Facts about Ulcers 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. Ulcers can occur on the skin or genitals, or in the mouth, stomach, eye (cornea) or veins. Ulcers are lesions that are often painful.
2. Ulcers on the skin are characterized by an inflamed, red, open sore that produces pus. On the skin, ulcers are most commonly known as bed sores. Long term pressure on the skin that is not alleviated by movement can cause skin ulcers, such as occurs in bedridden patients. However, skin ulcers can also occur to due extreme temperatures, skin irritation or blood circulation problems.
3. Venous ulcers also occur on the skin, usually the legs, and are most likely due to problems with blood flow in the veins. These ulcers are difficult to treat and usually are a reoccurring condition.
4. Genital ulcers are often, but not always, a symptom of a sexually transmitted disease. With the exception of genital herpes, ulcers in the genital area will heal by treating the underlying condition.
5. In the mouth, ulcers are often known as canker sores. If the ulcer occurs on the outer edge of the lip, they are known as cold sores. The herpes simplex virus causes cold sores. Sores inside the mouth can occur from a wide variety causes, including physical injury (like biting the inner cheek or lip), chemical injury (such as from pill coatings) and infection (viral, bacterial or fungal).
6. Aphthous ulcer is the medical term for canker sore. Recurrent sores are common medical condition of the mouth, and many patients have family history of the condition.
7. Ulcers in the digestive system are called peptic ulcers. These sores most often occur at the beginning of the small intestine, called the duodenum. They may also occur in the stomach and esophagus, and less commonly throughout the entire digestive system.
8. Corneal ulcers in the eye can cause pain, tearing, and vision loss. Vision loss is usually temporary, although more serious ulcers may cause long term blindness. Typically, however, these ulcers heal themselves within four days. This is a common eye condition.
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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