1. They are not your friend.
2. They are not looking out for your medical needs.
3. Their job is get the doctor to return you to work ASAP.
4. Doctors do not like nurses or anyone else telling them how to do your job or suggesting they know better.
5. If the Doctor is harassed enough (when can he return to work, when can she return to work) he may return you to work before you are ready. It happens all the time.
6. If anything they are trying to save money for the insurance company by preventing testing and treatment, physical therapy etc…
7. Do not let them talk to your doctor outside your presence. They will try to get the doctor to switch his opinion on restrictions.
8. It is best to not let them talk to your doctor at all.
9. They will tell you the law is that they can legally talk to your doctor. That is just not true.
10. You have Hippa rights. You do not give those up. The claims adjuster has a right to get the medical records per the law, but not to orally discus the case.
11. If you have signed a release allowing them to talk to your doctor you can revolt that right you have given up.
12. Advise your doctor that you do not want them talking to the nurse manager or the adjuster. Tell the office staff as well.
13. Call my office ASAP once you feel your rights are being violated.
Law Offices of David Zimmerman
Administration (SSA) maintains a “Listing of Medical Impairments” (known as the blue book) that automatically qualify you for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), provided certain conditions are met. If your medical condition, or its equivalent, is on SSA’s Listing of Impairments, then you are generally considered disabled and therefore eligible to receive SSA disability benefits. If your medical condition is not on the list, you may still be eligible under other SSA guidelines.
Medically Approved List of Impairments
The SSA’s Listing of Impairments is generally broken down by bodily system or function. There are separate lists for adults and children under the age of 18. For adults, the medical conditions that qualify for SSDI or SSI include:
Musculoskeletal problems, such as back conditions and other dysfunctions of the joints and bones
Senses and speech issues, such as vision and hearing loss
Respiratory illnesses, such as asthma and cystic fibrosis
Cardiovascular conditions, such as chronic heart failure or coronary artery disease
Digestive tract problems, such as liver disease and inflammatory bowel disease (IBD)
Neurological disorders, such as multiple sclerosis, cerebral palsy, Parkinson’s disease, and epilepsy
Blood disorders, such as sickle cell disease or hemophilia
Mental disorders, such as depression, anxiety, schizophrenia, autism, or intellectual disability
Immune system disorders, such as HIV/AIDS, lupus, rheumatoid arthritis, and kidney disease
The list of medical conditions for children under the age of 18 is virtually identical to the one for adults. Growth impairment is the only medical condition covered for children that isn’t covered for adults. For a complete list of impairments, including detailed evaluation methods, visit www.ssa.gov.
What If Your Medical Condition Is Not on the List?
Even if your medical condition isn’t on the Listing of Impairments, you may still qualify for SSDI or SSI if certain criteria are met. First, the medical condition must be a medically determinable impairment. A medically determinable impairment is a medical condition that has been the subject of clinical and laboratory testing. In other words, your medical condition must be supported by clinical reports.
Next, the medical condition must limit your residual functional capacity (RFC). RFC is determined by looking at the most demanding activity you can still do despite your medical limitations. Based on your residual functional capacity, a disability claims examiner will determine your exertional level. Exertional levels vary from sedentary work to very heavy work and are based on how much weight you can lift and carry.
The RFC also includes non-exertional limitations, like the ability to climb or bend down, the use of hands, the capacity to cope with anxiety or depression, and any environmental restrictions. The disability claims examiner will take your medical history, reports, and residual functional capacity into consideration to determine if your medical condition qualifies for disability benefits.
What Medical Evidence Do I Need to Show?
Medical evidence for a Social Security disability case can include:
Treatment notes or reports
Mental health records
Blood work panels
The medical evidence must be recent and must encompass the time period from when you became disabled to the present time. Further, your medical records must show that your condition is severe enough to prevent you from performing your standard work-related duties.