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Archive for July, 2011

Syracuse-related study raises serious questions about fairness of SSA disability judges

Saturday, July 30th, 2011

TRAC finds wide disparity among ALJ  rulings

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No study about SSA Disability in recent memory deserves more attention than the one recently released (and subsequently pooh-poohed by the SSA) from Syracuse University’s Trans­ac­tional Records Access Clear­ing­house (TRAC), a non-profit research orga­ni­za­tion.

Don’t let the system beat you down

If you (or a family member or friend) are one of the unlucky minions to feel trapped and ignored by the federal government’s program to aid disabled persons, please don’t let the findings of this admittedly bleak report stop you from pressing forward with your claim. If anything, this report should legitimize the idea that disability judges can be arbitrary in their rulings and therefore a trained, experienced disability attorney could be your best ally in this notoriously time-consuming process.

Huge disparity among judges’ approval rates

The following is from a Baltimore news site called Baltimore City Paper Blogs; it begins with a district centered in San Antonio, Texas–but the grim numbers apparently apply across the nation:

In San Anto­nio, Texas, peo­ple hop­ing to get Social Secu­rity dis­abil­ity pay­ments could see their cases assigned to any of 17 judges. The luck of this draw mat­ters a lot. One of the judges grants ben­e­fits in just 14 per­cent of cases. Another judge hands over benefits—which range from about $700 per month to about twice that—92 per­cent of the time.

That 78 per­cent dis­par­ity rate makes San Anto­nio the sec­ond most lottery-like sys­tem in the Social Secu­rity Administration’s arch­i­pel­ago of hear­ing offices, accord­ing to a data analy­sis by the Trans­ac­tional Records Access Clear­ing­house, a non-profit research orga­ni­za­tion housed at Syra­cuse Uni­ver­sity. (Dal­las is num­ber one, with 83 per­cent disparity).

“To a sur­pris­ing extent the records on dis­abil­ity deci­sions show again and again that even within the indi­vid­ual offices there is not a clear con­sen­sus among the judges about which claims should be awarded ver­sus which should be denied,” the authors of the report , David Burn­ham and Sue Long, write. “The prob­lem today is some­what worse than it was four and a half years ago.”

This study is from a group aligned with Syracuse University

In case you missed the in-line link, here it is again, the link to the report summary by TRAC, the research outfit aligned with Syracuse University, which reports studying nearly two million claims filed with the Social Security Administration. The report starts thusly:

A court-by-court analysis of close to two million Social Security Administration (SSA) claims has documented extensive and hard-to-explain disparities in the way the administrative law judges (ALJs) within the agency’s separate hearing offices decide whether individuals will be granted or denied disability benefits.

These findings — discussed in detail below — suggest that in many SSA hearing offices today, the chance a disability claim is granted or denied is often determined more by the particular judge assigned to handle it than by the facts and circumstances presented in the case. The findings further document that the problem is not simply the result of a few judges whose decisions are far out of line with those of other judges on the bench. Rather, the agency’s own case-by-case evidence demonstrates that the problem is systemic. To a surprising extent the records on disability decisions show again and again that even within the individual offices there is not a clear consensus among the judges about which claims should be awarded versus which should be denied.

Systemic.

That doesn’t sound good, as anyone with a systemic disease knows and understands. That means whatever the problem is, it’s not localized but instead spread throughout the entire system.

USA Today reports on ‘disparity’

Following is an excerpt from a recent USA Today report, illustrative of the perception of the status quo in such matters:

Congress and the agency’s inspector general have begun looking at the disparity. Yet both Social Security officials and advocates for the disabled say they are reluctant to interfere with the judges’ independence.

“Congress has been pretty enthusiastic about the idea of ALJ independence,” said Social Security Commissioner Michael Astrue, adding that only “a handful” of judges have approval ratings above or below average.

“They can’t tell an ALJ how to decide cases, but they can make sure they follow the agency’s policies.” said Ethel Zelenske, government affairs director for the National Organization of Social Security Claimants’ Representatives.

The Social Security Administration reports about 8.4 million disabled workers nationwide get an average monthly benefit of $1,069. Another 8.1 million low-income disabled people with little work history get about $500 a month in Supplemental Security Income. More than 2.9 million people applied for disability-worker benefits in fiscal year 2010, up 38% over the past five years, agency figures show.

To cope with the increase, Social Security has added about 200 judges in the past five years and streamlined the process of reviewing claims. The average wait time for a decision has steadily dropped, from a peak of 532 days in August 2008 to 354 days last month, agency data show.

TRAC responds to SSA’s response

To be fair, the SSA did respond to TRAC’s study-report, and TRAC’s response to that can be found here.

Just remember, we can help connect you with a compatible, trained attorney who can help you with your case–if nothing else, it’s possible that an experienced attorney might be able to steer your case toward a more reasonable outcome.

 

 

Membranous Nephropathy and Receiving Social Security Disability

Friday, July 29th, 2011
A diagram of the pathological changes in a glo...

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Your kidneys are located in your abdomen toward the back. Normally, one is situated on each side of your spine.

Your kidneys have a critical part to play in your body functioning like it should. Your kidneys filter your blood and remove waste products. They also control your blood pressure, balance the levels of electrolytes in your body and stimulate the production of red blood cells.

Membranous nephropathy is a slowly progressive kidney disease. It is one of the more common types of nephrotic syndrome.

Membranous nephropathy is a kidney disorder that is characterized by inflammation and changes of the glomerulus and glomerular basement membrane inside your kidney that help filter fluids and waste. The glomeruli are the inner structures of your kidney that include small capillaries that are surrounded by membranes through which your blood is filtered to become urine. This inflammation results in difficulties with your kidneys working like they should.

Membranous nephropathy is most common in people between the ages of 30 and 50. It develops in approximately 2 out of every 10,000 people in the United States. About 40% of people with membranous nephropathy develop end-stage renal (kidney) failure after 10 years.

There are two kinds of membranous nephropathy. About 80 to 85% are considered to be primary membranous nephropathy. This means the cause of the disorder is not known (idiopathic). The other type is referred to as secondary membranous nephropathy.

Membranous nephropathy results from thickening of part of the glomerular basement membrane. As just mentioned, why this occurs is not known with the primary kind of this disorder. The secondary form of membranous nephropathy may result from:

  • Certain medications, such as captopril and NSAIDs
  • Malignant tumors, especially carcinoma of the lung and colon and melanoma
  • Autoimmune conditions like lupus
  • Inorganic salts
  • Infections like hepatitis B, syphilis and malaria.

In many instances there are no signs or symptoms with membranous nephropathy. If signs and symptoms are present, they will usually vary. Some of the signs and symptoms that you may experience include:

  • A foamy appearance to your urine
  • Edema (swelling) in any part of your body
  • Poor appetite
  • Excessive urination, especially at night
  • Unintended weight gain
  • High blood pressure.
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Cutaneous Melanoma and Receiving Social Security Disability

Thursday, July 28th, 2011
Title: Pathology: Patient: Melanoma Descriptio...

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Your skin is the outer protective cover for your body. It may surprise you to know that your skin is the largest organ of your body.

Your skin is composed of multiple layers of ectodermal tissue. Your skin protects your underlying ligaments, internal organs, muscles and bones. Your skin plays a crucial part in guarding your body from excessive water loss and infectious agents (pathogens).

Skin cancer is cancer that starts in the cells of your skin. Most of the time, skin cancer is the abnormal growth and proliferation of skin cells that develops on areas of your skin that have been exposed to the sun or some other kind of ultraviolet light. However, skin cancer can also occur on parts of your skin that are not normally exposed to ultraviolet light.

Cutaneous melanoma is one of the three main forms of skin cancer. The other two are squamous cell carcinoma and basal cell carcinoma.

Cutaneous melanoma is the rarest of these three main kinds of skin cancer. Cutaneous melanoma represents about 5% of all skin cancer. This means that over 50,000 new cases of cutaneous melanoma are diagnosed each year in the United States.

Cutaneous melanoma is the most serious type of skin cancer. It causes the most deaths even though it is the rarest of the three main kinds of skin cancer.

Cutaneous melanoma begins in cells that are known as melanocytes. These cells produce a skin pigment that is called melanin. Melanin is what determines both your skin and hair color.

The hallmark sign or symptom of cutaneous melanoma is usually a sore, lump, growth or mole on your skin. Another thing to watch for is bleeding that results from a growth of your skin.

There is an ABCDE guide that can help you in watching out for the signs and symptoms of melanoma. It is:

  • A – Look for growths with asymmetrical, irregular shapes, such as one that has two halves that do not look alike.
  • B – Look for growths that have notched, scalloped or irregular borders.
  • C – Look for growths that have changes in color, an uneven distribution of color, or many colors.
  • D – Look for a growth that is larger than ¼ of an inch.
  • E – Look for a growth that is evolving or changing over time, such as changing color, shape or growing in size.
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Cacchi-Ricci Disease and Receiving Social Security Disability

Wednesday, July 27th, 2011
Medullary sponge kidney as seen in an intraven...

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Your kidneys have a vital role to play in your body functioning the way that it should. Your kidneys filter your blood and get rid of waste products. They also control your blood pressure, stimulate the production of red blood cells and balance levels of electrolytes in your body.

Your kidneys are placed in your abdomen near the back. One is located on each side of your spine, normally. Your kidneys receive their blood supply from the renal arteries directly out of your aorta, and they transport blood back to your heart through the renal veins to the vena cava. (The term “renal” is taken from the Latin name for kidney.)

Your kidneys have the capacity to monitor the acid-base balance of your body. They also monitor the concentrations of electrolytes like sodium and potassium and the amount of body fluid that is in your body. Your kidneys filter uric acid from DNA breakdown and waste products of your body metabolism like urea from protein metabolism.

Cacchi-Ricci disease is a disease in which tiny sacs that are referred to as cysts form in your medulla. This is the inner part of your kidney. These cysts create a sponge-like appearance. They prevent urine from flowing freely through your tubules. Tubules are tiny tubes that are located on the inside of your kidneys through which urine flows.

Some of the problems caused by Cacchi-Ricci disease are urinary tract infections, hematuria (blood in your urine) and kidney stones. In rare instances, this disease results in more serious difficulties like total kidney failure.

Although Cacchi-Ricci disease is congenital (present at birth), signs and symptoms do not usually begin until between the ages of 30 and 40. Cacchi-Ricci disease affects about 1 in 5,000 to 20,000 people in the United States. About 20% of the people who have kidney stones develop this disease.

Cacchi-Ricci disease may not cause you any signs or symptoms at all. Usually, the first sign or symptom of this disease is when you get a urinary tract infection or a kidney stone. Other possible signs and symptoms include:

 

  • Urine that is dark, cloudy or bloody
  • Burning or pain when you urinate
  • Urine that smells really bad
  • Vomiting
  • Pain in your back, lower abdomen or groin
  • Chills and fever.
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Senior-Loken Syndrome and Receiving Social Security Disability

Tuesday, July 26th, 2011
Frontal section through the kidney

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Your kidneys have a crucial part to play in the way your body works, not only by getting rid of waste products and filtering your blood, but also by controlling your blood pressure, stimulating the production of red blood cells and balancing levels of electrolytes in your body.

Your kidneys are situated in your abdomen near the back. When things are normal, one is located on each side of your spine. The blood supply to your kidneys is through the renal arteries that come directly from your aorta, and they carry blood back to your heart through the renal veins to the vena cava. (The term “renal” is derived from the Latin name for kidney.)

Sensors within your kidneys determine how much water to excrete as urine. These sensors also decide your concentration of electrolytes when blood flows to your kidneys. For example, if you are dehydrated from sickness or exercise, your kidneys retain as much water as possible. Your urine becomes extremely concentrated. When you have enough water in your body your urine becomes clear and much more dilute.

Senior-Loken syndrome is a rare genetic (inherited) disorder. It is a disorder that involves the formation of cysts in the center of each of your kidneys that gradually cause your kidneys to lose their ability to function. Senior-Loken syndrome is evidenced by progressive wasting of the filtering unit of your kidney and progressive eye disease.

Senior-Loken disease is inherited in a manner that is known as autosomal recessive. What this means is that you have to inherit a defective (faulty) gene from each one of your parents in order to have the possibility of getting this syndrome.

There are several different signs and symptoms that you may have that may be an indication of Senior-Loken syndrome. Some of these include:

 

  • Excessive urination (polyuria)
  • Inability to concentrate urine
  • Renal salt wasting
  • Thirst
  • Kidney failure
  • Arterial hypertension (high blood pressure)
  • Anemia
  • Metabolic acidosis
  • Thickening of kidney filtration tissues
  • Increased blood creatinine level
  • Increased blood urea nitrogen
  • Retinitis pigmentosa
  • Progressive vision loss
  • Blindness
  • Tubulointerstitial nephropathy
  • Tapetoretinal degeneration
  • Growth retardation
  • Mental retardation
  • Endstage kidney disease.
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Glycogenosis Type V and Receiving Social Security Disability

Monday, July 25th, 2011
Glycogen, a branched polysaccharide

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Glycogenosis type V is one of the glycogen storage diseases. What this means is that there is an inborn error of metabolism. It is an autosomal recessive metabolic disorder. Glycogenosis type V is evidenced by a deficiency in glycogen debranching enzymes.

Glycogenosis type V is a rare disorder. It takes place in around 1 out of every 100,000 live births in the United States.

Glycogenosis type V is a genetically linked metabolic disorder involving the enzymes that regulate glycogen metabolism. This is in common with other glycogen storage diseases. These enzymes affect synthesis or the processing of glycogen breakdown within your liver, ahaha muscles and other cell types. The process is halted if any one of these enzymes is faulty and does not finish its step. A different enzyme is involved in each step of the process. The type of glycogen storage disease that you have is determined by which particular enzyme is defective.

Glycogenosis type V is marked by a problem with glycogen storage in your body. There is an abnormal build up of glycogen in your muscle tissue. Glycogenosis type V usually starts in early childhood.

Glycogenosis type V is an hereditary (inherited) or genetic condition. As mentioned at the beginning, the pattern of inheritance is what is known as autosomal recessive. This means that you have to inherit a defective (mutated) gene from each one of your parents in order to have the possibility of having glycogenosis type V.

The dominant form of the disorder is rare. Glycogenosis type V is caused by a deficiency of myophosphorylase. This is the muscle isoform of the enzyme glycogen phosphorylase. Myophosphorylase helps break down glycogen into glucose so that it can be used within your muscle cells.

There are several signs and symptoms that you may experience that may be an indication that you have glycogenosis type V. Most of these signs and symptoms are related to exercise. Possible signs and symptoms are:

  • Painful cramps
  • Early fatigue
  • Exercise intolerance with myalgia (muscular pain)
  • Weakness of exercising muscles
  • Myoglobinuria (the presence of myoglobin in your urine).

You may show substantial muscle loss and progressively increasing weakness as you age. The signs and symptoms of many people get worse after middle age due to muscle wasting.

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Angiomatoid Fibrous Histiocytoma and Receiving Social Security Disability

Sunday, July 24th, 2011

Your body is composed of 206 bones. Your bones help provide structure and shape to your body. Your bones help protect your fragile organs, contain bone marrow that stores and produces new blood cells and help control your body’s collection of various proteins and nutrients.

Angiomatoid fibrous histiocytoma is a rare disease that is evidenced by the formation of nodules under your skin. It is a tumor that is found in your soft tissues or bone. This tumor usually occurs in your limbs or trunk. However, it can begin in other parts of your body, also. There are cases of angiomatoid fibrous histiocytoma starting in the abdomen, muscles, kidneys and lungs.

Angiomatoid fibrous histiocytoma is regarded as a low-grade malignancy. This is because of its rare metastasis (spread to other areas of your body) and slow growth.

If angiomatoid fibrous histiocytoma begins in your soft tissues, you may develop an enlarging painless mass. You may develop fractures if it starts in your bone

Angiomatoid fibrous histiocytoma occurs most often in young adults and children. 80% of the people with this disease are under the age of 30.

The exact cause of angiomatoid fibrous histiocytoma is not known. Mutations (defects) occur in normal cells, but no one knows why this happens.

What is known is that research has shown that people with certain risk factors are more likely to have this disease than others without them. Some of these risk factors include:

  • Having had radiation treatment for cancer
  • Having a history of certain diseases like sickle cell disease, non-Hodgkin’s lymphoma, multiple myeloma or Hodgkin’s lymphoma
  • Having a history of Paget’s disease.

As mentioned above, you may have a broken bone or painless enlarging mass that will be the first sign or symptom that you experience with angiomatoid fibrous histiocytoma. Other common signs and symptoms of this disease that you may have are:

  • Fever
  • Low blood sugar
  • Unintentional weight loss
  • Nodules or a mass under your skin.

You need to take note of the fact that none of these signs and symptoms are exclusive to angiomatoid fibrous histiocytoma. They may be indications of other medical disorders and conditions. Your doctor is the only one who can determine whether they are signs and symptoms of this disease.

You or a loved one may be afflicted with angiomatoid fibrous histiocytoma. Angiomatoid fibrous histiocytoma and/or complications that have been brought about by it or other conditions that you have besides this disease may have led to you or your loved one’s disability and not being able to work.

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Clinical Depression and Receiving Social Security Disability Benefits

Saturday, July 23rd, 2011
On the Threshold of Eternity

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Depression is an issue that millions and millions of people in the United States have to cope with. The way that depression affects you can range all the way from something that is a mild nuisance to a severe medical disorder that can have dangerous and deadly complications and consequences.

Severe, ongoing depression is referred to as clinical depression. Doctors use the term “clinical depression” to refer to depression that causes significant disruptions in your daily life. This involves things like social activities, school and work.

Clinical depression is serious, persistent depression. Clinical depression is depression that lasts for weeks and months. It is a form of depression that can prevent you from even doing your normal daily activities. It can even cause you to think about taking your own life.

Clinical depression is something that can affect anyone. It may affect people of any age or sex, and this includes children.

Depression may be caused by a medical ailment like a thyroid disorder, substance abuse or a loss, like the death of a loved one. Clinical depression is not that kind of depression.

There is no single cause of clinical depression just as there are no single causes for any other kind of depression. Genetics (heredity), environmental and biological factors all probably play a part in causing clinical depression.

There are other factors that may play a role in causing clinical depression to occur. Some of these include:

  • Medications
  • Hormones
  • Personality
  • Nicotine use
  • Illnesses
  • Stress
  • Drug abuse
  • Use of alcohol.

The signs and symptoms of clinical depression are when you have one or more recurring episodes, and your severe depression has lasted for more than two weeks. It also means that you are having at least 5 of the following signs and symptoms:

  • Crying spells
  • Feelings of worthlessness and guilt
  • Significant increase or decrease in your appetite
  • Loss of pleasure and interest in normal daily activities
  • Significant weight loss or gain
  • Thoughts of suicide or death
  • Excess sleeping or an inability to sleep
  • Irritability or agitation
  • Feeling sad and blue
  • Loss of energy or fatigue.

Clinical depression may also result in physical complaints like headache and backache.

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Angina Ludovici and Receiving Social Security Disability Benefits

Friday, July 22nd, 2011
Swelling in the submandibular area in a patien...

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Angina ludovici is a serious, potentially life-threatening infection of the tissues of the floor of your mouth. It usually develops in adults who have bordering dental infections.

Angina ludovici is not the same thing as angina pectoris that is commonly known as “angina”. “Angina” is a word that is taken from the Greek word ankhon, meaning, “strangling”.

Angina ludovici is used in reference to the feeling of strangling, not the feeling of chest pain. However, it is possible for you to experience chest pain with angina ludovici if the infection spreads into your retrosternal space.

Angina ludovici is a type of cellulitis that involves inflammation of the tissues of the floor of your mouth, which is under your tongue. Many times, it develops after a mouth injury or an infection of the roots of your teeth.

Angina ludovici usually results from a bacterial infection, like streptococci or staphylococci. There are also other bacteria that can cause this infection.

Angina ludovici seems to develop most often in people with a condition of lowered immunity, but it can occur in healthy individuals also. With the coming of antibiotics, angina ludovici has become a rare disease.

There are several different signs and symptoms that you may experience which may be an indication that you have angina ludovici. Some of these include:

 

  • Swelling of your neck
  • Neck pain
  • Redness of your neck
  • Difficulty swallowing (dysphagia)
  • Swelling, pain and raising of your tongue
  • General feeling of weakness or sickness (malaise)
  • Swelling of the tissues of your  sublingual and submandibular spaces
  • Fever
  • Drooling
  • Earache
  • Confusion or other mental changes
  • In severe cases, difficulty in breathing.

 

There are important signs and symptoms to watch for with angina ludovici. These include when you are not able to swallow your own saliva and when you have audible difficulty in breathing. As mentioned at the beginning, angina ludovici can be life-threatening because the swelling of tissues develops quickly and may block your airway.

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Spastic Colon and Receiving Social Security Disability Benefits

Thursday, July 21st, 2011
Percentage of population with IBS reported in ...

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In gastroenterology, spastic colon is a functional bowel disorder that is evidence by changes in bowel habits and abdominal pain which are not associated with any abnormalities seen on routine clinical testing. Spastic colon should not be confused with inflammatory bowel disease which is a more severe medical condition.

Spastic colon is one of the main reasons why people go to their doctor. It is such a common problem that one out of every five adults in the United States has spastic colon. Spastic colon is something that women have twice as often as men. However, spastic colon is something most people do not like to talk about because the signs and symptoms of this disorder are considered to be embarrassing.

Spastic colon does not cause changes in bowel tissue, inflammation or increase your risk of colorectal cancer. In this way, spastic colon is unlike ulcerative colitis and Crohn’s disease. They are the two most prevalent types of inflammatory bowel disease and are more serious intestinal diseases.

As mentioned at the beginning, spastic colon is a functional bowel disorder.  It is a problem that affects your large intestine.

The exact cause of spastic colon is unknown.  Some researchers believe that it results from changes in your nerves that control muscle contractions or sensation in your bowel.  Other researchers believe spastic colon may be due to your central nervous system affecting your colon.

Since women get spastic colon twice as often as men, hormonal changes may play a role in the occurrence of this disorder. Also, women say that the signs and symptoms they experience get worse in and around their menstrual period.

There are other things that appear to be triggers of spastic colon. These include stress, certain foods like dairy products and other illnesses.

The signs and symptoms that are caused by spastic colon may vary greatly from person to person. These signs and symptoms are common to several other diseases. Some of the possible signs and symptoms that you may experience with spastic colon include:

  • Mucus in your stool
  • Abdominal cramping or pain
  • Gas
  • Diarrhea and constipation, sometimes alternating between the two
  • Feeling like you need to have a bowel movement after just having had one
  • Feeling bloated.
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