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Can I get Social Security Disability for Fibromyalgia?

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Does Social Security Disability Recognize Fibromyalgia as a Real Condition?

Fibromyalgia is a frequently misunderstood and very real medical condition that affects a person with widespread pain throughout their body. It took the Social Security Administration a very long time to believe that statement.

Only in 2012 did Social Security issue guidelines for how they will evaluate fibromyalgia when someone applies for Social Security Disability. Yet, the condition was first identified in 1904 by Sir William Gowers. The modern definition was outlined in 1972 by Dr. Hugh Smythe.

Forty years later, Social Security caught up with modern medicine. With Social Security Ruling 12-2p, the regulations for evaluating fibromyalgia as a disability were set.

How Do I Get Social Security Disability for Fibromyalgia?

With the establishment of SSR 12-2p, Social Security outlined exactly what you have to prove in order to win your claim for disability. It’s no surprise that the majority of the evidence that Social Security will require must come from a doctor.

How much weight the doctor’s opinion is given in your case can be affected by what kind of doctor makes the diagnosis. For example, a family doctor who makes an official diagnosis of fibromyalgia may not be considered the same way as a rheumatologist who makes that same diagnosis. That’s because a rheumatologist is an expert in systemic (whole body) musculoskeletal diseases and autoimmune conditions such as fibromyalgia.

Social Security will also consider other information that you provide, such as statements from your spouse or family about how your condition has affected you. The condition itself has to have lasted for 12 months or has to be expected to last for twelve months – usually not a problem for someone with a diagnosis of fibromyalgia.

If Social Security isn’t clear about your diagnosis, they can also send you to a doctor they choose, often called a Consultative Examination. Social Security pays for this evaluation and if you get scheduled for one, it’s very important that you attend and that you tell the doctor everything that is wrong with you.

What If I Have Other Conditions Along With My Fibromyalgia?

More often than not, it’s been my experience that people who are affected by fibromyalgia are also suffering from other conditions. For example frequently clients will have several conditions which affect their entire body like Chronic Fatigue Syndrome — which is NOT the same thing as fibromyalgia! — and Chronic Pain Syndrome.

Our clients will be on many different medications to try to control their pain and those medications can cause their own problems. It’s important then to make sure that when Social Security is given information about a client’s condition that the entire disability picture is presented.
We make sure to get records from every treating source and to get the information from our clients to be able to demonstrate to Social Security the full impact of disability on their lives.

Fibromyalgia is a very real condition that affects more than 5 million people What causes fibromyalgia isn’t yet known, but we do know how it affects people. Symptoms include pain, stiffness, tenderness, headaches, numbness, tingling, real fatigue, confusion, problems with memory and more.
It is a condition that is hard to treat and frequently requires a team of doctors and professionals to address the condition to just allow the patient to function.

If fibromyalgia has taken away your ability to work and you’re applying for Social Security Disability, or if you’ve been denied and turned down for Social Security Disability for fibromyalgia, feel free to call our office for help. We understand your frustration, and we would be happy to help you.

Surveillance Not Uncommon in Workers’ Compensation Cases

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Private investigators and hidden camera surveillance might seem like the stuff of suspenseful TV shows.

But getting “caught” on camera can be a concern in a workers’ compensation case.

In fact, it’s much more common than you might think. A worker gets hurt at work and sees a doctor. The doctor gives the worker restrictions and says, “These are the things you are not supposed to do or else you could hurt yourself. Don’t do these things and you will get better.”

The worker goes about their life, and their case progresses towards a mediation.

Then the worker and their attorney get to mediation and the attorney for the employer and insurance company pulls up a video that the insurance company claims to show the employee doing things that they were not supposed to do. The case is now in trouble.

In workers’ compensation, we call this surveillance.

Insurance companies routinely hire private investigators to video a hurt worker in the hopes that they will “catch” them doing something that is inconsistent with the restrictions the doctors set.

Even if you think you’re aware of your surroundings and that you would know if you were being watched, that’s often not the case.

A good private investigator is invisible and if they do their job well they stay that way.

I’ve seen video taken from a private investigator in a car, in a van, and even posing as a customer in a restaurant. And in this day in age where everyone has a mobile phone with a built-in video camera, you’re probably not even aware of how often in a day you could potentially be on camera. (You should also be careful about what you share on social media because those posts could be used against you, as well.)

Clients have asked me, “Is this legal? He filmed me at MY house and when I was in my yard!”

The answer is yes, it is legal.

It’s legal for anyone to videotape you in your yard, or anywhere else in public view. There is no expectation of privacy when you are in view of the public.
Clients have also said to me, “But I wasn’t doing anything outside my restrictions and the investigator’s report says that I was lifting or carrying more than my restrictions without any apparent difficulty. How would they know that?”

It is very easy for an investigator who was hired by an insurance company to say that you “appear” to be doing something outside your restrictions, or that you were lifting, carrying or walking without any apparent difficulty. We see those types of phrases in investigators’ reports all the time.

While we can always argue that the investigator is biased or just plain wrong, it’s much easier if we simply don’t have to make these arguments.

So, what does this mean to your case as an injured worker?

Does it mean you can’t live your life or that you should be paranoid about everyone around you? Draw the curtains at home and never go out? No.

It means you should be mindful of your surroundings and made sure you are following your doctor’s restrictions all the time regardless of where you are.

That means that if you have a lifting restriction of 20 pounds that you should not be trying to carry in that 40-pound bag of dog food from the store.

If you aren’t supposed to be standing more than 15 minutes at a time then at 16 minutes you should be finding a chair at the church luncheon.

Following your doctor’s restrictions all the time — both inside and outside of work — will not only help keep your worker’s compensation case on track, it will also help you heal and get better faster.

If you think you might be under surveillance on your workers’ compensation claim and you would like help, please contact us as soon as possible.

Help for veterans with PTSD

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What does the face of PTSD (Post-traumatic Stress Disorder) look like?

For too many veterans, they simply have to look in the mirror to know the answer to this question.

PTSD is a serious and very complex disorder that affects veterans as a result of the horrors of war, injury, or other in-service event that acts as the root of the disorder.

Once it was called combat fatigue, shell shock and war neurosis.

It affects men and women, the young and old. Often it happens as a direct result of combat. Sometimes it is a result of intense fear.

But one thing that remains common among veterans suffering with PTSD is that it doesn’t simply “go away”.

In my practice I’ve had the privilege to meet many vets who have been diagnosed with PTSD and many who were referred out to medical providers for evaluation of PTSD.

The VA seems to do a decent job of screening for PTSD symptoms. Just ask anyone who has been asked those questions over and over again every time they go in to the VA for even a hangnail.

But there is good reason for this constant screening. In 2011, nearly a half-million veterans were treated at the VA for PTSD. The rate of PTSD in Vietnam veterans has been found to be as high as 30 percent, according to the National Vietnam Veterans Readjustment Study. Persian Gulf war vets reflect a PTSD rate as high as 24 percent; and the Iraq and Afghanistan war vets it is currently at 12.5 percent, with that number expected to rise dramatically.

PTSD also affects families.

Many vets talk to me and make it clear that what we discuss stays between us, allowing the vet to have a kind of compartmentalization of their life in war outside of their life now.
We all value how our family “sees us,” and I think vets don’t want to burden their families with stories of war time when discussing their VA Disability claim.

That’s a situation where being an attorney, outside of the family, actually is a benefit for the veteran. The vets status as a father, spouse, brother or sister doesn’t have to then be tainted by a far away war. An important part of my job is just listening and being that safe place where veterans can talk openly about what they saw and experienced in service to their country.

What kind of symptoms do vets suffering from PTSD experience? Let’s see what the VA has to say about this:

  • The veteran has bad dreams or nightmares about the event that happened in service or something similar to it.
    • The vet behaves or feels as if the event were happening all over again (this is known as having flashbacks)
    • The vet has a lot of strong or intense feelings when reminded of the event
    • The vet has a lot of physical sensations when reminded of the event (for example, a racing or pounding heart, sweating, finding it hard to breathe, feeling faint, feeling like they are going to lose control)
  • The veteran has symptoms of avoiding reminders of the traumatic event that they experienced in service:
    • Avoid thoughts, feelings, or talking about things that remind them of the event
    • Avoid people, places, or activities that remind them of the event
    • Have trouble remembering some important part of the event
  • Since the event happened, the veteran notices that they:
    • Have lost interest in, or just don’t do, things that used to be important to them
    • Feel detached from people; find it hard to trust people
    • Feel emotionally “numb” or find it hard to have loving feelings even toward those who are emotionally close to the veteran
    • Have a hard time falling or staying asleep
    • Are irritable and have problems with anger
    • Have a hard time focusing or concentrating
    • Have a feeling that they may not live very long and feel there’s no point in planning for the future
    • Are jumpy and get startled or surprised easily
    • Are always “on guard”
    • Stomach problems
    • Intestinal (bowel) problems
    • Gynecological (female) problems
    • Weight gain or loss
    • Pain, for example, in back, neck, or pelvic area
    • Headaches
    • Skin rashes and other skin problems
    • Lack of energy; feel tired all the time
    • Alcohol, drug, or other substance use problems
    • Depression or feeling down
    • Anxiety or worry
    • Panic attacks

There are other symptoms, specific to women who are suffering from PTSD. I’ll address women veterans and PTSD in a later blog post.

If you see several of these symptoms in yourself or a loved one, talk to a professional about it.

There are an incredible number of ways for veterans to discuss and get help with PTSD:

  • The VA Veteran Crisis Line: (800) 273-8255, Option 1 (You can also TEXT them: Text to 838255)
  • The Veteran Combat Call Center (87) WAR-VETS (1-877-927-8387) to talk to another combat war veteran
  • DOD Defense Center for Excellence  (866) 966-1020
  • Military OneSource (800) 342-9647 (counseling and other resources)
  • Support for Families of those who suffer from PTSD

If your claim for PTSD was denied by the VA, please consider contacting my office. As a Navy veteran, I am very proud to work with veterans who are still paying the price for our freedoms. If I can help, I’m honored to do it.

VA Benefits for Gulf War Syndrome

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Frequently in my practice I meet veterans who have a variety of symptoms that can’t be attributed to a single cause. The vets go to doctors in and outside the VA who can’t easily figure out what is going on with their health, and they are often misdiagnosed as a result. The problems are very real for the veteran and, unfortunately, the answers are few and far between.

There are nearly 700,000 service members who served in the 1991 Gulf War. The VA estimates nearly 35 percent of those veterans continue to suffer ongoing, chronic symptoms and illnesses, the result of what is commonly called Gulf War Syndrome.

Symptoms affecting Gulf War vets may include headaches, fatigue, joint pains, insomnia, dizziness, indigestion, breathing disorders and memory problems. The VA no longer uses the diagnosis Gulf War Syndrome, but instead refers to these illnesses as chronic multi-symptom illness and undiagnosed illness because of how widely the symptoms can vary from person to person.

What causes Gulf War Syndrome?

Even the VA doesn’t have a definite answer to this yet. Was it because of a chemical exposure, an airborne hazard, vaccination, pollutant or other cause? Possibly.

According to the BBC:

“One popular theory was that soldiers had become ill after exposure to depleted uranium in tank shells. However, troops not exposed to this were just as likely to suffer chronic health problems later on. The same was true of those exposed to fumes from burning oil wells. In fact, no link could be found between veteran ill health and specific jobs or tasks.

“Pesticides have also been suggested as a cause, perhaps affecting the nervous system. But detailed studies found no evidence of damage that could explain this.”

The VA and the Institute of Medicine are conducting a multi-year study now to determine possible causes of Gulf War Syndrome and the best treatment options for combatting the symptoms that veterans still suffer.

Though Gulf War Syndrome is a very real condition with debilitating symptoms, it still largely remains a mystery 25 years later, confounding doctors and medical researchers. For veterans suffering from these symptoms, it can be difficult to get answers and effective treatment.

American and British troops first began complaining of symptoms of Gulf War Syndrome when they returned home, but it would take five years before any medical research was begun on the illness, according to BBC News.

The U.S. and British governments set up disease registers and initially assessed more than 100,000 veterans, according to news reports, but failed to find a pattern to symptoms to indicate a new condition.

From news reports:

In the mid-1990s, scientists at King’s College London (KCL) conducted X-rays and blood tests on British Gulf War veterans suffering ill health. However, they couldn’t find any physical differences between them and a control group.

Yet the suffering was undeniable. A further KCL study in 2009 found Gulf veterans were two to three times more likely to report 53 different symptoms, including chronic fatigue and nerve pain, compared with soldiers deployed to Bosnia. None of the symptoms were unique to the Gulf War, but they were experienced in far higher numbers.

“They’re known as medically unexplained physical symptoms,” says Neil Greenberg, a professor of defence mental health at KCL. “The symptoms are very real, but like with irritable bowel syndrome, there is no obvious physical problem causing it.”

A study by Boston University researchers, published in the journal Cortex earlier this year, reports “the first conclusive scientific evidence that ‘clearly and consistently’ shows that exposure to pesticides and other toxins caused Gulf War Illness,” according to a report by Newsmax.

The researchers concluded that “exposure to pesticides and pyridostigmine bromide (PB) — prophylactic pills intended to protect troops against the effects of possible nerve gas — are ‘causally associated with GWI and the neurological dysfunction in Gulf War veterans.’”

Treatment and Help for Gulf War Syndrome

While the VA might seem best equipped to help veterans suffering from Gulf War Syndrome, often vets need to look outside the system for answers and treatment.
Veterans deserve the very best care that modern medicine can provide.

Often multiple-system illnesses like Chronic Fatigue Syndrome, fibromyalgia, chronic gastrointestinal problems and other undiagnosed illnesses don’t get the attention or classification veterans feel they should.

This is when a doctor outside the VA may be better able to identify the problems as being multi-system. When the VA is evaluating disability claims to determine if a condition is service-connected, they look for consistent medical treatment to prove the existence and extent of a condition. This applies to Gulf War Syndrome, as well as other illness.

As I frequently tell vets in my office: The VA won’t take your word for it that you have a problem. They want to see that the problem is bad enough that you seeking medical help to try to get better. And sometimes that means seeing doctors outside the VA.

If you are a veteran suffering from illnesses related to your service in the Gulf War, there are several other benefits and services for which you may be eligible, in addition to disability compensation and benefits from the Veterans Administration.

North Carolina veterans may be eligible for a variety of other benefits, including a Gulf War Registry health exam, the Airborne Hazards and Open Burn Pit Registry, as well as health care and disability compensation for the disease or diseases they suffer from that are related to military service.

Fixing the VA Benefits Backlog

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Recently, the Secretary of Veterans Affairs advised Congress that it must do something to reduce the time it takes for a veteran’s appeal for disability benefits to be resolved.

As of January, an estimated 400,000 veterans had appeals pending with the Veterans Administration. It takes an average of 1,000 days — nearly three years — for these appeals to be resolved, according to news reports.

Proposed legislation, HR 800, also known as the The Express Appeals Act, would give veterans the option speed up that process, instead of going through a traditional appeal. While we support fast-tracking veterans’ appeals, there’s a better way to do it than what has been proposed in HR 800 and the similar Senate Bill 2473.

We are in agreement with NOVA, the National Organization of Veteran’s Advocates, that there are three major problems with HR 800:

  1. The bill would create two separate tracks for appeals
  2. To get an express appeal, the veteran must waive the right to submit additional evidence;
  3. There is a very real possibility that this bill will mislead veterans to believe that if they give up their right to submit further evidence, then their appeal will be heard sooner.

A better solution to the backlog problem, which I recently outlined in a letter to U.S. Senator Richard Burr, would not prevent veterans from submitting new evidence once a fast-track appeal is submitted.

I won’t go into too much detail here about how the VA benefits claims process works, but you can read more here about what happens when you apply for VA benefits.

In short, a veteran files an files an initial application for benefits. When that is denied, they file a Notice of Disagreement (NOD). The regional office VA then reviews the claim and a new decision is made.

If the claim is denied again, as is typically the case, the VA then issues a Statement of the Case. The veteran has to file a VA9 form appeal, which takes the claim to the Board of Veterans Appeals for a hearing.

I believe the notice of disagreement, or NOD step, is unnecessary, is not productive and is inefficient. Eliminating this step in the appeal process will save time and money, while still protecting the rights of the veterans.

In my proposed scenario, after a veteran’s claim is first denied, he or she would file a VA9 appeal. The regional VA office would then be required to review the appeal within a time certain (which would require amending the law) and issue a statement of the case. The statement of the case would be the VA’s argument supporting its denial of the claim.

Next, the veteran would have the opportunity to submit additional arguments and evidence in response, up to the point where the Board of Veterans Appeals reviews the appeal. This scenario eliminates a step in the process, and saves time and money, but not at the expense of the veteran’s rights.

As it stands now, the Notice of Disagreement stage of appeal process seems more of a rubber-stamp of the VA’s initial denial of a claim.

The Secretary says the VA is working to clear its backlog of cases.

However, most efforts to eliminate the backlog have been aimed at initial claims, not appeals.

In the last three years, claims pending for four months or more dropped from 612,000 to as low as 80,000 this week. In that same time frame, the number of appeals has risen by more than a third, to 440,000 cases. Resolution of these appeals is averaging more than two years, which is too long for veterans to wait for medical treatment and benefits they are entitled.

Eliminating the Notice of Disagreement step in the process could help, but the Board of Veterans Appeals needs to be prepared to handle those cases when they reach them for adjudication.

I  believe decentralizing the Board of Veterans Appeals would also help the process.

Similar to the Social Security system, Veteran Law Judges could be assigned to regional VA offices. This would reduce the number of veterans who have to travel to Washington DC, for an appeals hearing, wait for a video conference hearing or wait for a traveling Board hearing. This would help to further reduce the backlog and ensure that veterans get their benefits sooner.

Additionally, assigning BVA judges to regional VA offices would give them more opportunity to train ratings specialists on the issues they see as slowing down the claims process.

I realize that the VA may not yet be ready for such an undertaking, but I do believe that it is an issue worth considering to more effectively and timely resolve pending veterans ‘ disability claims.

I would like to encourage veterans and their family members to contact Senator Burr and other members of Congress about HR 800 and legislative changes to the VA appeals process.

New Hope for “Blue Water Navy” vets Exposed to Agent Orange?

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During the Vietnam War, 90,000 Navy vets served offshore and may have been exposed to Agent Orange. But they are not eligible for VA disability benefits for health problems they suffered as a result of that exposure.

These sailors, who served on ships off the coast of Vietnam during the war, were initially eligible for compensation under the Agent Orange Act of 1991. But the VA changed its interpretation of the act in 2002, and the Blue Water Navy vets have been fighting ever since to get their benefits restored, according to a reporting by ProPublica and The Virginian-Pilot.

Last year the Court of Appeals for Veterans Claims ruled the VA must review its policy on Blue Water vets. Two senators, Jon Tester and Steve Daines, have sponsored the Blue Water Navy Vietnam Veterans Act, which would force the VA to reverse its decision to exclude Blue Water Navy veterans from VA care and benefits. In September, the Senate Veterans’ Affairs Committee heard testimony from medical experts on how vets may have been exposed to Agent Orange while onboard ships, even if they never stepped foot in Vietnam.

Agent Orange, a herbicide widely used to kill foliage in the jungles of Vietnam, contained the chemical dioxin. It has been linked to diabetes, cancer, Parkinson’s Disease, peripheral neuropathy and heart disease.

One theory on how Blue Water vets were exposed is that the chemical “could have washed into rivers and out to sea, where patrolling Navy vessels sucked in potentially contaminated water and distilled it for use aboard the ships —a process that would have only concentrated the toxin,” according to the ProPublica report. “Every member of the crew would have been exposed: Distilled water was used in showers, to wash laundry and to prepare food. It was used to make coffee, as well as a sugary beverage known as ‘bug juice,’ which flowed from fountains in the enlisted mess.”

Senators Tester and Daines, along with Senators Richard Blumenthal and Kirsten Gillibrand, recently wrote a letter to VA Secretary Bob McDonald, urging him to reverse the 2002 rule excluding Blue Water Navy vets from VA disability benefits related for Agent Orange exposure.

“Thousands of veterans who served on Navy ships during the Vietnam War are suffering from significant health conditions associated with exposure to toxic herbicides,” they wrote, noting that Blue Water vets are suffering from many of the same cancers and illnesses as vets who were exposed to Agent Orange in country.

We’re monitoring the VA’s response and any changes in policy related to Blue Water veterans closely. If the policy changes, thousands of Vietnam veterans could become eligible for VA benefits for conditions that were not previously considered service-connected.

Wounded Warrior Project’s Spending Under Scrutiny

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The Wounded Warrior Project is the country’s largest veterans’ charity, but 40 percent of donations cover overhead, like salaries, travel and public relations. In 2014, $124 million went to overhead instead of to directly help wounded veterans.

By comparison, the Disabled American Veterans Charitable Service Trust spends 96 percent of its budget on veterans; Fisher House, 91 percent; and Semper Fi Fund, 92 percent.

The Wounded Warrior Project’s lavish spending has been the subject of two recent news investigations by CBS News and the New York Times. The reporting has shown:

  • Spending on conferences and meetings went from $1.7 million in 2010, to $26 million in 2014, the same amount Wounded Warrior Project spends on combat stress recovery.
  • The group’s annual meeting in 2014 cost a reported $3 million.
  • CEO Steven Nardizzi’s salary was $473,000 in 2014.
  • The Wounded Warrior Project spent more than $34 million on fund-raising in 2014
  • By 2014, the group was spending $7.5 million per year on travel, according to tax forms.

“Their mission is to honor and empower wounded warriors, but what the public doesn’t see is how they spend their money,” said Army Staff Sergeant Erick Millette, a former employee of the charity, told CBS News.

The Wounded Warrior Project says it spends 80 percent of donations on programs, including those that help veterans readjust to society, attend school, find work and participate in athletics. But, according to the Times, “former employees and charity watchdogs say the charity inflates its number by using practices such as counting some marketing materials as educational.

Charity Watch, an independent monitoring group, gave Wounded Warrior Project a “D” rating in 2011 and has not given it a grade higher than C since.

The Wounded Warrior Project raised $372 million in 2015, mostly through small donations from people older than 65, according to news reports.

Before donating to a charity, like the Wounded Warrior Project, you may want to check out its financial records first through a watchdog group like Charity Navigator or GuideStar to ensure that your donation will be used the way you intended.

These tips will help you become a savvy donor to charity.