Reviewed by Louise Chang on July 01, 2016

Sources

Christine Miserandino, Author, The Spoon Theory, Founder: ButYouDontLookSick.com; Winnie Pannell, P.C., Social Security Disability Specialist; Lisa Pittarelli, Living with Lupus over 10 years.

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Video Transcript

CHRISTINE MISERANDINO: Hey, come on in. Nice to meet you. I'm so glad you came. Let's move over here. Oh, wow. Look who's here.

Lisa, I know that you're on Social Security disability, and I know that process can be a bit daunting.

LISA PITTARELLI: It was an absolute nightmare. That's about the only thing I can say about it.

CHRISTINE MISERANDINO: And I'm sure so many people are feeling that, and that's why we brought Winnie here, Winnie Pannell. She's a Social Security disability specialist. How can we maybe empower our audience with some skills to make our claim go easier or better? What can we do?

WINNIE PANNELL: I think the first thing to do is when you go to the physician, take a note. Sign it Christine. Sign it Lisa. Date it, and explain what's going on. I've been running a fever. I have severe fatigue. I've had involuntary weight loss. I can't sit long. I can't stand long. My fingers don't work on the computer.

CHRISTINE MISERANDINO: So keeping notes--

WINNIE PANNELL: That's right.

CHRISTINE MISERANDINO: --and keeping a journal even.

WINNIE PANNELL: And put it in the doctor's files, say would you please keep it? Because at some point, if your physician is asked, how is Lisa functioning? How is Christine? If they don't have a clue, they're going to say, I can't respond to this. I don't know.

CHRISTINE MISERANDINO: OK.

WINNIE PANNELL: They may not understand that you have lupus brain fog, and that is sometimes you don't concentrate. You make mistakes at work. They may not understand that you are an unreliable employee. Why? Because your lupus is unpredictable. You may be there three days one week, five days the next. You never--

CHRISTINE MISERANDINO: Miss some weeks altogether.

WINNIE PANNELL: --know with lupus.

CHRISTINE MISERANDINO: Right.

WINNIE PANNELL: And the other thing in terms of the physician, they're very busy. And so oftentimes, they'll just write back and say, oh, my patient is 100% disabled and can't work. And of course, Social Security will throw that in the trash can. That tells them nothing.

CHRISTINE MISERANDINO: One sentence is not enough. WINNIE PANNELL: Well, there you go

LISA PITTARELLI: And it's a very short turnaround period, I found out. Sometimes they'd only give you 10 days from receipt of the letter to respond.

WINNIE PANNELL: If you need an extension, ask Social Security, because what physician can write your diagnosis, the clinical findings, the objective findings, your subjective complaints, your treatments, your side effects, your medication. CHRISTINE MISERANDINO: Wh wh wh wh whoa.

WINNIE PANNELL: And your function in two days, if you can ever get them to.

CHRISTINE MISERANDINO: Right.

LISA PITTARELLI: I totally agree. To me, documentation was the key. I took it upon myself to copy everything-- the notes, the lab results, x-rays, everything, and I sent it in with my initial application. I did get approved the first time, thank the lord. And the case worker said, I'm really glad you sent those records in, because when we submitted requests for all your doctors in the hospitals, none of them sent anything in. She said, you would have been denied.

WINNIE PANNELL: Wow.

CHRISTINE MISERANDINO: So now what can I do to maybe speed up the process or to make the process go as smoothly as possible?

WINNIE PANNELL: You first apply for Social Security. More than 85% of people are denied when they apply.

CHRISTINE MISERANDINO: So we should expect that and not take that personally.

WINNIE PANNELL: That's right. And you should appeal, and you should appeal on time, or you will lose your claim. So then you go back into reconsideration. Over 80% of the people are denied the second go around.

LISA PITTARELLI: Oh, really?

WINNIE PANNELL: One of the biggest mistakes is people just feel defeated right off the bat when they're turned down, and so they drop their claim, which means eventually that they will reapply, and they may lose some benefits. They may lose all of their benefits, because they wait until after their insured status has expired. Now where does that leave you? You have an option to go to a hearing before an administrative law judge. And I'll say right now, you don't go to a hearing before an administrative law judge without an attorney, because that is where most claims are won, particularly if you have lupus.

CHRISTINE MISERANDINO: Gotcha.

WINNIE PANNELL: OK. You could be looking at a year or more before you're even able to request a hearing.

LISA PITTARELLI: That's a long time.

WINNIE PANNELL: It's a very long time. LISA PITTARELLI: What do you do?

WINNIE PANNELL: Here's one of the problems. When Social Security asks a claimant, who are your doctors, and you fill out the paperwork and so forth, most people start with the doctors they're treating with now. Well, you both know you may have been through five or six years of physicians, half of whom didn't even know what was going on with you. Right?

CHRISTINE MISERANDINO: Right.

LISA PITTARELLI: Right.

CHRISTINE MISERANDINO: Definitely.

WINNIE PANNELL: OK. All of those records are important. You don't just wake up and say, I'm disabled. So an attorney at that second stage oftentimes can look at the claim and say, wait a minute. This file is totally inadequate.

CHRISTINE MISERANDINO: OK.

WINNIE PANNELL: We want to show five years of struggle with this disease, and you've worked the whole time. Don't forget this. Your rabbi or your minister, your priest, your parents, your husband, your friends-- all of these people know pretty well what's going on with you. Those sources can be used.

CHRISTINE MISERANDINO: Really?

WINNIE PANNELL: You bet. Get an affidavit from your parent or from your minister.

CHRISTINE MISERANDINO: Because that goes towards the social aspect that you were speaking about?

WINNIE PANNELL: That's right.

CHRISTINE MISERANDINO: OK.

WINNIE PANNELL: Let's say that you planned a birthday party for your five-year-old, and guess what. You don't go. And that could be evidence to show an administrative law judge, well, for heaven's sakes. What mother doesn't go to her five-year-old's birthday party?

LISA PITTARELLI: So maybe--

WINNIE PANNELL: She's obviously sick.

LISA PITTARELLI: --the lupus patients that haven't been able to afford to go to the doctor, they could use all of these avenues.

WINNIE PANNELL: Absolutely. Lisa, that's a very good point.

CHRISTINE MISERANDINO: And as far as getting a representative or getting an attorney, Winnie? I cannot afford these things, and I am scared.

WINNIE PANNELL: Well--

CHRISTINE MISERANDINO: I am scared, and I do not have money. How do I do this?

WINNIE PANNELL: That is an excellent question, and most people who apply for disability don't have the money. And Social Security has structured it so that the attorney is not entitled to any attorney's fees, unless number one, there's a contract, number two, social security approves it, number three, the claim is won, and then the fees are limited to 25% of the past due benefits with a statutory cap. And right now, that statutory cap sits at $6,000.

CHRISTINE MISERANDINO: So the most that they can get is $6,000.

LISA PITTARELLI: That's the maximum?

WINNIE PANNELL: That's right. I mean how else could a person who's disabled pay for an attorney? This is a specialty. You need to find an attorney who knows Social Security disability. There is a national organization, NOSSCR. That's National Organization of Social Security Claimant's Representatives.

CHRISTINE MISERANDINO: Oh, wow.

WINNIE PANNELL: They have a referral service nationwide, and the number is 1-800-431-2804. And it'd be helpful if they understand lupus, because lupus is not just like any other claim. LISA PITTARELLI: It's very complicated.

WINNIE PANNELL: It is complicated.

CHRISTINE MISERANDINO: So it's just a long process that we need to prepare ourselves for.

WINNIE PANNELL: We have to be warrior women.

CHRISTINE MISERANDINO: Warrior women.

LISA PITTARELLI: Yes.

CHRISTINE MISERANDINO: I like that.

LISA PITTARELLI: That's a good thing to have.

CHRISTINE MISERANDINO: Thank you.

WINNIE PANNELL: Thank you.