SSDI Review--I'm already on SSDI--assigned to meet a Pdoc

I filled out a bunch of SSDI review documentation a few months ago, and have now heard back that I have to meet with a pdoc they've assigned. Early March. I'm spooked about it. I don't believe that a 1-time appointment with someone can provide enough info and exposure to a person for that pdoc to make a well-informed assessment of such gravity.

I especially have problems with T's and pdocs taking a long time to get to understand me, and it's not just me who says that. It's T's that I've had who've said it took them a long time to understand me.

I very much want to hear from people who've been through this or know more about the review process itself. Thanks.

The only advice I can give you is to take someone along with you; so they see you are incapable of taking care of yourself; that you need someone to help you think and speak, etc.
Y'see, if you come by yourself they already see you as competent enough. And seriously if they see any competence you lose your chances.
Then, do not respond to their questions sensibly. Honestly, if you do, they will say you are capable of holding down a job. So just answer stupidly. if they ask what is one plus one say eleven. Seriously. been there done that.
I'm sorry they make it so tuff for those who truly need it and a one-time appt. will not tell them much.
They do give weight to your doc's documentations. So hopefully your doc knows how to write up something convincing.
Not trying to cheat the system here, but the system is not very good at picking up when we truly need their help, so gotta work with what we have.
I was denied twice and then with the help of an attorney I got one year of disability. Still better than nothing. No one who knows me thought I could hold down a job at that time. The folks at work said I am so young yet have the energy of an eighty-year old. Would come home from work and fall asleep, could not take care of kids. Getting the benefits helped me take a year of from work and take care of my kids instead. And if there are no kids involved, you need to take care of yourself; you're also a person who needs caretaking.

For me, when I saw the pdoc SSDI sent me to, I answered everything completely honestly and to the best of my ability. And then was approved on the first round, with no appeal etc! I think that if you have anxiety, it works to your benefit. I was so anxious, that when he asked me who the vice-president of the USA was, I honostly could not remember! This was a few years ago, and I believe I said something like "I know who it is, I can't think of his name...that old guy!". lol If you are on medications, take them all with you. The doc may ask you what each one is for, if you don't know or aren't sure, that may work to your benefit also. Alternatively, if you DO know, say so! But if you are on something like an antipsychotic, you might say its "so those freaky spirits can't find me" (or whatever experience the med is helping with), instead of "its an antipsychotic".

Definitely have someone drive you, do not "dress up", and make sure you are not acting at ease and confortable while waiting...I have heard that the assessment begins when you walk in. The pdoc and or the reception person will be observing you before you are called back.

When I went the doc asked me about my meds, a very few questions about my daily functioning, and then gave me a standard mental status exam...that's it. For the daily functioning, make sure you know what you claimed originally on the paperwork as your issues...its okay to add some, but make sure you talk about some that are on the paperwork.

i had one & i was also so nervous i flunked the basic who is what, etc exam...i was twitching like a fool...dropped all the meds, couldn't remember anything, even with my list, got things messed up etc.

honestly i would go with just being who you are...& not playing too many games...i feel if you start playing to many games it comes back to bite you is the posterior...look if you pride yourself as being intelligent and together with all these reviews saying so, and walk in there and act dumb as the dirt you stand on well obvioulsy something isn't right....these docs have seen that act before...alot.

my initial application was denied..but i was young...and i had many physical conditions along with it..but i reapplied and it was accepted immediately.

ima ~ I see a lot of good info above. But to answer your question, experienced pdoc/MH professionals are better than you would think in getting an accurate assessment of someone during one session. This doesn't mean that they understand you, just that what you report is either false or helpful in guiding them through the diagnostic manual. They have to do one-time assessments so frequently, that they get very skilled at it. You would be surprised. I agree with not dressing up and stressing your symptoms as much as you can, but also agree with reporting essentially the same symptoms as on your previous application. Thanks for the question and information provided above!

I did not play any games and was my true self, therefore was denied for two years. Mine was/is a physical disability, with full documentation of my doctors. Was still denied. In hindsight, I think it was because I appeared at all appointments by myself. Though their doc saw the objective physical symptoms I was still DENIED.

My conclusion, after my experience, is that going with another person is a help.

Hi,
You've gotten some good advice so far. I have been on ssdi for a really long time due to health problems and I do know that once your on it, its very hard for them to disaprove you and kick you off. As long as you have been consistently keeping all you T or pdoc appts. they can't say anything much. Alot of times they make you see their docs because they didn't get enough info for one of your treating docs. Hope this helps a tiny bit.
Akunia

Thanks for this.

Yes, I started in March 2002 with disability date of fall 1999.

The thing is I've been so much treatment in the past year that I would've thought that made it a slam-dunk. I did 3 weeks of partial hospitalization, 3 months of Day Treatment, have 2 individual T's, a pdoc, and am in a wekkly depression supoort group led by a PhD T. I had gotten so bad off (sui) that I wnet through that and got a T for the first time in a few years, a new pdoc, etc. to try and shake things up. I posted once about it, and I think I met with 8-9 T's on a 1-1 basis and 3 pdocs plus the group stuff last year with all of it. I'd think having so many PhD T's and pdocs diagnose me as depressed last year would be enough.

I'd like to hear more about them not taking you off SSDI if you've been on for a long time. My life is not appreciably better.

How about side effects of meds, and how the side effects impact on your ability to hold down a job?

I've been on since 1993 for a seizure disorder. I also have bipolar and ptsd but I didn't file under that. Anyway..one of my reviews sent me to their docs and it was because my gp had been lazy and not sent all the paperwork they requested. Because you just started seeing a new pdoc he may have not sent something in and triggered them sending you to one of their docs. You have more then enough evidence that are still in treatment and still disabled. When trying to get ssdi you first have to prove your disabled....for them to kick you off THEY have to prove your NOT disabled.
Try not to get super stressed out, easier said then done I know. And do take someone with you at least for moral support. I saw a one of their pdocs just because I was taking an antidepressant and like another person mentioned, was so nervous couldn't answer most of her questions.
Akunia

thats for sure...so many affect cognitive abilities. Mine just totally knock me out half the day and have no short term memory.

i had been denied first time (DID and fibro seem to not exist) and at hearing level pushed for anxiety because that is what it the most prominant issue. I got lucky - it went thru with no hearing and no 2nd round drs. I too fear the renewal process. Mom actually works for an attourney's office for SSDI and tells me all sorts of horror stories where ppl report on others so they lose ssdi and ssdi call ppl and ask them what they're doing and then kick them off for doing something they "couldn't do".
I bet a lot depends on where you live.
I would say, keep breathing, have someone drive you to your apnt (that came up in mine too grrrrr) and stare at the floor a lot and be slow to answer questions lol. I know they say "be normal, don't try and fake it". but it is so nerve wracking that it is hard for ppl to not be high strung!
holding that it ALL GOES WELL for you.

My appointment with the SSDI appointed pdoc is toiday at noon.

I'm nervous.

A lot to talk about given all the treatment I've been through/am going through this past year.

2 indiv. T's, group therapy, pdoc, Partial Hospitalization a year ago, Day Treatment sprign until July last year.

I've also tried doing some productive things this past year under prssure from T's and programs. Little sucess, but some. But minor volunteer stuff 20 hours over the year since June '09. None paid. Not for an organization. A lot of failed attempts--far more. I fear that even having tried will make me look better than I am.

This is a Re-Evaluation, not an initial evaluation, so if anyone has experience with Re-Eval for mental illness and can offer comments, or words of support, I'd appreciate it.

impy, no experience, but much love & support heading your way . good luck.

No experience here either - but good luck!

Thanks Deli and ahc82. 90 minutes to go.

You must be through it by now - how did it go???? I'm on it, but not at that point - 3 years still to go. I've heard you need a lot of Dr support (written), and to keep track of all your appointments and meds. (Not that any of this helps by this point....)

Hoping it is alright and that you get what you need.!

how did it go, impy? *poke*

Quote:

Originally Posted by deliquesce how did it go, impy? *poke*

It was weird.

He didn't seem to know anything about me, like he hadn't read any reports supplied by my multiple T's and pdoc or what I had submitted. I'm pretty sure he didn't know anything coming into it.

He said there was half an hour for it, and then I could take some time at the end if there was stuff I wanted to bring up or ask questions.

He was not very people-friendly, but I do believe he was friendly overall; a good-hearted person. Very cut and dried; read from a prepared list of questions. Assembly-line .The questions were very standard and very "square" in that they didn't lend themselves to dealing with material that was somewhat related but not exactly on topic. But I took advantage when possible of having my say and not letting what he heard be defined by overly simplistic, narrow questions.

I started off needing to make the general case for "so what are the problems you have that prevent you from working?" Then came the narrow, very concrete questions.

There's a problem that I've always had with being evaluated by new people--going back to my first T visit 25 years ago--of coming across too well. My main T suggested that I bring it up right away for this evaluation to make this pdoc aware of the dynamic. I couldn't get to it right away given the flow, and brought it up later when I had to. Basically I have test scores that are way off the charts--99.999 percentile. Added to that I'm considered extremely articulate, particularly about complex material and concepts. So I end up sounding very on top of things, together, aware of everything going on inside and outside me, and explain myself in extremely impressive ways. I've had problems with T's not taking me/my problems seriously--at early meetings--because I seem so very highly functioning and able communication-wise, self-analysis/awareness, super ability to understand and explain. This pdoc gave me that rap about how good a job I did at explaining things, etc. that it would work against me in an assessment of my functioning. The point with my therapist and others is that they've come to see that in some I am extremely highly functioning mentally, but still unable to function--or I function extremely poorly--in other way.

So after this guy gave me that, I gave the explanation that my T suggested I make. After talking about it a bit he seemed to understand. He used the metaphor that I might look like a brand new, shiny, souped-up, top of the line Cadillac but only have a 1-cylinder engine working inside, all appearances aside. So I think he got it.

On that theme, it really drove me crazy with these little word, letter, number tasks they ask. One was to ask who the current President is, I said Obama, the he asked "and who was P before him?" and I said George W. Bush, before? Clinton, before, George Herbert Walker Bush, before that? Reagan. He raised his eyebrows like he was super-impressed, like questioning how difficult things could be for me. But I've been a political junkie my whole--before school even, my family was political, all 4 kids in my family were polisci majors, and I had completed 3 years of PhD work in political science at an Ivy League school when I fell apart. It's not a big deal at all to remember all the presidents from the past 30 years for me--it's to be expected with my background. I could probably go all the way back and miss only a few.

Then there were some number things. I think I got them all right. He seemed impressed. They were child's play for me. I have that super high math aptitude and could have gone to college on a math scholarship. I have a particular math accomplishment that I won't get into but that is genius-level quality. And I also worked in accounting/finance for many years where I walked around juggling numbers and formulae in my head all my waking hours. I have a general thing for counting things--OCD--so I'm also categorizing and organizing things in my head in numerical terms always. Numbers are easier for me than words even.

So the idea that my good performance on those could hurt my chances for demonstrating disability due to mental illness enrages me.

There must be outliers for those sorts of tests at the level of sophistication they use, but I was given no indication that they try to evaluate performance in a more sophisticated way than a one-size-fits-all.

Another problem is that I used a word--given to me by a T as a way to categorize some of my problems with trying to do productive work, the whole process of--"avolitional." The examining pdoc didn't know the word--it's common for the profession. Belittled it as "well that's a big word" and after I explained it attached a definition to it that's at odds with the meaning and that is denigrating in what it says about someone labeled with it. I didn't want to get into an argument with him so I let it go. My two individual T’s that I’ve told this about can’t believe he didn’t know the word or concept (by that word at least).

So 30 minutes of his thing and then 10 minutes of my follow-up to try and make sure certain things were understood? I don't have faith that he knows me well enough from that time to make a meaningful assessment. It was very assembly line. But, I do feel that in the end he expressed some sympathy and degree of understanding how much I suffer. He wrote a report that SSDI will use. From there, I don’t know what’s next.

Can't say I feel enlightened about where it's at or that I have faith in the process.

impy, you tried your best. i'm impressed you let the 'avolitional' thing slide. the president thing - it's the mini mental state exam - who is the president (the australian version has a little asterisk and says "substitute prime minister if required"), the one before him, can you tell me the date etc. austin-t tries it with me every time (and i get grouchy at him) but i never get the date right. i dont even try. apparently this shows i'm not of sound mind. dimwits.

my experience getting onto the pension sounds similar to yours, though. he's probably a first year intern or something - next year i'll be able to do assessments for other ppl - bizarre, right? you get your list of questions, ask them, record answers, etc. what got me through was the list of 13meds i've been on. i think the psych (she was surely my age, if not younger) got scared (oh the scary deli is going to eats you) and was like, well if you've been on this many then certainly you are crazy and unable to function. which served it's purpose (i got the pension) even if i had to grit my teeth and try not to educate her at the same time.

your doc/examier/question reading boy sounds like he understood you and was listening, so it sounds promising. i will keep my fingers crossed for you. i think you did well.

Sometimes it definitely pays to be un-intelligent.

If you don't get approved can you appeal?

The problem in Australia though is that you have just as much a chance of getting a physiotherapist at the assessment as getting a psychologist. I think I had a social worker. Plus we have to be reviewed every 2 years

Probably the questions are a set that all reviewers have to ask. Sounds like he understood what you were saying though. I bet you're glad it's over.

Skyliner, physical is different from mental; I have a friend who is quadriplegic and every time after he works a job and reapplies to be reinstated (after he gets laid off; he'd love to work if he could get the jobs) he gets denied. Lying in answer to questions just to appear more handicapped is fraud.

Impatient-
I agree with Deli- it sounds like the person did the mini mental state exam. Just so you know, at least in the US, most people can't go back five presidents, even if they were alive for all of them, or they get them out of order or something. So it was impressive that you were able to get all of them. I also think that the structured sense of the interview was probably because he did have a set of questions that he had to ask so that everyone has the same questions. I will keep my fingers crossed for the outcome of your review.