Great news today! The Social Security Administration has published a NEW Social Security Ruling (SSR) in the Federal Register on March 18, 2015, for evaluating interstitial cystitis (IC) in adults and children. The SSR takes effect immediately.
New SSR 15-1p rescinds and replaces prior SSR 02-2p for establishing IC as a medically determinable impairment (MDI) and determining the level of disability for applicants applying for disability benefits. It takes into consideration information about IC recently developed by the American Urological Association (AUA) and the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
The ruling makes for fascinating reading and we strongly suggest that every current applicant, those currently appealing denials or patients considering making an application read the ruling in its entirety. It offers a LOT of clues about the types of information SSA expects and needs to approve disability benefits.
For example, the new ruling shares they will look at the previous 12 months of medical records prior to the application. They want longitudinal data on how IC has presented itself, what symptoms the patient is having, how the diagnosis was made, what treatments were tried and, of course, how that diagnosis and symptoms are now interfering with you ability to work.
With the thousands of patients who have tried to game the SSA system, they now act with an abundance of caution and require medical evidence. They won’t take just your statement that you are disabled, nor is your doctors statement that you are disabled compelling enough. They want valid medical evidence. So, they’ll be looking at your medical records, your test results, the signs of IC as seen during a hydrodistention, etc. etc.
Take special note here! One of the most important things that you should do at EVERY SINGLE DOCTORS APPOINTMENT is provide them a voiding and pain diary for your medical file. This provides compelling data to support your claim. It will show your frequency over time, your pain levels over time, your progress or lack of progress with treatments. It adds more objective data for symptoms which many judges have felt were too subjective. It’s powerful evidence that has helped other patients successful appeal claim denials.
In the new SSR, they explain that the following evidence can establish the MDI of IC:
- A diagnosis of IC by an acceptable medical source who reviewed the claimant’s medical history and conducted a clinical examination;
- IC symptoms, as indicated in the AUA and NIDDK descriptions; and
- Medical signs or laboratory findings.
The new SSR also provides guidance in the following areas of adjudication:
- Obtaining medical and other evidence;
- Arranging consultative examinations;
- Resolving inconsistencies in the evidence;
- Evaluating claimants’ statements about symptoms and functional limitations; and
Using the five-step sequential evaluation process for determining disability.
We’ll be doing an in-depth review of these changes in the Spring 2015 issue of the IC Optimist magazine, coming in April!
You can review the Ruling online at: http://www.gpo.gov/fdsys/pkg/FR-2015-03-18/pdf/2015-05680.pdf