Some people have health problems that result in “good days” and “bad days.”  Individuals with inflammatory arthritis, migraines, seizures, fibromyalgia, and some mental health difficulties, may feel relatively normal on some days, and completely incapacitated on others.

You may be found eligible for disability benefits at a hearing if bad days would cause you to miss 1 to 2 unscheduled days of work per month.  The difficulty, however, is to prove this.  Below are some ways we have used to document symptoms that come and go:

1. If you worked for a time with your health problems and had many absences, get a report from your employer about the number of days over a year or so when you left work early, came in late, or took a sick day.
2. Keep a diary of daily symptoms associated with your disabling condition. We can provide you with a specially tailored form to do this.  If you have a seizure disorder or another condition that makes you an inaccurate historian of your own symptoms, have a witness help you with your record.  Give your attorney a copy of your symptom diary.
3. Share your symptom diary with your doctor, and get regular care. This will help you get the care that you need, and will also insure that your doctor understands your condition.  Hopefully, your doctor will record the number of symptom flares and severity of those flares in your treatment record and adjust treatment accordingly.  Medical evidence is always the most convincing evidence to a judge.

Your claim for disability benefits is generally won or lost based on doctor and other provider records.  Seeing someone for the problems that cause you difficulty working is extremely important to both your general well-being and your claim for benefits.

You should be able to get insurance:

Idaho Medicaid sign-up: Apply for Medicaid | Idaho Department of Health and Welfare

Washington Medicaid (Apple Health) sign-up: Apply for or renew coverage | Washington State Health Care Authority

If finances or lack of insurance is an issue, here is a list of free or reduced fee clinics:

Benewah Clinic, 1115 B St., Plummer, (208) 686-1931; medical, dental, counseling, sliding scale.

Latah Community Health (a CHAS Clinic), 719 S. Main St., Moscow, Medicare, Medicaid, private insurance, sliding scale.  Mental health services also available.

Lewis Clark Health Center (a CHAS Clinic), 338 Sixth St., No. 101, Lewiston, (866) 729-8258 (208) 848-8300; Medicare, Medicaid, private insurance and sliding scale.  Mental health services also available.

Palouse Health Center, Sandra K. Schorzman, ARNP, 235 E Main St, Palouse, WA 99161, (509) 878-8000.  Sliding scale fee for those who apply, almost all insurance accepted.

Idaho Department of Health and Welfare provides free or reduced-fee mental health services at the following locations: Moscow office (208-882-0562), Lewiston office (208-799-4440), Grangeville office (208-983-2300).

Snake River Clinic, 215 10th St., Lewiston, (208) 743-5899; basic health care, referrals, non-narcotic drugs, prescription refills and laboratory work for patients without insurance only. Care for free or small fees. They provide care on Mondays and Wednesdays from 10:00 am to 4:00 pm and on Thursdays from 5:00 pm to 8:00 pm.  Call for an appointment or with questions.

Imaging:

If you are paying out-of-pocket for imaging like X-rays or MRI’s, shop around.  St. Joseph Regional Medical Center is often considerably more reasonable than other area hospitals.

Fibromyalgia is often a serious, debilitating condition that makes gainful work difficult.  However, many Fibromyalgia patients who apply for Social Security Disability are initially denied.  This is because the cause of Fibromyalgia is not understood yet, and because its symptoms are largely subjective.  There are not typical objective indicators – like an X-ray or blood test – of the disease or of its severity, which makes it difficult for the Social Security Administration (SSA) to evaluate.

While the SSA doesn’t have a specific disability “Listing” for the condition, they will look at how the combination of a) your physical limitations from all of your conditions (as described by doctors and yourself), b) your age, and c) your past work experience and education; limit your ability to find gainful employment.

At Kirsch & Clark we have successfully obtained disability benefits for clients with Fibromyalgia.  We urge clients to get a formal diagnosis of Fibromyalgia (if they have not already) from a Rheumatologist who uses American College of Rheumatology (ACR) guidelines.  (See http://www.rheumatology.org/Portals/0/Files/2010%20Fibromyalgia%20Diagnostic%20Criteria_Excerpt.pdf).  Regular doctor visits documenting your symptoms and your efforts to follow doctors’ directives also are important.  If you have other conditions – arthritis, sleep disorders, degenerative disc disease, depression, for example – make sure you are getting help for those too, since the SSA will look at the whole picture.  It is also important to make sure your doctor understands how Fibromyalgia, and any other conditions you have, affect you.  His or her support will heavily influence the success of your claim.

At Kirsch & Clark we use our experience and legal expertise to advocate for you.  We make sure your record is complete and encourage you to journal about your symptoms.  If your claim requires a hearing (which is often the case when Fibromyalgia is involved), we carefully document and describe your condition in the most objective way possible in a written legal brief and go with you before the judge.   We realize your condition affects your ability to concentrate and get things done without being overwhelmed, and we can help so your claim for benefits is more manageable.

If you are considering an application for Social Security disability, you must first be able to answer “yes” to the following multi-part question:

• Is your condition severe enough that you won’t be able to work for at least 12 months?  Or, if you are still working, are you either . . . earning less than $1,350 per month (substantial gainful amount as of 2022) in gross earnings due to your condition OR is your employer accommodating your limitations by changing the job or paying you more than you earn?

If you answered “YES,” you should then educate yourself about what disability programs you potentially are eligible for.  Start by finding out from the Social Security Administration whether you are “disability insured” and what monthly cash benefit you might be eligible for if you are found disabled.  Here’s how:  go to www.ssa.gov and click on “My Social Security.”  You will be prompted to create an account.  Once you create the account you can review your earnings history.  Social Security will tell you if you have enough work credits to be covered by Disability Insurance.  If your disability insurance coverage ended recently, you may still be eligible for benefits if you can prove your disability started before your coverage ended.

Even if you are not disability insured, there are other benefits you may be eligible for.  Visit www.benefits.gov/ssa/home to find out more. If you have low income and few assets (a home and a car do not count), you may be able to qualify for Supplemental Security Income (SSI).

If you have questions about Social Security Disability Insurance or SSI please contact Kirsch & Clark (208-882-3598 or 1-800-921-3700).   Kirsch & Clark is a specialized law firm limiting its work to Disability and Elder Law.  We handle the following types of disability claims:  Social Security Disability Insurance, SSI, Long Term Disability Insurance, PERSI Disability Retirement, and Disabled Veterans.  We help people at ALL stages of the process of getting Social Security Disability benefits, including completing the initial application.  We have found that time spent making a complete and accurate application can pay off in the long run.  Our knowledgeable staff knows what information the Social Security Administration needs and how to best explain your case.

We also practice in the area of Elder Law, helping with Medicaid applications, guardianships, Special Needs Trusts, Probate and Wills.