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Topic: Social Security Questions and Answers

Forum: Employment, Insurance, and Other Financial Issues —

Employment, insurance, and financial concerns are common. Meet others here to discuss and for support.

Posted on: Jun 20, 2011 03:52PM, edited Jun 20, 2011 03:56PM by NMM

NMM wrote:

Dear All,

My wife asked me to wrote this post as she thought I might be useful.

Background on my wife. 36, wife, mother of a 4 yo boy and turning 2 in August girl, and as of June 3 stage IV bc with mets to the liver.  Yeah I know, sucks.

As for me, bad news I am an attorney. Good news, I am an attorney who devotes 100% of his practice to representing individuals who have been denied disability by the SSA.

So I may be able to help address some concerns and quesitons about this topic.

First off, this is not an advertisement. Just trying to be helpful.

Second, I will try to answer any questions in a general manner. My answers are not meant to be legal advice and should not be taken that way. So when I read a post with a specific question or problem I will try and answer it in a broad general way.

Third, again this is not a troll for clients. While we are in California SS is a federal program so the laws and rules are the same across the country. So I think I can be helpful.

Fourth, again my answers should not be construed as legal advice.  While I have experience in this area of law any response I make may or may not be correct and you should not rely on it.  there is no substitute for your own due diligence.

Fifth, I would liek to keep this topic focused on dealing with what is, not what it should be.  Basically, SSA is the largest administrative system in the world.  Getting frustrated that it is not set up they way it should be does not help focus on the way it is and how to navigate to improve your chances of getting approved.

So here are some inital thoughts:

1. If you have/get an attorney, under federal law they cannot charge you any money up front for the attorney service. Period. It is actually a federal crime for an attorney to receive payment for attorney services from a SS client from anything except their back benefit.

The law says that any attorney fee cannot exceed 25% of the back benefit. If you have an attorney and they help when the case at or before a first hearing with an Administrative Law Judge (ALJ) the fee is 25% or $6,000 whichever is smaller.

So if an attorney tells you that it is 25% if you win or some less amount of money if you lose that is not correct. If you don't win your case or even if you win but get no back money, your attorney gets zero.

Now the one thing is that your attorney can charge you, win or lose, any costs that he pays to get medical records to help prove your case. So if your attorney gathers medical records from your doctors who charge him $25, $50, etc.. And you lose your case, an attorney can send you a for that cost. Because it is not an attorney fee but a cost.

2. Some of you may have what is called an overpayment issue. Where SSA pays you some money and then at some point says they paid you too much and they want their money back. If that happens to you, or if it happened to me, I would call/visit SSA and request forms/file a waiver of overpayment form. It is pretty simple and SSA should help you. It is not hard to do and it may reduce or eliminate what SSA says you owe.

Anyway, feel free post some general questions and I will try and address them.

Take care

Steven

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Jul 11, 2011 10:58PM bak94 wrote:

Steven,

Thinking of you and your wife. I hope her second treatment went smoothly. You are so kind to provide information under your circumstances, as I am sure you are very busy.

A big thank you!

Not really sure what stage I am-Some docs say 3C, others say stage 4. I had no auxillary nodes positive but had internal mammary nodes positive and possibly mediastinal node positive. It's just a number anyways, right? Dx 4/5/2011, IDC, 2cm, Stage IIIc, Grade 3, 0/2 nodes, ER-/PR-, HER2- Dx 12/15/2002, IDC, 3cm, Stage IIb, Grade 3, 2/40 nodes, ER-/PR-, HER2- Surgery 11/30/2011 Mastectomy of one or both breasts: Mastectomy of my left breast, Mastectomy of my right breast Surgery 01/02/2003 Lumpectomy in one or both breasts: Lumpectomy in my right breast; Lymph node removal (also called dissection): Underarm (axillary) lymph node removal (also called dissection) , Lymph node removal (also called dissection) on my right side Hormonal Therapy 08/02/2012 Hormonal Therapy 04/10/2012 Aromasin (chemical name: exemestane, class: aromatase inhibitor) Targeted Therapy 05/14/2011 Avastin (chemical name: bevacizumab) Radiation Therapy 02/11/2012 Radiation Therapy 07/08/2003 Chemotherapy 02/05/2003 Adriamycin (chemical name: doxorubicin), Taxol (chemical name: paclitaxel) Chemotherapy 04/27/2011 AC: Adriamycin and Cytoxan Chemotherapy 07/29/2011 Abraxane (chemical name: albumin-bound or nab-paclitaxel)
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Jul 12, 2011 12:45AM Mazy1959 wrote:

Steve,

I dont know if you realize it but this thread you started is priceless. There are so many on this site who are so confused about SSI/SSDI. I thank you so much for helping the members of BCO. I dont know if this will help anyone but my oncologist told me that she fills out all SSDI paperwork herself to avoid errors which would delay approval. She said that silly little errors can cause months of waiting for approval and although she trusts her staff, she feels its best done by herself when she is not being interrupted etc. I had MRI, PET, Xrays,CT scans, biopsies and bloodwork as part of my proof of my condition. I received my award paperwork in less than 6 weeks.  Many ladies say that Stage 4 is automatic and you are always approved for it but according to our SSDI office that is not true. Thx Steve for being a light in the storm..Hugs, Mazy

Bone marrow mets in 90% of bone marrow. Dx 3/6/2003, ILC, 3cm, Stage IIb, Grade 2, 2/9 nodes, ER+/PR+, HER2- Dx 12/19/2006, ILC, 4cm, Stage IV, Grade 2, 0/0 nodes, mets, ER+/PR-, HER2- Dx 4/25/2012, ILC, Stage IV, Grade 2, 0/0 nodes, mets, ER+/PR+, HER2- Dx 8/4/2012, ILC, Stage IV, Grade 2, 0/0 nodes, mets, ER+/PR+, HER2- Chemotherapy 08/09/2012 Abraxane (chemical name: albumin-bound or nab-paclitaxel)
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Jul 12, 2011 12:56AM Mazy1959 wrote:

You, your wife and family are all in my prayers. Hugs, Mazy

Bone marrow mets in 90% of bone marrow. Dx 3/6/2003, ILC, 3cm, Stage IIb, Grade 2, 2/9 nodes, ER+/PR+, HER2- Dx 12/19/2006, ILC, 4cm, Stage IV, Grade 2, 0/0 nodes, mets, ER+/PR-, HER2- Dx 4/25/2012, ILC, Stage IV, Grade 2, 0/0 nodes, mets, ER+/PR+, HER2- Dx 8/4/2012, ILC, Stage IV, Grade 2, 0/0 nodes, mets, ER+/PR+, HER2- Chemotherapy 08/09/2012 Abraxane (chemical name: albumin-bound or nab-paclitaxel)
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Jul 13, 2011 02:43PM Chickadee wrote:

Steven, sending cyber <<<<<HUGS>>>>>>>>>> and good wishes.  Take care of yourself and your loved ones and thank you so much for this thread.

I'm in such bad shape, I'm wearing prescription underwear." Phyllis Diller 1917-2012 Dx 9/1/2009, IDC, 1cm, Stage IV, Grade 3, mets, ER+/PR+, HER2-
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Jul 13, 2011 04:18PM NMM wrote:

General Post:

As I have mentioned I have not had much experience helping people actually apply attorneys are not needed until a person gets denied at least once.

Well I have some experience now as I helped my wife apply. So i will share my experience, hopefully it will help others.

First, I need to give credit to Chickadee and the others who were on another thread about Stage IV and getting SSA. That thread and the questions on this thread got me doing some research at SS that helped me when we applied.


I have a bad habit of turning short stories into long ones...so here is a quick highlight. We applied on June 28, 2011.

On June 29, 2011 we received a phone call that asked if we could come in and drop off the Medical Authorization form so they could get moving on the application. I brought the med auth in with some medical records on June 30, 2011. She was approved on July 6.

Here are some things I think may have helped:

1. I filed online. SSA has spent a lot of time and money getting as automated and electronic as possible. By filing online I saved the time of waiting on the phone or going in person.

2. I made sure I was very detailed about what the alleged disability is. I figured that SSA probably has an automated way of catching key words.

On the app I put down

Breast/Liver Cancer Stage IV -IDC - Metastize To Liver

On the disability report I put down as her conditions:

1 Metastatic Breast Cancer Stage 4
2 Invasive ductal carcinoma with metastasis to the Liver

Again I knew what I was going for so I wanted it to jump out.

Likewise in the comments section I put down the following:

Please see POMS DI 23022.125 Breast Cancer. This claim should be coded and processed as a compassionate allowance.

If you go back and read what I posted about the internal guidance manuals. Instead of having the SSA employee have to look it up I figured I might as well tell them which manual section covered my wife's claim. Hoping to save time.

Again not sure if it helped but there are some 40 different medical conditions eligible for a compassionate allowance. Don't think it can hurt to alert the SSA person to that one that covers your situation.

3. When I took in the Med. Auth. form I also took in the relevant medical records.

If you read the POMS that govern BC they are looking for confirmation of stage IV. Biopsy, labs, scans, etc.

So I made sure that I had copies of her mamo, ducto, right breast biopsy, MRI, PET scan, and the liver biopsy.

You don't have to do this as SSA will get that after you sign med req auth form. But it takes a few days for SSA to send it out...then you are hoping that one or more doctors offices get on it (fast is 2 weeks avg is 30 days) and then the records are processed.

Dropping off the key records to SSA I think can save time.

4. Disability onset date. Ok here is where it gets tuff to talk about and you might want to get a tissue.

As our tagline and first post state my wife was diagnosed, via a right breast biopsy, with IDC on June 3, 2011.

Saw oncologist on June 7..General Surgeon on June 8 decide on double mast, June 9 MRI, June 10 met with plastic surgeon who let us know surgery scheduled for June 17.

On June 16, 2011 the day before her scheduled surgery we went in for a PET scan because onco saw some spots on the liver in MRI. Said 99% gonna be some kind of cyst. But got to make sure, have PET over by 10:30am...surgeon office calls at 11:30 says doc wants to see you at 1. yeah as Scooby would say...Rut-roh...anyway mets to the liver no surgery goes straight to chemo and stage IV.

Anyway, getting to picking an onset date, here is the kicker...in late September 2010 my wife feels a lump in the right breast...goes to see PCP who feels it and refers to local breast center.

Wife as ultrasound and mamo in mid to late October...mass is seen...scheduled for biopsy and ductogram in late October and early November.

Goes in for biopsy...MD sets up ultrasound and can't find mass...says "hey was nothing after all no need to do biopsy" send my wife home...she still has ductogram because she is expressing a dark fluid out of her nipples when squeezed hard by MD...nothing significant.

Told to come back in six months for follow up ultra sound.
She does in late May 2011...now mass is back and bigger. Has the June 2 biopsy. that results in June 3 being told hey you got IDC.

Doctor who said no need biopsy back in October calls my wife and says crying "I am so sorry...I should have done the biopsy in October...I screwed up.'

We try not to live in the past or play the blame game and I am not wanting to do that here ...we just said hey let's just stay focused on fighting this....gotta stay positive.

Anyway...we put down the onset as 11/1/10 because I felt that the ultrasound from 10/10 showed the presence of the tumor and that the biopsy in June confirmed it.

I probably could have pushed it to October 1 and explained about the lump but just went with 11/1.

Why the first day of the month? Remember there is a five month waiting period from approval to getting paid. So any date of disability other than first day of month 5 months don't start counting until next month. But if disability begins on the first day of the month then they count that month as the first month of the 5 months.

So whatever date your reports are go ahead and back dated it to the first of the month because it is medically reasonable that the cancer did not begin on the day that it was confirmed so picking as an example 4/1 when your biopsy or other confirming test is dated 4/25 should be ok.

And if you can document some treatment for a lump months before go for that to...example...you feel a lump in 2/11..go to doctor who can't feel it...you feel it again in 4/11...go back to dr. who feels it this time and refers you out for tests...you don't get the test until sometime in 5/11. I would put down as onset date 2/1/11 because the tests of 5/11 only confirmed what you tried to treat back in 2/11.

Anyway that is our story on how it all began and how it worked for us applying.

Steven

Dx 6/3/2011, IDC, 2cm, Stage IV, Grade 3, mets, ER+/PR+, HER2-
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Jul 13, 2011 04:22PM NMM wrote:

To all

Thaks for the well wishes.

I am thinking as this thread grows I should try and cull out the relevant info and put it at the top as an edited post.  Sorta of a mini faq so people dont have to read the whole thread looking for info.

 If anyone wants to read through and find the quesitons and answers (not just from me buit everyone) and handle the cut and paste part of it and send it to me that would be cool.  I hope to eventually do it but just don't have time right now.

Steven

Dx 6/3/2011, IDC, 2cm, Stage IV, Grade 3, mets, ER+/PR+, HER2-
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Jul 13, 2011 05:32PM bak94 wrote:

Thank you for the new info. I think what you just posted should be added to the top! I wish I had know when I applied about the date thing. I put April 5th, as that is the day I got the call "you have cancer" but my mammo and biopsy was march 31rst. I also thought I was stage 3C, and that is what I reported, but on a ct report it shows me as stage 4 because where on of my positive mammary nodes is, possibly not a mammary node but a mediastinal node. I think I am in denial and keep saying stage 3! I wish I also would have put the POMS also.

I get the not looking back. My mammo a year ago the radiologist said that there is nothing to worry about but also that he could't really see anything because of my dense breast, he suggested at some point I should have an mri, but it was not urgent. In my case it was not the doctors fault, but my fault. I should have immediately booked an mri because of my personal and family history of breast cancer. I waited a year for my next mammo, and the lump was almost missed, the radiologist said possibly some dcis, I needed a stereotactic biopsy, but then called me back because he looked at the films again and saw something even more suspicous and I needed to come in right away for an ultrasound guided biopsy of the area, instead of waiting for the stereotactic biopsy. Sorry this is long, but I really get the not looking in the past, just moving forward with the knowledge we have today is all we can do.

I can't say thank you enough, the information you provide is priceless.

Not really sure what stage I am-Some docs say 3C, others say stage 4. I had no auxillary nodes positive but had internal mammary nodes positive and possibly mediastinal node positive. It's just a number anyways, right? Dx 4/5/2011, IDC, 2cm, Stage IIIc, Grade 3, 0/2 nodes, ER-/PR-, HER2- Dx 12/15/2002, IDC, 3cm, Stage IIb, Grade 3, 2/40 nodes, ER-/PR-, HER2- Surgery 11/30/2011 Mastectomy of one or both breasts: Mastectomy of my left breast, Mastectomy of my right breast Surgery 01/02/2003 Lumpectomy in one or both breasts: Lumpectomy in my right breast; Lymph node removal (also called dissection): Underarm (axillary) lymph node removal (also called dissection) , Lymph node removal (also called dissection) on my right side Hormonal Therapy 08/02/2012 Hormonal Therapy 04/10/2012 Aromasin (chemical name: exemestane, class: aromatase inhibitor) Targeted Therapy 05/14/2011 Avastin (chemical name: bevacizumab) Radiation Therapy 02/11/2012 Radiation Therapy 07/08/2003 Chemotherapy 02/05/2003 Adriamycin (chemical name: doxorubicin), Taxol (chemical name: paclitaxel) Chemotherapy 04/27/2011 AC: Adriamycin and Cytoxan Chemotherapy 07/29/2011 Abraxane (chemical name: albumin-bound or nab-paclitaxel)
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Jul 13, 2011 06:30PM Chickadee wrote:

Steven, I'm a little confused on the date of disability issue.  The diagnosis date is necessary, I get that, but isn't the date of disability tied to the last day of work as well?  Unless at the time your wife was not working, then the diagnosis date would be key.  Maybe I just answered my own question.

I will say this, your SS office must have been very efficient.  With all the details I provided it still took a call to the disability determination office in Tx. to nudge the caseworker to get the file off his desk and on to the next step.  Took about 5 weeks for approval.

I'm in such bad shape, I'm wearing prescription underwear." Phyllis Diller 1917-2012 Dx 9/1/2009, IDC, 1cm, Stage IV, Grade 3, mets, ER+/PR+, HER2-
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Jul 14, 2011 10:10AM 3katz wrote:

May I add something about SSD? I don't believe you covered this one, Steven - you may have & I just don't remember. But it's about SS disability and Medicare:

http://ssa-custhelp.ssa.gov/app/answers/detail/a_id/155/session/L3RpbWUvMTMxMDY1MjI0MS9zaWQvTV9vbFVZeWs%3D

Receiving Medicare and disability benefits

Updated 06/10/2011 03:31 PM | ID# 155
Do I automatically receive Medicare benefits if I'm eligible for disability benefits?

You will receive Medicare after you receive disability benefits for 24 months. When you become eligible for disability benefits, we will automatically enroll you in Medicare. We start counting the 24 months from the month you were entitled to receive disability, not the month when you received your first check.

Residents of Puerto Rico or foreign countries will not receive Part B automatically. They must elect this benefit.

Special rules apply to:

End-stage renal disease (permanent kidney failure). People with permanent kidney failure get Medicare beginning:
•The third month after the month a regular course of renal dialysis begins; or
•The month of kidney transplantation.

Lou Gehrig's Disease (amyotrophic lateral sclerosis). People with amyotrophic lateral sclerosis get Medicare beginning with the month they become entitled to disability benefits.

Medicare has four parts:
•Hospital insurance (Part A) helps pay hospital bills and some follow-up care. The taxes you paid while you were working financed this coverage, so it's premium free.
•Medical insurance (Part B) helps pay doctors' bills and other services. There is a monthly premium you must pay for Medicare Part B and you have the option to refuse this coverage.
•Medicare Advantage (Part C) plans generally cover many of the same benefits a Medigap policy would cover, such as extra days in the hospital after you have used the number of days Medicare covers. People with Medicare Parts A and B can choose to receive all of their health care services through one of these provider organization under Part C. There might be additional premiums required for some plans; and
•Prescription drug coverage (Part D) helps pay for medications doctors prescribe for treatment. Anyone who has Medicare hospital insurance (Part A), medical insurance (Part B) or a Medicare Advantage plan (Part C) is eligible for prescription drug coverage (Part D). Joining a Medicare prescription drug plan is voluntary and you pay an additional monthly premium for the coverage.

Amy D - orig dx 2005, stage III / recur-mets Stage IV dx 2008, multiple bone lesions / er/pr+, her2neu+++ / Dx 5-2010 brain met
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Jul 14, 2011 12:40PM , edited Jul 14, 2011 06:45PM by Medigal

This Post was deleted by Medigal.
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Jul 14, 2011 01:24PM Chickadee wrote:

I just love it when SSA online implies one thing and SSA local rep tells you another.  Wish they'd get on the same page.  At least online you don't have to sit around for interminable amounts of time waiting for your number to be called.  I did it online(late at night and at my convenience) and though the approval was not any faster than normal, the process started immediately as I received an envelope with some medical release forms 2 days later.  Doing it online also allowed me to interrupt the process and gather documents/information that had I not brought it to the local window, they'd have told me to come back yet another day. 

When I did my son's online, it requested that I print out several copies of the medical release form and bring it to the office and sign it in the presence of the rep.  Well I did that and the rep didn't want them and handed me her form to sign and said they'd make copies.

Part of this process is the states disablity determination office......they are not SSA employees,  SSA will not do anything until the DD office makes the decision.  When you want to follow up on your approval, that is who you call, not the SSA office.  At 30 days out, I made the mistake of visiting the SSA office to ask about my status only to be told it would be 3-4 months because they were so backed up.  That turned out to be false once I found out about the DD office and called them.

Jumping through hoops. Such fun.

I'm in such bad shape, I'm wearing prescription underwear." Phyllis Diller 1917-2012 Dx 9/1/2009, IDC, 1cm, Stage IV, Grade 3, mets, ER+/PR+, HER2-
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Jul 14, 2011 04:44PM Fearless_One wrote:

NMM, did your wife work?   It is my understanding that even if my cancer were to go to stage IV, that I would have to have not worked for 6 months before I would be approved.   I could apply while still working, but I would not be approved.   I am a little confused on this issue and I think about it a lot because I have no resources if my cancer spreads and I am trying to educate myself on all this stuff.   Thank you so much for helping everyone....

lump/chemo/rads/hyster-ooph/mastectomy/implants
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Jul 14, 2011 06:29PM NMM wrote:

Fearless
Did my wife work? Yes. She worked enough in her life to earn sufficient quarters of coverage to qualify for a Title II DIB, I don't have time to get into what quarters of coverage are and how one earns them, and etc. right now but will someday.

Was she working when the breast cancer was discovered? No. She stopped working a little before our son was born in 2007.

There is no minimum waiting period to being approved once your disability begins. But your disability won't begin, usually, until you stop working. As I have said previously, no matter how serious a DX is, if one works earning what SSA calls SGA one is not disabled.

But if your last day working (assuming SGA) is June 23 because your condition gets worse than June 24 would be your disability onset date. And you could be approved as of that date, but would not get paid until five full months later in December.

You are correct in noting that while you could apply while working you would not be approved (assuming your work is SGA) while you worked because that is the first test/question asked by SSA, is the person working/earning SGA?

I understand it is a scary proposition about not having any resources if you stop working.
Best advice for anyone is, as Chick mentioned, it is never to late to save. Next, if you are working and stop working most states have a short term state disability insurance (usually up to a year).
So if one stops working they should file for state and SSA, as well as any LTD policy they may have. There was a post above where I talked about the various programs that exist.

Steven

Dx 6/3/2011, IDC, 2cm, Stage IV, Grade 3, mets, ER+/PR+, HER2-
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Jul 14, 2011 06:42PM Fearless_One wrote:

Thank you, Steven.   I guess this stuff can get pretty complicated.   But I know now not to bother applying for SSDI if I get mets, since I will still be having to work .   But I need to research the other things that you mentioned and other state programs that may be available to me, should the time come.   I have no LTD plan at my work, and of course, cannot get it now.

lump/chemo/rads/hyster-ooph/mastectomy/implants
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Jul 14, 2011 06:52PM Chickadee wrote:

Fearless One, I know that you know that if your BC metastasizes it may not be your choice to continue working depending on how it affects you.  You may be fine with few SE's from treatment or you may be debilitated.

At this point you are fortunate and do not have mets.  All you can do now, as you are doing, is look at every option available to you and prepare a "rainy day" plan should you ever have to join our club(that no one wants to join).  No matter how tight your finances, save something, anything. Perhaps do a financial diary and write down every dime you spend for a month and see where you discretionary funds are going and if those funds could be diverted to savings instead.  Sometimes that means giving up a small treat or luxury but most of us don't realize how much money is getting out of our hands until we have to put it in black and white.

I wish you continued mets free living and hope you never have to consider SSDI.

I'm in such bad shape, I'm wearing prescription underwear." Phyllis Diller 1917-2012 Dx 9/1/2009, IDC, 1cm, Stage IV, Grade 3, mets, ER+/PR+, HER2-
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Jul 14, 2011 07:09PM , edited Jul 14, 2011 07:11PM by Fearless_One

Thanks, Chickadee.   I meant I would have to work until (or if) I became debilitated.     I thought of getting a second job, but I am in the middle of reconstruction right now, maybe when I am done...

Thank you for your kind words; I know I am putting the cart before the horse, but like you said - just educating myself on my options (or lack thereof) if something happens.   I have kind of an ominous feeling , I can't explain it.   I know I need to not think like that, though...

lump/chemo/rads/hyster-ooph/mastectomy/implants
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Jul 14, 2011 07:28PM scuttlers wrote:

Just wanted to clarify that the statement of "not working" can be in error. I was able to be approved while utilizing my accrued sick pay in combination with approval to "work" 4 hours per week and in combination with FMLA. (I filed the FMLA tp protect my return to work if possible. I had the doctor approve 4 hours per week in order to have full pay, with the accrued sick days for those 12 weeks.).

Therefore, I was approved for SSDI while continueing to work part hours (although drawing full pay with the sick time). Moved directly to STD after the 12 weeks and LTD and SSDI slide right in after the STD.

My favorite side effect of treatments is BEING ALIVE! Dx 2/4/2009, IBC, 6cm+, Stage IV, Grade 3, 11/17 nodes, mets, ER+/PR-, HER2+
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Jul 14, 2011 08:17PM Marybe wrote:

   For sure I am going for it...today I got the results of my CA 27.29 and it is a whoppin' 3,173.9....it was bad enough before 5 wks ago at 2,935, but at least it had dropped a little.  I am getting the bone scan tomorrow and CAT on Mon,but obviously with the tumor markers making a jump like that this is yet another chemo that is not working so I am expecting the tumors in my liver as well as my bones to be larger. I am still working, but have been averaging less than 20 hrs per week, too many I know, but if you say I need to stop working altogether to get the disability I will do it.   I have an appt with my IRA guy after I go to the SS office so I will just set it up so I am getting enough out every month to pay the mortgage and some other bills.  I am still working, but am keeping my appt on the 25th anyway and am starting to get my paperwork done with the forms on line.  Even though I am still capable of working, I am just afraid to put this off much longer because the last three chemos have failed and things are not going in the right direction.  So we shall see what happens. 

Marybe Be you own advocate and keep on your toes. I went from no stage (1990) to Stage lV while under an onco's supervision. Dx 4/1998, IDC, Stage IV, 0/19 nodes, mets, ER+/PR+
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Jul 14, 2011 09:38PM Chickadee wrote:

Marybe, wishing, HOPING that the results of your tests are better than expected.........and the tumor markers are wrong. 

Then again retirement can be a most interesting part of our life's journey. 

I'm in such bad shape, I'm wearing prescription underwear." Phyllis Diller 1917-2012 Dx 9/1/2009, IDC, 1cm, Stage IV, Grade 3, mets, ER+/PR+, HER2-
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Jul 15, 2011 12:05AM Fearless_One wrote:

Scuttlers, yes, by work, you can't go over 1K a month for SSDI.   So by working 4 hours a week, you would certainly get approved.   I meant a person who works full time and gets mets would not be approved - and would not necessarily be able to quit their job.

lump/chemo/rads/hyster-ooph/mastectomy/implants
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Jul 15, 2011 12:46AM SpecialK wrote:

Just wanted to check this with you folks - I left work 10/29/10, had surgeries and chemo, was on FMLA and STD, then ADA leave with LTD until end date of 7/1/11.  Total of 8 months off.  Returned to work on 7/1 and will work until 7/19 and then have more surgery.  I will have worked 12 days and made about $800.  After this surgery I am not going back - can't handle it, too chaotic and physical, also inflexible on time off and I am still in active treatment.  Here is the question - do I now restart my no-work clock since I returned, or do I bolster my claim since I can't physically keep up after making an attempt?  Apparently even though I am only stage II I meet the "too old to be retrained" criteria.

Dx 9/27/2010, DCIS, Stage 0, Grade 3 Dx 9/27/2010, IDC, 2cm, Stage IIb, Grade 3, 2/14 nodes, ER+/PR+, HER2+ Hormonal Therapy 08/01/2011 Femara (chemical name: letrozole, class: aromatase inhibitor) Hormonal Therapy 06/20/2012 Arimidex (chemical name: anastrozole, class: aromatase inhibitor) Hormonal Therapy 07/18/2013 Femara (chemical name: letrozole, class: aromatase inhibitor) Targeted Therapy 02/17/2011 Herceptin (chemical name: trastuzumab) Surgery 01/21/2011 Reconstruction of my left breast Surgery 07/20/2011 Reconstruction of my left breast: Tissue expander placement Surgery 02/24/2012 Reconstruction of my left breast; Reconstruction of my right breast Surgery 12/14/2010 Reconstruction of my left breast; Reconstruction of my right breast Surgery 12/14/2012 Reconstruction of my left breast; Reconstruction of my right breast Surgery 03/07/2014 Reconstruction of my left breast; Reconstruction of my right breast Surgery 04/02/2014 Reconstruction of my left breast Surgery 11/13/2014 Reconstruction of my left breast Surgery 05/09/2014 Reconstruction of my left breast Surgery 11/01/2010 Mastectomy of one or both breasts: Mastectomy of my left breast, Mastectomy of my right breast; Reconstruction of my left breast: Tissue expander placement; Reconstruction of my right breast: Tissue expander placement Surgery 12/06/2010 Lymph node removal (also called dissection): Underarm (axillary) lymph node removal (also called dissection) , Lymph node removal (also called dissection) on my right side Surgery 12/21/2010 Reconstruction of my left breast Surgery 01/07/2011 Reconstruction of my left breast Chemotherapy 02/17/2011 Carboplatin (brand name: Paraplatin), Taxotere (chemical name: docetaxel)
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Jul 15, 2011 12:12PM Chickadee wrote:

My gut says that they will not take anything before your last day of work into account.  That is the day you felt you could no longer engage in substantial gainful activity or SGA due to your disability.

You will have an uphill battle claiming SSDI without being Stage IV but you certainly should try. 

I'm in such bad shape, I'm wearing prescription underwear." Phyllis Diller 1917-2012 Dx 9/1/2009, IDC, 1cm, Stage IV, Grade 3, mets, ER+/PR+, HER2-
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Jul 15, 2011 01:35PM Fearless_One wrote:

SpecialK, I don't believe having stage II qualifies you, no matter your age.   You would have to ask Steven to be certain, but I read the medical criteria for BC, and earliest they accepted was stage III with intrammary node involvement. 

lump/chemo/rads/hyster-ooph/mastectomy/implants
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Jul 15, 2011 02:00PM , edited Jul 15, 2011 02:02PM by Merilee

Hi Steven

FIrst let me say I am sorry you are having to do chemo.

Here's one for you. I have had BC 3 times in the last 2 1/2 years. A total of six surgeries Bilateral mastectomy. The last one nicked my ulner nerve and I have big issues there. Total I have had 24 doses of chemo in the last 2 years. I dragged my but to work for  a few weeks after my last surgery and latest chemo started and used all my sick time during that time. I am now laid off for the summer thank God. During my last round of chemo which just ended 3 weeks ago, I had to be my brother's caretaker, and he died of cancer. I am now scheduled for radiation that will last 6 weeks which will be past my call back date to work. Needless to say I am a wreck both mentally and physically. I am working with a PT to try and get my arm and hand to work with out feeling like I have put my finger in a light socket every time I squeeze or lift any thing. Also , if I wan'snt having enough fun, the Taxotere left me with neurpathy in my arms, hands and feet. All three times my tumor has been less than 2 cm so I am still called a stage one. I am also seeing a shrink for PTSD and anxiety. I did apply for SSDD 2 months ago and am waiting to hear if they will approve me. I am a mental health therapist working with tiny tots at HeadStart.I all ready know that there is no way I can safely supervise a tantruming child, which is the clients that I get. The thought of having to go back to work in a few weeks is enough to give me anxiety attack. I also had a short stint on Tamoxifen which has left me deaf in my left ear .Where do you think I stand?

breastcancerbeast.blogspot.com & downsyduderescueranch.blogspot... Dx 4/4/2011, ILC, 1cm, Stage I, 0/9 nodes, ER+/PR+, HER2-
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Jul 15, 2011 04:02PM , edited Jul 15, 2011 04:27PM by SpecialK

Actually Steven already answered this - and said if I was denied and lived in his state he would take my case. My LTD insurance company called me after I had been on ADA leave/LTD for several months, and after my FMLA/STD had run out..  They said after a review of my case they felt that I was a candidate for SSDI because of the combination of the nature of my job and my age.  The SSA considers over 55 to be "advanced age" so if you have a job you can no longer do physically, due to breast cancer - regardless of stage, and you are at the "advanced" age of 53 or older, SSA feels that due to that "advanced age" you may be unable to be retrained into a new job. It is the combination of your previous job description and age, not your BC stage in this case.  My question is geared more toward the work attempt for 12 days, after being off for 8 months, and inability to perform it adequately, earning less than $800, and the effect on disability date.

Dx 9/27/2010, DCIS, Stage 0, Grade 3 Dx 9/27/2010, IDC, 2cm, Stage IIb, Grade 3, 2/14 nodes, ER+/PR+, HER2+ Hormonal Therapy 08/01/2011 Femara (chemical name: letrozole, class: aromatase inhibitor) Hormonal Therapy 06/20/2012 Arimidex (chemical name: anastrozole, class: aromatase inhibitor) Hormonal Therapy 07/18/2013 Femara (chemical name: letrozole, class: aromatase inhibitor) Targeted Therapy 02/17/2011 Herceptin (chemical name: trastuzumab) Surgery 01/21/2011 Reconstruction of my left breast Surgery 07/20/2011 Reconstruction of my left breast: Tissue expander placement Surgery 02/24/2012 Reconstruction of my left breast; Reconstruction of my right breast Surgery 12/14/2010 Reconstruction of my left breast; Reconstruction of my right breast Surgery 12/14/2012 Reconstruction of my left breast; Reconstruction of my right breast Surgery 03/07/2014 Reconstruction of my left breast; Reconstruction of my right breast Surgery 04/02/2014 Reconstruction of my left breast Surgery 11/13/2014 Reconstruction of my left breast Surgery 05/09/2014 Reconstruction of my left breast Surgery 11/01/2010 Mastectomy of one or both breasts: Mastectomy of my left breast, Mastectomy of my right breast; Reconstruction of my left breast: Tissue expander placement; Reconstruction of my right breast: Tissue expander placement Surgery 12/06/2010 Lymph node removal (also called dissection): Underarm (axillary) lymph node removal (also called dissection) , Lymph node removal (also called dissection) on my right side Surgery 12/21/2010 Reconstruction of my left breast Surgery 01/07/2011 Reconstruction of my left breast Chemotherapy 02/17/2011 Carboplatin (brand name: Paraplatin), Taxotere (chemical name: docetaxel)
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Jul 15, 2011 04:21PM Merilee wrote:

I will be 52 in October.

breastcancerbeast.blogspot.com & downsyduderescueranch.blogspot... Dx 4/4/2011, ILC, 1cm, Stage I, 0/9 nodes, ER+/PR+, HER2-
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Jul 15, 2011 04:25PM NMM wrote:

Scuttlers

Working 4 hours is not working as defined by SSA.  When I use the term "working" I am using SSA strict definition not any other.  So while in general converation someone who works 1 hour a day or 4 hours a day is working, but for the purposes of this thread all work or working references are to SSA def which is SGA.

So if you make below SGA amounts while "working" part-time 4 hours you are not "working" (actually the term is engaging in substantial gainful work activity) as defind by SSA.

Also has someone else asked, money one recieves form an employer as a result of vacation, sick time, etc., doe snot appear to be conisdered counted towards SGA.

 Steven

Dx 6/3/2011, IDC, 2cm, Stage IV, Grade 3, mets, ER+/PR+, HER2-
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Jul 15, 2011 04:30PM Merilee wrote:

Here is another question

I have 125 pages of medical documents pertaining tomu case. When I checked my status on line there was a note indicating they were processing the medical portion of my claim. I took that to men that they were contacting my doctors. Since this can obviously be a very slow process, would it help  for me to send in my copies of these records? I had to collect them to apply for Unium which I was finally able to do last week. The delay in that was the severe brain fog I was in for 14 weeks while on chemo.

breastcancerbeast.blogspot.com & downsyduderescueranch.blogspot... Dx 4/4/2011, ILC, 1cm, Stage I, 0/9 nodes, ER+/PR+, HER2-
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Jul 15, 2011 04:40PM NMM wrote:

Fearless
I may have given the wrong impression so far in this thread. There are a lot of ways to be found disabled by SSA.

So far I have focused mainly on a dx of stage IV because that is what my wife has, that appears to be what everyone wants to talk about, and I started this thread after being on the SSA and stage iv thread.

Stage IV dx are also the type of case that is coded as a compassionate allowance. Which may sound great until as I have said what is good for a SSA claim is usual not good for a person's health.

I have helped a woman who was stage I or II get it (twice)...non cancer related I helped a woman get two years of benefits for post partum depression...after her 3rd kid. (you think she would have stopped after getting depressed after the 1st...LOL).

Each case is different and the system is so complex that at this point that when you can't work you should apply.

Here is my best non-legal advice to anyone.

f you go out of work on an illness or injury cancer related or not...and there is an indefinite time where you may not be able to work...or if it is not certain the treatment you are undergoing is going to reduce/remit/cure your medical condition....apply the day you stop working,...like NOW.
worst thing that happens...you apply...get a treatment cycle...don't work for 3-4 month...go back to work...call SSA up and withdraw your app and wait for the next time.

But filing right away when you stop working even though you hope to or in the past have gone back to work in a few months does not mean you should not apply, because unfortunately one of those times you won't get back to work asap or at all. And at least you have your app in.

Steven

Dx 6/3/2011, IDC, 2cm, Stage IV, Grade 3, mets, ER+/PR+, HER2-
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Jul 15, 2011 04:41PM NMM wrote:

Merilee

Sure mail or walk them in.

Steven

Dx 6/3/2011, IDC, 2cm, Stage IV, Grade 3, mets, ER+/PR+, HER2-

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