limitations can be great enough to make work activity not possible (or, for a child, make it impossible to engage in age-appropriate activities).
Why are so many disability cases lost at the disability application and reconsideration appeal levels?
There are several reasons but here are just two:
1) Social Security makes no attempt to obtain a statement from a claimant's treating physician. By contrast, at the hearing level, a claimant's disability attorney or disability representative will generally obtain and present this type of statement to a judge.
Note: it is not enough for a doctor to simply state that their patient is disabled. To satisy Social Security's requirements, the physician must list in what ways and to what extent the individual is functionally limited. For this reason, many representatives and attorneys request that the physician fill out and sign a specialized medical source statement that captures the correct information. Solid Supporting statements from physicians easily make the difference between winning or losing a disability case at the hearing level.
2) Prior to the hearing level, a claimant will not have the opportunity to explain how their condition limits them, nor will their attorney or representative have the opportunity to make a presentation based on the evidence of the case. This is because at the initial levels of the disability system, a disability examiner decides the case without meeting the claimant. The examiner may contact the claimant to gather information on activities of daily living and with regard to medical treatment or past jobs, but usually nothing more. At the hearing level, however, presenting an argument for approval based on medical evidence that has been obtained and submitted is exactly what happens.
About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here.
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