Thursday, July 29, 2010

ALERT: NEW TREND in US Medicine: Putting Patients First!

This new trend is called "Patient-Centered Medical Homes". Now, this just means putting the PATIENT at the center of all things medical. Consider this explanation from the article:

[Patient] care is team-based, preventive and comprehensive, rather than one-on-one, fee-for-service or managed. Record keeping and sharing is seamless and electronic, rather than unwieldy and paper-based. Clinicians from the team are easily accessible in person, on the phone or via the Internet within 24 hours, rather than hidden behind labyrinthine automatic answering services and overbooked clinic schedules.

Here is the link to the NEW YORK TIMES article:

(Note: just copy the url and past it in your browser.)

Wednesday, July 28, 2010

Brain Changes in MS May Spur Depression

If I did the "insert" correctly, you should be able to click on the link below and go directly to the link and read the article. If my cognitive ability failed me, please copy and paste the link into your search bar.

This article - from a fantastic MS research website that I subscribe to - talks about the "Brain Changes" in the brain of the MS patient that may spur depression.

Most of us with MS ALREADY KNOW that we also suffer from depression. Hopefully, this article just might help MS folks better communicate with their doctors.

Saturday, July 17, 2010

WHO should collect an Applicant's chart notes for a Disability Insurance (like SSDI and/or SSI claim?

If you ask the SSA (Social Security Administration) you will probably be told that they can get the medical info for you, as soon as you sign the release form(s).

HOWEVER, the DisabilityKey process HIGHLY recommends that YOU - the APPLICANT - gather up all the chart notes and read them, underlining the parts that refer to your symptom impairments, and WHERE THERE MIGHT BE DISCREPANCIES between what you say in your documentation and the drs' chart notes, you can resolve any differences BEFORE the notes go into SSA.

Here are 3 situations where the applicant did NOT do the chart note gathering, reading and resolving FIRST. They were DISQUALIFIED because of issues that they could have resolved ahead of time if they had only obtained the chart notes ahead of time; read and resolved any discrepancies BEFORE submitting them to the SSA.

1) The dr's admin compiled the files to send to SSA upon request of the SSA Case Worker's request; the office had 2 people with the same last name; the admin sent in the case files for the WRONG PERSON!!

2) The applicant reported she could not drive due to symptom impairments; had lost her license. The dr's latest chart notes sent in at the request of the SSA's Case Worker - without review by the applicant - showed that the applicant could still drive; the applicant was denied benefits because the SSA said they couldn't "trust" her documentation. When the applicant later talked to the dr, the dr apologized; corrected the chart notes to reflect that she HAD INDEED lost her license 3 yrs ago! The dr had written the latest chart notes WITHOUT referring to the applicant's past history!

3) The SSA Case Worker did not want to contact the applicant's multiple drs for chart notes, so denied the applicant disability benefits, saying that there was "insufficient evidence of ADL (Activities of Daily Living) symptom impairment; therefore the applicant could perform SGA (Substantially Gainful Employment". AND REMEMBER - it is YOUR responsibility to PROVE your impairment.

The SSA states the following (get my new FREE ebooklet to learn more):

Under both the Title II (SSDI) and Title XVI (SSI) programs, medical evidence is the cornerstone for the determination of disability. Each person who files a disability claim is responsible for providing medical evidence showing he or she has an impairment(s) and the severity of the impairment(s).

AND, this:

(a) General. In general, you have to prove to us that you are blind or disabled. Therefore, you must bring to our attention everything that shows that you are blind or disabled. This means that you must furnish medical and other evidence that we can use to reach conclusions about your medical impairment(s) and, if material to the determination of whether you are blind or disabled, its effect on your ability to work on a sustained basis. We will consider only impairment(s) you say you have or about which we receive evidence.

Sunday, July 11, 2010

SSA's "Blue Book" Criteria for Autoimmune conditions

GREAT NEWS: The SSA has a Blue Book that lists "common disorders" and the criteria that need to be met to qualify for either SSDI or SSI.

OK - please don't freak out when you see the info I'm copying below. I'm just showing you the YARDSTICK against which an SSA Analyst will measure YOUR situation. AND, that's why you need to get the DisabilityKey Workbook found at the DisabilityKey website: for the process instructions, forms and examples to document your symptom impairments to meet these criteria!! AND, to assist your doctor(s) in supporting you!

Here's the link to this Immune Disorder category: ... .htm#14_10

From that link, here's what is said about "Autoimmune" conditions:

2. Autoimmune disorders (14.00D).Autoimmune disorders are caused by dysfunctional immune responses directed against the body’s own tissues, resulting in chronic, multisystem impairments that differ in clinical manifestations, course, and outcome. They are sometimes referred to as rheumatic diseases, connective tissue disorders, or collagen vascular disorders. Some of the features of autoimmune disorders in adults differ from the features of the same disorders in children.

Here's what the SSA says they need to show that you have an immune system disorder. And REMEMBER - they also state - elsewhere - that it is YOUR responsibility to obtain and provide this information to them in support of your case.

Under both the Title II(SSDI) and Title XVI (SSI) programs, medical evidence is the cornerstone for the determination of disability. Each person who files a disability claim is responsible for providing medical evidence showing he or she has an impairment(s) and the severity of the impairment(s)

Here now are the "immune disorder (autoimmune) criteria.

B. What information do we need to show that you have an immune system disorder? Generally, we need your medical history, a report(s) of a physical examination, a report(s) of laboratory findings, and in some instances, appropriate medically acceptable imaging or tissue biopsy reports to show that you have an immune system disorder. Therefore, we will make every reasonable effort to obtain your medical history, medical findings, and results of laboratory tests. We explain the information we need in more detail in the sections below.

C. Definitions

1. Appropriate medically acceptable imaging includes, but is not limited to, angiography, x-ray imaging, computerized axial tomography (CAT scan) or magnetic resonance imaging (MRI), with or without contrast material, myelography, and radionuclear bone scans. “Appropriate” means that the technique used is the proper one to support the evaluation and diagnosis of the impairment.

2. Constitutional symptoms or signs, as used in these listings, means severe fatigue, fever, malaise, or involuntary weight loss. Severe fatigue means a frequent sense of exhaustion that results in significantly reduced physical activity or mental function. Malaise means frequent feelings of illness, bodily discomfort, or lack of well-being that result in significantly reduced physical activity or mental function.

3. Disseminated means that a condition is spread over a considerable area. The type and extent of the spread will depend on your specific disease.

4. Dysfunction means that one or more of the body regulatory mechanisms are impaired, causing either an excess or deficiency of immunocompetent cells or their products.

5. Extra-articular means “other than the joints”; for example, an organ(s) such as the heart, lungs, kidneys, or skin.

6. Inability to ambulate effectively has the same meaning as in 1.00B2b. (Find the citations for 6-8 at this link: ... -Adult.htm)

7. Inability to perform fine and gross movements effectively has the same meaning as in 1.00B2c.

8. Major peripheral joints has the same meaning as in 1.00F.

9. Persistent means that a sign(s) or symptom(s) has continued over time. The precise meaning will depend on the specific immune system disorder, the usual course of the disorder, and the other circumstances of your clinical course.

10. Recurrent means that a condition that previously responded adequately to an appropriate course of treatment returns after a period of remission or regression. The precise meaning, such as the extent of response or remission and the time periods involved, will depend on the specific disease or condition you have, the body system affected, the usual course of the disorder and its treatment, and the other facts of your particular case.

11. Resistant to treatment means that a condition did not respond adequately to an appropriate course of treatment. Whether a response is adequate or a course of treatment is appropriate will depend on the specific disease or condition you have, the body system affected, the usual course of the disorder and its treatment, and the other facts of your particular case.

12. Severe means medical severity as used by the medical community. The term does not have the same meaning as it does when we use it in connection with a finding at the second step of the sequential evaluation processes in §§404.1520, 416.920, and 416.924.

Saturday, July 10, 2010

ALERT: 2009 Disability Insurance Statistics....

The Council for Disability Awareness (CDA) at this link: ... y_2010.asp released its recent 2010 review of long term disability claims (of all types). While you can read all of the info at this link, I've copied below the SSA info.

"New claim applications submitted to the Social Security Disability Insurance (SSDI) program continued to surge in 2009. More workers are applying for SSDI claim payments than at any time in history, with new applications totaling 2.8 million in 2009 - an increase of 21 percent, and by far the most ever. New SSDI claims are projected to continue to rise dramatically in 2010. Over 5 percent of the workforce, or 7.8 million workers, were receiving SSDI at the conclusion of 2009.

At the same time, the approval rate for initial SSDI claims continued to decline. The approval rate fell to 35 percent in 2009, representing a continued steady decline from 52 percent 10 years ago. The CDA Claims Review found that 31 percent of individuals receiving private group long-term disability insurance benefits did not qualify for SSDI assistance and 95 percent of claims were not job-related."

The 31% of individuals receiving private group LTD benefits that did NOT qualify for SSDI assistance is very troubling for 2 reasons:

1) Insurance companies are often TERMINATING a person's LTD if they do NOT subsequently qualify for SSDI.


So, once again, I BEG of you to contact me for the DisabilityKey process BEFORE you start the application process for any type of Disability Insurance.

Wednesday, July 7, 2010

Statistics supporting the need for Chronic Disease Self-Management

The future of medicine is management of chronic disease.

* In 2000, it was estimated that 125 million Americans had 1 or more chronic medical condition.

* This number is expected to increase to 157 million by 2020.[1]

* Moreover, about 60 million have multiple chronic illnesses, a number that could rise to 81 million by 2020.

Are YOU prepared for Chronic Disease Self-Management? Assessment Tool

Self-Efficacy has been defined as the ability to "self-manage" your own symptoms toward maximizing your quality of life. It assumes that:

1) You HONESTLY know you body and yourself and your symptom impairments and are willing to partner with your health care team to identify, use and maintain whatever "intervention mechanisms" determined for your particular symptom (i.e., medication, exercise, rest, etc.).
2) You are willing to know what you can and cannot do and are willing to seek assistance when necessary.

If you want to determine if you ready for Chronic Disease Self-Management, please consider taking this test from the Stanford Patient Education Research Center on "Chronic Disease Self-Efficacy":

Tuesday, July 6, 2010

Ask ? of Master MS Neuros; See Archived ?

Ever want to ask a question of Experts about MS? Here is your opportunity!

Now, the site is targeted for clinicians, but I - as an MS person and a Disability Advocate - found lots of info in the Archives section; that link is below.

"If You Could Ask a Question of One of the Top Experts in Multiple Sclerosis, What Would You Ask?

Now you have that chance, with

More information has been published about multiple sclerosis (MS) in the past decade than in the entire history of medical literature. Clinical practices even a few years out of date may not be in the best interest of our MS patients. But it’s nearly impossible to keep up with all the advances, much less apply them in a disease that varies greatly among patients.

That’s why we created This website is a forum for specialists with the latest expertise on MS to share their knowledge with you, the MS clinician. It’s simple: register for the site, enter your question, and our experts will address it directly. Or browse the archived topics on the site."

Link to Archives section:

I particularly liked the info about MS Symptoms!