80% VA rating and I/U P&T - Rich

[RichBap]

Hi all this is my first post. Great forum we have. The value of the information here is unbelievable.

My question is this: I'm a chapter 61 retiree with about 17 years on active duty. I was retired in 2011 due to contracting vasculitus, psoriasis, psoriatic arthritis and an injury to my left shoulder.

The VA awarded me an 80% rating, I/U P&T. My SSDI application is complete but has been in quality review since Oct 11th... Would anyone have a warm and fuzzy on what I might expect from SSDI? They have never contacted me and they did not ask me to do any kind of medical exam.

Thanks in advance.

[Bonzai]

Hi all this is my first post. Great forum we have. The value of the information here is unbelievable.

My question is this: I'm a chapter 61 retiree with about 17 years on active duty. I was retired in 2011 due to contracting vasculitus, psoriasis, psoriatic arthritis and an injury to my left shoulder.

The VA awarded me an 80% rating, I/U P&T. My SSDI application is complete but has been in quality review since Oct 11th... Would anyone have a warm and fuzzy on what I might expect from SSDI? They have never contacted me and they did not ask me to do any kind of medical exam.

Thanks in advance.

Welcome to the Board!  I am an 100% P&T disabled veteran and I was denied by a biased anti-veteran Administrative Law Judge (ALJ) (Ex-Air Force JAG Officer who couldn't cut it, I researched him). 

The ALJ stated that the Social Security Administration proclaims that determinations of disability by other non-Governmental or Governmental agencies is not binding upon them, and completely disregarded my VA disability rating.

See: https://www.ssa.gov/OP_Home/cfr20/404/404-1504.htm

However, the Social Security Appeals Council slapped the ALJ's hands and stated that SSR 06-03p states that the Social Security Administration must consider a determination by non-Governmental or Governmental agencies in their determination of whether or not a claimant meets their definition of disability.

See:  https://www.ssa.gov/OP_Home/rulings/di/01/SSR2006-03-di-01.html

With that and numerous other issues, I received a remand hearing and was awarded benefits.

That was a few years ago, and things have changed.  More veteran positive rulings have been passed that the Social Security Administration has to adhere to.  Your case is in somewhat of a gray area, as you haven't been declared 100% disabled by the VA, and the Social Security Administration requires that a claimant must be 100% disabled, unable to earn Substantial Gainful Activity ($1,130/mo for 2016).  I have no idea if you have other non-service connected impairments, in addition to your service-connected ones.  So there is no way to even hazard a guess at what the Quality Review Board's decision will be.  We have had members approved and denied after Quality Review.

To be determined disabled by the Social Security Administration, one has to prove that they meet or equal the criteria for a listing in Social Security Administration's Blue Book: Listing of Impairments -  Adult Listings (Part A).   See: https://www.ssa.gov/disability/professionals/bluebook/AdultListings.htm  This is easier said then done, because meeting a listing is difficult for many claimants, and they have to have a hearing and go before an ALJ, who will make the determination if a claimant is disabled.

The Social Security Disability Process flows as follows:  Initial Application - Denied and Appealed ==> Reconsideration (some States) - Denied and Appealed OR ==> ALJ Hearing - Denied and Appealed ==> Social Security Appeals Council - Denied - Final Action ==> U.S. District Court (outside of Social Security Administration's authority and over it).  Anywhere along this process, a claim may be decided as Favorable = Benefits awarded, and after the intial ALJ hearing, a claim may be remanded back for another hearing, multiple times, in some cases.

Once again, a short post has turned into a ramble.  Please don't hesitate to ask questions!   

[RichBap]

Thanks Bonsai!

The VA did not award me 100% but they did award me I/U P&T. I hope that helps with my case. I just found out today that my file that arrived to QR on Oct 11 was sent back to DDS on Nov 7. I haven't been contacted at all..

Yeah.. You got screwed by that failed fly boy but I'm happy to hear you are now receiving your benefits.

Back to the wait game ha.

By the way, thank you for your service !

[Glyn]

I don't think my judge ever considered my disability retirement from the state. but don't surprise me.

Hi all this is my first post. Great forum we have. The value of the information here is unbelievable.

My question is this: I'm a chapter 61 retiree with about 17 years on active duty. I was retired in 2011 due to contracting vasculitus, psoriasis, psoriatic arthritis and an injury to my left shoulder.

The VA awarded me an 80% rating, I/U P&T. My SSDI application is complete but has been in quality review since Oct 11th... Would anyone have a warm and fuzzy on what I might expect from SSDI? They have never contacted me and they did not ask me to do any kind of medical exam.

Thanks in advance.

Welcome to the Board!  I am an 100% P&T disabled veteran and I was denied by a biased anti-veteran Administrative Law Judge (ALJ) (Ex-Air Force JAG Officer who couldn't cut it, I researched him). 

The ALJ stated that the Social Security Administration proclaims that determinations of disability by other non-Governmental or Governmental agencies is not binding upon them, and completely disregarded my VA disability rating.

See: https://www.ssa.gov/OP_Home/cfr20/404/404-1504.htm

However, the Social Security Appeals Council slapped the ALJ's hands and stated that SSR 06-03p states that the Social Security Administration must consider a determination by non-Governmental or Governmental agencies in their determination of whether or not a claimant meets their definition of disability.

See:  https://www.ssa.gov/OP_Home/rulings/di/01/SSR2006-03-di-01.html

With that and numerous other issues, I received a remand hearing and was awarded benefits.

That was a few years ago, and things have changed.  More veteran positive rulings have been passed that the Social Security Administration has to adhere to.  Your case is in somewhat of a gray area, as you haven't been declared 100% disabled by the VA, and the Social Security Administration requires that a claimant must be 100% disabled, unable to earn Substantial Gainful Activity ($1,130/mo for 2016).  I have no idea if you have other non-service connected impairments, in addition to your service-connected ones.  So there is no way to even hazard a guess at what the Quality Review Board's decision will be.  We have had members approved and denied after Quality Review.

To be determined disabled by the Social Security Administration, one has to prove that they meet or equal the criteria for a listing in Social Security Administration's Blue Book: Listing of Impairments -  Adult Listings (Part A).   See: https://www.ssa.gov/disability/professionals/bluebook/AdultListings.htm  This is easier said then done, because meeting a listing is difficult for many claimants, and they have to have a hearing and go before an ALJ, who will make the determination if a claimant is disabled.

The Social Security Disability Process flows as follows:  Initial Application - Denied and Appealed ==> Reconsideration (some States) - Denied and Appealed OR ==> ALJ Hearing - Denied and Appealed ==> Social Security Appeals Council - Denied - Final Action ==> U.S. District Court (outside of Social Security Administration's authority and over it).  Anywhere along this process, a claim may be decided as Favorable = Benefits awarded, and after the intial ALJ hearing, a claim may be remanded back for another hearing, multiple times, in some cases.

Once again, a short post has turned into a ramble.  Please don't hesitate to ask questions!   

[Atticus]

RichBap:

"However, the Social Security Appeals Council slapped the ALJ's hands and stated that SSR 06-03p states that the Social Security Administration must consider a determination by non-Governmental or Governmental agencies in their determination of whether or not a claimant meets their definition of disability".

Thanks for that tid bit. In speaking with my DDS worker, I mentioned to her that I receive a disability pension from the State. She had me fax her a copy of the medical report/disability form to her. I figured I should mention it because it is pertinent to my case, and at the least might plant an idea in her head.

[RichBap]

Atticus,

I'm going to do the same thing. Thanks for the great advice folks!

[Atticus]

Atticus,

I'm going to do the same thing. Thanks for the great advice folks!

Make sure and fax it in using the barcoded fax cover sheet. Will it make a difference? I don't know because SSA has there own rules and regulations, and have much higher standards in order to meet a disablity than my State retirement system does.   On the other hand, the form reads like a medical record, so i consider it to be part of my medical records since one of my treating doctors filled it out. My hope is it may influence my DDS worker. Although she is constrained by rules, policies and regulations, she is also a human being. I was a former government worker for 25 years. One of my jobs was being a Medi-cal worker. A young lady called me and she had a pending medical bill for like $100,000.00! She tugged at my heart strings, and i approved her so she could get those bills paid off. To this day, i am still not quite sure if I should have, but i did it anyway.

Good luck!

[RichBap]

I was denied social security

[grove800]

Were you denied at a hearing or is this just the beginning?

[blgreens]

RichBap:

Thanks for that tid bit. In speaking with my DDS worker, I mentioned to her that I receive a disability pension from the State. She had me fax her a copy of the medical report/disability form to her. I figured I should mention it because it is pertinent to my case, and at the least might plant an idea in her head.

I was retired from the state, as well, back in September of 2015. Their doctor said that the onset (when it became more than I could stand) was April of 2015. The problem with mine is..He stated that it should only last for 6 months to a year. Seems he was wrong since it is coming up on two years.
Problems in his report: He mentioned my fusion but, said it was probably stable (This was prior to the MRI showing it had failed). Also, he said that my cervical collar was probably home made...? Has this guy never seen a C-Collar in all his years in practice? I have to buy a new one every 6-8 months because they wear out quickly.
My job told me that if I was ever able to be/get fixed, I can come back without loosing my years of service. I put in almost 18 years and need/want to put in the 2 something to have a nice retirement. What they pay for disability retirement is nothing and I don't want to live like this in my retirement years 
I am debating on weather I should turn it in or not.

[RichBap]

I was denied on my initial

[Lit Love]

RichBap:

Thanks for that tid bit. In speaking with my DDS worker, I mentioned to her that I receive a disability pension from the State. She had me fax her a copy of the medical report/disability form to her. I figured I should mention it because it is pertinent to my case, and at the least might plant an idea in her head.

I was retired from the state, as well, back in September of 2015. Their doctor said that the onset (when it became more than I could stand) was April of 2015. The problem with mine is..He stated that it should only last for 6 months to a year. Seems he was wrong since it is coming up on two years.
Problems in his report: He mentioned my fusion but, said it was probably stable (This was prior to the MRI showing it had failed). Also, he said that my cervical collar was probably home made...? Has this guy never seen a C-Collar in all his years in practice? I have to buy a new one every 6-8 months because they wear out quickly.
My job told me that if I was ever able to be/get fixed, I can come back without loosing my years of service. I put in almost 18 years and need/want to put in the 2 something to have a nice retirement. What they pay for disability retirement is nothing and I don't want to live like this in my retirement years 
I am debating on weather I should turn it in or not.

You can't pick and choose which medical documents you submit.  They all must be submitted or you need to at least notify SS that you saw him and they can request it.

[blgreens]

Lit Love,
I reported my retirement and the doctor who saw me. I did not leave any of them out. Even listed one of my doctors that just passed away in June.  I did not have a copy of the report at the time. I have been requesting my medical records from ALL the doctors and hospitals in case I need to get a lawyer. I just got the report on Thursday and did not know he thought my collar was home made...lol.

I requested a copy of my CD over a month ago and want to compare what I obtained to what SS obtained.

[Helper]

Lit Love,
I reported my retirement and the doctor who saw me. I did not leave any of them out. Even listed one of my doctors that just passed away in June.  I did not have a copy of the report at the time. I have been requesting my medical records from ALL the doctors and hospitals in case I need to get a lawyer. I just got the report on Thursday and did not know he thought my collar was home made...lol.

I requested a copy of my CD over a month ago and want to compare what I obtained to what SS obtained.

You can also contact the doctor & ask him to make corrections to the report.  He may not want to change anything re: prognosis since that is a guess based on your status when you saw him & further info changed it in the future.  But stuff like the homemade  c-collar can be corrected.  I have had reports corrected when they go on about the problem with my right knee (when they operated on the left knee - the good thing was they were supposed to be operating on the left side.)

[blgreens]

Reading his report, he touches on some psychological issues. I am not claiming anything on psych...purely physical but, will talk with my pcp about this report.
He does explain why I was unable to continue working so, that might be helpful. He also states" the member is substantially incapacitated. The disability began April 2015".  They started the process in March because, in February, my doctor limited my time at work to no more than 4 hrs a day. They were ok with me having all the restrictions when I was reduced to 6 hrs a day.
I am getting copies of all the work restrictions I was given over time and including this.

Thank you all for the helpful information on this site. I realized, after applying, that I had not been thorough enough. This is probably why I was medically denied. However, for the reconsideration, I am sending in everything I can get my hands on. Never know what SS actually requested or received since I still don't have a copy of my file.