We’ve been hearing “the sky is falling” for years, at least when it comes to Social Security disability. But is it possible that it’s actually true this time?
As this article from MSNBC.com makes clear, there are some new challenges an applicant for disability must face. Many of these challenges result from both short- and long-term effects of the U.S. economic crisis. Some are a result of an aging population.
One of most immediate problems is the effect of rampant and increasing rates of unemployment on the number of applications for disability. When older workers get laid off due to the economic downturn and cannot subsequently find employment, more and more they’re turning to Social Security disability to make up the shortfall in income. There’s already a documented 50% increase in the number of applications from ten years ago.
That increase in turn causes yet another problem: a serious backlog. It used to be that an applicant would wait approximately a year for a hearing on her appeal of an initial denial (and remember, most initial applications are denied). Now that timeframe has been extended to two years, and it may increase further.
Another problem is the growing threat of insolvency of the fund itself. This is simple math: the more applications received, the more approved applications, and the greater the amount of money flowing out to recipients.
What does this mean for you? Perhaps everything — perhaps not much. It may affect your chances at a successful outcome statistically speaking. Yet when it comes to filing for disability, statistics are just numbers and have nothing to do with any individual case. You shouldn’t let dire predictions alone talk you out of speaking to an attorney about filing an application for disability. But it does make sense to educate yourself about the process. even though, as the process is continually evolving, that might be tougher than it used to be.
Filed under Hearing strategies by on Sep 12th, 2011. Comment. 
Once in awhile, medical study reports are so interesting and so compelling that the reader simply cannot wait to share the news. Here’s an example, via the European Society of Cardiology.
We’ve undoubtedly all heard about the maxim “Laughter is the best medicine.” Norman Cousins, the late author, wrote several books about his experiences as a heart patient in which he maintained his constant conscious exposure to humorous movies, books, and programs helped heal his condition.
Now comes word from the ESC summer meeting in Paris (August, 2011) of a study conducted by the University of Maryland School of Medicine that backs up Cousins’ claims, ScienceDaily.com reports. Dr. Michael Miller, who headed up the study, got the idea after reviewing previous studies that looked at the inverse proposition — that stressful thoughts caused vascular constriction — and concluded that it was, in fact, true.
Another link the research chain was provided by the study authors’ earlier research. That earlier study found that out of a set of 300 volunteers (some with and some without heart disease), the people who did have coronary health issues were 40% less likely to find a particular situation funny, as measured by a questionnaire.
In the most recent study, the test subjects watched portions of comedies such as There’s Something About Mary and serious segments of dramatic movies like the opening 20 minutes of Saving Private Ryan. After watching the stressful scenes, the subjects developed vasoconstriction – a narrowing of the blood vessels which reduces the flow of blood in the body. That finding was consistent with earlier studies on stress and blood vessel response.
The real surprise came when the subjects viewed the funny movie scenes. The blood vessels actually expanded. Reports ScienceDaily:
Overall, more than 300 measurements were made with a 30-50% difference in blood vessel diameter between the laughter (blood vessel expansion) and mental stress (blood vessel constriction) phases. “The magnitude of change we saw in the endothelium after laughing was consistent and similar to the benefit we might see with aerobic exercise or statin use” says Dr. Miller.
The endothelium has a powerful effect on blood vessel tone and regulates blood flow, adjusts coagulation and blood thickening, and produces chemicals in response to injury and inflammation. It also plays an important role in the development of cardiovascular disease.
“The endothelium is the first line in the development of atherosclerosis or hardening of the arteries, so it is very possible that laughing on a regular basis may be useful to incorporate as part of an overall healthy lifestyle to prevent heart disease. In other words, eat your veggies, exercise and get a good belly laugh every day” says Dr. Miller.
The authors were quick to point out that further research is definitely needed on this phenomenon. Dr. Miller stated, “What we really need is a randomized clinical trial to determine whether positive emotions reduce cardiovascular events above and beyond today’s standard of care therapies” — in other words, a study that compares the relative effectiveness of laughter therapy and standard or traditional medical protocols like surgery and medication.
In the meantime, it can’t hurt to laugh more.
Filed under heart disease research by on Sep 5th, 2011. Comment.
In yet further support of what we undoubtedly already knew, two lines of thought about cardiac disease and nutrition have emerged lately in the press.
The story that got more media attention by far was former President Clinton’s embrace of the vegan lifestyle. Of course, Clinton is widely remembered for his fondness for junk and fast food. Campaign pit stops frequently took in the local McDonald’s, and he was fond of distributing doughnuts as treats to tired staffers.
But then he got a wake-up call, as do over 250,000 people each year in the United States: heart bypass surgery (quadruple bypass, in his case), following an episode of significant chest pain.
And as many spouses before her have done, Clinton’s wife, Secretary of State Hillary Clinton, decided her husband’s dietary choices needed a makeover. After consulting with Dr. Dean Ornish, a well-known cardiac specialist who has authored a number of books on heart disease and lifestyle changes, the Clintons went vegan.
Veganism is a more restrictive form of vegetarianism. A true vegan diet consumes no animal products whatsoever. Thus, where a vegetarian might choose to eat eggs or drink milk, the vegan diet eschews both eggs and all dairy products. Dr. Ornish and other cardiac health specialists believe that a plant-based diet not only reduces the risks associated with heart disease, but may even reverse the course of cardiac disease once it’s begun in a patient.
The second story which, although it didn’t get as much attention in the press, will undoubtedly be seized upon with much less resistance than the vegan-diet story, is that a recent controversial study concluded increased chocolate consumption reduces heart disease. But before you go out to stock up on M&Ms or Godiva, you should know that many experts assert that there is no proof that chocolate consumption has any direct impact on heart health, and there are indicators that increased calorie & sugar intake can be harmful to your health. It should also be noted that the study in question was an observational one — not based on the control-vs-test group approach — and it depended on participants to accurately self-report their chocolate intake.
Bottom line? When it comes to coronary disease and nutrition it seems to be:
- Salads: yes, especially without the fat-drenched dressings
- Chocolate: maybe, but definitely in moderation (and better dark than milk)
Filed under heart disease research, Tips for a healthy lifestyle by on Aug 30th, 2011. Comment.
Social Security Listing 4.05 provides for a finding of disability for individuals with recurrent arrhythmia not controlled by medication or implanted cardiac defibrillator. Interestingly Social Security recognizes that even if you have an implanted defibrillator that works to stop arrhythmias, you still be found disabled because of the side effects of these devices. Specifically, Social Security recognizes that defibrillators may produce “inappropriate shocks, often repeatedly, in response to benign arrhythmias or electrical malfunction” or as a result of proximity to magnetic or electrical fields.
An ICD (Implantable Cardiac Defibrillator) is an electronic device that is implanted into the chest cavity in order to prevent the person dying from a cardiac arrest that is caused by an abnormally rapid heart rate or tachycardia.
Thus, a claimant with a working implanted defibrillator may still be found disabled due to what Social Security calls “psychological distress” which may be evaluated under Listing 12 (mental health disorders).
Now comes word that many implanted defibrillators may not have been necessary after all. Medical News Today, the online health news site, published information regarding a study that was done at Duke University between 2006 and 2009 about cardiac defibrillator implants and some 112,000 patients that received them. Cardiac defibrillator implants are performed on individuals who have critical heart conditions and are designed to prevent the sudden death of a person suffering with advanced heart failure. Although that sounds like a positive procedure, there was one glaring statistic that stood out regarding this issue.
The study revealed that 22% of the 112,000 patients mentioned above really didn’t need the implants. The implants were either recommended for reasons that fell outside of the standard medical guidelines or were completely unnecessary. As a result, it’s going to be difficult to determine whether or not these unnecessary implants will ever prove to be beneficial for the persons receiving them. And it is very likely that some of those with unnecessary implants may end up on disability because of psychological distress.
Filed under Heart Disease - medical developments by on Jan 29th, 2011. 1 Comment.
While bacon is not for everyone, let’s face it, it’s a pretty popular food item that we as Americans have a slight obsession with! Now, a new study is linking not only bacon, but sausage, hot dogs, and deli meats with an increase in heart disease. More importantly, it may not even be for the reason that you think.
A Harvard research team analyzed data from approximately 1,600 studies that were conducted to determine whether a link existed between meat consumption and heart disease and diabetes. They defined meat as beef, pork, and lamb, but not poultry. Additionally, the study recognized processed meats preserved by salting, curing, smoking, or using preservatives, bacon being one such processed meat. According to Food Consumer, the research team found that consuming approximately two ounces or fifty grams of processed meat per day was associated with a forty-two percent increased risk of heart disease. They could not, however, find any association between consuming regular, unprocessed meat with an increased risk of the harmful condition.
The researchers believe that it must be the preservatives, such as salt, sodium nitrate, and nitrate salt that are responsible for the increase. This stands to reason due to the fact that the wholly unprocessed meats did not return the same results. Even doctors and other professionals that encourage low carbohydrate dieting, in which many people consume meat, including bacon, recommend eating nitrate free products for this very reason. Despite the conclusions of the study, the results are not meant to show a direct cause between the consumption of these products and heart disease. It was merely a finding of connection between the two.
If you are concerned about the impact of preservatives in your meat products, you are in luck. Many retailers now carry these items with no preservatives and you can always seek out local farmers who sell them in their whole state. As with any food, the closer it is to nature the better it is going to be for your body and as a protection against diseases, such as heart disease.
Filed under heart disease research, heart disease risk factors by on May 26th, 2010. Comment.
When most people think of calcium they think about how it strengthens our bones and helps our teeth remain healthy. It may even be beneficial in weight loss. For the most part, calcium in our bodies is a good thing. However, new research has shown that calcium deposits in our arteries may be an accurate predictor of heart disease in some individuals. This calcium build-up is indicative of the accumulation of plaque in our arteries, otherwise known as atherosclerosis. According to WebMD, the amount of calcium in the arteries is directly related to the amount of plaque present, and the latter can be measured by a calcium score.
This new study stemmed from the fact that although calcium build up is a symptom of coronary artery disease and usually a precursor for an arterial blockage, it is not known whether a calcium score itself can predict if a person will develop heart disease. Approximately 5,878 participants, ages forty-five to eighty-four, were involved in the study, known as the Multi-Ethnic Study of Atherosclerosis. Researchers used CT scans to evaluate whether the individuals had calcium accumulation in their arteries. The participants had not been diagnosed with coronary disease at the start of the study and came from various cultural and ethnic backgrounds. The researchers spent the next six years following up with the individuals, noting any new medical conditions, heart health, hospital visits, and even deaths. They found that 209 participants had a heart attack, cardiac arrest, or heart disease.
When the researchers examined the CT scans, they were able to accurately identify the individuals who eventually developed heart problems at a rate of seventy-seven percent. When not using the CT scans and only looking at other risk factors, the identification accuracy fell to sixty-nine percent. The researchers believe that this score, used with the determination of other risk factors, is a useful tool in predicting whether an individual will develop heart disease. They did not note, however, whether this ease of detection will improve a person’s quality of life. Further, they did not condone a CT scan as a routine test for everyone, noting its expense and small exposure to radiation. It does appear that the researchers are working in the right direction and that more studies will need to be conducted to understand the outcomes of the calcium score on heart disease. What’s more is that if this scoring eventually becomes the norm, more people may have a concrete diagnosis of heart disease. This will allow them to get the treatment they need and maybe even the social security disability benefits that they deserve.
Filed under heart disease research, heart disease risk factors by on May 25th, 2010. Comment.
I once tried a case before a very nitpicky Administrative Law Judge. The case involved a 55 year old woman who suffered from a heart condition. The woman had a pacemaker including a defibrillator. She experienced shortness of breath, chest pain and severe fatigue. She had a consistent work history over the past decade. She also had 2 treating physicians, and both doctors supported her disability claim. The woman had the following:
- Thorough medical records
- One or more functional capacity forms explaining her work activity limitations
- She was a credible claimant
- She had a long work history
Sounds like a winning case, right?
Well, the judge thoroughly examined the claimant’s medical records and stated that the test results (cardiac tests in order to measure the heart’s pumping capacity) showed very little pumping capacity limitation. However, the doctor’s notes stated that the patient indeed experienced severe limitation. So there was a discrepancy between what the test results showed and what the doctor’s notes said.
This was the first distraction in what I expected to be a relatively east and straightforward hearing. Luckily, based on experience, I was able to steer away from this discrepancy which the Judge was focusing on to focus his attention instead on how my client’s disability affected her ability to work overall.
During the hearing, I created an argument that the claimant had a severe medical problem (no matter how you looked at the evidence) and that her inability to hold down a job was due to her medication side effects, fatigue, and other related symptoms.
Fortunately, the judge issued a favorable decision. Even though this was considered an extremely stressful hearing, it only reiterated the importance of hearing preparation and things to always keep in mind when it comes to arguing for disability. Here are a few tips to consider during your hearing:
1) Argue that your ability to work for a living has been greatly reduced because of medical conditions. You are unable to be a productive worker on the job because of your medical problems.
2) When you are asked about your ability to perform day to day tasks such as standing, sitting, walking and lifting, don’t give general answers. Be specific. For example, never say something like “I can’t sit for very long.” Instead, say something like “I can’t sit for longer than 20 minutes because it gives me intense pain in my back and knees to the point where I’m unable to focus and concentrate on what I’m doing.” Also, it is important to note, if you testify that you are unable to site for more than 20 minutes without pain, don’t come to the hearing and sit calmly for 40 minutes! Try standing up and moving around throughout the course of the hearing if you feel uncomfortable.
3) When you are asked about your pain, try using scale of 1 to 10 with 1 being a mild headache and 10 being a kidney stone. Never say your pain is constantly at level 10. It is better to say that your pain is constantly at a level 5, but that it will, at times, shoot up to around 8 or 9.
The above principles may be used in a cardiac disability case or any disability case for that matter. Just remember to focus on how your condition keeps you from being able to work and you are off to a good start.
Technorati Claim Code: CTVNY3UACPC2
Filed under Hearing strategies, Heart Disease - Case Strategies by on May 3rd, 2010. Comment.
It has long been known that sugar is a villain in the world of oral health and that it is largely responsible for a huge diabetes epidemic in the United States, but what many may not know is how sugar negatively impacts our hearts. We have mostly assumed that it was the fat in our diets that was clogging our arteries and raising our cholesterol. A new study, however, is changing that general presumption to include sugar as one of the primary factors influencing heart disease.
The study, published in the Journal of the American Medical Association, asked approximately six thousands participants about their diets. They were then grouped according to their cholesterol numbers and sugar intake. The researchers found that almost sixteen percent of the participants’ daily calories came from sugar. When assessed even further, they concluded that those who ate the most sugar ingested about forty-six teaspoons of sugar per day, while those who ate the least amount of sugar clocked in at three teaspoons per day. This influx of sugar may lead to heart disease and stroke, as well as risk factors for the disease, including high blood pressure, diabetes, and high cholesterol. In fact, the American Heart Association feels so strongly about limiting sugar that it has issued new guidelines about its consumption, limiting women to eating only six teaspoons of sugar per day, while men can consume up to nine teaspoons.
But, sugar has been around for years and has not been considered a culprit for heart problems until very recently, so why the new change? Well, sugar has been added to virtually all of our foods and it comes in various names other than simply ‘sugar.’ Usually, anything ending in –ose is a sugar variant, and of course anything with the word ‘syrup’ is a sugar derivative. The sweetener is in many beverages, prepared foods, and even ‘healthy’ foods such as granola, oatmeal, and yogurt. It has been hard for people to limit their sugar intake simply because it seems like it is in everything. Some new legislation is trying to change that, however, by attempting to impose a tax on sweetened soft drinks. But, much like with a tax on cigarettes, we will have to see if a sugar tax detracts people from buying soda.
So, if it is in everything and causes harm to our hearts, how can we limit our intake? You can start with simple steps like cutting out the sugar in your coffee or limiting it to half of a teaspoon. Also, switch your regular sodas for diet, or better yet, drink tea, water, or coffee. Finally, limit the amount of processed and packaged foods that you consume, as this will easily cut down your sugar intake. Getting rid of the white stuff will definitely boost your health and your heart will thank you.
Filed under heart disease research, heart disease risk factors, Tips for a healthy lifestyle by on Apr 29th, 2010. Comment.
Do you sit down to a meal and automatically categorize the food on your plate as being a “bad” food or a “good” food? Do you avoid certain dining establishments because the food that is served is full of butter, fat, or grease? Most of us have been conditioned to think that fatty foods raise our “bad” cholesterol, LDL, while lowering our “good” cholesterol, HDL. Millions of individuals in the United States are on statins to control their cholesterol, yet the number of people developing or even dying from heart disease continues to grow. It appears we have taken all precautions to fight heart disease (by taking the fat out of our foods, taking a lot of medications, exercising regularly, etc.), and yet still our heart disease numbers continue to grow. According to an article in Men’s Health, perhaps the reason is due to the flawed logic and studies behind demonizing fat and LDL cholesterol as a whole.
The prevailing idea over the last number of years has been that LDL is wholly bad and that a high number in LDL testing is a marker for heart disease. Additionally, we have been taught that saturated fat consumption raises our chances for developing heart disease. All of this is now being called into question by Dr. Ronald Krauss of the Children’s Hospital Oakland Research Institute and the director of the atherosclerosis department. He has developed an instrument, using ion mobility process that separates the LDL particles down to small components. The theory behind using this machine is that LDL is made up of many sub particles and not all of them are “bad” or cause heart disease. Therefore, simply relying on one number associated with LDL could lead many people to begin using drugs they have no need for, changing their diet when it doesn’t need changing, and more importantly, actually putting them in danger of developing a heart problem.
According to Men’s Health, LDL comes in four different types: the benign, big fluffy type; the medium, relatively harmless type; the small, dangerous types; and the very small, very dangerous types. Researchers have found that individuals who eat a diet high in saturated fat boast the big fluffy LDL particles, while those who eat a low-fat, high carbohydrate diet have smaller LDL particles. Because the standard blood test does not differentiate these types, Dr. Krauss and his team decided to use the ion mobility analysis on blood samples from 4600 healthy Swedish men and women. They found that the strongest indicators for heart disease, from highest to lowest were: high levels of medium and small LDL particles combined with low HDL; low HDL levels; and high total LDL levels. What is even more concerning is that because a standard lipid test only shows the total LDL number, most of what makes up that number can be large, fluffy particles.
Dr. Krauss also wanted to test the impact of diet on cholesterol, specifically on LDL numbers. Using data from the Framingham Heart Study, he found that a diet high in saturated fat did in fact increase LDL numbers, but only the large, fluffy, benign type. Meanwhile, individuals who ate a low fat, carbohydrate heavy diet increased the small LDL, thereby increasing the overall heart disease risk. Strikingly, people who change their diets in the hope of decreasing their overall cholesterol number may be doing more harm than good.
Filed under heart disease research by on Apr 21st, 2010. Comment.
We know that fat plays a role in heart disease, but just which fats are responsible for damaging our cardiovascular system? For many years, it was believed that the saturated fat in that juicy steak was to blame. Then, many researchers and doctors noted that there were good fats, such as the essential fatty acids found in some types of fish, which are great for the body and heart. Until recently, many doctors did not understand why, while more people decreased their overall fat intake and continued to consume “healthy” fats, there was still a rise in cardiovascular disease, especially among women. Now, due to many current studies, doctors are confident that trans fats, found in many processed foods, and are to blame for widespread heart disease.
A study, conducted by Rodale Health and published in the American Heart Journal, examined information from 86,000 women who participated in the Nurse’s Health Study. The researchers found that women who ate the most trans fats, relatively two and a half percent of their daily caloric intake, were three times as likely to suffer cardiac arrest as compared to women who only consumed one percent of trans fats according to the New York Daily News. These findings led the research team to believe that there is an unequivocal link between the consumption of trans fats and the development of heart disease. Whereas saturated, monounsaturated, and polyunsaturated fats occur naturally in the foods we eat, trans fats are created during the processing of certain foods. These manufactured, chemically altered fats raise your bad cholesterol (LDL) and lower your good cholesterol (HDL), both of which contribute to cardiovascular problems.
The problem is that most of these trans fats are found in many of the foods that we eat, especially in fried foods (such as doughnuts and french fries), and in baked goods (such as pies). It is critical to know what you are eating and to read the labels of any processed food that you are consuming. If you already have heart disease, it is even more crucial to get rid of all of the trans fats in your diet. The risk of having cardiac risk is even greater if you combine an already diagnosed heart disease condition with a consumption of trans fats. Although those Little Debbie snack cakes may sound like a good idea, it is best to find an alternative option to avoid unnecessary trans fats and an unnecessary heart disease diagnosis, or even worse, a heart attack of stroke.
Filed under heart disease research, heart disease risk factors, Tips for a healthy lifestyle by on Apr 15th, 2010. Comment.
