You are so right Phil. The process is so over welling,and if your wording
isn't to perfection or their understanding ther is more stress. Thats why I
say contact an attorney who knows exactly what & how to do it.  Shirley
-----Original Message-----
From: Phil Tompkins <[log in to unmask]>
To: [log in to unmask] <[log in to unmask]>
Date: Friday, February 04, 2000 8:36 PM
Subject: Re: ssdi


Based on Greg's experience, the key to approval is the medical evidence
supplied by the physician.  I'm in the application process now, and here are
my thoughts on this.  I'll let you know if they are correct after I hear
from
SSA  ;-).

The average physician probably doesn't know what is required by SSA,
does not know of the free SSA publications like "Disability Evaluation
Under Social Security" (SSA Publication no. 64-039) containing
instructions to physicians, and may not be inclined to read it anyway -- the
book is 200+ pages in length.  So someone other than the physician must
research the disability criteria and guide the assembly of medical evidence
for the application.

There are a few pages in the book that outline requirements for
medical reports.  In general, reports should include

* medical history

* clinical findings (results of examinations)

* laboratory findings [there are no lab tests for PD]

* the diagnosis

* the prescribed treatment, with response and prognosis

* the physician's opinion, based on the above medical findings, as to what
the claimant can still do despite his/her impairment(s), in terms of general
work-related capabilities (e.g., handling objects, lifting, understanding
and
carrying out instructions).

This book is available for the asking from Social Security Administration,
Office of Communications,  Public Information Distribution Center,  P.O.
Box 17743,  Baltimore, MD 21235 as are a few more I haven't seen:

Answers for Doctors and Other Health Professionals(Pub. No. 64-042)
Evaluating Disability Under Social Security (Pub. No. 64-045)
Social Security Disability Public Information Products List (Pub. No. 64-
065)

The SSA booklet "How To Apply For Social Security Disability Benefits,"
on-line at http://www.ssa.gov/disability.html, outlines the five-step
process
to determine disability:

"1. Are you working? If you are and your earnings average more than $500
a month, you generally cannot be considered disabled.

"2. Is your condition severe? Your impairments must interfere with basic
work-related activities for your claim to be considered.

"3.  Is your condition found in the list of disabling impairments? We
maintain a list of impairments for each of the major body systems that are
so severe they automatically mean you are disabled...."

Once the presence of a listed condition with the indicated severity is
established, there is no need to go on to steps 4 and 5.

Further details on this are given in Social Security Ruling #SSR 82-53 at
http://www.ssa.gov/OP_Home/rulings/di/01/SSR82-53-di-01.html

The listing of impairments, which comprises the bulk of the 200+ page
book, is at http://www.ssa.gov/OP_Home/cfr20/404/404-ap09.htm   There
is a brief entry in the listing for PD:

"11.06  Parkinsonian syndrome with the following signs: Significant
rigidity,
bradykinesia, or tremor in two extremities, which, singly or in combination,
result in sustained disturbance of gross and dexterous movements, or gait
and station."

So the physician's report must include medical evidence of the presence of
the above diagnosis and of its "signs" and indicate the appropriate
severity.
There's no  definition, however, of "significant" or "sustained
disturbance".

Nothing is said explicitly as to whether control of symptoms by medication
is disqualifying.  This is explicit for certain other neurological
disorders,
however. For petit mal epilepsy a seizure more than once a week despite 3
months of prescribed treatment is qualifying.  For myasthenia gravis there
must be "significant difficulty with speaking, swallowing or breathing while
on prescribed therapy."  This suggests to me that with PD the presence of
"significant" response fluctuations to medications is an indicator of
qualifying severity.

There is nothing mentioned about fatigue from PD.  If fatigue is an
important
impairment to working, then perhaps evidence needs to be given indicating
the similarity to some other condition on the list in which fatigue is an
explicit and crucial part, such as MS.  For MS to qualify there must be
"significant,  reproducible fatigue of motor function with substantial
muscle
weakness,  on repetitive activity, demonstrated on physical examiation..."
This sounds  like the PD neurological test where you are asked to repeat
opening and  closing your fist. I didn't see any reference to overall
fatigue
preventing you  from getting through the day -- but I was too tired to read
the whole thing.

There are special requirements for documenting mental, including affective,
disorders -- too much to go into in this message.

I hope this helps.

Phil Tompkins
Hoboken NJ
age 62/dx 1990