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.
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 Crazymeds 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: JerodPoore on: 2014–04–11
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Almost all of the material on this site is by Jerod Poore and is copyright © 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014, and 2015 Jerod Poore. Except, of course, the PI sheets - those are the property of the drug companies who developed the drugs the sheets are about - and any documents that are written by other people which may be posted to this site will remain the property of the original authors. You cannot reproduce this page or any other material on this site outside of the boundaries of fair use copying without the express permission of the copyright holder. That’s usually me, so just ask first. That means if want to print out a few pages to take to your doctor, therapist, counselor, support group, non-understanding family members or something like that - then that’s OK to just do. Go for it! Please. As long as you include this copyright notice and something along the lines of following disclaimer, I’m usually cool with it.
All rights reserved. No warranty is expressed or implied in this information. Consult one or more doctors and/or pharmacists before taking, or changing how you take any neurological and/or psychiatric medication. Your mileage may vary. What happened to us won’t necessarily happen to you. If you still have questions about a medication or condition that were not answered on any of the pages you read, please ask them on Crazy Talk: the Crazymeds Forum.
The information on Crazymeds pertains to and is intended for adults. While some information about children and adolescents is occasionally presented (e.g. US FDA approvals), pediatric-specific data such as dosages, side effects, off-label applications, etc. are rarely included in the articles on drugs or discussed on the forum. If you are looking for information regarding meds for children you’ll have to go somewhere else. Plus we are big pottymouths and talk about S-E-X a lot.
Know your sources!
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.
All information on this site has been obtained from the medications’ product information / summary of product characteristic (PI/SPC) sheets and/or medication guides - which is all you get from sites like WebMD, RxList,
NAMBLA NAMI, etc., the sources that are referenced throughout the site, our personal experience and the experiences family, friends, and what people have reported on various reputable sites all over teh intergoogles. As such the information presented here is not intended as a substitute for real medical advice from your real doctor, just a compliment to it. You should never, ever, replace what a real doctor tells you with something from a website on the Internet. The farthest you should ever take it is getting a second opinion from another real doctor. Educate yourself - always read the PI/SPC sheet or medication guide/patient information leaflet (PIL) that comes with your medications and never ever throw them away. OK, you can throw away duplicate copies, but keep at least one, as that’s your proof of purchase of having taken a med in case a doctor doubts your medical history. Plus they take up less space than a bottle, although keeping one inside of a pill bottle is even better.
Crazymeds 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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‘Everything is true, nothing is permitted.’ - Jerod Poore
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?* I don’t even need my big-ass rant any more. Heartbleed has made my case for me. And that’s just the one that got all the media attention. The very nature of an open source operating system makes security as much of an illusion of anonymity. Before you flip out too much: the domain Crazymeds is hosted on uses a version of SSL that is not affected by the Heartbleed bug. That’s one of the many reasons why I pay a lot of money and keep this site on Lunarpages.
* Yes, I know I’m using open source browsers. I also test the site using the now-defunct IE and Safari browsers. Their popularity - and superiority - killed IE and Safari, so that’s why I rely on the open source browsers. It’s like brand vs. generic meds. Sometimes the generic is better than the brand.