LiverHope

Speeding up Your Social Security Claim

Jacques Chambers, CLU, Benefits Consultant

October 20, 2009 - Getting Social Security to make a decision on a claim for disability has never been a rapid process; however, it is now taking even longer. Claims for disability have increased dramatically, but the staff at Social Security has not.

In addition, Social Security contracts with each state to provide a Disability Determination Department that reviews and decides the medical eligibility of applicants. As states try to balance their budgets during this recession, many of those departments have suffered staffing shortages and unpaid furlough days, even though the federal government reimburses the states in full for those departments

Because of this increased volume, short staff, and budget restrictions, it is taking longer and longer for a disability claim to go through the process to the point that it is not uncommon in some regions for an initial disability claim to take six months or more from initial interview to final decision.

Is it possible to reduce the processing time? While there is no formal “fast track” system, there is a lot you, the claimant, can do to make sure your claim doesn’t get stuck and continues through the system as quickly as possible often cutting months off the timeline.

Start the Applications Online. Social Security has greatly improved the online filing system. No longer does your claim just vanish and go to some unknown central processing system. Now, once you submit the two online disability forms, they go directly to your nearest Social Security office for processing.

The two initial forms can be completed online, both the Application for Disability and the Disability Reports, one for adults and one for children. They are available at http://www.ssa.gov/; follow the links. The forms are quite user friendly.

Completing the forms online also gives you the opportunity to save your work before submitting it so you can take a break, look up some information, or complete them over a period of days.

Go for an In-Person Interview. Once you have submitted the online forms, call Social Security at 800-772-1213 and make an appointment to go into your local district office for the initial interview. This will give you the opportunity to meet the representative assigned to track your claim through processing, and to get his or her direct phone number. It also allows you to bring any documents that Social Security needs to see without worrying about losing them in the mail.

Because you have already entered all the information on line, this initial interview is usually very brief, usually just to review the information you submitted and get your assurance that the documents are accurate to your best knowledge.

Take Your Medical Records with You. The one thing that slows down the processing of claims the most is the analyst requesting and waiting to receive copies of your medical records from your treating physicians. Because of the analysts’ work load, they can only send the request to your doctors and then wait a month or so to see if they are returned before requesting them again. If you can provide all your medical records at the initial interview, you are greatly reducing the time your claim just sits and waits.

It is not always easy to collect your medical records; however, it can be worthwhile to get your claim processed faster. Some doctors may attempt to charge you for the records; although if asked, they will often waive the fee if they know you are using them to apply for Social Security. If they insist on charging, you will need to decide whether it is worth it to reduce the processing time.

If you do submit your medical records at the initial interview, you will need to make a photocopy of them. It is not uncommon for records and other paper documents to get lost between the Social Security office and the state agency that actually reviews them. This seems to occur more often as Social Security moves to paperless files.

If You Can’t Take the Medical Records with You. If you choose not to submit medical records with your initial claim, you should get the name and phone number of the analyst processing your claim. Your representative at Social Security will be able to provide these once your claim is assigned to an analyst.

You can contact the analyst to find out when and from which doctors the records were requested. Follow up with each doctor to confirm they got the request and ask them when they will be sent. If they haven’t received the request, get the doctor’s fax number and ask the analyst to fax the request.

You should continue to work as the go-between and make sure the requests are received by the doctor, the records are sent from the doctor, and the records are received by the analyst.

Because of the analyst’s workload, it may be difficult to speak directly with the analyst; however your communication can be accomplished using the analyst’s voice mail. Don’t lose patience if they are slow to respond. You want to be perceived as helpful not nagging.

Complete Questionnaires Promptly. Once your claim is received by the analyst, you will often be sent a packet of questionnaires to complete. Usually this will include a questionnaire on how you function with your symptoms as well as some specialized questionnaires based on your diagnoses, such as questionnaires that focus on pain, fatigue, mental/psychological, neurological, etc.

The analyst will normally give you ten days to complete the questionnaires. While you should do your best to get it returned in that time, if you need an extension you can get it by calling the analyst, whose name and number will be in the cover letter

Fax the Questionnaires if Possible. You will have the choice of submitting completed questionnaires by mail or by fax, using a cover sheet with a bar code. Faxing will enter the questionnaire directly into your electronic file at Social Security for instant availability to the analyst. Mailed questionnaires must be scanned into the computer which slows down the processing.

One Don’t. Contacting your Congress member does not help when first filing a claim. That should remain as a last result if the claim should get stalled and is not moving at all.

While the process of applying for disability with Social Security moves slowly, by following these tips and periodically checking with your analyst to make sure he/she has everything they need to make a decision, you can cut the processing time, often dramatically.

November 11, 2009 - Hepatitis C virus (HCV) is the most common blood-borne infection in the United States and worldwide – surpassing even HIV/AIDS – yet most people know little about it. Assistant Professor of Sociology Alicia E. Suarez, who studies the affects of stigma on those who have HCV, offers an explanation for this divide.

"HCV is transmitted blood to blood," Suarez explains. "That means it mainly affects intravenous drug users. Hemophiliacs and people who receive blood transfusions are affected as well, but that's very unlikely now that blood is screened. Suffice it to say that HCV is not culturally visible."

The disease itself can be symptomatically invisible, as well. Many people don't know they've been infected until they're diagnosed with some sort of liver disease, such as cirrhosis.

"As many hepatologists will say, most people will die with HCV, not from it," Suarez says.

illness – research that looks at illness experience. In the United States, that experience is typically related to ever-increasing life spans.

"Disease in our society is characterized by chronic illness," Suarez says. "One hundred years ago – or in less-developed countries today – it might have been more characterized by what we would call acute illness, which either goes away or kills you quickly. Instead, we live a long time and often with some sort of illness."

Whereas a biologist might examine how a pathogen affects organ tissue, Suarez studies factors external to the disease that can affect a person's quality of life. While these approaches to illness are different, she argues that they are complementary.

"Taking a look at medicine through a sociological lens provides vast insight into how we treat patients and understand illness, disease and inequalities in health," she says. "Medical schools are recognizing this and requiring students to take courses that look at the social and cultural aspects of health and illness."

"You have to show students the big picture with statistics, but you also need to personalize it," she says. "I invited people who are HIV-positive to come speak to a class. It's not just a statistic anymore – it's this person who lives in Indianapolis who's sitting with us and talking about his illness. Numbers affect a person's perception, but giving a voice to the disease gives students a way to relate other than the behavior associated with the disease."

Suarez's ultimate goal is to reduce stigma associated with HCV, both among the public and medical community, so that people who are infected with it are more likely to seek and receive help.

"People think that if they tell someone they have HCV, they'll risk stigmatization," she says. "But if they don't tell, they won't have access to social support. There's a lot of research that shows that having support is very important for people who are ill. It's a Catch-22."

Suarez conducted research on this phenomenon in the American South that revealed the cultural complexity of HCV. She found that a respondent's race could greatly affect how he or she experienced the disease. In general, African-American respondents were less willing to disclose their illness to others, while white respondents reported significantly higher feelings of stigmatization. She has shared her findings at conferences across the country, including ones sponsored by the American Liver Foundation and Washington State Department of Health. She hopes that her work will both help fight the spread of HCV and improve the quality of life for those who suffer from it.

"All sick people deserve access to treatment and knowledge about their illness," Suarez says. "How people get a disease doesn't mean they should be treated with any less dignity."

In January 2008, we started offering a quarterly cirrhosis patient education evening lecture series and forum for patients with cirrhosis. The meetings are held on the third Tuesday in January, April, July and October from 6:30 – 8:30 p.m. at the Division of Gastroenterology, located in the 3^rd floor conference room of the VFW building, 406 Harvard St. S.E., Minneapolis, MN 55455.

We hope you can join us. If you have any questions about the program or need directions please call Aynsley Smith at 612-625-8438 or email at smit0288@umn.edu.

Congressman Hank Johnson, of the 4th congressional district in Atlanta, announced on December 7, 2009, that he has been battling a chronic hepatitis C infection for over a decade.

He learned of his infection in 1998, and is currently undergoing an experimental treatment to put the virus into remission. Although he does not know how he contracted his infection, the hepatitis C virus (HCV) is transmitted through direct contact with infected blood.

It is believed that at least 4 million people in the U.S. have HCV, though many infections continue to be undiagnosed due to the silent nature of the infection.

Mr. Johnson is the first member of Congress to publicly acknowledge having hepatitis C and has voiced his active support of the current Viral Hepatitis and Liver Cancer Prevention and Control Act (HR 3974) that was recently introduced in Congress.

Women, Blacks, Medicare Recipients Less Likely to be Evaluated for Liver Transplants

September 1, 2009 - Patient race, gender and insurance status influence decisions about who will go on to receive liver transplants, according to a University of Pittsburgh School of Medicine study. Available online and published in the September issue of the American Journal of Transplantation, the study indicates that women, blacks and patients with Medicare who are in end-stage liver disease are less likely to be referred and evaluated for liver transplantation.

"There currently is no comprehensive oversight of liver disease patients as they go through evaluation, referral and are put on a waitlist for transplantation," said Cindy L. Bryce, Ph.D., study lead author and associate professor of medicine, University of Pittsburgh. "We know what happens once patients are selected for transplantation since they are closely monitored, but what happens prior to this point is fairly invisible. Ours is the first major study to look at whether everyone with liver-related conditions has a fair shot of being considered for transplantation, and points out that many patients are being excluded from this process."

The study, which followed 144,507 patients hospitalized in Pennsylvania with liver-related conditions, sought to determine whether any potential barriers exist at the referral and listing steps in the transplantation process. Dr. Bryce and colleagues found that 4,361 of these patients underwent transplant evaluation. Of these, 3,071 were waitlisted and 1,537 went on to transplantation. Patients were significantly less likely to undergo evaluation, wait listing and eventual transplantation if they were women, black or covered by Medicare.

Disparities were especially apparent in the early stages of the process when evaluation and listing occurs - 61 percent of men were evaluated for transplantation compared to 39 percent of women; 73.8 percent of whites were evaluated compared to 8.6 percent of blacks; and 62 percent of patients with commercial insurance were evaluated compared to 4.7 percent with Medicare only.

"While our study was not designed to identify causes for these disparities, current practices for identifying and referring liver disease patients for transplantation should be made more transparent," said Dr. Bryce. "Although we face a worsening gap in the supply and demand for organs for liver transplantation, race, gender and insurance status should not be factors that preclude patients from being evaluated for transplantation."

The study was funded by the National Institute of Diabetes and Digestive and Kidney Diseases at the National Institutes of Health.

Co-authors of the study include Derek Angus, M.D., Robert Arnold, M.D., Chung-Chou Ho Chang, M.D., Max Farrell, B.S., and Mark S. Roberts, M.D., University of Pittsburgh School of Medicine; Cosme Manzarbeitia, M.D., and Ignazio Marino, M.D., Thomas Jefferson University.

Source: Clare Collins, University of Pittsburgh Schools of the Health Sciences

Healing Hepatitis C: A Patient and a Doctor on the Epidemic's Front Lines Tell You How to Recognize When You Are at Risk, Understand Hepatitis C Tests, Talk to Your Doctor About Hepatitis C, and Advocate for Yourself and Others, by Christopher Kennedy Lawford and Diana Sylvestre, Harper Paperbacks, 2009, paperback, 208 pages, $14.99

There are a number of good books about hepatitis C (HCV). I have read most of them. When I ordered Healing Hepatitis C, I expected it to be much like the others. What I didn’t expect is that I would pick it up and not want to put it down until I finished it. Yes, it was that good.

I am acquainted with one of the authors, Diana Sylvestre. A physician, researcher, and faculty member at the University of California, San Francisco, Sylvestre’s passion is working with disenfranchised patients. Her warmth shines through the pages. The other author, Christopher Kennedy Lawford (yes, of the Kennedy-Lawford family) provides good humored insight from the

Healing Hepatitis C is different from most of the other HCV books. The format is a dialog between the two authors, but it manages to come across as if the authors are speaking to the reader. Although I enjoyed it immensely, this style may not appeal to everyone. My only criticism of the book is sometimes I wasn’t sure which author was narrating.

Lawford expands the dialog concept when he converses between “Sober Chris” and “Junkie Chris.” I don’t know how other readers will find this, but it worked for me. It illustrates some of the turmoil that we experience over this disease, particularly regarding treatment. I assume that patients who have not wrestled with addiction will still be able to relate to the inner struggles that seem to go with living with HCV.

Lawford and Sylvestre address the core issues and fears associated with HCV treatment that many of us have. This is the magic of this book. It is real yet it reads like a novel. The book is not highly technical yet it succeeds in getting across a lot of information without boring the reader. The Online Resource section provides tools for the reader wanting to know more about various aspects of HCV.

Healing Hepatitis C offers genuine hope for HCV patients. It can be summarized best in the authors’ own words, “…we hope to walk you through the process of facing the diagnosis and treatment head-on, to show you that it is possible to get through this hepatitis C thing—and to be cured—without surrendering your life to it.”