Just one week after my last update on my disability application status, I received a denial notice by both email and USPS. The email (and my web portal page) contained zero details, but the printed copy gave the exact reason why. It also summarized which professionals submitted information, which did not, and which told the SSA that they had no records for me.
Lessons Learned
It turns out, when a doctor gets a request from the SSA to submit their files on you, they don’t have to comply.
They aren’t held accountable for lying (Virginia Mason, in Seattle, performed a major diagnostic test and two surgeries on me in 2020, yet said they didn’t have any records on me).
And they don’t have to submit more than their notes from your last visit.
Yes, you read that right- if your doctor wrote “patient appears functional; advised to continue medication” in their notes, the SSA takes them at their word and believes there’s nothing wrong with you.
I also learned that the SSA believes you’re functional if you can earn $1,500 or more each month (at least as a single person with no dependents). Yet Medicaid (and SNAP) requires you to work 20+ hours/week. So if you live in a high-expense area and have a 10 hour/week job that grosses $1,501/month, you’re not disabled and also don’t qualify for Medicaid and also don’t qualify for private medical insurance through your employer.
I’m honestly not sure what the criteria is for deciding someone is functional, when you put a dollar amount on it like that. Even though my earnings clearly show I do not make that much, the SSA decided there’s no reason I shouldn’t make that much, therefore I’m not disabled.
I also learned the actual reason behind it, because of course it’s not about truth, fairness, or compassion…it’s about money.
I’m only 42, which means that if I were awarded disability, I’d be paid for 23 years before my Social Security kicked in. That’s a lot of $$ (that they assume I’ll survive that long is laughable, too) so they’d rather not. This is likely also one reason they drag the process out over about 3 years.
Next Steps
On some advice from folks who were awarded SSDI, I hired a lawyer to help me file an appeal. With the SSA not doing due diligence in tracking down complete and accurate medical info, and me being barred from submitting my medical records, the lawyer’s team will take point in getting those files. Per the usual, if I’m awarded SSDI he’ll take 25% of the backpay (up to $7K).
We have 60 days to submit that appeal, and then it’ll be another 7-9 months for them to have a new group of doctors gather and review my files.
I’ve also made it a point to ask all of my current physicians to ensure visit notes are accurate about my medical limitations that keep me from working more hours. Luckily, several of them have worked with patients who filed disability, and seem confident in helping me. My hope is to narrow the number of physicians to get my medical files from, this time around.
Before, I was focused on them getting the files with my diagnoses and all the therapies I’ve tried that didn’t help. For the appeal, I’m going to focus on just the last 3 years of constant decline.
And I’m looking into putting my money into a medical trust, because having any sort of savings counts against you. Which is ironic, because every financial advisor will tell you to keep 3+ months of living expenses in the bank at all times. It’s not enough to be disabled beyond any hope of a career, you have to be disabled AND flat broke so you can never have financial peace of mind.
Oh yeah- I lost Medicaid and SNAP last month, too, so the biggest lesson is: Don’t be poor and sick in America, especially if America is the reason you got sick in the first place.
Needless to say, this year has been very challenging so far. My mental health is not doing well at all, but I have several doctors in my corner and my lawyer seems good. Wish me luck!
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