Facts about Hernias and Filing for DisabilityThese selected pages answer some of the most basic, but also some of the most important, questions for individuals who are considering filing a claim for disability benefits. Facts about the condition 1. Inguinal hernia, commonly referred to as simply a hernia, are caused by a hole in the abdominal wall. The condition occurs when a weak or torn spot in the lower abdominal wall allows part of the intestine or other soft tissues to bulge through. 2. Inguinal hernias may occur without known cause, but often they occur due to pressure in the abdomen and/or a pre-existing weak spot in the wall of the abdomen. This weak spot may occur in infants at birth, if the abdominal lining does not close normally. 3. Frequently hernias occur with age as muscles weaken, therefore strenuous physical activity or heavy lifting may lead to a hernia, especially in older adults. Pressure in the abdomen leading to a hernia may also be from straining during a bowel movement, excessive coughing or sneezing, pregnancy or excess weight. 4. Inguinal hernias are very common, especially among men. Men are 10 times more likely to develop a hernia than women. 5. Symptoms include a bulge on either side of the pubic bone, pain or discomfort in the groin area, and a heavy sensation in the groin. Sometimes there may be no pain or noticeable symptoms, but a doctor will find the hernia during a routine annual exam. 6. The bulge from a hernia is most easily seen when standing. It can usually be pushed easily back into the abdomen when lying down. 7. An incarcerated hernia is a condition that occurs when a loop of the intestine becomes trapped in the hole of the abdominal wall. This obstructs the bowel causing inability to pass gas or have a bowel movement. This may also cause severe pain, nausea and vomiting. This is a medical emergency needing immediate attention. 8. To prevent life-threatening complications or significant pain and discomfort, surgery is usually recommended once the inguinal hernia becomes painful or begins to grow in size. Qualifying for disability benefits with this condition Whether or not you qualify for disability and, as a result, are approved for disability benefits will depend entirely on the information obtained from your medical records. This includes whatever statements and treatment notes that may have been obtained from your treating physician (a doctor who has a history of treating your condition and is, therefore, qualified to comment as to your condition and prognosis). It also includes discharge summaries from hospital stays, reports of imaging studies (such as xrays, MRIs, and CT scans) and lab panels (i.e. bloodwork) as well as reports from physical therapy. In many disability claims, it may also include the results of a report issued by an independent physician who examines you at the request of the Social Security Administration.
Qualifying for SSD or SSI benefits will also depend on the information obtained from your vocational, or work, history if you are an adult, or academic records if you are a minor-age child. In the case of adults, your work history information will allow a disability examiner (examiners make decisions at the initial claim and reconsideration appeal levels, but not at the hearing level where a judges decides the outcome of the case) to A) classify your past work, B) determine the physical and mental demands of your past work, C) decide if you can go back to a past job, and D) whether or not you have the ability to switch to some type of other work. The important thing to keep in mind is that the social security administration does not award benefits based on simply having a condition, but, instead, will base an approval or denial on the extent to which a condition causes functional limitations. Functional limitations can be great enough to make work activity not possible (or, for a child, make it impossible to engage in age-appropriate activities).
Why are so many disability cases lost at the disability application and reconsideration appeal levels? There are several reasons but here are just two: 1) Social Security makes no attempt to obtain a statement from a claimant's treating physician. By contrast, at the hearing level, a claimant's disability attorney or disability representative will generally obtain and present this type of statement to a judge. Note: it is not enough for a doctor to simply state that their patient is disabled. To satisy Social Security's requirements, the physician must list in what ways and to what extent the individual is functionally limited. For this reason, many representatives and attorneys request that the physician fill out and sign a specialized medical source statement that captures the correct information. Solid Supporting statements from physicians easily make the difference between winning or losing a disability case at the hearing level. 2) Prior to the hearing level, a claimant will not have the opportunity to explain how their condition limits them, nor will their attorney or representative have the opportunity to make a presentation based on the evidence of the case. This is because at the initial levels of the disability system, a disability examiner decides the case without meeting the claimant. The examiner may contact the claimant to gather information on activities of daily living and with regard to medical treatment or past jobs, but usually nothing more. At the hearing level, however, presenting an argument for approval based on medical evidence that has been obtained and submitted is exactly what happens. About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here. Most popular topics on SSDRC.com Social Security Disability in North Carolina Common Mistakes to avoid after being denied for Disability Tips to Prepare for Filing for Social Security Disability or SSI Advice to Win SSD and SSI Benefit Claims Social Security Disability SSI Questions What is the difference between Social Security Disability and SSI? How to get disability for depression Getting disability for fibromyalgia SSI disability for children with ADHD What is the Application Process for Social Security Disability and SSI? Social Security Disability SSI Exam tips More Social Security Disability SSI Questions What makes you eligible for Social Security Disability or SSI? |
