Our previous page on Supplemental Security Income gave an overview and description of SSI. This page will help in the application process. Our next page will be on How to Appeal a Denial of Supplemental Security Income.
Since lymphedema is not listed in the Social Security Bluebook of recognized disabilities, we may need to take some special actions and build our case on the disabling factors of our condition.
I also want to mention an important point when apply for SSDI. While you should never exaggerate your disability, neither should you under rate it either. So many of us with LE have had to fend for ourselves for so long that we take great pride on our independence. For example, if asked, “Can you maintain your home?” Think carefully about the answer. In my case, in self-pride, I would want to say, “Well, yes. If may take me hours to vacuum one room but eventually I get the job done.”
That is not taking care of your home. Stopping several times to rest and breath hardly rates as maintaining anything. Think carefully whether or not you are answering from reality or what you would want to be reality.
With lymphedema document all accompanying medical conditions and focus on loss of the ability to do normal activities (limitations), loss of range of motion, the pain.
June 20, 2008
There are two types of lymphedema, secondary lymphedema and primary lymphedema. Primary lymphedema is a congenital disease, while secondary lymphedema usually is the result of an injury to the lymphatic system. Both types of lymphedema are characterized by excessive lymph fluid collection in the soft tissues of the body (usually arms and legs). This fluid retention generally results in severe swelling. Treatment options for lymphedema usually involve some type of manual drainage, massage of the affected areas, and compression dressings. There is no cure for lymphedema, and if left untreated lymphedema may result in severe infections, ulcers, cellulitis, or lymphangiosarcoma.
Can you win social security disability or SSI disability benefits on the basis of lymphedema?
Answer: The Social Security Administration's disability evaluation system does not focus on a claimant's diagnosis, but, rather, on the functional limitations a claimant has. In other words, the name of the condition is not the chief consideration. How the condition “affects and limits” the individual is the primary concern. So, yes, disability benefits can be won on the basis of nearly any condition provided that the condition is sufficiently limiting.
When applying for disability is Lymphedema the primary reason for claiming or the damage it does?
Disability determination is addressed in SSA Publication No. 64-039 “Disability Evaluation Under Social Security” (also known as the 'Blue Book')
Lymphedema is not recognized in the Blue Book as a malfunctioning of the lymphatic system that will result in an automatic determination of disability. I would suggest therefore that time be spent in seeking disability due to “disorders of the musculoskeletal system”. See Part A Section 1.00 of the Blue Book. Loss of function from any cause is discussed in this section, and it is my opinion that your lawyer should read this section and discuss an approach with you based on your situation.
It will be a difficult fight to establish disability for lymphedema, but I believe it meets all the requirements.
Bob Weiss LymphActivist Not a lawyer or licensed to give legal advice. These are my observations and
SSI and SSDI have the same disability requirement, but are different in other respects. Your clients who are homeless may be eligible for one or both programs if they have a physical or mental problem that keeps them from working and is expected to last at least one year or result in death, and if they are blind, or at least 65 years old. To qualify for SSDI, your client also must have worked and paid Social Security taxes. The SSI program has no specific work requirements, but your clients must meet the income and resource limits to qualify for SSI payments.
1.) Apply as soon as you and your doctor consider you disabled.
2.) Keep a diary.
3.) Don't understate your condition, but don't exaggerate either.
4.) Fill out in detail every question on the forms . Add extra pages if you need more space to be complete.
5.) Be descriptive about your condition and how it affects your life . . . give specific examples.
6.) Keep a record of all medication changes, any reactions you may have, how often you take the medications, etc.
7.) Follow medical advice.
8.) Keep a record of how much time you spend traveling to and from the doctor or clinic, how many days a month you do this and how long you wait in the office to be seen.
9.) When something is wrong, don't delay in seeking the doctor's advice, or speaking to the nurse; this way it will be entered into your medical record.
10.)Make sure that all medical evidence about your condition is on file.
11.)Remember the Primary Treating Physician's opinion carries the most weight! The Social Security examiners have never seen you.
12.)Have your doctor do a complete examination and write a letter explaining your condition in detail.
13.)If you're turned down on the initial application, you are entitled to go into the SS office and copy both the medical and non-medical file, but there probably will be a copying charge.
14.)If you are turned down, do not become discouraged, You will probably do better if you appeal and have the appeal handled by a lawyer specializing in appealing such cases. the fees of such lawyers are determined by the Social Security Administration, and are moderate.
Tip 1: Take everything you are told about your Social Security Disability claim with at least one grain of salt.
Tip 2: Get copies of your medical records and supply these with your SSD or SSI disability application.
Tip 3: Respond to letters and notices regarding you disability case promptly–from social security, DDS, or your attorney.
Tip 4: The rule of three always applies–for those who are applying for benefits or appealing a denial.
Tip 5: If you are denied for Social Security Disability or SSI, you will need to file an appeal.
Tip 6: Call DDS for updates on your SSD or SSI claim, not the local Social Security office.
Tip 7:Representation will increase your chance of winning Social Security Disability or SSI benefits.
Tip 8: If you have dire financial problems and have a Disability case, let people know.
Tip 9: If you have representation on a Social Security Disability or SSI disability case, keep your attorney or non attorney representative fully informed.
Tip 10: If you have child support obligations which you cannot fulfill, ask your attorney or representative to help.
Tip 11: Contact your congressman or senator to help you with your Social Security Disability or SSI claim.
Tip 12: If you have been approved for Social Security Disability or SSI, you will receive…
Tip 13: Get your doctor to write a supporting statement for your Social Security Disability or ssi case.
Tip 14: Make sure your doctor REALLY DOES support your SSD or SSI disability case.
SSI requires that you have both limited “resources” and limited “income.” The SSI financial eligibility rules are very complicated. An SSI financial eligibility worker will help you find out if you are eligible.
SSI requires that you have below $2,000 in countable resources, and as a couple, below $3,000. Resources are things you may own, including cash, stocks, bonds and so forth. However, not all assets are countable. Your home does not count, no matter what its value. Personal belongings, household goods, insurance policies and cars may not count either, depending on their value and what they are used for. No matter how disabled you may be, if the resource limit is exceeded, then resources must be used or disposed of in a manner acceptable to SSI before you can receive SSI.
The SSI “income” rules have categories of income such as earned, unearned and in-kind. In-kind income is the value of food, clothing or shelter. If you are given these things without having to repay anyone, then SSI will reduce your SSI monthly check by one-third. If you received a loan, instead of a gift, for food, clothing or shelter, then there is no one-third reduction in your check. Earned income, usually wages, is treated more favorably, reducing the SSI monthly check one dollar for every two dollars of earned income after the first $65 in earnings. Income such as VA benefits, Social Security Disability Insurance payments, rental income, and pension benefits reduce SSI one dollar for every dollar of unearned income received.
People who get SSI benefits must immediately report changes in income, resources, living arrangements, and health. If changes are not reported to Social Security, or, sometimes even if they are, Social Security may issue more in SSI benefits than it should, causing an overpayment that the recipient might have to pay back. Changes should be promptly reported in provable ways. For example, if you return to work and call Social Security to report your earnings, you will not be able to prove the telephone call was made. However, if you take your payroll check stub to the local office, and social security date-stamps a photocopy for you, then the photocopy is your proof that the income was reported.
Social Security is responsible for assuring that persons stop receiving SSI if they stop being disabled or financially eligible. You may receive questionnaires requesting medical records, or be required to see a doctor or psychologist for an examination from time to time.
It is sometimes possible for people receiving SSI to become partially employed without losing their right to SSI. A program representative can explain the rules, which are different for those who get SSI based on their age than for those who get SSI because of a disability.
To apply for disability benefits for an adult, you will need to complete an application for Social Security Benefits AND an Adult Disability Report. The report collects information about your disabling condition and how it affects your ability to work. You can complete the forms online, or you may call us to schedule an appointment and we will help you in person or by phone.
How to apply
Please follow these steps:
Step 1. Review the Adult Disability Starter Kit. This kit answers common questions about applying for benefits and includes a worksheet that will help you gather the information you need.
Step 2. Fill out the online application for Social Security Benefits. (If you've never worked, skip this step and contact us after you complete Step 3.)
Step 3. Fill out the online Adult Disability Report. At the end of the report, we will ask you to sign a form that gives your doctor permission to send us information about your disability. We need this information so we can make a decision on your claim.
NOTE: If you previously started an online application or online disability report but did not finish it, you can:
Contacting Social Security
If you don’t want to do this online or need help, call us toll-free at 1-800-772-1213. If you are deaf or hard-of-hearing, call our toll-free TTY number, 1-800-325-0778. Representatives are available Monday through Friday between 7 a.m. and 7 p.m.
You can apply for SSI benefits by:
Calling us at 1-800-772-1213 (or TTY 1-800-325-0778 if you are deaf or hard of hearing) and making an appointment to apply for SSI benefits. With an appointment, one of our representatives will help you apply for benefits. You can have an appointment to apply for benefits on the telephone or in person at your local Social Security office.
Having someone else call and make the appointment for you or assist you with your application for SSI benefits. For more information, see our chapter on HOW SOMEONE CAN HELP YOU WITH YOUR SSI.
Visiting our office to apply without making an appointment, but you may have to wait awhile.
You will have to provide information and work with us to get documents concerning SSI eligibility.
You will have to file an application.
Most of the forms to apply for SSI benefits are not designed for self–completion. Our claims representative interviews you and uses a personal computer to complete the forms with information you give to us or someone else gives to us on your behalf.
Apply as soon as possible so that you do not lose benefits. We cannot pay benefits for time periods earlier than your application effective date.
If you call us to make an appointment to apply and you file an application within 60 days of the call, we may use the date of your call as your application filing date.
If you do not keep this appointment and you do not contact us to reschedule the appointment, we will try to contact you. If we do not get in touch with you to reschedule the appointment, we will send you a letter. The letter will say that if you file an application within 60 days from the date of the letter, we will use the date of your original contact with us as your SSI application date.
If you are in a public institution, but you will be leaving within a few months, you may not be eligible for SSI benefits until you leave. You may, however, be able to apply before you leave so that SSI benefits can begin quickly after you leave. Check with the institution and us about filing an application under the “prerelease procedures.”
We will complete the application forms for you based on information you give to us.
We will help you get documents you need to show that you meet the SSI eligibility requirements.
If you are applying because of disability or blindness and we decide that the medical information needed to make a decision is not available from existing sources, we will pay for you to have a doctor’s exam or test and make the appointment for you. If you need a medical exam or test, you must go to the exam or test in order to receive SSI benefits. We may also pay your travel costs to get to this exam or test.
For information on when we pay for travel to medical exams, see our SSI Spotlight on Payment for Travel to Medical Exams or Tests.
You may appoint someone to help you with your SSI claim and go with you to your appointment(s) with us.
See our chapter on HOW SOMEONE CAN HELP YOU WITH YOUR SSI for further information.
We will notify you in writing of any determination about your eligibility or any change in your benefit amount. We will also send copies of all notices to your representative if you have one. Each notice affecting your eligibility or change in SSI benefit amount will explain your appeal rights.
You or your representative may examine and get a copy of the information in your case file, upon request, with the exception of files containing confidential or medical information that may not be disclosed. You or your representative also may review and copy the laws, regulations and policy statements used in deciding your case.
You may appeal most determinations we make about your eligibility for SSI benefits, or changes we make in your benefit amount.
Our administrative appeals process has three levels.
See our chapter on the APPEALS PROCESS for further information.
You may not need all of the following documents. Sometimes one document can substitute for another. The lists are not all–inclusive. We will tell you what you need and what other documents are acceptable. We will help you get them if you are having trouble.
Social Security Card or Number
Proof of Age
Note: If you already proved your age when you applied for Social Security benefits, you do not need to prove it again for SSI.
Citizenship or alien status record
If you are a citizen, examples of documents you may need are:
If you are an alien, examples of documents you may need are:
If you are an alien who has served in the U.S. Armed Forces, you may need to show us your military discharge paper (form DD–214).
Proof of Income
If you have income, you may need to provide the following:
Proof of Resources
Proof of Living Arrangements
If you are applying as a blind or disabled person, you need to give us:
your medical reports, if you have them; and
names, addresses, and telephone numbers of doctors and other providers of medical services to you and the approximate dates you were treated.
If you are applying as a disabled child (or on behalf of a disabled child), we need the names, addresses, and telephone numbers of people (teachers, caregivers) who can provide information about how your (the disabled child's) medical condition affects his or her day–to–day activities.
Things to Remember
Do not wait to apply. If you think you may be eligible for SSI benefits, you should contact us right away. The earliest we will pay benefits is the month after the filing date of your application, or the month after you first meet all the eligibility requirements, whichever is later. We may use the date you contact us as the filing date. If you do not have all of the things we need, you can get them later.
We need to see the original documents. We do not accept photocopies. We will return the original documents to you.
Try to keep a copy of things you send us. Keep track of the dates you send information to us, or talk to us, as well as the name of the Social Security employee with whom you spoke.
Join us as we work for lymphedema patients everywhere:
Advocates for Lymphedema
Dedicated to be an advocacy group for lymphedema patients. Working towards education, legal reform, changing insurance practices, promoting research, reaching for a cure.
Lymphedema People / Advocates for Lymphedema
Children with Lymphedema
The time has come for families, parents, caregivers to have a support group of their own. Support group for parents, families and caregivers of chilren with lymphedema. Sharing information on coping, diagnosis, treatment and prognosis. Sponsored by Lymphedema People.
Lipedema Lipodema Lipoedema
No matter how you spell it, this is another very little understood and totally frustrating conditions out there. This will be a support group for those suffering with lipedema/lipodema. A place for information, sharing experiences, exploring treatment options and coping.
Come join, be a part of the family!
MEN WITH LYMPHEDEMA
If you are a man with lymphedema; a man with a loved one with lymphedema who you are trying to help and understand come join us and discover what it is to be the master instead of the sufferer of lymphedema.
All About Lymphangiectasia
Support group for parents, patients, children who suffer from all forms of lymphangiectasia. This condition is caused by dilation of the lymphatics. It can affect the intestinal tract, lungs and other critical body areas.
Lymphatic Disorders Support Group @ Yahoo Groups
While we have a number of support groups for lymphedema… there is nothing out there for other lymphatic disorders. Because we have one of the most comprehensive information sites on all lymphatic disorders, I thought perhaps, it is time that one be offered.
Information and support for rare and unusual disorders affecting the lymph system. Includes lymphangiomas, lymphatic malformations, telangiectasia, hennekam's syndrome, distichiasis, Figueroa syndrome, ptosis syndrome, plus many more. Extensive database of information available through sister site Lymphedema People.
Teens with Lymphedema
All About Lymphoedema - Australia
Updated Dec. 22, 2011