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Questions on physical exam from SSD physician

lynnsyllynnsy Posts: 197
edited 06/11/2012 - 8:39 AM in Health Insurance Issues
Fri, 11/27/2009 - 13:54 (new) #3 .lynnsy

Joined: 06/22/2008
Posts: 198
Points: 396 Questions about physical exam for SSD

I've began my "jump through the hoop" scenario with SSD about 130 days ago, and just received notice 2 days ago about my "Medical Doctor examination" with SS doctor? I had a 3 level lumbar fusion almost 2 years ago and am unable to work due to constant pain sitting, standing, twisting, lifting, etc... I have accepted my physical situation as depressing as it is.

I have a lot of questions on the physician they are sending me to first. Is this going to be like work/comp docs? I sure hope not!! That was the most aweful thing I've ever been through. I swear those idiots are brainwashed, and don't look at each individual AS an individual. I think anyone on here that has a work related injury knows what I'm talking about. Do they examine us like "real" physicians, or are they brainwashed also to say, "Oh she's fine, nothings wrong"? Or do they give their TRUE REAL findings back to SS?

Also, is it a good situation that they are sending me to one of their docs to be examined? Am I one step closer to this being approved?


"If you're lucky enough to live in the mountains, you're lucky enough"



  • I would hope that they look at it case by case. Jeaux, who has helped many of us on here, told us that the doctors SS uses are contracted doctors, not employees of SS. So, since they are contracted, I would assume their evaluation and opinion is fair.

    Quite a few people on here have been sent to a SS doctor, so hopefully they respond to you.
  • Hello, I was sent to an SSD doctor who was very nice and he did a number of tests ie.knee taps etc.He also took x-rays of my knees and shoulders(checking for arthritis)and I think I was in his office for 30 min or so.It was about 2 weeks later that I was awarded SSD.Good luck and I would suggest just being totaly honest about your symptons and your disabilities, Sincerely,Turkersmom
  • I can only tell you my experience with this. The doc that I saw did report his true findings. The test was not that bad. Anything that I was not able to do I was not forced to try. The examiner did find that I was totally disabled. At that point I was only 3 or 4 months out from my surgery so he said that he did not know if my disability would last for 12 months (requirement for SSD).

    I was denied on those grounds. I appealed. Denied again. Appeal to ALJ. ALJ gave me a fully favorable decision.

    The whole process took about 1 1/2 years. My lawyer felt that if I had waited to apply after I had already ben disbled for 1 year I may have been approved on the first try.

    So I don't think that it is better or worse that you are going for the IME. I think that SS has decided that they need more info on your medical condition.

    The test is simple things like bending forward and back as far as you can. Walking heel to toe. Leg raise. Things like that.

    Good luck and keep us posted.
  • First, what is a ALJ? Second my surgery was almost 2 years ago, so I have definately waited the 12 months....

    I was just trying to figure out if SS IME is anything like the W/C exams, where it doesn't matter what you say, or what kind of pain you're in, what you can or cannot perform anymore, W/C ALWAYS has EVERYTHING go in their favor. I am just hoping that SS is real, looks at MRI's, xrays, and are "empathetic" to your chronic condition? I remember W/C physicians PUSHING and FORCING my body into positions, making me cry!!!

    I do know for sure that I will not take any pain pills before I go to my exam so they can get an accurate observation!! (Gawd, I hope I can do it without...) Then as soon as I limp out of the office, take my pain meds.
  • An ALJ is "Administrative Law Judge".

    Generally, SSA cannot make a decision on any condition if medical records in file are 6 months old (or older). OR, if you have no records of treatment for a particular condition. As Caity stated, these doctors do not "work" for SSA. They are paid to do an evaluation. Period. They will not prescribe medication or treatment (although they may suggest one or the other).

    Here's an Example: Say your are stating you are disabled because of back pain, numbness in the legs. Your medical records show you are indeed being treated for back pain with radiation into your legs. You are taking a muscle relaxer, a couple of pain pills, maybe something for sleep. ALSO your records show you are taking a medication that is generally taken by people who are depressed. Hmm... no records showing you are being treated for depression.... So, SSA schedules a Mental Status examination. The doctor they send you to does just that... a mental status exam. He writes his report and gets it in to SSA within 10 days, because SSA will pay an additional $20-$30 if it's sent in early (this keeps the claimant from having to wait on a decision). SSA gets the report and sees that you are not depressed; turns out - this anti-depressant is used off-label for nerve pain in your legs... BUT, SSA had to address it so that it would not come back to haunt them later down the road.

    That's just one example. I'm sure that's no where near the scenario in your case, but you get the picture.

    Just relax. Be yourself. Answer what ever questions the doctor asks truthfully and to the best of your knowledge. Bring a list of your medication and doseage.

    Most likely, this will be nothing like the WC evaluation you were speaking of. SSA would not put you through that.

    Good luck to you!

  • think that it will be anything like the w/c evaluation. I was not made to do any at all that I could not do. Also the docs are not employed by Social Security. The doc that I went to was just a physical rehab specialist that anyone could go to. I do not think that they have any motivation to side with Social Security and be untruthful about your condition. Just be honest with them because I have heard that they are trained to look for folks that are exaggerating their condition at all.

    ALJ = Administrative Law Judge. After 2 denials you move to this stage that your case goes in front of a judge.

    Good luck.
  • First of all, thanks again guys for responding. And yes I am on Prozac to help with the depression that rides along with me day in and day out over not being able to do things that I use to do since my injury/surgery. And I do take 1/2 valium at night to help me sleep at night and through the pain of turning over. And I still wake up numerous times during the night with throbbing pain, especially with barometer changes. (and here in the mountains of Colorado, we have A LOT!!!! I still have to "roll" out of bed, then stand up slowly, then my left leg takes quite a while to work, but then with a limp, UNTIL I take a percocet... I have total numbness in my inside left thigh, knee cap, and it's been there since surgery, and did not go away like my surgeon said it would. That's really "buggy"....
  • to discuss this, but I take 5-10mg of Valium and flexeril at bedtime. Makes a big difference in sleep!

    Read Jeaux post, not that I am applying, but what would the difference be if the person were found to be depressed or say in my condition Bipolar type II? Does the mental aspect damage the case for disability or improve it?

    Just talking averages here, I know nothing is ever set in stone.

    EDIT: I want to mention something else on your numbness. When I was 24 I had bakers cysts taken out of my left wrist, big entangled mess. Anyway I ended up with a dead numb area on the back of my hand, behind my thumb and index fingers. drove me buggy, hurt when touched. It took a LOOOOooooooong time but eventually the nerves rerouted and it now feels completely normal. I should probably mention that was 24 years ago, probably not the news you want to hear. But, there is still hope!
  • You are right - nothing is set in stone, and every disability case is different. The mantra at the office there was "Case by Case Basis".

    Having a mental illness in no way, shape or form jeopardizes a disability claim.

    But, with regard to your question, the claims that involved mental impairments were always, for me, the most difficult to evaluate.

    If you have a broken leg, you have an xray that proves that; also, you have xrays that show whether the bone (or bones) is healing or not. Not so with mental impairments.

    So, the disability examiner has to go through the records literally with a fine-tooth comb. Some mental impairments just pop up out of the blue (such as situational depression), but most are a life-long condition. Once we learn about the history and treatment, we have to decide how that person's responding to the treatment, or if they are following what the doctor says.

    Once we've established the "longitudinal history" of the illness/es, we have to determine how severely it impacts their day to day lives. How do they get along with others? Can they handle the stressors of a "normal" work day?

    I enjoyed the "investigational" aspect of evaluating the claims. It was the fact I had to deny so many claims that I knew should have been allowed; likewise, allowing so many claims I knew should have never made it to my desk.

    For instance, individuals with Schizophrenia. First off, that word is hard to type. Next, schizophrenics hardly ever feel they are ill. So, they do not seek treatment, and if they do, they do not follow prescribed treatment (taking medication). Because they are not "following prescribed treatment" the claims have to be denied (this is where the Judge's are handy. they can see through the "black and white" rules and regulations and find the grey area... and approve the claims). On the other hand, if they take meds as prescribed and go to treatment as scheduled, they can actually live productive lives. The medication helps. So, since they have a positive response to treatment and are functional, they are denied (again, this is where the ALJ says "huh?" and reverses the denial).

  • I have been suffering greatly this last week as our temperatures have been in the "below zero" ranges, with new fronts coming in everyday and through our week-end. I would think that my case is very obvious and apparent, as I cannot get off the couch, pain meds aren't touching the pain. I can stand roughly about 5 minutes, then I have to sit down, or I can sit for maybe 15-20 minutes before I have to stand up, move around, or just lay down. A reclyned position is my longest lasting position, (ie:sitting here with my laptop)

    So another question to you is, what job is possibly going to put up with me calling in sick every other day because I can't get out of a reclyning position. Or, "excuse me boss, but I need to stand up every 5 minutes because I cannot sit in this hard chair for more than 5 minutes". OR, "could I please have a extremely soft reclyner chair to sit at my desk with?" OR "excuse me boss, but I cannot lift that box of paper because I cannot lift over 20#, you'll have to pick it up sir". OR, "sorry sir, but a front is coming through, and I can't walk, so I won't be in today, again".

    How does SS look at these scenario's? All-be-it, these are just a few examples.

    If I shave my legs (sitting in a bathtub) I am totally worthless for 2 days following. Walking is very painful. (I HATE shaving my legs, I have to make sure my husband is home to aid me in getting out of the tub).
  • When I was in the process of applying I asked similar questions to myself (So another question to you is, what job is possibly going to put up with me calling in sick every other day because I can't get out of a reclyning position. Or, "excuse me boss, but I need to stand up every 5 minutes because I cannot sit in this hard chair for more than 5 minutes". OR, "could I please have a extremely soft reclyner chair to sit at my desk with?" OR "excuse me boss, but I cannot lift that box of paper because I cannot lift over 20#, you'll have to pick it up sir". OR, "sorry sir, but a front is coming through, and I can't walk, so I won't be in today, again".).

    I thought how can I do anything because I can't stand or sit for very long. I can't lift, bend, twist, etc.

    All I can say is, have faith. If you have enough medical evidence, you should be fine. If this is your first time applying, there is a good chance you will be denied. Just appeal it, keep pushing. I was shocked when I was approved. The first time I applied in Dec 2007 I was denied, and my appeal May 2008 was denied as well. I re-applied July 2009 and was approved October 2009.

    I would suggest keeping an open line between your examiner and yourself. I did. I was very honest with him. I asked hiim any question that came to mind.

    Hang in there sweetie!

    >:D< >:D< >:D<


  • Unfortunately, SSA does not look at "Who will hire me?" THey are only concerned whether or not you can do some kind of work.

    At the disability office that is processing your claim, there are medical and vocational "experts" who look at your claim from every angle. If the medical staff feels you can't work and the vocational expert says you can do "__________", the vocational guy has to show there are significant number of that particular job in the economy. He can't just pull something out of the air.

    I remember one claim I worked on - the lady was a secretary for over 30 years; had neck problems and carpal tunnel syndrome - and a bad response to the carpal tunnel release surgery. I deemed her to be disabled. The vocational expert sent the claim back to me, citing a job that appears in the national economy in large numbers he felt she could to: Psychic Hotline.

    I was furious! I grabbed the file, marched in his office, threw the file on his desk and told him that was an insult! He about fell out his chair laughing at me; it was a joke on me. He'd been wanting to play that joke on someone, and instantly thought about me. He said he thought I'd find it funny; he certainly did not expect my response... After I realized he was joking, I unscrewed the wheels on his desk chair the next morning before he got to work....

    He'd never played a joke on me like that again....


    Some of the disability examiners actually care about their claimants...
  • Hi guys.... thank you so much for all of your responses :) Yesterday was my physical exam by the SSD Doctor, and she was absolutely awesome. Completely empathetic, understanding and after viewing my reports, MRI's and x-rays first thing out of her mouth was "I can't figure out why they even sent you to me, it's obvious that you cannot work". I was 100% honest with her about how debilitating my pain is 24-7, I even let her know that I can't make love to my husband... She even told me up front that she was recommending me for SSD benefits. BUT!!!

    There's a HUGE BUT!!! All the money in the world couldn't have prepared me for what happened. She took x-rays, 3... Bad news... There is absolutely no disc between my L-5 and S-1 and the curve in my spine is actually worse. My fusion made it curve even more, AND the S-1 is SHOT so...... Now I've got to go back into my Neurosurgeon (when-ever I get the balls) because I know for a fact that he is going to want to include the S-1 in my L-3-4-5 fusion. But you know what really pisses me off? When I had the surgery done almost 2 years ago, my Neurosurgeon told me at that time, "there's a real good chance that the fusion is going to weaken the S-1"..gggrrrrrr.

    But as soon as this SSD doc showed me the x-rays, I immediately started crying, freaking out at the thought of another surgery (that's worse than giving birth to a child) but it was very obvious on even the x-ray that there is no disc there.

    So, I'm not even thinking about the benefits part of this exam,...it's the furthest thing from my mind. Now I'm totally freaked out with what I saw on those films.... I don't EVEN want to go to my Surgeon.

    And atleast I had all my questions answered as to "why I'm still in so much pain after almost 2 years.... I knew there was something wrong :(
  • Oooh - sorry to hear about the new events... My PM doc told me the same thing. When you have surgical procedures on one disc, either the disc above or below (sometimes both) become symptomatic after some time. It's what she called "a normal progression". BUT, at least now you "know your enemy", and that will shed light on the "why?" of other things that have been going on.

    Please remember - this doctor does not have any say in whether you get it or not; she is just providing objective medical evidence. At the very least, I hope you are approved your benefits so you can at least be rid of the financial stressors in your life.

    Granted, everyone knows it's better to work (financially) because disability benefits aren't all that great, but something is better than nothing.

    Man. I wish I had something (anything) to tell you to make things better.

    Good luck, hon. Keep us posted.. ?
  • Sorry to post something that you may find totally depressing, but there are some exceptions to what I am about to say - just not very many.

    It has been my experience and also documented by hundreds and hundreds of people on both sides of the equation - both claimants as well as those having worked with/for the SSD industry, that their job is to decline pretty much every application that crosses their desk. I am not exaggerating here. I have known people with polio, muscular dystrophy, cancer, double amputatees and all were turned down. I believe it is an attempt to weed out everyone but the most determined. I guess they figure if you are that determined, than maybe you really are disabled.

    I have had an instance similar to the OP, where their own doctor recommended 100% disability as it was obvious to him that I could not work. They over-ruled him without any further evaluation. It is a travesty in my opinion. But you can win once it gets to an appeal judge, and if you are one of the very very fortunate ones (like my neighbor) you will be granted disability after your initial request. For most, the process takes from 2 to 4 years, all of which time you cannot be working so unless you have a family or spouse that can take care of you during that time or have thousands saved up, you will never last to make it to trial. That is what they are counting on.

    Sorry for such a pessimistic view, but it is good to know what you are likely getting involved in. Wish you all the best.
  • John Doe's statement:

    " It has been my experience and also documented by hundreds and hundreds of people on both sides of the equation - both claimants as well as those having worked with/for the SSD industry, that their job is to decline pretty much every application that crosses their desk. "

    As a disability examiner, I was never cautioned to arbitrarily deny every claim that came across my desk. Neither was the group of examiners who were in class with me.

    Fact of the matter is this: Disability claims are like lawsuits. People will file for just about anything.

    True, there were claims I HAD to deny that were so totally against my belief to do so, and those were eventually approved down the line by an Administrative Law Judge (either before or at the hearing). That is just the way the Program Operation Manual is written. I had also told each and every one of those claimants before they received their denial letter that I had to deny them and why, and to file their appeal as soon as they received their letter.

    The reason I had to deny them was because at that very point in time they were actually CAPABLE of performing SOME type of work, regardless of whether said work was "beneath them" or what they were used to doing. But due to the progressiveness of their impairment, were approved a few months down the line.

    I used to get so angry when people would say that's what SSA does - deny every case that comes along. The majority of the disability examiners try very hard to APPROVE those claims with merit.

    But, it's daunting when you have people who file claims for migraines - which turn out to be nothing more than sinusitis, or lung cancer - which turns out to be bronchitis but the claimant had a neighbor whose cousin had the same cough and the claimant - who had never seen a doctor - diagnosed themselves, or the person who had NEVER HAD A JOB - EVER, then pulls a muscle in their back and decides they are too disabled to work for real, etc. The erroneous claims have to be weeded out.

    It's way more complicated than all that. The process is flawed, there is no doubt. But would you want any one of the 3 examples I cited above drawing disability payments for the rest of their lives? Talk about depleting the funds!

    Ok. Sorry if I offended. I am off my soap box now...

    Have a great day everyone!
  • I think you did a nice job of spelling things out. It is too easy to jump on someone's bandwagon as they drive by waving a flag of discontent and discouragement. If we never make the effort to do something in the first place, then we don't have the right to complain about what we are or are not given.

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