Winning a Social Security disability claim for an invisible illness is difficult but not impossible. These illnesses require a little bit more work since they don’t always show up in films (Xrays, MRIs, etc).
They also rely mostly on “self-reported” symptoms. This means that the judge has to believe you without a lot of proof that you are telling the truth.
If you have a spinal condition it’s easy to show how severe things are with a Xray or MRI.
But what if you have a migraine, or the dreaded Fibromyalgia, for example?
To diagnose these illnesses your doctor relies mostly on you telling him/her your symptoms. Then the doctor looks for some “recognizable” symptoms that in the doctor’s experience meets diagnostic criteria that “acknowledges” that you have “something“.
But doctors are not always right and on occasion, they are just too lazy to dig deeper to find a proper diagnosis.
Diagnosing an Invisible Illness
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We learned that an invisible illness is sometimes diagnosed with your “self-reported” statements.
With any luck, your doctor recognizes it and gives it a name. Other times, the doctor really doesn’t know what it is and just gives you a “default” diagnosis.
Just to give you something to start with.
These “default” diagnosis can actually complicate things because:
1. They can actually be the wrong diagnosis. Doctors have been diagnosing patients with “Fibromyalgia” for most illnesses related to chronic pain without a “visible” cause because it “mimics” a lot of other medical conditions that are also hard to diagnose;
2. Judges are looking for your doctor’s own assessment to see if you are disabled. Most medical records from invisible illnesses fail to show real “visible” symptoms;
3. Judges are naturally suspicious because of “fakers“. They will suspect everyone with an invisible illness for that same reason. Especially because these illnesses rely on your “word“.
4. Even when you have a well diagnosed invisible illness, it is difficult to assess “how disabling“ it is since pain is not necessarily “measurable“.
So, How Does One Measure Pain If it’s Invisible?
I often use the example of the stereo to describe how difficult it is to measure pain.
If you hear a song on the radio and you think “this is my jam“! You crank up the volume and you can tell how loud it is. Heck, your neighbors would tell you right away how loud it is!
But measuring pain is very difficult.
You look “normal” on the outside. You may have a tired look or a “sickly look“. But no one knows “how loud” the pain really is.
It’s like listening to loud music but with a headset. People can hear a little bit of the sound from the outside (when they see you looking a bit tired). But since the headset is not in their head, they can’t hear the music “full blast” on their own. Then all they see (er, hear) is the faint sound of the music.
So while you know your pain is an “11“, most people will only see the outside of that pain as “you look tired today“.
The same goes for the judge.
And that’s why it’s so hard to prove a pain/invisible illness case. There is no measure of how painful it is for you, from an outside perspective.
Here is a common example that even disabled claimants say a lot and it’s an eye-opener:
We are always quick to judge and we often hear: “My neighbor walks around just fine and he gets disability, why shouldn’t I?”
If you think that way about your neighbor, you are doing the same thing others are saying about you and your impairment.
You don’t “see” how bad things are for that person. You don’t know if that person just went to the mailbox and back and after that had to lie down to rest because that was too much activity. You also don’t know if that person has psychological issues. Despite allowing for physical activities these require extreme mental stamina to perform the smallest tasks.
So now that we know how difficult it is for an outsider to understand your pain, how do we prove that the pain exists? And how bad it is if there are no measurements for it?
Proving an Invisible Illness Claim- First Step
If you read all my blog posts you know that I talk about medical records like a “broken record“. Treatment is key for all claims and much more important for an “invisible illness/pain” claim.
The first step to prove a pain/invisible illness is to show credibility.
I talk about this in my post about Winning your claim for Fibromyalgia. When judges hear about pain, their first reaction is to suspect the person and think:
“Why should I believe you?“
Have you ever heard the story about the boy who cried “wolf“?
It’s kinda similar because the judge hears people talking about pain all day long during hearings. He/she sees all kinds of people in front of him/her: Real people, good people, bad people, fakers, malingerers, you name it.
So he/she had to develop a “radar” for sensing when people are lying, exaggerating and/or telling the truth.
But the judge is also human and sometimes those “signals” get crossed. And that’s when a lot of good people get denied.
To minimize the chance of getting denied on an invisible illness claim you MUST show credibility.
A good work history, demonstrating that you have a great reputation in your community, work ethic, service to country can help.
You can accomplish this by way of letters from coworkers, church members, anyone who ever supervised you, awards, certificates etc.
I know it sounds crazy to show an award.
Yet, judges like “credentials“. And this will bolster your credibility with the judge.
But what if you never won an award and your boss was “less than helpful” or just an average boss?
Friends letters are ok, but it would help to get any third party letters from people who know you and know your qualifications as a credible person.
Proving an Invisible Illness -Step Two
Step two is the most obvious one but it’s important to talk about it…….for the millionth time: MEDICAL RECORDS!
That’s right! The most obvious way to prove your claim is through your medical records. You can read my post about The Importance of Medical Records to learn more.
But what if your medical records just contain generic statements of pain such as the part of the records where YOU describe your pain to the doctor (check “History” in your own records). And what if everything else is “normal” or “within range“?
Once you proved your credibility on step 1, what you describe in history will be given a little bit more weight compared to someone who has not established credibility.
You should also take a look at other parts of your medical records and see your blood pressure (high blood pressure is a good indicator of pain). Also, other “vital” signs may indicate certain difficulties such as the inability to lose weight, loss of focus and concentration due to pain (you can get this through a neuropsychological evaluation), things like that.
The treatment part of the record is also important (also named “Assessment” or “Plan” in your records).
Your treatment may show “radical” options (like Botox injections for migraines) that most people would not consider if they were “faking” their invisible illness. Who wants to get an injection on the temple? A “faker” wouldn’t!
Same with Fibromyalgia diagnosis.
You may meet the definition of the diagnosis with the 11 out of 18 trigger points required to confirm the “fibro” diagnosis. But how you handle a series of physical therapy sessions and what the therapist writes down as your limitations will confirm the difficulties you face as opposed to just general statements saying you meet the criteria.
Follow up treatments showing that the injections (or other radical treatment) didn’t help can also assist the judge in assessing how bad things are even though he can’t tell how bad your pain is.
It’s Important to Remember:
Proving an Invisible Illness -Step Three
Other methods to prove an invisible illness include a creating a pain calendar.
You should always bring your calendar to each doctor consult. Then your doctor can tweak your medications and suggest other treatments based on a review of your calendar.
The calendar should include:
- Time of day the pain started
- What you ate and when
- Stressors (money, family, other illnesses)
- Medications you took to stop the pain and how long it lasted. That way your doctor can figure out if certain activities or foods will trigger your pain. It will also help if he needs to reduce your medications or change them because they are simply not working.
- You should also include side effects after taking that medication. The doctor can see if you are allergic or if the meds are simply not working at all.
Proving an Invisible Illness -Step 4
This one goes hand in hand with step 2. We saw that having medical records is important. Now we need to talk about medical treatment.
There are a few things you need to consider when it comes to medical treatment:
- You MUST have a specialist handling your pain treatment.
Relying on pain meds given by a primary physician is not enough.
I say this over and over again but primary physicians are seen as someone who treats the “sniffles”.
The same goes for nurses, physician assistants (PAs), social workers or anyone who is NOT an MD, DO, Ph.D. or PsyD.
2. If a specialist says there is not much he can do, be sure to at least discuss a referral to a pain management clinic.
The pain clinic will keep working on improving your pain or offering other treatment to help you.
3. Treatment for coping with pain is also helpful.
You may not have any mental impairments per se. But pain can really drive one “nuts“.
If you start seeing a psychologist for coping therapy, this can be a good indicator that things are not so great.
Plus, mental health therapists are great with forms. They are also great writing down how you are presenting that day (sad, wincing with pain, adjusting yourself to your seat, tearful, etc).
This can greatly enhance your credibility too and show that you are not making things up.
For information on how to improve your medical records and treatment, you can check my post about How to Fix Your Medical Records.
Learn How to Read Your Medical Records
I always tell my clients that they should learn how to read their medical records.
If my clients wish to learn how to read them I usually sit down with them and show them how to do that.
But most attorneys will not do that. Probably to preserve some of their expertize. Or because some attorneys don’t really know how to read medical records like they should.
I fell that if my clients know how to read their records, they are not only able to fix them earlier in the game, but they also feel more empowered about their claim.
Who wants to be in the dark about their chances to win their claim until it’s too late?
With that in mind, I decided to create a course where claimants can learn to read their own medical records.
If you wish to learn how to read your medical records and find out if they are really supporting your claim, you may sign up for my Medical Records Reading 101 Course.
The course is very reasonably priced (only $9.99) so you won’t break the bank.
In the course, I show you the method I use to read my client’s medical records. I also show you how to “fish out” problems that can cost your case and how to fix them.
But wait, there’s more!
I know, I sound like a cheesy infomercial but you’re gonna like this one.
If you wish to take an in-depth “peek” for FREE, you can sign up below for my FREE Mini-Course on How to File Your Social Security Disability Claim like the pros.
The course talks mostly about filing a claim, but I get a little bit into the “medical records reading” so you can see if you like my method of teaching before you invest in the Medical Records Reading course.
No Strings! It’s completely FREE!!
Plus you get to join an exclusive Facebook page created just for the course students.
I said it before and I’m going to say it again:
Medical Records and Treatment is everything in a case, EVERYTHING!
Even more in “pain/invisible illness” claims, since your case may only have “circumstantial” evidence compared to “visible” claims (Spine, Gastrointestinal, etc).
So, start now!
Start working on improving your records and making any changes to your treatment to prove your “invisible illness“. ASAP!
You do not want to go through this entire process in the dark and with the wrong evidence.
It takes too long to have “your day in court” and you want to go well prepared.
Until next time,