Facts about Necrosis 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) Necrosis comes from the Greek word for dead, and refers to the death of living cells and tissues dying brought on by a variety of external causes.
2) Apoptosis is the normal process of cell death, to which the immune system has an appropriate response. Necrosis, however, causes dead cells to build up and stops them from regenerating.
3) Necrosis is often caused by poison or venom, such as from spiders (particularly the brown recluse) or from snakes like the rattlesnake. It is also caused by infections from bacteria nicknamed 'flesh-eating' bacteria. Infarction, which occurs when blood flow to muscle tissue is blocked, can cause necrosis due to lack of oxygen in the affected cells.
4) Other various causes include injury to, as well as cancer and inflammation of, cells and tissue.
5) The only spider known to have necrosis causing venom is the brown recluse in the United States, and recluse spiders of the same family in other countries have caused similar rates of necrosis.
6) It is difficult to determine which other spider venoms cause necrosis, since many bites are not painful at first and the spider is not identified. Doctors will often immediately remove skin that is possibly necrotic to avoid more damage.
7) In order to treat necrosis, the cause must be addressed. Treatment such as antibiotics or anti-venom will stop the process, then the dead tissue can be addressed.
8) Dead tissue caused by necrosis cannot be reversed, because the immune system does not recognize the dead cells and therefore will never regenerate them.
9) Surgical removal of tissue is the most common treatment. The extent of the necrosis determines whether removal of a patch of skin or an entire limb is necessary.
10) Other options include chemical removal, or even maggot therapy in very rare cases, to eliminate the dead tissue without harming the remaining living cells.
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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