SSDI for TBI AD... Should I apply?

Zomglawlz

Zomglawlz

PEB Forum Regular Member
PEB Forum Veteran
Registered Member
I've done a lot of reading on the forums. I know people can get SSDI while on active duty. I was discussing it with my wife and was thinking about applying but even with all the info here and the ssa website I'm not too sure if I'd be able to qualify, or if I should bother to apply.

Suffered TBI 7 (Sep 12) months ago on deployment and haven't been able to really do much work since. I've mostly been doing call in musters once I got back from deployment and placed on LIMDU (Nov 12). I was PCS'd to Walter Reed in Feb 13 to start treatment since I was stationed in Japan and they were unable to treat there. I'm still going through the basic evaluations here at the warrior clinic to formulate the best plan. But with my first LIMDU period expiring next month and no treatment started yet, I'm certain I'll be getting at least one more LIMDU period. So the 12 month requirement for SSDI should be met without a problem. As for my problems, that's where I'm unsure. I have the TBI, along with daily migraines, serious balance problems, memory problems, anxiety, concentration, anger, depression, and some other cognitive issues. Hell, im not even allowed to drive. I've got to have my wife take me everywhere. Since I haven't really been receiving treatment the past 7 months it isn't documented well in my record. It is documented. Just no major tests or any of that because they weren't available until I got here. I'm sure it will all be documented better in the near future since the docs here seem a lot better.

So should I bother applying? Should I wait until I get better documentation in my record? I honestly don't know how much magic these docs have, I'm hoping for a full recovery since I've got 16 years in, but damn.... I'm just not feelin it so I'm trying to prepare my family as much as I can.
 
Go ahead and apply now. I would because it takes so long for the process and if you get better you just have to tell them. Personally though I would find a lawyer that does just social security disability. That way if you for get better and are turned down you will have someone to appeal for you. Just my personally opinion.
 
apply dude, the wtu will usually have a lawyer contact if it gets denied and the lawyer only gets paid if you do so what can you lose?
 
Brother,
Im in the same boat as you.
what do you do when they ask for your dd214?
 
From what I saw on the ssa website you just don't give the 214 and they are not supposed to hold up the request because of that. But I'm new to the whole thing.
 
just go on the website fill out the forms they get your med records and everything
 
Welcome to the PEB Forum!

SSA's SSDI is an "all" or "none" based total disability program, unlike the DoVA which compensates for numerous medical conditions which may not be totally disabling.

Upon submitting your application, ensure that you annotate in the “remarks section” that you are a “Wounded Warrior still on Active Duty.” From what I have read, some SSA Field Offices are NOT following their instructions, policies and procedures in reference to Wounded Warrior applicant cases. They are having significant challenges with making the SGA determination for active duty service members since they usually continue to receive full military pay while receiving medical treatment. Per SSA guidelines, they are supposed to "determine the reasonable worth of a claimant’s actual work activity by comparing it to work activities from people in the civilian work force...do not evaluate the claimant’s work activity based solely on military wages."

The SSA uses a GRID of Rules if a disability applicant doesn't meet a medical impairment listing.
The GRIDs are set up as a series of charts which can be confusing. SSA will make a determination on what level of exertion you can perform at in a work environment. The categories are from least level of exertion to most: sedentary, light, medium, and heavy.

Moreover, the GRID of rules calculate when an applicant is disabled as based on age, RFC level (sedentary, light, medium, or heavy work), education level, and work history and skills. If the applicant's impairment(s) does not met or equal a listing, the GRID rules come into play when an individual has a severe medically determinable physical or mental impairment, is not working at SGA level, and the impairment prevents an individual from performing any of their past relevant work (PRW).

With that all said, it's a good idea to request a complete copy of your SSA case file (for a nominal fee) upon availability. The "disability determination explanation" packet will include at a minimum "findings of fact and analysis of evidence" and an "assessment of vocational factors" write-ups which are very detailed to yield better explanations of any potential SSDI denial.

At your leisure, I suggest that you again visit the follows resources to obtain detailed information about the SSA disability evaluations and SSA SSDI GRID of rules:

1. http://www.ssa.gov/OP_Home/cfr20/404/404-app-p02.htm
2. http://www.ultimatedisabilityguide.com/grid_rules.html
3. http://www.ssa.gov/disability/professionals/bluebook/

Thus, possessing well-informed knowledge is truly a powerful equalizer.

Best wishes in your pursuit to obtain a favorable "disabled" SSA SSDI determination!
 
I completed the online application today. Fingers crossed. I was surprised when I checked in with the Navy Wounded Warrior Safe Harbor office here at Walter Reed and that was the first thing they told me to do. In fact they walked me right over to another part if the hospital where the SSA comes every Tuesday to help process applications. Since the SSA seems proactive with the hospital and famine with the Wounded Warrior program I'm hoping to avoid the inevitable first stage denial. That application and online report was a beast to fill out, I'm thankful I had my wife to help me.
 
Zomglawlz said:
I completed the online application today. Fingers crossed. I was surprised when I checked in with the Navy Wounded Warrior Safe Harbor office here at Walter Reed and that was the first thing they told me to do. In fact they walked me right over to another part if the hospital where the SSA comes every Tuesday to help process applications. Since the SSA seems proactive with the hospital and famine with the Wounded Warrior program I'm hoping to avoid the inevitable first stage denial. That application and online report was a beast to fill out, I'm thankful I had my wife to help me.
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Outstanding news to hear, brother! :)

To that extent, the SSA may request that your wife complete a "Function Report - Adult - Third Party Form SSA-3380-BK" which would be mailed to her because they may need to obtain additional information to process your application for SSDI benefits under the Social Security Act. More specifically, the SSA may need to know how you function on a day-to-day basis since you probably listed your wife as someone who has this knowledge.

Moreover, the SSA's Maryland Disability Determination Services (DDS) is the agency responsible for assisting the Social Security Administration in determining if an individual qualifies for benefits. Your wife may receive the aforementioned form in the mail and SSA Maryland DDS would prefer for the form be returned within 10 calendar days via an enclosed postage-paid envelope.

Thus, best of wishes for a successful and favorable "disabled" SSDI determination.
 
I received an SSA-3373-BK , Function Report - Adult, in the mail. Gonna take a bit to fill out, my wife will have to write it for me.
 
Zomglawlz said:
I received an SSA-3373-BK , Function Report - Adult, in the mail. Gonna take a bit to fill out, my wife will have to write it for me.
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This is good news! :)

If I may offer a suggestion, please ensure that the SSA-3373-BK, Function Report - Adult is completed legibly and thoroughly describe all of your medical conditions as the affect your activities of daily living (ADLs).

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer."

Best Wishes!
 
I called SSA today to update them on some new meds I'm on (Effexor/Ativan) and let him know that I was seeing an additional psychiatrist and was put on a second LIMDU. He told me he just finished writing my summery and sent it up and I should expect an answer as early as tomorrow. He said he would note my updates and send those up as well. I'm not sure if that sounds favorable for me or not. I'm expecting the typical first application denial. I guess we will see.
 
ssgt said:
Brother,
Im in the same boat as you.
what do you do when they ask for your dd214?
Click to expand...

They asked for prior DD214's, if your still on active they understand that you will not have a current one, your command will provide you with a letter.;)
 
Zomglawlz said:
I completed the online application today. Fingers crossed. I was surprised when I checked in with the Navy Wounded Warrior Safe Harbor office here at Walter Reed and that was the first thing they told me to do. In fact they walked me right over to another part if the hospital where the SSA comes every Tuesday to help process applications. Since the SSA seems proactive with the hospital and famine with the Wounded Warrior program I'm hoping to avoid the inevitable first stage denial. That application and online report was a beast to fill out, I'm thankful I had my wife to help me.
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Well I'm glad you applied and glad your wife helped you get through the paperwork part (Tell your wife Thank You ;)).
My WTU at Rock Island informed me about the process, and because I had trouble getting through the online application (TBI) a SSA rep called and spent four hours going through the application paperwork process with me on the phone. He was prior military and disabled, so he understood and was very helpful (I'm not sure they are all like that).

It sounds like your going through the whole process with good advise and great assistance. Sometimes social security reports speak in different language then military doctors... so they may have you see one of there doctors that they use that is familiar with the language they require. This is not a Big Deal... In my case it was the Social Securities Doctor taking military language and turning into social security language. Hope this helps... I have walked that long gray line and if you ever have questions or concerns please let me know... Good Luck Brother and God Speed. :)
 
The only real bummer about the intial SSDI appication process is that the SSA collects the information and determines if it should be forwarded to the State Disability Determination Office. The state agency almost always denies first time applicants unless they are expectant (going to die soon) Quite often you will have to go through the appeals process (do not let this get you down) Just keep on appealing until you get a ALJ hearing.

If you file your initial claim within 12 months of your event that caused you to mno longet be able to perform substantial gainful activity (SGA) then your case will be retroactive to that date. If you file the claim more than 12 months after the event, then your claim can be back dated 12 months from the date you filed.

There is a 5 month waiting period after the benefits are granted before you can receive payments, the first payment will begin on the sixth month.

Here is an example from my personal case.

Last date of SGA with Army (20090714)
Date Filed SSDI (20100503)
Date of SSDI ALJ Hearing (20120910)
Benefits Granted at Hearing retroactive to (20090714)
Five month waiting period (August to December 2009)
First day eligible for retroactive payment (20100101)

So it basically took from May 2010 to Sep 2012 to get a decision from SSDI and this was a Military Casualty Case so it has the highest priority.

I saw money for the first time on Nov 3, 2012, make sure you ask for 10% of your claim to be withheld for income tax. I had to pay quite a bit because of the retroactive payment that I received.
 
gsfowler said:
The only real bummer about the intial SSDI appication process is that the SSA collects the information and determines if it should be forwarded to the State Disability Determination Office. The state agency almost always denies first time applicants unless they are expectant (going to die soon) Quite often you will have to go through the appeals process (do not let this get you down) Just keep on appealing until you get a ALJ hearing.

If you file your initial claim within 12 months of your event that caused you to mno longet be able to perform substantial gainful activity (SGA) then your case will be retroactive to that date. If you file the claim more than 12 months after the event, then your claim can be back dated 12 months from the date you filed.

There is a 5 month waiting period after the benefits are granted before you can receive payments, the first payment will begin on the sixth month.

Here is an example from my personal case.

Last date of SGA with Army (20090714)
Date Filed SSDI (20100503)
Date of SSDI ALJ Hearing (20120910)
Benefits Granted at Hearing retroactive to (20090714)
Five month waiting period (August to December 2009)
First day eligible for retroactive payment (20100101)

So it basically took from May 2010 to Sep 2012 to get a decision from SSDI and this was a Military Casualty Case so it has the highest priority.

I saw money for the first time on Nov 3, 2012, make sure you ask for 10% of your claim to be withheld for income tax. I had to pay quite a bit because of the retroactive payment that I received.
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In my case the application was completed in Sept, I was directed to one exam and it was submitted in Oct. It was approved in Dec and I received back pay in Jan. A rather painless process that was relatively quick. :)
 
NDBravehart84 said:
In my case the application was completed in Sept, I was directed to one exam and it was submitted in Oct. It was approved in Dec and I received back pay in Jan. A rather painless process that was relatively quick. :)
Click to expand...

Some States DDD are very painless when it comes to Military
 
I know, I really fell that because the SSA guy helping me was prior military disabled and assisting me with my claim made a big difference... He would say things like... Oh I know what answer they want in that block... when he was filling out the application. Either way the system evolves (both good and bad) and I think it is a important step wounded warriors need to take... you can always turn it off if you want to attempt a return to work. If your under 55 it is also reevaluated every two or three years... For me I use the money to assist me in an easier, healthier lifestyle and have acquired my adaptive equipment that I want, not what VA wants... Good Luck My Friend :)
 
I'm not really getting my hopes up for an approval. I was just approved for SCAADL so that is helping. I had applied for SSDI before knowing it could take two years to get approved.

NDBraveheart84- what state did you apply in? I'm in MD. They are very familiar with the Wounded Warrior Program and military applicants here.
 
gsfowler said:
make sure you ask for 10% of your claim to be withheld for income tax. I had to pay quite a bit because of the retroactive payment that I received.
Click to expand...

That is good advice.
 
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