Signs and Symptoms of Congestive Heart Failure

Posted on August 6, 2010 by Editorial Board

Congestive heart failure (CHF) is a condition in which the heart can no longer pump enough blood to supply the body. Fluids back up in tissues and major organs as a result.

CHF is a chronic, long-term condition that usually develops slowly. Individuals may, however, experience a sudden onset of symptoms.

The symptoms of congestive heart failure vary according to the organs involved and how much the body compensates for the weakness of the heart. People who have CHF may experience some, all, or none of the following symptoms.

Signs and Symptoms of CHF

  • Shortness of breath (also called dypsnea) may occur during activity, while resting, during sleep, or when lying flat. Some patients may only be able to sleep sitting up. Patients may wake up feeling tired, anxious, restless, or even gasping for air.
  • Exercise intolerance means the person cannot handle even mild physical activity that she or he could do in the past.
  • Coughing or wheezing from fluid buildup in the lungs may produce mucus that is white or tinged with pink.
  • Buildup of excess fluids (also called edema) can cause weight gain and/or swelling in the feet, ankles, legs, or abdomen. Swelling may be most noticeable in the ankles or in the front of the lower legs.
  • Fatigue, dizziness, and weakness may cause difficulty doing everyday activities.
  • Abdominal pain or nausea may bring a feeling of being full or of being sick to your stomach, causing lack of appetite.
  • Confusion, memory loss, difficulty concentrating, and disorientation may first be noticed by family members or caregivers.
  • Increased or irregular heart rate can cause heart palpitations and a feeling that the heart is racing or throbbing.  This occurs as the heart beats faster in order to pump enough blood throughout the body.
  • Increased urination, especially at night, may result from extra fluid in the body.

When to See the Doctor

As mentioned earlier, people may have congestive heart failure and have some, all, or none of the common symptoms. Plus, many of the symptoms can indicate other diseases or conditions.  Medical providers recommend that people seek medical help if they:

  • Have shortness of breath that worsens, occurs with mild exercise, or causes difficulty sleeping;
  • Wake up during the night with shortness of breath;
  • Sleep better in a semi-upright position (for example, in a chair or recliner) than flat in bed;
  • Have unusual fatigue that rest does not relieve;
  • Have a dry cough that continues; or
  • Have unusual swelling in their ankles, legs, or feet.

If these symptoms develop suddenly, people should seek immediate emergency care.  If you can no longer work due to CHF you should really consider filing for Social Security Disability benefits.  Not everyone with a heart condition can win benefits, but if your medical impairment is severe enough to keep you from working you may be entitled to get monthly disability payments.

Posted in Heart & Circulation | Comments Off on Signs and Symptoms of Congestive Heart Failure

PTSD can be a Severe and Disabling Impairment

Posted on August 6, 2010 by Editorial Board

Post Traumatic Stress Disorder (PTSD) is term many are now familiar with in connection with troops returning from Iraq and Afghanistan, and it has long held a crippling presence in the lives of Vietnam War Veterans. PTSD is a mental disorder brought on by extreme stress or life threatening experiences.

PTSD has been officially recognized since 1980, but in terms of combat experiences it has been acknowledged for many years. In the past, it was labeled as ‘combat stress,’ ‘combat fatigue,’ ‘shell shock,’ or‘battle fatigue.’ During the Vietnam War, many sufferers were recognized by what was called ‘The Thousand Yard Stare,’ having become detached from the reality of their situation.

The condition is not limited to military experience and can be brought on by other stressful events people experience in civilian life as well, such as urban violence, domestic violence, rape, and racism. Those who experience trauma usually return to a normal mental state after a short period of adjustment, but others may take longer. PTSD is usually evident within a few months of the trigger experience but for some it may take years to develop.

If treatment for this disorder is not undertaken in a timely manner, it can become a very serious and debilitating condition, and in extreme cases lead to self harm or harm to others. The symptoms include a detachment from everyday reality, flashbacks and bad dreams, alcoholism, hyper-vigilance, self destructive behavior, and extreme anger.

PTSD need not be a condition that prevents a sufferer from working. In fact, with modern counseling techniques, mental stimulation, and anti-depressive medication, the vast majority of sufferers will be able to function normally—as long as it is detected in time and treated. Early diagnosis is a very important part of PTSD treatment.

For those who suffer extreme conditions of this stress disorder, keeping a job may not be possible.  Many who try to work with severe PTSD find it very hard to hold keep a job for very long. Fortunately, the US Government’s Social Security Disability program recognizes the condition as a serious one, and one that may warrant disability payments when certain criteria are met.

Under the SSD program, a sufferer must prove that they are not able to return to their previous work AND they must also prove that they are not able to undertake alternative employment. To qualify based on the listing in the “blue book”, the Social Security Administration’s list of impairments, the sufferer must meet two of three listed criteria.

The first criteria relates to the mental symptoms themselves such as flashbacks and nightmares. The second relates to the social function of the sufferer, such as detachment and concentration span. The final criterion is defined as an ‘inability to function independently outside the home’.  If the first and second criteria are met, or the first and third criteria are met, then a PTSD sufferer is said to meet the listing.

Read the listing at 12.06 in SSA’s Blue Book to investigate these elements in more detail.  If you meet or equal a listed impairment you have a good chance of winning Social Security Disability benefits.  Even if you do not meet or equal a listing you could still win disability benefits if you can show you would not be able to sustain employment because of the limitations placed on you from your medical impairment.

Posted in Mental Conditions | Comments Off on PTSD can be a Severe and Disabling Impairment

What to Expect from an Administrative Law Judge at your Hearing

Posted on August 5, 2010 by Editorial Board

Social Security Administrative Law Judges (“ALJs”) are judges who specialize in deciding Social Security disability claims.  They conduct live hearings, take testimony, review medical records and other documents in your file, and make determinations on whether to grant or deny claims.

ALJs are chosen based on their qualifications, test scores, and an oral examination before a government panel.  They are not hired for a specified period.  Essentially, ALJs can keep working as judges as long as they want to.  They do not undergo performance evaluations and they cannot receive bonuses or other incentives for their work.  As a result, ALJs are very independent.  They are not pressured by the Social Security Administration to award or deny cases.  Some ALJs award the great majority of their cases while others award only a small percentage.   The majority of ALJs fall somewhere in the middle.

ALJs also differ widely in the way they conduct their disability hearings and make their decisions.  In hearings some ALJs will ask very few questions of the claimant while others will ask many questions.  Some ALJs will ask aggressive questions, making the claimant feel the ALJ is against them.  Others are very friendly, but how the ALJ behaves in the hearing might have no relation to whether they will award or deny the case.

Federal regulations, Social Security Rulings, and the ALJs’ handbook give specific instructions to the ALJs on how to perform their duties.  ALJs sometimes depart from these guidelines.  Sometimes they do this intentionally and sometimes unintentionally.  The independence that Social Security gives its ALJs means that each one does their job differently.   Your disability attorney should inform you about the specific ALJ who will conduct your hearing.

Posted in Questions & Answers, Social Security Hearings | 1 Comment

Tips for your Social Security Disability or SSI Hearing

Posted on August 5, 2010 by Editorial Board

Dress and Attire

Social Security disability hearings are less formal than other legal proceedings.  The hearings are held in a small room with at most a handful of people in the room.  Still, it’s important that you wear proper attire to show respect for the judge and the administrative process.

You should not wear shorts, sandals, t-shirts, or revealing clothing.  Avoid wearing bright colors.  Cover any visible tattoos with a long-sleeve shirt or collar.  Do not wear any makeup or jewelry other than a wedding ring.  Your medical conditions might prevent you from wearing certain types of clothing such as closed-toe shoes.  If so, wear clothing that doesn’t cause you pain or aggravate your condition.

 

Addressing the Judge

Throughout your entire hearing address the judge as “sir” or “ma’am”.  Of course, you should be polite and respectful, but this can be difficult with some judges.  They might ask questions or make statements that are aggressive or even insulting.  Just like every group of people there are some ill mannered people among the judges.  Your attorney should prepare you in advance if you are facing a judge with a bad temper.  Regardless of how the judge acts it is crucial that you continue to be professional and respectful.  For better or worse the judge has your case in his or her hands, so you don’t want to make a bad impression.

 

Your Testimony

Don’t take notes or documents into the hearing room with you unless you have no attorney.  Just testify to the best of your memory.  If you don’t know the answer to a question you are asked just state “I don’t know” or “I don’t remember”.  Give answers that are short and to the point.  Stick to the subject of the question and don’t wander off into other matters.

 

Final Tips

Experts might be present at your hearing to testify about the medical or work issues involved in your case.  If you want to say something in response to an expert’s testimony it’s best to whisper it to your attorney rather than stating it out loud and interrupting the hearing.  Your attorney will have an opportunity to cross examine the expert after the judge finishes his or her questions.

Posted in Questions & Answers, Social Security Hearings, Winning Disability Benefits | 1 Comment