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Last updated January 1, 2014

Why not me?

A realistic look at the complexities in the disability system.

Joshua W. Potter, Esq. Fibromyalgia AWARE, Sept-Dec 2002

One of the most frustrating aspects of the disability programs, bar non, is the apparent unevenness in the award of benefits. This applies not merely to the amount of benefit but also to whether disability has even been granted. A common refrain among those enmeshed in the process is, I know someone who got disability and they aren't half as sick as I am." Sadly, the "truth" is in the eyes of the individuals who reach the simple--pay this one, deny that one--decisions. If it were possible to create two identical fibromyalgia claimants and to have two people provide identical truthful testimony, it is likely that one would win and one would lose. Why? Because two claims are never really exactly the same. The person with a superficial medical chart will fail. Consider also that judges, claims managers, even attorneys are people too...subject to the stresses of their jobs and their personal lives. Judges can make mistakes. However, unless a particular judge a]ways denies a type of claim or openly declares that the condition doesn't exist, the playing field is somewhat level and somewhat predictable. The completeness of the medical chart often determines the outcome.

Comparison of one case to another is a form of "disability profiling" by patients or doctors that often fosters a deep hostility in the patient that can permeate an entire case. No one is ever made whole, the money is never enough, and recognition of the condition is always too late, too little, and too insincere. No one can measure or feel your pain or fatigue. Were there a simple solution it would follow right here. As there is not an easy answer, it is paramount that you not allow yourself to be slowly consumed by the process. Hostility must e subordinated to rational thought. Anger must be replaced with bemusement and frustration with a knowing calculation.

The most fundamental level of any disability claim is the medical record. Your first interface with the health care system is the foundation upon which your case is built. Individuals who approach their physician and his staff with hostility, frustration, and anger can irreparably harm their entire case. It is important to keep things in perspective and to be more than polite.

A disability claim may start to unravel before you even see the doctor. The nurse who first touches your chart creates unchallengeable information that can be helpful, neutral, or hurtful. Once written, it exists and cannot be explained away. Being pleasant fosters the respect and interest necessary for someone to be willing to take the time to craft a complete medical chart. Fibromyalgia is a clinical condition which is symptom driven. The chart is technically if it recites the person "complains of fibromyalgia." However, no one has ever been granted disability because they have the label of fibromyalgia. Many have been granted disability because of their constellation of symptoms such as pain, fatigue, irritable bowel, and headaches. The only way to ensure a proper foundation for your case is to establish relationships with your medical professionals that are not hostile.

If decorum is important with the doctor's staff, imagine how much more important it is to the physician. The fact that doctors have very limited time to spend with each patient is a consequence of our health care delivery system. The patient's responsibility is to be concise, organized and complete. Try to focus on the heart of problem with brief information about the symptoms. Above all, appreciate that a nastiness simmering under the surface will not be disguised, and jibes couched in witty repartee will case a pall over the entire relationship. A sincere pleasant patient is more likely to be successful in receiving a few extra lines of charting from the physician. An organized, undemanding patient may be able to ask the physician to pull the chart and dictate the report after hours.

If it becomes necessary to embark on a quest for disability, the record created as a result of this silent, subtle relationship between staff, doctor and patient can make the difference between seemingly identical cases.




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