Gfg1 denied SSI and need suggestions

[TeDo]

Got the letter today that gfg1 has been denied for SSI. "The medical records do not show marked and severe functional limitations." This is a kid that won't remember to eat unless I make him (only 70 lbs at the age of 14), can't be left home unsupervised (don't get me started), doesn't think to shower unless I tell him to, can't cook anything because he forgets he's cooking (have the burn holes & ruined appliances to prove it), ...........

How do I get them to see that without me home, this kid would be off his meds and eventually die of starvation because he has VERY marked functional limitations, not to mention the legal and school issues we've had? The only reason he's not doing worse is because I am home 24/7 to make sure he gets everything he needs. A lot of this stuff probably isn't in his medical records since the only GOOD professionals we've found are the neuropsych he will be seeing every two years for a re-eval and an OT that no longer works with kids. The others were/are idiots and I'm sure their notes are very minimal but they are all we have access to.

Any ideas on how to get this decision turned around or should I not even bother to appeal it?

[InsaneCdn]

The OT and neuropsych should still be able to help you on this one. Being able to prove how severely disabled he WAS at the time of last treatment, and their opinions as to prognosis, do have weight. Ideally... one of them would be able to see him for a "status update" appointment, which would bring their opinion into "current" status.

[Dammit Janet]

You need to be able to prove he isnt progressing on the same rate as his peers. That is what they look at. You need to have him see doctor's religiously enough that they can say that he isnt anywhere close to a local boy of his age. Mom simply wont do it all the time. You can report this stuff but you need a doctor to back you up.

[Wiped Out]

Be sure to appeal. I was told once it can take several times.

[SearchingForRainbows]

I agree with everything the others have said. I know several people who had to appeal more than once before they were able to get their GsFG SSI. Make sure to keep copies of everything you send. Hang in there - It can be a frustrating process! SFR

[MidwestMom]

My son AND me got SSDI. Let me tell you what I was told.

They NEVER ok it the first time. Or the second. Or the third. It goes to a different person each time and not until the FOURTH try does it go to the RIGHT person. They are hoping you will quit trying. Do not quit trying. Apply again. Keep applying. Make sure you attach all the medical records you have. And if they turn you down the fourth time, then you can get a lawyer, but this is the way SSDI is done. It is the same for everyone, kids or adults. KEEP AT IT. He will eventually be accepted, but you have to stay the course.
Also certain key words help. "Autistic spectrum disorder" "cognitive delays NOS" "bipolar disorder"...they help a lot more than "ADHD" "ODD" "Conduct Disorder", "Sensory Integration Disorder" etc. What is his legal diagnosis. BTW, a cognitive delay can be many things. It does not have to mean he has a low IQ. On the Asperger's front, it is better if he is diagnosed with autistic spectrum disorder (my neuropsych knew to do that to son) although he is very high functioning. They need to think it is a lifelong disorder.

I would not appeal it. I would re-apply. Wait for the fourth time to do anything.

[confuzzled]

http://www.ssa.gov/disability/profes...dult.htm#12_10

carefully read it, know the qualifications and buzzwords and base your appeal around it.

its not necessarily true that everyone is turned down the first time, but plenty of people are, and the appeals process is there for a reason. take full advantage of it and include every last piece of documentation you can, including school evals and his IEP if he has one. and of course every report ever generated by a doctor, therapist, whomever.

but dont give up--its a long process.

[amazeofgrace]

is there a state case worker involved with his treatment, sadly this is when I was able to get benefits rolling for GFG...

[TerryJ2]

Wow. That's all I can say.

[TeDo]

We don't have such a thing as a state caseworker in Minnesota. They are all county and ours closed his case because the few services offered in our county are for lower functioning kids. They basically offer PCA's (I'm a stay at home mom so no need there), social skills services (counselor takes the kids 1:1 (no peer interaction) to do fun things and gfg1 won't go with the ONLY one here anymore because the counselor is convinced gfg1 is basically just ODD despite professionals saying otherwise), and horse therapy twice a year that she won't keep the case open for.

He's too high functioning for the services offered through our caseworker but not high functioning enough to be able to attend regular public school (don't get me started) or be left alone unsupervised. It really stinks being "inbetween".