A Parkinson s disease specific guide to Federal Social Security Disability (SSD) Application (this is not for SSI)

Transcription

1 A Parkinsn s disease specific guide t Federal Scial Security Disability (SSD) Applicatin (this is nt fr SSI) *All frms listed belw can be fund and dwnladed r cmpleted n-line at:* **The Scial Security Administratin (SSA) recmmends that frms be filled ut n-line.** 1 st Step Read the Disability Starter Kit. This is Frm SSA Yu will want t gather the infrmatin listed in the Disability Starter Kit prir t prceeding with yur applicatin. This will make the applicatin prcess easier t cmplete. 2 nd Step APPLICATION FOR DISABILITY INSURANCE BENEFITS, Frm SSA-16-BK is the next frm t be filled ut and turned in t SSA. This frm can be filled ut n-line, and in fact SSA prefers that it be filled ut n-line. SSA states that n-line frms can be prcessed quicker than paper frms. As f Nvember, 2008, Frm SSA-16-BK cntains 33 numbered sectins fr the applicant t cmplete. Mst f these sectins request basic demgraphic infrmatin abut the applicant. 3 rd Step DISABILITY REPORT ADULT Frm SSA-3368-BK is the next frm that yu will need t fill ut. This frm has 9 sectins. It requests infrmatin abut yur diagnsis, asks questins abut yur cnditin related t wrk, asks questins abut what yu are able t still d functinally (e.g.-lifting, carrying), and amng ther things, asks abut yur medicatins, dctr(s), and yur medical recrds. The majrity f the rest f this frm will serve as a PDspecific guide as t hw t cmplete this frm. The gal f this guide is t make it easier fr yu the patient t fill ut Frm SSA-3368-BK and t increase the chances yu win yur claim fr disability at the applicatin level s yu d nt have t appeal. Please, nte this is nly a guide, and is written frm the perspective f a patient filling ut the frm. There are many manners in which yu can fill this frm ut, and yu will need t take the language presented here and alter it t fit yu. Feel free t use the parts f this guide that apply t yu and yur cnditin, and disregard the prtins that d nt apply t yu.

2 Sectin 1 INFORMATION ABOUT THE DISABLED PERSON Questins A-I are all self-explanatry. Sectin 2 YOUR ILLNESSES, INJURIES OR CONDITIONS AND HOW THEY AFFECT YOU Questins in this sectin are lettered A-J. A. What are the illnesses, injuries, r cnditins that limit yur ability t wrk? Parkinsn s disease is a degenerative brain disrder fr which there is n cure. My symptms f Parkinsn s disease are significant rigidity, bradykinesia and/r tremr in my (list all extremities) which makes it s (here describe hw this impacts yur grss and dexterus mvements and/r yur gait and statin here. Highlight whether this impact is sustained and hw rigidity, bradykinesia, and tremr disturb yur grss and dexterus mvements). (*Federal disability claims peple require that the rigidity, bradykinesia, and/r tremr affect at least 2 extremities). My symptms are physical and I have significant difficulty with (Describe this here. Examples: clumsiness, lse balance frequently, awkward gait, falls, dyskinesia, drp things). My symptms have als been mental and emtinal and shw up as (Describe these here. Sme examples are: difficulty with cncentratin s I cannt finish even simple tasks, attentin, memry, sequential rganizatin, and multi-tasking irritability, lss f scial inhibitins, cnfusin, apathy, and significant depressin). Symptms will cntinue t get wrse until I can t walk, talk r swallw any mre, and dementia will eventually set in. B. Hw d yur illnesses, injuries, r cnditins limit yur ability t wrk? Increasing frgetfulness and lss f shrt-term memry make it almst impssible fr me t perfrm even rutine tasks (if this applies t yu). Any stress caused by due-dates r schedules exacerbates my symptms and makes my symptms mre exaggerated than they already are. Chrea mvements and lack f balance cntrl makes it impssible fr me t type, hld things, r carry things fr very lng. My impaired balance makes it very difficult t navigate the ffice envirnment withut a cnstant fear f falling r in fact falling. Thus far I have fallen 3 times at wrk. One fall resulted in me bruising and spraining my wrist. I frequently miss deadlines fr everyday prjects and tasks that require my sustained fcus, rganizatin f data, r multi-tasking. I am als unable t stand fr perids lnger than, withut having t sit and rest. C. Questin C is self-explanatry. D. When did yur illnesses, injuries, r cnditins first interfere with yur ability t wrk? Be sure t put dwn when yur cnditin/symptms first began t interfere with yur wrk, nt when yu were first diagnsed r when thers may have first nticed. E. Questin E is self-explanatry. F. Questin F is self-explanatry.

3 G. Questin G is self-explanatry. H. If Yes, did yur illnesses, injuries, r cnditins cause yu t: (check all that apply) Wrk fewer hurs? (explain belw) Change yur jb duties? (explain belw) Make any jb-related changes such as yur attendance, help needed, r emplyers? (explain belw) All f the abve. Due t the prgressive nature f Parkinsn s disease nce symptms start they cntinue t get wrse and wrse until yu are afraid t d things and lse the ability t d simple rdinary tasks. I had t miss days f wrk due t medical appintments and due t side-effects frm taking medicatins and medicatin adjustments necessary t attempt t get sme relief frm the insidius symptms assciated with Parkinsn s disease. I. Questin I is self-explanatry. J. Why did yu stp wrking? (belw is an example nly) I stpped wrking because I can n lnger perfrm the basic, essential functins f my jb. My disease has prgressed and I m having difficulty with memry, prblem slving, and cncentratin which significantly affected my perfrmance at wrk. Because f my lack f balance and chrea mvements I fell twice at wrk, with ne f the falls resulting in a sprained wrist. I have tried accmmdatins at wrk t help and even attempted t wrk at anther jb with sme different functins, but was still unable t perfrm the basic, essential functins f the jb. Questins in this sectin are lettered A-J. A.-J. Questins A-J are self-explanatry. SECTION 3 INFORMATION ABOUT YOUR WORK SECTION 4 INFORMATION ABOUT YOUR MEDICAL RECORDS Questins in this sectin are lettered A-F. A.-F. Questins A-F are self-explanatry. SECTION 5 MEDICATIONS Sectin 5 is self-explanatry. Hwever, be sure t take the time t discuss the side-effects that ccur fr yu with yur medicatins. Fr example, sme patients wuld want t reprt that they experience impending dm r emtinal discntrl when their carbdpa/levdpa wears ff. Be sure t state that yu will never be able t discntinue taking medicatins, and that many yu will have t take mre f in the future.

4 SECTION 6 TESTS Sectin 6 is self-explanatry. Sectin 7 is self-explanatry. SECTION 7 EDUCATION/TRAINING INFORMATION Sectin 8 is self-explanatry. SECTION 8 VOCATIONAL REHABILITATION, EMPLOYMENT, r OTHER SUPPORT SERVICES INFOMRATION SECTION 9 REMARKS In additin t using this sectin t expund upn r attach further infrmatin frm ther sectins, yu may wish t write smething like the fllwing in this sectin: Parkinsn s disease is an incurable, degenerative brain disrder that affects every part f an individual s life. Characteristic features f PD include invluntary mvements, memry deficits, rigidity in the bdy, bradykinesia that effects bth grss and dexterus mvements, as well as gait and statin. Family members may first ntice that the individual experiences, apathy, depressin, changed gait, and tremr. In the case f bradykinesia, tremr, rigidity, and balance difficulty, all will wrsen as the disease prgresses. Depressin may remit and recur multiple times. PD may affect the individual's memry and ther cgnitive functins. Early signs might include having truble driving, learning new things, remembering a fact, answering a questin, r making a decisin. Many peple with PD display changes in handwriting. As the disease prgresses, cncentratin n intellectual tasks becmes increasingly difficult. In sme individuals, the disease may begin with uncntrlled mvements in the fingers, feet, face, r trunk. These mvements which are signs f chrea ften intensify when the persn is anxius. PD can als begin with mild clumsiness r prblems with balance. Sme peple develp chreic mvements later, after the disease has prgressed. They may stumble r appear uncrdinated. Chrea ften creates serius prblems with walking, increasing the likelihd f falls. The disease can reach the pint where speech is s silent as t be unintelligible. Vital functins, such as swallwing, eating, speaking, and especially walking, cntinue t decline. Mst individuals with PD, hwever, remain aware f their envirnment and are able t express emtins and recgnize their lved nes. 4 th Step medical release frm Yu will likely be asked t sign and turn in signed cnsents fr the release f yur medical recrds.

5 Attachments prvided with this packet Cpy f frm SSA-3381 (Disability Starter Kit) Cpy f frm SSA-16-BK (Applicatin fr disability insurance benefits) Cpy f frm SSA-3368-BK (Disability Reprt Adult)