Awhile back a buddy of mine applied for both SSD and SSI.
He has never made much money at all - over the last 15 years
his SSA statements show that the best year he had only made 10K.
There are several years he did not report any income.
He is 61 years old and has an 8th grade education.
He is an honorably discharged - 2 tour RVN vet.
On Aug 12,2009 - he received two denial letters,
one for SSD and one for SSI.
The denial for SSD states:
"We have determined that your condition was not disabling on any date through 09/30/2007, when you were last insured for disability benefits. In deciding
this we considered the medical records, your statements, and how your condition affected your ability to wor.
You state that you are disabled and unable to work due to PTSD, gerd,
left shoulder and foot pain. We have insufficient medical evidence to fully evaluate your condition as of the date you were last eligible for disability benefits.
Because the record does not show that your condition
was disabling as of 09/30/2007, your claim for disability is denied.
QUESTION :
What does this part mean,
"your condition was not disabling on any date through 09/30/2007, when you were last insured for disability benefits.
Is there any way to disagree with it ? What would be needed ?
The denial for SSI states:
Based on a review of your health problems you do not qualify for
payments on this claim. This is because you are not disabled or blind
under our rules.
We have determined that your condition is not severe enough to keep
you from working. We considered the medical record and other information,
your age, education, training, and work experience in determining how
your condition affects your ability to work.
You state you are disabled and unable to work because of PTSD, gerd,
left shoulder and foot pain. We have reviewed the medical records,
and they show that you are being treated for your condition.
We realize that you are concerned about your health and feel that
you are unable to work; however. based on the medical records, we find
that you are capable of performing work such as you have performed
in the past as a fish cleaner.
Accordingly your claim for disability is denied.
Question:
I notice that with SSI - there is no statement (as in the SSD denial)
of "the record does not show that your condition was disabling as of 09/30/2007".
So apparently there is no type of date issue to fight with SSI.
Should I go ahead and help him file a reconsideration for the SSI claim ?
Prior to these denials he had submitted two medical records,
1) Progress Notes from his VA Psychiatrist dated 07/03/08,
that state,
PAST PSYCHIATRIC HISTORY:
Patient was at Bay Pines inpatient psychiatric unit under the care of Dr. XXXX from 04/23/2002 to 04/24/2002 with a diagnosis of adjustment disorder and mixed anxiety and depression. Global assessment functioning; admission 50, discharge 60.
QUESTION : Would the PAST PSYCHIATRIST HISTORY listed above be helpful in any way
in regards to the SSD denial -
in relation to SSD's statement of, " 09/30/2007, when you were last insured for disability benefits".
2)a letter of support from his Vet Center, Counseling Therapist MSW.
He also signed and submitted the proper ROI forms from VA to SSA.
On both of these denials - the only evidence listed are the two
medical records he submitted- one from his VA Psychiatrist and
a letter from his Vet Center, Counseling Therapist MSW.
Yesterday, his current Vet Center Therapist wrote him a letter
of support stating that in his opinion the veterans diagnosis
and severe symptoms from PTSD alone render him unable to be
employed under any circumstance, due to, PTSD (chronic) 309.81
including anxiety, startle response, avoidant behavior, hypervigilance, re-experiencing phenomenon, feelings of loss grief and guilt, nightmares
and isolative behavior related to his Military service and post-war adjustment issues. Mr. XXX suffers from a number of medical problems including Agent Orange related illness, degenerative joint disease, gastrointestinal espphageal reflux disease, shoulder injury, skin disorder and is rated service connected
at zero percent for residual of foot injury.
His Global Assessment of Functioning (GAF) is characterized by increasing
serious and clinically distressing impairment in psychological, social and
occupational functioning.
His behavior is considerably influenced by serious impairment in
communication and judgement and a marked decrease in functioning with
recurrent depression, lack of motivation, decrease in taking care of personal hygiene, frequent isolative behavior, feelings of being overwhelmed,
financial difficulties, lack of family relationships and support,
poor conversation, deficits in short term memory, tangential thought process,
perodic feelings of hopelessness with suicidal ideation, diminished insight
and judgement with increasingly serious medical problems referenced above.
He has been encouraged to consider a referral to the Bay Pines VA Medical Center
(VAMC) Stress Treatment Program for evaluation to the residential program.
He will continue in individual therapy, and group therapy upon availability, at this Vet Center pending outcome of referral to the STP and available
outpatient modalities.
Without more intensive interventions such as referenced above, his prognosis
for PTSD symptom improvement or mood stabilization is poor.
Please contact me if I can be of further assistance.
XXXXX LCSW
Vet Center Counseling Therapist
Now the letter above is only from a LCSW - Licensed Clinical Social Worker,
are those credentials adequate enough for SSA ?
Thanks for all guidance, help and opinions.
carlie