Author Topic: Suggestions!!! My Fiance Denied for SSDI With AN 2.2cm X 1.6cm X 2.0cm BS Comp  (Read 12453 times)

alicat

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Hello, my name is Ali. My Fiance is 49yr's of age was diagnosed with AN on May 29, 2012. His tumor as of last and only MRI of May 29, 2012 measures 2.2cm X 1.6cm in axial diameter by 2.0 vertical diameter.

His tumor was diagnosed after he had a fall landing on his right shoulder and neck area on May 15, 2012, which resulted in herniated disc's at the Level C-3 - C-7, with pinched nerves in his neck, severe damage was confirmed and located the Level C-3 -C-4 nerve roots.

His occupation is Operating Engineer / Non-Union Tower Crane Operator, yes he's one of those Crazy native american's that sits 300' plus in the air in a little Crane Cabin he'd climb those cranes from the ground to top and sit there for 8 - 14 hours a day building those skyscrapers we see in all the big cities here in the USA.

His company denied his workers compensation, and the attorney representing him, said that his case is not appeal-able, and that he should apply immediately for Social Security Disability Insurance.

We did apply for SSDI on July 5, 2013 after receiving letter from Workers Comp denial, at our Local SS office, we submitted Neuro-Surgeons medical records documenting all health related issues as a result of MRI's for Cervical Injury & AN.

We also had his personal Physician in a letter confirm that my Fiance is totally disabled and unable to do any type of work, and with current AN compressing brain stem that he is terminal without immediate removal of AN.

The local SS office accepted his application as a TERI / Quick Determination Case on July 5, 2103, and we received the denial letter on August 1, 2013.

I myself am a 2004 Survivor of a Intramedullary ependymoma of the spinal cord ( Spinal Cord Tumor ), and remembered that my former employer hired an Attorney for me to get SSDI.
Some Washington, D.C. Group who read this will know us as I've shared in the Group about surviving my 2004 spinal cord tumor removal, and that my Fiance is the native american guy who operates Tower Cranes.

So I rummaged thru old records and found the attorney (who represented me). We called him and he suggested that we file for re-consideration for his SSDI benefits, and if we succeed we've saved ourselves his $6000.00 fee.

We've attended the Washington, D.C. AN Support Group, and found it to be a great resource.

If any members here have experience applying for SSDI, and what information exactly would prove helpful in the reconsideration application ( Form SSA-561-U2 ), that would be greatly appreciated.

His symptoms are the following:
Hearing loss= yes 45% in right ear, confirmed by audiologist / hearing test.
Ringing in the ears= constant sound ringing.
Vertigo= yes even when trying to step up onto a step stool in kitchen.
Trouble balancing= occasionally comes and goes.
Pressure in the ears and/or head= yes it's like he's swimming under water
Facial numbness= very slight.
Facial weakness= very slight.
Changes in taste= this he say's has changed significantly, nothing tastes the same.
Difficulty swallowing= occasionally this symptom affects him
Headaches= yes headache pain is sometimes stabbing pain from right ear down into right side of his jaw, sometimes the headaches are of Migraine cluster types.
Clumsiness= yes he's noticeably become clumsy, sometimes it seems like he's off balance and not picking up his feet when walking, he has fallen down numerous times.
Confusion= We've noticed in conversing with him on rare occasions, he'll stop in mid conversation like he's taking in a breath of air and after about 60 seconds or so, he'll reply back to us what were we talking about, and once we remind him, he continues the topic or our conversation.
Severe Nerve Pain= yes neck area, shoulder pain, right arm pain, with severe muscle spasms in right tricep muscle right forearm muscle, with what he describes as an electric shooting pain from neck all the down into shoulder down right arm and this pain continues into his thumb, index and middle fingers. Not sure if this is caused be AN tumor or Cervical herniated disc's & pinched nerves.
Insomnia= yes he rarely sleeps more than a couple of hours without waking up.
Severe Fatigue= yes his sleeplessness is causing him to constantly feel weak and tired when he's awake.
Blurred Vision= yes he's described not being able to focus to see clearly frequently.
Depression= yes because of AN symptoms, he's lost interest in most everything he used to enjoy doing.


Again my Fiance, has no health insurance, we can't afford to buy him health insurance, and without SSDI, his Neuro-Surgeon won't perform surgery.

**Your suggestions as to anything that should be included in his Request For Reconsideration, such as what should Neurosurgeon should include in his findings, other than his condition has deteriorated continuously in the past year and half since AN diagnosis.   

Please PM me if you've had experience with applying for (and hopefully receiving) SSDI benefits. Any and all suggestions/responses will be welcomed and highly appreciated. Thanks so much!
Alicat
« Last Edit: August 26, 2013, 07:52:06 pm by alicat »

alicat

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Please, has anyone experience with going it alone without the attorney when filing second time it's the Request For Reconsideration Form, we are trying to save ourselves the fee award to an attorney.

We only have till October 1, 2013 to file the reconsideration form, my attorney that helped me get SSDI for my Ependymoma Spinal Cord Tumor, said he'd help us now but suggested we try to do it on our own.

My Fiance is very depressed, and his symptoms are debilitating him. I'm hoping some of you who have been down this road, will have some suggestions.

Again my Fiance, has no health insurance, we can't afford to buy him health insurance, and without SSDI, his Neuro-Surgeon won't perform surgery.

**Your suggestions as to anything that should be included in his Request For Reconsideration, such as what should Neurosurgeon should include in his findings, other than his condition has deteriorated continuously in the past year and half since AN diagnosis.   

Please PM me if you've had experience with applying for (and hopefully receiving) SSDI benefits. Any and all suggestions/responses will be welcomed and highly appreciated. Thanks so much!
Alicat
P.S. He my Fiance was denied by both SSI & SSDI, even with medical records from both Neurosurgeon & Personal Physician, both doctors stated that he's totally disabled and can't do any work of any kind, and is Terminal without Surgery to remove AN tumor from compressing Brain Stem. State disability determination office say's my Fiance doesn't meet there requirements for disability in denial letter from August 1, 2013
 

arizonajack

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Hire the lawyer.

Since he's been denied once, getting a second bite at the apple is incredibly complex and he is virtually guaranteed to fail without an attorney who knows the system and knows how to present the case properly.
3/15/18 12mm x 6mm x5mm
9/21/16 12mm x 7mm x 5mm
3/23/15 12mm x 5.5mm x 4mm
3/13/14 12mm x 6mm x 4mm
8/1/13 14mm x 5mm x 4mm (Expected)
1/22/13 12mm x 3mm (Gamma Knife)
10/10/12 11mm x 4mm x 5mm
4/4/12 9mm x 4mm x 3mm (Diagnosis)

My story at: http://www.anausa.org/smf/index.php?topic=18287.0

terisandler

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Hiring a lawyer is the best option.  I have an acquaintance whose attorney was successful.  She  was awarded the income back to the date she first applied and the attorney was paid a % of the back payments.   
3/25/13- dx 18x11x14 mm AN, hearing loss in right ear x 5+ years, 5 sessions of CK completed May 2013, now a "post toastie".  Follow up MRI 4/14/14 - 15x19x11 mm. Stable with some signs of necrosis.
 Yippee!

alicat

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arizonajack, and terisandlers, thank you both very much for your reply's.

I contacted National Institutes Of Health, on my Fiance's behalf, he hasn't had an updated MRI since May 26, 2012, and NIH Bethesda, Maryland has Clinical Trials that offer free MRI's, the NIH has a couple on going Research Trials for vestibular schwannoma /  acoustic neuroma tumor's.

His tumor we were told by Neurosurgeon Dr Shields from George Washington University Hospital in Washington, D.C. is " Quote, Compressing the brain stem which is like a super highway that sends / controls all bodily functions, and when it's compressing it's like cars on a freeway losing control and sometimes causing catastrophic accidents, and without it's removal the tumor is going to cause his untimely death. End Quote"

So all this is extremely overwhelming, with him not having health insurance etc..etc..

Thankfully we should have a reply from National Institutes Of Health, as to his being accepted for the Clinical Trials within 10 days.

We are now reconsidering having the attorney represent him for the Request For Reconsideration, since time is of the essence.

Still the SSDI, would not cover his surgery until after2-years, so why they put the cart before the horse is an oxymoron, he needs the medical benefits first not the monthly checks...

I've PM'ed a couple of Senior Forum members who have been successful with applying for SSDI, hopefully they'll reply back soon!

If any other forum members would care to reply, it is most appreciated.

Alicat

 

nftwoed

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alicat;

   Maybe try your nearest Dept. of Human services, re state Medicaid?

alicat

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alicat;

   Maybe try your nearest Dept. of Human services, re state Medicaid?

nftwoed, on July 1, 2013 we were told by local ss office after submitting first SSDI app for benefits, to go straight to Maryland State Dept. Of Human Service's, and apply for SSI benefits.

On August 1, 2013 received both letters from SS & Md Health & Human services, stating that he doesn't meet there definition of being diabled.
He'll be 50yrs of age in a couple of months, and has been working since age 15.

It seems the system is against those that need these benefits the most, what happened to the USA after the second world war most European citizens received health benefits, greedy insurance companies is what comes to mine.

Sorry, no not sorry about venting, not venting at anyone here in the forum just about having to deal with so much at once bureaucratic (BS) red tape.

We are seriously contemplating hiring the attorney to help with the Request For Reconsideration. Has anyone else tried to file the Request For Reconsideration without an SSDI attorney?

Alicat

alicat

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I forgot to ask? I've seen quite a few group / forum members post AN's in MM, my Fiance's is CM, oh I've got to sign off.

Dr shield said in June 2012 that my Fiance's tumor is medium to large.

Is this really a medium to large AN, his tumor from MRI of May 29, 2012 measures 2.2cm X 1.6cm in axial diameter by 2.0 vertical diameter.
This AN is compressing brain stem, so I'm really worried / traumatized, I know the look of despair, when I look into my Fiance's eyes! It is to put it plainly heart-wrenching, to say the least

Alicat

 


james e

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I recently posted in the INSURANCE section about SSDI. My surgery was March 2010. I applied for SSDI in April 2010 and was approved in October 2010. I started Medicare on my second anniversary.  I filled out the multi-page application form by myself after writing, rereading, rewriting, rereading, rewriting, etc. The MOST important part of filing for SSDI is to understand what the governments understanding of DISABILITY is.

If you cannot make your case in those few pages, you have little or no chance to get approved. Your second application is almost always rubber stamped NO. You need to get an attorney. Most communities have a legal aid number in the yellow pages, and you can consult with an attorney for free. They will give you some names of attorneys that handle SSDI.

It is a felony to lie on this application. Your first application is the MOST important. Know what disabled means to the government. The definition can be found on the SSDI web.

The SSDI income is based on your Social Security (voluntary tax) donations. Call SS and someone there will tell you what your income would be if you get approved. You will be shocked. I was lucky because I was ready to retire and I did all  the things you need to do to retire...save and invest. At age 49, it is unlikely you have any other income, and it would be a struggle to survive on SSDI for the rest of your life. You can actually get a job on disability and earn up to $1000 a month. You pay income tax on SSDI. I with hold 25% for income tax, and medicare is deducted by Uncle Sam. Not much is left...not enough to live on.

You might be better off to find a job.

James



Jim Scott

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Alicat ~

I concur with James E. and the other posters who recommend hiring an attorney that specializes in Social Security Disability claims.

In 1992, my wife was injured in an auto accident (rear-ended) and suffered serious spinal problems as a result.  She was eventually forced to go on long-term disability from her job at a major insurance company.  The company insisted that she also file for SSDI, even though she didn't want to, because they said it was 'an entitlement'.  She filed - and was turned down.  She then hired an attorney who specialized in SSDI cases.  Long story short: she won an 'award' (monthly benefit).  Her employer deducts the SSDI amount from the monthly check they are obligated to send her under the terms of her company disability insurance policy so her total 'benefit' amounts to what she would have received from the company policy, alone.   She was also required to file for Medicare and did so, although she keeps her Blue Cross policy as a secondary.  The attorney took as his his fee 33% of the back benefit she was awarded, which came to over $15,000. so he received about $5,000. and we felt that he earned it.

My wife had reams of doctor, lab and hospital reports that verified her condition and inability to work but until she had an attorney, it was ignored.  Of course, no one can guarantee that your husband will be approved because he has an attorney to represent him but it certainly gives him some advantage.

FYI: The SSA basically defines 'disabled' as not being able to work at any job, not just the job you had or the field you may be trained for.  The SSA will also require your husband to undergo an examination by a doctor of their choice (at no charge to you).

One other note.  At my diagnosis, my AN was 4.5 cm and according to my neurosurgeon, was 'pressing hard on my brainstem'. He was surprised that I was able to function at all.  He made it clear that 'this will kill you if it isn't removed'.  I believed him and underwent debulking surgery three weeks later, followed by FSR, as a precaution.  It all went well - no complications - and today, seven years later, I'm doing great.  So, although your husband's AN obviously has to be removed, he probably has some time to get this sorted out.  However, its quite clear that the sooner that happens, the better.

Like everyone here who reads your posts, I wish you and your husband success.

Jim
4.5 cm AN diagnosed 5/06.  Retrosigmoid surgery 6/06.  Follow-up FSR completed 10/06.  Tumor shrinkage & necrosis noted on last MRI.  Life is good. 

Life is not the way it's supposed to be. It's the way it is.  The way we cope with it is what makes the difference.

Pam Fraley

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If your fiancĂ© does not have any income (or minimal income), he should look into getting Medicaid.  Medicaid is not based on being disabled.  You can be perfectly healthy and qualify for Medicaid.  This would solve his medical insurance problem.  Good-Luck.
6mmx4mm a/n (left IAC)
8-9mm meningioma (right cavernous sinus)
Diagnosed 2/5/2013 MRI
Wait & Watch -  Dr. Arts, University of Michigan
MRI scheduled for 10/22/2013
No change, continue w&w, repeat MRI in 6months

alicat

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Pam Fraley, Jim Scott, and james e, thank you all very much, for your suggestions.

We went to National Institues Of Health, yesterday and applied to be part of their research trials. They are reviewing his MRI's & Neurosurgeons reports, audiometry test's etc to see if he can participate in a Clinical Trials for AN & NF-2 patients.

They will contact us in about 10-days, to notify us if they'll accept my Fiance.

We're almost 100% decided to allow the attorney to help with the SSDI Request For Reconsideration form's, we're not willing to take a chance at making a mistake in the paper work etc... it's just to stressful.

Alicat

arizonajack

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I've seen quite a few group / forum members post AN's in MM, my Fiance's is CM

Dr shield said in June 2012 that my Fiance's tumor is medium to large.

Is this really a medium to large AN, his tumor from MRI of May 29, 2012 measures 2.2cm X 1.6cm in axial diameter by 2.0 vertical diameter.

A centimeter (cm) is 10 millimeters (mm). Generally, anything larger than 10 mm is expressed in cm.

I think the consensus is that anything below 2cm is small. 2cm to 2.9cm is medium. 3cm and up is large.

But since it's compressing the brain stem, the size doesn't really matter.

There are, of course, varying degrees of compression so urgency likely depends on symptoms rather than size.

3/15/18 12mm x 6mm x5mm
9/21/16 12mm x 7mm x 5mm
3/23/15 12mm x 5.5mm x 4mm
3/13/14 12mm x 6mm x 4mm
8/1/13 14mm x 5mm x 4mm (Expected)
1/22/13 12mm x 3mm (Gamma Knife)
10/10/12 11mm x 4mm x 5mm
4/4/12 9mm x 4mm x 3mm (Diagnosis)

My story at: http://www.anausa.org/smf/index.php?topic=18287.0

Suu

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I'm in Australia and have been reading your thread for the last few days and just want to send my best wishes and hugs your way for a speedy end to the nightmare.

4cm Left side AN Translab August 18th 2010
Facial nerve not working
Nerve conduction Jan '11 Repeated 23rd May '11
SSD left side
5 ops in 6 weeks to fix CSF leaks
Tarsorrhaphy 9 Mar '11 Extended 26 Aug '13
Sling Thur 16 June '11
12/7 nerve graft 9 Feb '12

tamim.horizon

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Hello Suu

I am in Sydney. Could you tell where have you got treatment. I had my AN removal on 8th Oct,2012 in North Shore Hospital done by Dr. Biggs and a large team. Would like to hear your experience.

Right side AN : 4.8cm
Surgery: 8 Oct 2012
Platinam Chain on eyelid: 29th Dec, 2012
Sural nerve graft: 26th April, 2013
Next MRI: 25th Sep, 2012
Dr. Gates (Plastic) will follow up on 6th Sep. Now if I chew down my right face moves up which give me a small smile. Its not much but still a big change for me.
Thanks
Tamim