Facts about Scleroderma 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. Scleroderma refers to a group of progressive diseases affecting the skin. Scleroderma causes the skin to become hard and tight.
2. In some cases, scleroderma may affect internal organs including the heart, lungs, kidneys and digestive tract.
3. Early signs of scleroderma are common and may be attributed to other conditions or not related to scleroderma at all, making diagnosis more difficult.
4. One sign is Raynaud's phenomenon, a condition that causes exaggerated response to cold and stress, where hands and feet change color and go numb.
5. Another is gastroesophageal reflux disease, which causes excess acid in the stomach and esophagus.
6. Changes to the skin are a key symptom in scleroderma. Fingers and hands may swell, and skin may become shiny and tight on the hands and face. Flexibility and movement may be limited due to the tightness of skin.
7. Scleroderma diseases just affecting the skin are morphea and linear. Morphea is characterized by oval patches of thick skin with a while middle and purple outside edge. Linear is characterized by streaks of thick, hard skin on arms, legs, or forehead, and is more common in children than adults. Scleroderma that affects internal organs as well as the skin is called systemic. The specific type of systemic scleroderma is determined by the affected body parts.
8. Scleroderma is more common in women than men, and among Native Americans and African-Americans as well. The Choctaw tribe (in Oklahoma specifically, but not those in Mississippi), are around 20 times more likely to develop systemic scleroderma.
9. Environmental factors also appear to play a role in development of scleroderma. The silica dust from coal mines and rock quarries, solvents like paint thinner, and some chemotherapy treatments all increase the risk of scleroderma.
10. Aside from prescription drug treatment and therapy, scleroderma can be managed at home by exercising, managing reflux and heart burn problems, keeping skin warm, and refraining from smoking.
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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