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Long Term Disability Insurance Claims: What Are Other Specified Somatic Symptoms?

Published on March 27, 2015 by

The full name of this condition is actually Other Specified Somatic Symptom & Related Disorder. So what does that mean?

Well, this is a category where people display specific symptoms that are somatic in nature or characteristic of a related disorder but don’t actually add up to meet the criteria for any of the specific conditions outlined in this diagnostic class in the DSM-5. Essentially, you’ve got a somatic medical problem that includes specific symptoms, but the experts can’t fit it into a clear box – at least not yet.

In order for someone to be diagnosed with this disorder, the symptoms they are experiencing need to impair their ability to function in occupational, social, or other aspects of life or lead to significant clinical distress. Some examples of this include:

Brief illness anxiety disorder. When someone suffers these types of symptoms related to illness for under six months.

Brief somatic symptom disorder. When someone suffers these types of symptoms related to somatic disorders for under six months.

Illness anxiety disorder without excessive health-related behaviors. When an individual meets all of the requirements to be diagnosed with illness anxiety disorder except for Criterion D, they may be diagnosed with this condition.

Pseudocyesis. When someone shows objective signs of being pregnant, displays symptoms of pregnancy, and believes that they are pregnant despite the lack of any actual pregnancy.

Disability becomes complicated when someone is suffering from these issues, and it’s not something that you want to figure out on your own. Different disability insurance policies handle these issues in different ways, so you should learn as much as you can by checking out our free disability eBook and speaking with an experienced long term disability attorney as soon as possible.

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How Can You Win Social Security Disability Benefits for Contraction of the Visual Field in the Better Eye? Try using SSA Listing 2.03

Published on March 26, 2015 by

A normal person has a pretty wide visual field. They can see 60 degrees inward (toward their nose), 100 degrees outward (away from their nose), 75 degrees below the horizontal, and 60 degrees above it. If you’re having trouble imagining what those numbers really mean, think about how you can often see something “out of the corner of your eye.” This ability is related to the height and width of your visual field.

But for those whose visual field is contracting, this is an impossibility. Rather than the panorama that most of us are used to, seeing for them is more like looking through a tunnel. As you might imagine, this inability to see anything that isn’t right in front of you can make even simple tasks daunting. Those with a severe visual field contraction often have trouble finding and keeping a job.

Because of this, Contraction of the Visual Field in the Better Eye is included in the Social Security Administration’s Listings of Impairments. What is the Listings of Impairments? It is a compilation of all of the disorders officially recognized by the SSA as disabilities.

For every single listing, there is a definition and a clear list of criteria a person must meet in order to qualify and get Social Security Disability benefits. In other words, visual field contraction is a recognized disability, and those who suffer from it can qualify for disability benefits.

How? There are two ways:

Match the Listing. If your problem is included in the Listings of Impairments and you meet the requirements there, you automatically qualify for benefits.

Prove Equivalency. If your issue does not precisely meet the definition and criteria from the Listings, you can still get benefits if you are able to prove that it is equal in severity to a disability that is listed.

Since it’s easier to prove that your impairment meets their criteria than it is to show equivalency, matching a listing should always be the first goal. What are the criteria?

Qualifying for Contraction of the Visual Field Benefits

In order to qualify for benefits under Listing 2.03, you need to show one of three things:

  1. That your visual field efficiency is at 20 percent or less. Use kinetic perimetry to prove this.
  2. That -22 or worse is your mean deviation. Use automated static threshold perimetry to prove this.
  3. The widest diameter subtending an angle around the point of fixation no greater than 20 degrees.

If those words and numbers don’t mean much to you, don’t worry. A knowledgeable disability lawyer will be able to put you in contact with an experienced eye doctor, who can test the contraction of your visual field and let you know if you meet the criteria.

There are several tests you can use:

  • Saccade Testing of Visual Fields
  • Electrooculography
  • Twinkle Test
  • Ophthalmoscopy
  • Tonometry
  • Automated Detection of Diabetic Retinopathy
  • Ocular Ultrasound
  • Tonography
  • Strabismus Tests
  • Fluorescein Angiography
  • Electroretinography

Get positive results on one or more of these tests, and it can go a long way towards ensuring that you receive the benefits you need.

What If You Don’t Meet the Listing?

Of course, not everyone with serious visual field contraction issues meets the listing criteria. If you fall into this category, the best thing you can do is use the Five Step Sequential Evaluation Process.

Those who go this route can still qualify – they just need to prove that the issue they are suffering from has prevented them from working for at least 12 months. This isn’t as simple a task as meeting a Listing’s criteria, but it can be done with the help of experienced counsel.

Learn even more about the claims process by reading our Social Security Disability eBook for free

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Winning Long Term Disability Insurance Benefits for Factitious Disorder

Published on March 20, 2015 by

If you file a claim for long term disability, one of the things the doctors and insurance representatives look for is whether or not the issues that you are suffering from are real or falsified – and if they aren’t real, if the falsification constitutes factitious disorder.

What is factitious disorder? This is a real psychological condition where someone is driven to fake the symptoms of an illness, either in themselves or another person, even when there is no logical reason to do so, such as to gain a monetary award.

How the DSM-5 Diagnoses Factitious Disorder

In order to be officially diagnosed with factitious disorder, there are several criteria that you are required to meet.

  • You need to have faked the signs or symptoms of a condition, injury, or disease in order to deceive. These faked symptoms can be psychological or physical, and they can be self-imposed or imposed on another person.
  • You need to have presented yourself (or someone else) to other people as being injured, impaired, or ill even though you are not.
  • You need to engage in this kind of deception in an almost impulsive way, faking sickness or harm even when there is nothing for you to gain from doing so.
  • The deceptive behavior that you engage in cannot be better explained by a different psychological condition like delusional disorder.

When doctors evaluate individuals for this kind of disorder, they are expected to specify whether the deceptions they engage in are about them personally (“I’m a schizophrenic.”) or another person (“They are a schizophrenic.”). Additionally, they will attempt to determine whether the behavior is something that has occurred only once (a single episode) or happened two or more times (recurrent episodes).

Learn more about disability laws and disability insurance policies by reading our free eBook, and if you have questions about your specific situation, contact our experienced attorneys to find out what you can do to get the benefits you deserve.

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How Can You Win Social Security Disability Benefits for Loss of Visual Acuity? Try using SSA Listing 2.02.

Published on March 19, 2015 by

When you are talking about visual acuity, you are dealing with the ability to effectively see detail. That means being about to do things like read or make out small objects when they are at a significant distance from you. Obviously, if you are unable to do this, it can pose a serious roadblock to your ability to perform at many different kinds of jobs or even live a normal life.

That is why the Social Security Administration includes a Loss of Visual Acuity as a disability that can qualify you for Social Security benefits. But you have to prove that you are eligible before you can start receiving those benefits. That means that you either need to:

a.) Show that your particular problem is in their Listings of Impairments and meets the medical severity requirements that they have laid down or,

b.) If your issue does not quite match their definition, you have to use the Five Step Sequential Evaluation Process to prove it is equivalent to one of the disabilities that actually does qualify.

So what exactly is the Listings of Impairments? It is a guide created by the SSA to define every single qualifying disability they recognize and explain the criteria an individual has to meet in order to receive benefits for each of these disabilities.

Your best bet at qualifying for disability benefits is to prove that you have one of these listed impairments and that you meet the criteria they have set down.

What does that mean where Loss of Visual Acuity is concerned?

Criteria for Loss of Visual Acuity Benefits

The criteria that the Listings of Impairments has for receiving Social Security benefits for Loss of Visual Acuity is ridiculously simple: you qualify if the vision in your better eye is 20/200 or less after best corrections have been done.

How do you prove this? There is a wealth of tests out there that the SSA will accept:

  • Visual Evoked Responses
  • S100B Protein
  • Cystatin C
  • Laser Doppler Flowmetry
  • Visual Acuity Tests
  • Transcorneal Transillumination
  • Tonometry
  • Tonography
  • Swinging Flashlight Test
  • Strabismus Tests
  • Slit Lamp Examination
  • Shirmer’s Test
  • Refraction
  • Ophthalmoscopy
  • Ocular Ultrasound
  • Keratometry and Keratoscopy
  • Fluorescein Angiography
  • Endothelial Photography
  • Electroretinography
  • Electrooculography

Positive results on any of these can help to support your claim and win you benefits.

Beyond the Listings of Impairments

If your issue does not qualify you for benefits based on the criteria in Listing 2.02, don’t give up hope. Remember that it is still possible to get the help you need by going through the Five Step Sequential Evaluation Process.

It is not as straightforward as simply matching a listing, and you will probably require the assistance of an experienced disability attorney. But if you can prove your disorder has kept you from working for 12 months or longer, the SSA should award you the benefits that you need.

Learn even more about the claims process by reading our Social Security Disability eBook for free

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