Tulsa, OKCathy is in bad shape. She has degenerative disc disease, fibromyalgia, carpal tunnel syndrome and chronic knee pain, but she hasn't been diagnosed as disabled. What are her chances of getting approval for an Oklahoma social security disability claim (SSDI) or Supplemental Security Income (SSI)? Social Security Attorney Eric Brown of Garret Law Office weighs in.
To make matters worse, Cathy says she doesn't currently have insurance, but she has been treated for all of the above conditions by her physician. As well, Cathy's fiancé has paid a psychiatrist to help treat her difficulty with swallowing rather than take medication.
"I am 54 years old and have found it difficult to return to work because of all the pain I am living with," says Cathy, who has been unemployed since 2009. She wants to know what her chances are of winning a social security disability claim (SSDI) or Supplemental Security Income (SSI).
"Simply having a diagnosis of degenerative disc disease, fibromyalgia, chronic knee pain, and carpal tunnel is not sufficient, in and of itself, to get someone benefits," says Attorney Eric Brown. "It is all a matter of both degree and records. She says that she has been treated for all of them, which is great, because without medical records to back up your claims, you don't have a case.
"A lot of people simply deal with pain and do not seek treatment because of financial hardship. That creates a problem if they want to apply for benefits. Usually we recommend that people go to free clinics and take advantage of any program out there that they can in order to get some history of their illness and treatment if they do not have it. And even if they do have the records, their impairments have to be severe. They have to be debilitating to the point that there is no job opportunity out there for them."
Brown says he gets cases all the time about someone like Cathy, who has all of the above diagnoses but none of them so severe that they can't work any job. "In those cases, attorneys have to take a cumulative approach and say that the aggregate effect of the impairments is of sufficient severity for them to be deemed disabled," adds Brown. "It is a harder argument to make than having one diagnosis that is severe on its own."
Cathy also inquired about the possibility of collecting Supplemental Security Income (SSI), which is for low or no income individuals who are 65 years or older, blind or disabled. It provides money for basic needs. The money comes from general tax revenues. Cathy would have to be disabled and she must have less that $2,000 in resources ($3,000 if married) to qualify for SSI. Benefits are paid the month after the application is filed. If she receives SSI, she may also qualify for Medicaid, which is state-dependent.
In Oklahoma, the percentage of cases won in 2010 was 37.9 percent at the application and 16.8 percent at the first appeal stage. The denial rate was 62.1 percent at application and 83.2 percent at reconsideration. Because the denial rate is high, it is imperative that anyone applying for social security benefits get help from a qualified insurance attorney, and preferably at the beginning of the application.
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