After my initial rejected application filed back in September 2018, my "reconsideration" application was also recently rejected. My next option is to request an appeal with an administrative law judge, which could take up to 18 months!
Am in process of pursuing legal advice. Not sure if it is worth it as I am 64 and just 2 years away from eligibility for full retirement benefits. I had believed that stage 4 metastatic PC was an automatic approval. Apparently not.
If you have metastasis to the bone, then yes your case should be expedited under the agencies compassionate allowance program.
Here's the excerpt:
Refractory Disease occurs when the cancer is recurrent (comes back despite hormonal intervention) or the cancer has spread to the bone or visceral organs (visceral metastases) such as the liver and lung.
Also here's the reference to it in their POMS manual: DI 23022.282
I'd make sure that your records clearly state that it shows it has spread to the bone. Then see if you can get the claims examiner at your state disability determination office on the phone and talk to them. If it truly falls under the CAL program (and that's for them to decide) it makes no sense for it to appeal thru the adjudicative level.
Sounds like good advice. Even though my reconsideration was denied, it could possibly be overturned without going thru the ALJ appeal process? Should I get a lawyer to help?
If you’re in the Washington, DC area, I can share a lawyer’s name.
Thanks for your response; live in NJ.
Hi Yost, I am in the same boat and could use a good lawyer referral if you can provide one. I am in Maryland DC suburb.
Thank you,
Jim
Sheri Abrams in Oakton, VA. Not sure whether she covers Maryland, but she can refer if not. sheriabrams.com/
Thanks! I will contact her.
This is really troubling to me. I was accepted as a 54 year old, Gleason 9. The cancer was wrapped around my seminal vesicles but none was found outside of the pelvis and it has not metastasized. When I applied, the standard seemed to be "Cancer outside of the prostate--accepted". I'm afraid that this standard may be tightening under the current administration.
So much of working with Social Security feels variable. It often appears to come down to whether or not the person looking at your claim is on the ball or not.
Yes, reapply. Make sure you tell them in the clearest terms possible the the cancer has grown outside of the prostate, has metastasized. I am now appealing my case because they arbitrarily decided I was diagnosed a year after I actually was, so we are in an admin appeal as well.
Stick with it! Often I've heard it takes several tries. I wish it were simpler.
Good luck
Erik
I retired and filed at 64 and Medicare starts next January. When I reviewed the numbers with my lawyer he suggested not filing for SSDI since it’s not a guarantee.
You paid into it your entire life, this is what "compassionate conservatism" looks like. You're going to need to get an attorney and make sure to have a doctor sign off that you are disabled and unable to work.
That the medications are making you fatigued or the cancer is causing you some type of pain in which you are unable to work. But this is what they do - i'm a social worker - i know. You either need to have a mental deficit, which is really hard to disprove, or you need to be extremely physically disabled in some areas.
What state do you live in?
New Jersey
"Compassionate conservatism"? I believe the problem is that SSDI has been used for many many years as substitute welfare when the old welfare became difficult to get and came with work requirements. Hundreds of thousands , if not millions of people that wer not actually disabled jumped on the SSDI tit, and now the system is running out of money, even for those of us with advanced cancer
Oh, is this the same as those who find obtaining a disabled placard as just another American fringe benefit? Sorry, lost my head again!
For those who are qualified, an attorney specializing in SSDI should be retained. There is no fee to client unless accepted and this is limited by law,,,comes out of your initial benefits. Be cautious and research well your Attorney candidates, as with your Physicians there are bench warmers and there are starters.
I was accepted at Stage 3. No metastasis found. This was 3 years ago age 62. The wording and requirements have changed I'm sure . What I just read I wouldn't be accepted now. Im going to look for my application to see what it was? Hopefully I have it. Turn 65 in 2+ weeks (April ). After all SSDI wait and acceptance periods just got Medicare started last December. That helps.
After thinking about it further, your best bet is going to come at this from both a physical and mental angle. Go to a psychologist or therapist that could diagnose and explain to them you have both depression and anxiety due to your cancer. Don't come out and say "i have depression and anxiety" but look ups the DSM-5 diagnostic criteria and compare it to what you are experiencing. You can talk about how your depression does not want to make you move and how your heart starts to race when you start doing tasks. Loss of apatite etc. How your mind is always on the cancer.
I just looked at the page and it became effective 12/2018. Nothing like when I applied . This was no where in my page then with this statement "progressive or recurrent despite initial hormonal therapy". Hormonal therapy I didn't start until my lung mets were found last October. Two plus years after removal and radiation . My page stated if you had two recurrent failures in attempt to stop PSA (me removal and radiation) then it was considered for compassionate allowance. They made it a whole lot harder.
They sure did make it harder.
Since switching my therapy my PSA has recently dropped.
That’s good.
Those bastards.
Wow. To say the least you have had one heck of a challenging ride.
I live in NJ.
We all have.. You have rights.. these current politics are going against helping those in need.
I'm just explaining to you why the SSDI system is out of money, they are known facts.. I guess that's what the left calls propaganda
Barron, It is clear that you are passionate about your politics. However, please understand many on this site are equally passionate about their politics. This is a forum for us to help each other thru a difficult disease and it does an incredible job at that. This is not supposed to be a forum for political commentary. We’ve all done a pretty good job of avoiding the polarizing rhetoric that seems to be common place now in this country. Please help us to not allow this wonderful forum to turn into political battles that can not won or lost here. Thank you in advance for your consideration.
Schwah
BRAVO! Well Said!
Good Luck, Good Health and Good Humor.
j-o-h-n Monday 04/01/2019 5:58 PM DST
I've got bone Mets but I was turned down because I make too much moneyI guess you can't make more than $1,200 a month to even apply
You are talking about ssdi not regular social security disability, right?
It's the same thing.
Yes it it political. Yes the past two Republican presidents made it clear to SSA that they had to reduce the numbers of approvals. That is on the public record. That said, if your doctor's notes do not _specifically_ say how your cancer affects your capacity to work and attend to other "ADL", your doctor is not giving the buzzwords and information needed by either the adjudicator or the counselor to allow approval. The legal language is very specific and it is the rare physician who has ever read the Guidelines. I would bet a steak dinner that your oncology notes scarcely mention fatigue, weight loss, sleep loss, poor balance, mental fog, sedation from medication, muscle wasting, depression affecting alertness to task. I write these reports so I had to make myself aware. Get an attorney who _specializes_ in disability law, not just as a sideline mentioned on a billboard.
When wife went on SSDI got lawyer (recommended by insurance co. paying out on disability from work insurance) because she insisted over my objections that "I can do this." Wife was absolutely right. Took a while. Lawyer was paid out of back payments due and they were limited by law as to percentage they could collect. It was very reasonable. We were very happy at the outcome. And yes lawyer firm only doing disability law. You give excellent advice.
GM Hoping
When my husband was DX in 2011 we went down to the SSI office to ask questions.
He was already Metastatic.
We were told to apply for permanent disability however because of my husbands age (53) wouldn't get medicare for 2 years., meaning we would have to pay for cobra which is cost prohibitive with hardly no income except SSI.
We decided for my husband to stay employed because of the medical benefits and it keeps his mind off this dreaded disease.
He now is 61 so has 4 more years until medicare can kick in, unless he just can't work any longer, then we would cross that bridge.
There is so much to consider when DX. and it's so unfair but we have been advised that one needs an Lawyer when trying to get Perm Dis. as we live in Ca.
The laws may be different in each State.
Good luck with your decision.
BOOGEE
The laws are defined by the Federal government. There may be differences locally on how they are administered, but I see the real problem as being the information that physicians apply in the application process. If they do not use the write language and buzz words, they do not make it easy to get approved.
If you've been turned down twice and you reach 65 and on medicare it's ballgame for SSDI correct? I was diagnosed when I was 59. I'm M1 bone mets, distant matastasis.
Not necessarily the ball game. Have you found an attorney who specializes in disability insurance? We have a firm here in Providence who do not much else and they seem to have a strong track record, even if people have been turned down several time. This is in part political. George W Bush on coming into office told SSA not to approve cases except in the most dire circumstances. That culture persists in the current administration. "Make it as hard as you can."
Yes I am using a SSDI law firm that I found on atticus.com.
This is all really interesting to me. I am 60 and will turn 61 in June. I've just talked the Oncologist and will have a break from all but Leupron for (cross my fingers) the next 10 months. No Xtandi basically. The reason I'm taking the break is because I found the Xtandi to be unbelievably tough to take. The pain in my joints was debilitating, and sleep was limited to 5 hours or less per night, along with dizziness. Along with a general mental fog.
I will face this at some point in the future, and I thank you all for the updates! Keep fighting this BEAST!
Bees
Hello, I saw your issue with ss a few days ago and posted that you maybe you should contact a member Litlerny who was with ss for 30 years and whose wife is a consultant for ss users. Try him if you wish.
Good Luck, Good Health and Good Humor.
j-o-h-n Monday 04/01/2019 6:02 PM DST
You applied and were rejected twice. What did your treating medical oncologist’s accompanying letter say? I asked this question, based on my personal experience ten years ago. My MO told me that he would be hard pressed to write a letter given my response to treatment - age 61, metastatic - besides he continued, an accompanying letter if accepted would mean that you are on your last legs. You really do not want me to write “that letter”.
Gourd Dancer
One of the factors considered by the judge is the effects of medications and treatments on the patient. My experience with MOs both personally and as reflected in this forum is that they downplay the ill effects of their treatment. Probably unconsciously, possibly deliberately. If that bias is reflected in the MO letter, they will leave out the critical information about weakness, muscle loss, bone loss, mental fog, memory loss, increased body fat, fatigue, bone pain, etc. that the judge needs in order assess work capacity. "Doing so well"? What does that mean?
Your MO clearly does not understand the SSDI law.
Just not my experience. I wish you the best.
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