§1. Talk to Me
When you go to the interview, go with a friend, family member, or roommate — someone who knows you well. Don’t have a cell phone with you. Dress in normal clothes. Remember the person at the Social Security Office is not a doctor. Be as polite as possible. Don’t try to fake hysteria or anything. But the “claims representative” (the person who conducts the interview) is supposed to take note of your mannerisms (e.g. poor eye contact, trembling, also if you state “I’m a bit nervous right now” sometime during the interview). Have the person coming with you have the forms to hand in, including copies of any forms you’ve already mailed back to the SSA. These should be completed in full — the claims representative will look over the forms for any incomplete information.
Be sure to KEEP YOUR APPOINTMENT. Rescheduling causes more delay, and if you miss your rescheduled appointment you have to wait another 60 days before you can schedule another appointment. Hey, no one said that the process is friendly toward folks with mental illness!
The SSA should tell you what you need to bring to the appointment. Among the list includes copies of your medical records. Don’t bring these along — unless you have COMPLETE medical records of ALL your medical sources. The SSA only will accept signed copies of medical records that have “certified as a valid copy of the original.” It is strongly recommended that you let the SSA contact your medical sources directly to avoid any confusion. Also, if you currently have health insurance coverage — be sure to have the name and address of the insurer with you.
Note from Jerod - If you previously applied in person or on the phone and have an in-office interview scheduled, this is where all those HIPAA authorization for disclosure forms come in, and why applying online to avoid HIPAA paperwork makes more sense.
Always bring someone with you to any meeting you have with SSA. You’re more likely to get there on time, have the required forms, and be able to answer their questions if you have someone with you. Assuming that person isn’t in a crisis like you probably are. If you’re in bad enough shape to require disability benefits, you’re in bad enough shape to need someone to help you navigate the SSA’s bureaucracy.
§2. The Exam
SSA will likely schedule a CE (consultative examination). This means that the SSA will send you to their psychiatrist and/or PhD.-level clinical psychologist.
Note from Jerod - there are fewer and fewer actual doctors doing the CEs these days.
Keep in mind that this examiner does not determine whether you are disabled, but rather s/he reports findings to the SSA. Try to secure a copy of your recent psychiatric records. Go with someone who knows you well, who can give these records to SSA’s doctor and help explain your condition. You’re supposed to bring the bottles of all the medications that you take, too. If you cannot attend the examination (because it is too far, you cannot afford transportation — or cannot attend because of your condition — e.g. agoraphobia, etc., you need to call AND write Social Security and let them know — they can reschedule it, sometimes even arrange for a taxi — or in extreme cases, have someone come to your house (agoraphobia so severe that you cannot leave your house). To avoid delays, however, MAKE EVERY EFFORT to attend the CE (and go with someone!). Your examination should be AT LEAST 40 minutes and include an objective psychological testing — such as the MMPI-2 or the WAIS (IQ test), as listed on Social Security’s Listing of Impairments. You should be treated with courtesy, too. If the exam is too short, the doctor is rude, or your test is not one of the SSA-approved tests, you need to write AND call and explain the problem completely and that you would like to be sent for another consultative examination.
If the SSA decides to sends you for the Consultative Exam (CE) — that is, their own doctor, you have the RIGHT, instead, to have your “treating doctor” perform the CE if s/he is willing to do so. Your “treating doctor” refers to the doctor or clinic with whom you have had an ongoing treatment relationship. The doctor has to agree to it (so the patient should ask one’s doctor first) and the doctor will get paid for it at the expense of the SSA. The claimant/patient has to tell the SSA that the treating doctor is willing to perform the exam and that this would be the [claimant’s] preference.
SSA regulations actually mention a preference for the CE to be done by the claimant’s “treating doctor.” It’s in Section 616.2 of the SSA Handbook. In practice, though, it is easier for the SSA to have the CE with their own doctor. But who do you think would be best to perform the CE — a doctor who you’ve never seen before who doesn’t have access to your records, or your own doctor who has known you for quite some time?
Note from Jerod - My normal answer is, “Bureaucracy is the antithesis of logic.” But with all of the funding cuts, they might be far more willing to let your doctor do the exam than they were ten years back.
To arrange a CE by your own doctor:
- First, you should call your doctor and ask if s/he is willing to perform the exam for the SSA (paid at the expense of the SSA).
- If s/he is willing, you need to call the DDS (call collect through the operator---call the operator directly, for the DDS should have a message stating that they accept collect calls), and clearly leave your name (spelled out) and SSN and explain that you would like to have your treating doctor perform the exam as per Section 616.2 of the SSA Handbook). The DDS is the “Disability Determination Specialist,” or disability examiner. Leave a phone number (including area code) at which you can be reached and best time to reach you.
- Make a note of the call (Date and time and what was said).
- Then follow up with a letter to the DDS mentioning the phone call and explain your preference, citing Section 616.2 of the SSA Handbook.
For more information about the CE guidelines, visit: The SSA Health Professionals’ Green Book
Regardless of who does the CE, one thing you should do is go in with not just a log of the meds you’ve taken, but with as many bottles as you have on hand of individual meds. Or boxes, or whatever the original container is. This would suggest compliance with medications as well as credibility.
Note from Jerod - the first CE I had was done by a total dick. I filed a complaint with the SSA and the California medical board. The guy was an asshole whose idea of testing for mental illness was browbeating people and giving them the MMPI. I did get a second CE.
Now you get to wait at least six months.
Follow suggestions in the books “How to Get SSI & Social Security Disability: An Insider’s Step by Step Guide.” In the meantime, keep a list of all your appointments with name address, phone/fax number, dates and times of appointments, any changes in medications/what doses/reasons for stopping/starting. etc. You’ll need those in case you’re denied.
Jerod again. So, how do you know if you’ve been approved? Either you’ll get a check (and the SSA doesn’t like sending out checks any more) or the money will magically appear in the bank account set up to receive your benefits. What you get first is your back pay - everything they owe you from the time you first contacted the SSA until they approved your claim. With SSDI that can be a lot of money. With SSI it won’t necessarily be all that much, and not just because the government thinks you can live on $700 a month1. When you apply for SSI you might immediately qualify for Medicaid, food stamps, and maybe even other assistance programs. Do you think that stuff is free? Anything you receive while waiting for SSI is deducted from your back benefits. This is why most lawyers won’t take SSI cases that are less than two years old, if not longer. In any event, you get paid before you get your award letter that tells you your claim has been approved and you’ll be receiving a packet that explains your benefits and how everything works.
Another crazy thing about SSI’s back benefits is you have to spend all of what you get within nine months, otherwise the SSA might consider you as being too well off (“over the resource limit”) to qualify for SSI. That’s right, saving money for a medical emergency that Medicaid won’t pay for is not allowed. At least not in your own name. This does explain why I saw a Hummer with disabled plates parked in two handicapped spaces at 6:30 one morning in the parking lot of a ghetto grocery store. That must have been one long-ass appeals process.
Back to Bryan’s original article.
Also worth mentioning — when and if you get approved for SSI, you will likely have to appoint a “Representative Payee,” a person or organization who receives your money and manages funds on your behalf. You can choose the person or organization. The person can be a friend, relative, or anyone you know who agrees to manage your funds, who has not been convicted of a felony and is capable of managing your money. The SSA maintains of list of organizations willing to serve as your Representative Payee. You have the right to change your Representative Payee at any time. The Representative Payee has to periodically report to the SSA how the funds are being used (how much goes toward food, rent, and miscellaneous expenses).
You see, SSA’s assumption is that if you are really too disabled to work full-time in some job in the nation’s economy, then surely you are not capable of managing your funds in your best interest. I believe that you can receive your own funds if you have a letter from your doctor stating that you are capable of managing your benefits funds.
SSA prefers that a Direct Deposit arrangement is made (versus receiving checks in the mail or at your location). If you set up a checking account and it will need to be in your name with the “representative payee” being the one who manages it. In other words, you cannot withdraw funds or write your own checks.
Note from Jerod - When it comes to SSI and you’re applying for benefits due to being crazy, be honest: are you really together enough to handle your own money? How much of this process have you been able to do yourself? As difficult as it is, it’s easier than paying bills on a regular basis. Believe it or not, I have been someone’s representative payee. It’s a lot of work.
After being approved, your case will be reviewed periodically through a process called the Continuing Disability Review (CDR). Generally, for mental illnesses that have been well-documented, this would be “no sooner than every 3 years.” The SSA has been cracking down on conducting the CDRs in a more timely manner. If you are still sick, keep seeing a doctor, and keep a journal with all your appointments, etc. The SSA also has “work incentives”--including programs which allow you to work part-time while still receiving some benefits. More information on SSA’s “work incentives” and CDR’s are in the aforementioned book, Nolo’s Guide to Social Security Disability: Getting and Keeping Your Benefits.
Note from Jerod - Since 2007 budget cuts have reduced CDRs to little more than a form you fill out. As long as you’re still seeing a doctor you’ll probably be fine.
Also, eligibility for SSI means eligibility for Medicaid in most states (called Medi-Cal in California). This means health coverage from approved providers, including prescription drug coverage. In some states, you will need to apply for this separately; check with your county’s Department of Social Services (look in the front of your telephone directory). Also, if approved for SSDI, within two years from the date that SSA determines that your disability began is the date that you become automatically eligible for Medicare, which includes ambulance services and hospitalization coverage.
Note from Jerod - isn’t that crazy? We’re disabled for a medical reasons, but we have to wait two years for medical coverage? In the meantime it still means juggling credit card debt in order to pay for medical expenses before Medicare kicks in. This article was written before the existence of Medicare drug coverage, so while SSI sucked in so many more ways than SSDI, at least on SSI you could get Medicaid as soon as you applied and that covers some drugs.
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If you have any questions about SSDI/SSI or similar issues, there’s a part of the Crazy Meds forum devoted to insurance, drug prices, applying for disability, etc. Medication Costs, Insurance, Disability & Assorted Issues - It Costs How Much? with the topic Q & A On The SSDI Approval Process.1 Dear God someone please tell me I'm wrong and the amount isn't practically the same as it was eight years ago.
Applying For SSDI/SSI: Part 4 The Interview & Consultative Examination (CE) by Bryan is copyright © 2004
Author: Bryan. Date created: 24 October 2004 Last edited by: Jerod Poore on: September 20, 2012, at 12:50 PM
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Nobody on this site is a doctor, a therapist, or a pharmacist. We don’t portray them either here or on TV. Only doctors can diagnose and treat an illness. While it’s not as bad as it used to be, some doctors still get pissed off by patients who know too much about medications, so tread lightly when and where appropriate. Diagnosing yourself from a website is like defending yourself in court, you suddenly have a fool for a doctor. Don’t be a cyberchondriac, thinking you have every disease you see a website about, or that you’ll get every side effect from every medication1. Self-prescribing is as dangerous as buying meds from fraudulent online pharmacies that promise you medications without prescriptions.
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Crazy Meds is not responsible for the content of sites we provide links to. We like them, or they’re paid advertisements, or they’re something else we think you should read to help you make an informed decision about a particular med. Sometimes they’re more than one of those things. But what’s on those sites is their business, not ours.
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1 While there are plenty of books to help you with hypochondria, for some reason there’s not much in the way of websites. Then again, staying off of the Internet is a large part of curing/managing the disorder.
2 Remember kids, Microsloth operating systems are like TOS Star Trek movies with in that every other one sucks way, way more. With TOS Star Trek movies you don’t want to bother watching the odd-numbered ones. With Microsloth OS you don’t want to buy and install the even-numbered ones. Anyone who remembers ME and Vista knows what I mean.
3 Have I mentioned how open source operating systems for commercial applications is one of the dumbest ideas in the history of dumb ideas?
[begin rant] I rent a dedicated server for Crazy Meds. It’s sitting on a rack somewhere in Southern California along with a bunch of other servers that other people have rented. The hardware is identical, but no two machines have exactly the same operating systems. I don’t even need to see what is on any of the others to know this. If somebody got their server at the exact same time, with the exact same features as I did, I’m confident that there would be noticeable differences in some aspects of the operating systems. So what does this mean? For one thing it means that no two computers in the same office of a single company have the same operating system, and the techs can spend hours figuring out what the fuck the problem could be based on that alone. It also means that application software like IP board that runs the forum here has to have so many fucking user-configurable bells and whistles that even when I read the manual I can’t find every setting, or every location that every flag needs to be set in order for a feature to run the way I want it to run. And in the real world it means you can get an MBA not only with an emphasis on resource planning, but with an emphasis on using SAP - a piece of software so complex there are now college programs on how to use it. You might think, “But don’t people learn how to use Photoshop or Adobe Illustrator in college?” Sure, in order to create stuff. And in a way you’re creating stuff with SAP. But do you get a Bachelor of Fine Arts degree with an emphasis on Photoshop?
Back in the Big Iron Age the operating systems were proprietary, and every computer that took up an entire room with a raised floor and HVAC system, and had less storage and processing power than an iPhone, had the same operating system as every other one, give or take a release level. But when a company bought application software like SAP, they also got the source code, which was usually documented and written in a way to make it easy to modify the hell out of it. Why? Because accounting principles may be the same the world over, and tax laws the same across each country and state, but no two companies have the same format for their reports, invoices, purchase orders and so forth. Standards existed and were universally ignored. If something went wrong it went wrong the same way for everyone, and was easy to track down. People didn’t need to take a college course to learn how to use a piece of software.
I’m not against the open source concept entirely. Back then all the programmers read the same magazines, so we all had the same homebrew utilities. We even had a forerunner of QR Code to scan the longer source code. Software vendors and computer manufacturers sponsored conventions so we could, among other things, swap recipes for such add-ons and utilities. While those things would make our lives easier, they had nothing to do with critical functions of the operating system. Unless badly implemented they would rarely cause key application software to crash and burn. Whereas today, with open source everything, who the hell knows what could be responsible some part of a system failing. [/end rant]