US Government Information/CDR Denial Appeals Process
QUESTION: Hi Darlene,
I'm here to bother you once again. Sorry about that. Recently, I wrote to you that I'd been denied on my first CDR and that I was appealing. You were of the opinion that someone at SSA had messed up.
I am trying to keep positive and think that this can be resolved, hopefully sooner than later. After all, the facts are plain. They never looked at the main doctor's records (which I am providing them with). I've never had the surgeries they claim I did to correct my condition (which they now know). My doctors have declared me worse, not better. I will also have letters of support from the physicians caring for me. Still, I'm scared.
Anyway. That's me venting; my question for you is something else. I have a question about the hierarchy of the CDR appeals process as it pertains to the beginning.
Right now, I have been in a hurry to get all of the records and support I can together ASAP and then some. I thought that someone was reviewing the case in the same fashion as it was the first time, without a hearing, and that maybe I could get all of this vital new information in front of them before they make a choice.
My family, which is already of the negative view that all is lost, believes that I will be heading straight into a hearing and we're just waiting for a date at this point.
Is there nothing between "I'm here to appeal" and the DHO hearing which might see this overturned without the physical and mental stress of a hearing? Lawyers just won't help you with an appeal, so I - who can barely leave my house - am going to have to represent myself in any hearing.
Thanks very much,
ANSWER: The disability hearing for a medical cessation is the reconsideration level appeal. This is better than the normal reconsideration because it gives you a chance to dicuss the evidence and to make sure all evidence is in file. Not as formal as the ALJ appeal. The next step will be the ALJ hearing.
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I had read the papers as stating that another assessment party would reconsider the evidence, old and new, and that they would be unrelated to and unbiased by the first assessment group. Does this mean I will still have to have a hearing?
They are very stressful, of course, and it's tough for me to go anywhere for long periods of time when my condition has me mostly bedridden. I had hoped that getting ahead of things by getting as much medical backing as I could ASAP might result in averting a trial.
Anyway. Given what I have told you in the past, I wonder if you think I have a good chance at the decision being overturned. My pain mgmt doctor's notes not being considered, wrong name for my condition, claims of several beneficial surgeries which never happened, claims of improvement to the point that I can work not backed by my doctors, etc.
I am worried that I will not be able to adequately defend and voice myself at the DHO hearing, if I have to go to one. I'm just not that type of person. Unfortunately, because there is little profit in it, it is proving impossible to find an attorney to represent me.
Here is the one of the letters my doctors have provided me with, on the mental side of my situation, to give you an idea of the general tone. Maybe this will give you an idea of my odds, if these letters even help:
"X has been a patient under my care since December 27, 2013. He is being treated for Major Depression and Generalized Anxiety Disorder. He was last seen for an office visit on November 3, 2014. He is taking Valium and Hydroxizine to help deal with the anxiety and mood issues. He has a chronic, severely debilitative history of chronic pelvic pain syndrome. This condition makes it difficult to function on multiple levels. From a psychiatric perspective his related problems with anxiety and depression are likewise incapacitating as his life is so adversely affected by chronic pain. The nature of his psychiatric status is of a disabling nature and contributes to his inability to work in any capacity indefinitely."
The letter sounds good, but I think I have advised in the past that I have no medical background and deal with the non-medical parts of Social Security. You can waive your right to appear in person, but if it were me, I would go. Have you tried Legal Aid? They charge based on income. Perhaps they could assist.