NeverputdownjustFMasadiagnosisonyourssdpaperwork

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1、Personal Summary Vanessa Handbeard Summary Of Condition1. Doctors diagnosis 1. Dr. Binegar/Dr. Tarlano: Fibromyalgia 10/2002. Pain management work until April 2003, released from care since there was no more they could do for me; permanent pain level will most likely always be a 6-7, managed with me

2、dication and relaxation biofeedback techniques learned with Dr. Tarlano.2. Dr. Hutter: Chronic Severe Migraines. Migraines began in 1990, treated with various medications and treatments with several doctors over the years, after seeing Dr. Hutter past few months determined there was nothing more tha

3、t could be done but manage the headaches when they occurred, 2-3 times per week. Ocular auras began in February 2003, occurring 100% of the time, nothing can be done about them. 3. Katie Rowan Koenan: Asthma 10/20024. Dr. Broderick: Severe Depression : Depression was diagnosed in 1989, was treated w

4、ith meds and counselling over the years. Severe depression onset in spring 2001 when the severe pain and headaches were becoming debilitating. Got worse as pain got worse, became most severe as the severeity of pain, frustration of roadblocks in care, and financial pressures and problems increased.

5、Medications have been varied, and they are physically tolerated now, but the depression is still very severe. The financial pressure, constant severe pain and frustration with SSA is overwhelming.5. Dr. Fiocco: Fibromyalgia : Seen a few times regarding the FMS, he has me working with Jill Schueller

6、Physical Therapist on a weekly basis. Our work has been severely set back due to chronic issues with the problems in my lower back, the disc pressure that is pinching my nerves and making it difficult for me to do the PT exercises. 2. Any specialist seen 1. Dr Hutter: Neurology2. Dr. Tarlano: Pain M

7、anagement3. Dr. Fiocco: Rheumatology4. Dr. Broderick: Psychologist5. Dr. Binegar: Physical Medicine3. Major tests done/to do 4. Date illness started : Symptoms started most noticeably after Gallbladder removed in 1996. Symptoms increased to disabling degrees in spring of 2001.5. Describe a typical d

8、ay/night 6. Medications taken, or currently using 7. What happens when you try to do various mental or physical activities, how many hours or days you may need to recover 8. Main disabilities; - effects - severity - hindrance - how you deal with it 9. Where you have lived : Wisconsin and Arizona10.

9、Family situation : 3 children all adults living in Phoenix. Live at home with husband.11. Financial problems : My income was the primary income for 17 years. Cashed out everything possible, retirement, etc. Filed bankruptcy in Oct 2002. Currently selling everything we can to make ends meet. Income i

10、s $9 too high to receive foodstamps. May only be able to keep car one more month, maybe the house a few more months. We have insurance through my husbands job, but with that our medical and prescription co-pays are approximately $270 per month alone. 12. Housing situation : Own our home for now, but

11、 barely making the payments, husband had to cash out his IRA to catch up the payment to May. Not sure how much longer we will be able to keep it.13. Job and education history 14. Recreational activities, before and after illness 15. What are you doing to try to get better :16. State that the illness

12、 is severe and pro-longed 1. Dr.Binegar and Dr. Tarlano have released me from care stating that there is nothing else they can do for me, that this is what my life will be like, and that I have to learn how to work with it. Dr. Binegar suggested doing research on the internet, and Dr. Tarlano taught

13、 me how to do relaxation exercises when I had flare ups that were overwhelming. Dr. Tarlano also taught me how to manage my time, re-learning how to lead my days: be up for 10 minutes, wash a few dishes, lay down and maybe write a few notes I need to write for 30 minutes while I rest, get up and tak

14、e a shower (assisted with my shower chair), lay down for an hour to recover from the shower, etc.2. Dr. Hutter has stated that there is nothing else he can do for me at this point. The migraines are 2-3 times a week, but managed with Maxalt when they come, which reduces their length of time from 3 d

15、ays to 1 day. The auras I have at the edge of my vision permanently are distracting, but not painful or harmful, just something that can happen to someone who suffers from severe chronic migraines. I am required to have two separate prescriptions for the maxalt, since I can only get 6 tablets per pr

16、escription, and I need more than 6 per month.17. State that you cannot do ANY job 18. What reduction in work? (eg 90%) This document can be given to any new specialist or doctor you go to (or others that have to know about your disability), without having to repeat to each one what has been happenin

17、g with your illness. Create this document using a word processor program. This will enable changes to be easily made. Give a complete picture of your situation. The time you spend composing this letter is well-spent, as you will use it often. Include this letter with your benefits application. Gener

18、al LetterCompose a general letter, one page in length, for your doctor to sign, that describes your symptoms (eg you cannot work because of poor concentration, cognitive disorder, extreme fatigue, and you unable to take public transportation, etc.) Do not use a standard form letter; create a letter

19、with your personal details. Photocopy the letter onto your doctors letterhead. You can use this letter when you apply for disability benefits.Many doctors are unaware of the exact wording or specifics needed when applying for benefits. Make sure you are aware, confirm that he is, and that he will pu

20、t down what is required.Have your doctor state a recovery date as far into the future as possible on any disability claims. He can always change the date if you recover sooner than expected. There are several reasons for this suggestion: To avoid bringing the form back year after year for your docto

21、r to sign. Since the regulations are being tightened for disability benefits, you may be disallowed when the form is changed and needs to be signed again the following year. Ensure the earliest date of disability is put down by your doctor - the year and month that any amount of impairment started.

22、This can then be used to back-date many benefits (eg Disability Tax Credit if available). Conclusion:By taking these rigorous, but necessary steps, Fibromyalgia Syndrome patients partially protect themselves from the exasperating process of disability benefit claims. Documention and persistence pays

23、 off in the long run. the treatment of this disease I would consider that Dr. Morris has reached her maximum improvement and is permanently disabled from regularly working in any occupation involving prolonged concentration, standing, physical activity, decision makingApptsStart DateSubjectStart Tim

24、e5/15/2002krk-lab-potassium12:00 PM5/15/2002krk-lab-protein12:00 PM5/15/2002krk-lab-cbc/platelet12:00 PM5/15/2002krk-lab-sed rate12:00 PM5/15/2002krk-lab-tsh12:00 PM5/15/2002krk-eval & mgmt12:00 PM9/4/2002unite-xray l spine12:00 PM9/4/2002krk-eval & mgmt12:00 PM9/4/2002unite-Ordering physician12:00

25、PM9/4/2002krk-lab-creatinine12:00 PM9/19/2002edwards-eye exam12:00 PM9/19/2002edwards-determination12:00 PM9/24/2002ellis-mammogram12:00 PM9/24/2002krk-lab-glucose-blood12:00 PM9/24/2002krk-lab-sgot-transam12:00 PM9/24/2002wittchow-lab-pap smear12:00 PM9/24/2002krk-hemogram w/plate12:00 PM9/24/2002k

26、rk-lab-sed rate12:00 PM9/24/2002krk-lab-tsh12:00 PM9/24/2002krk-lab-eval-mgmt12:00 PM9/24/2002wittchow-ordering physician12:00 PM9/24/2002ellis-ordering physician12:00 PM10/1/2002edwards-replace contacts12:00 PM10/1/2002edwards-eval & mgmt12:00 PM10/14/2002binegar-lab-creatine pho12:00 PM10/14/2002b

27、inegar-office consult12:00 PM10/14/2002binegar-referring physician12:00 PM10/17/2002danning-office consult12:00 PM10/17/2002danning-referring physician12:00 PM10/21/2002krk-eval& mgmt12:00 PM10/24/2002Pool02:00 PM10/26/2002Halloween Party Work07:15 PM10/28/2002MMPI appt 12:00 PM10/28/2002PRitchett03

28、:00 PM10/30/2002Class Talks07:30 AM10/30/2002Class Talk09:30 AM10/30/2002cheyney-chest xray12:00 PM10/30/2002krk-eval&mgmnt12:00 PM10/30/2002Class Talk12:30 PM10/30/2002Class Talk02:30 PM10/30/2002Trevins b-day party06:00 PM10/31/2002Sleep Lab09:15 AM11/1/2002osseo07:00 PM11/12/2002Binegar10:30 AM11

29、/12/2002krk-eval&mgmt12:00 PM11/13/2002brauer-office consult12:00 PM11/15/2002Behavioral Health08:30 AM11/15/2002binegar-Eval & mgmt12:00 PM11/21/2002Katie08:45 AM12/16/2002broderick-med-check12:00 PM12/20/2002krk-eval & mgmt12:00 PM1/13/2003cindy-counseling 12:00 PM1/17/2003broderick- med check12:0

30、0 PM1/20/2003hutter - office consult12:00 PM1/20/2003cindy-counseling 12:00 PM1/27/2003cindy-counseling 12:00 PM1/28/2003fiocco - eval & mgmt12:00 PM1/30/2003tarlano - psych exam12:00 PM1/30/2003tarlano - psych eval12:00 PM2/3/2003cindy-counseling 12:00 PM2/7/2003tarlano - individual psychotherapy 1

31、2:00 PM2/10/2003jill-physical therapy12:00 PM2/10/2003cindy-counseling 12:00 PM2/17/2003broderick - med check12:00 PM2/17/2003jill-physical therapy12:00 PM2/18/2003krk-lab-creatinine12:00 PM2/18/2003krk-lab-glucose12:00 PM2/18/2003krk-lab-sed rate12:00 PM2/18/2003krk-lab-tsh12:00 PM2/18/2003krk-lab-

32、serum vitamin12:00 PM2/18/2003krk-lab-serum ferrit12:00 PM2/18/2003krk-lab-eval & mgmt12:00 PM2/20/2003gundersen-ct head scan12:00 PM2/20/2003gundersen-locm omnipaque12:00 PM2/24/2003jill-physical therapy12:00 PM2/24/2003cindy-counseling 12:00 PM3/3/2003jill-physical therapy12:00 PM3/10/2003jill-phy

33、sical therapy12:00 PM3/10/2003cindy-counseling 12:00 PM3/17/2003jill-physical therapy12:00 PM3/24/2003broderick-med check12:00 PM3/24/2003cindy-counseling 12:00 PM3/31/2003jill-physical therapy12:00 PM4/2/2003tarlano-individual pain mgmt12:00 PM4/7/2003jill-physical therapy12:00 PM4/7/2003cindy-coun

34、seling 12:00 PM4/9/2003tarlano-individual pain mgmt 12:00 PM4/14/2003jill-physical therapy12:00 PM4/18/2003lamboy-acupuncture12:00 PM4/21/2003jill-physical therapy12:00 PM4/21/2003cindy-counseling12:00 PM4/25/2003lamboy-acupuncture12:00 PM4/28/2003cindy-counseling12:00 PM4/30/2003jill-physical thera

35、py 12:00 PM5/2/2003lamboy-acupuncture12:00 PM5/5/2003jill-physical therapy 12:00 PM5/5/2003cindy-counseling 12:00 PM5/7/2003massage06:00 PM5/9/2003lamboy-acupuncture12:00 PM5/12/2003jill-physical therapy 12:00 PM5/14/2003massage06:00 PM5/16/2003lamboy-acupuncture12:00 PM5/19/2003jill-physical therap

36、y 12:00 PM5/19/2003cindy-counseling 12:00 PM5/20/2003fiocco - eval & mgmt12:00 PM5/22/2003krk-eval & mgmt12:00 PM5/22/2003massage 06:00 PM5/23/2003lamboy-acupuncture12:00 PM5/27/2003broderick-med check01:30 PM5/27/2003mri03:45 PM5/28/2003jill-physical therapy 12:00 PM5/29/2003massage06:15 PM6/2/2003

37、jill-pt10:00 AM6/2/2003cindy-counseling11:00 AM6/4/2003tarlano-neuropsych testing12:30 PM6/5/2003angela-county visit01:30 PM6/9/2003jill-pt10:00 AM6/9/2003hutter-migraines01:30 PM6/23/2003neurosurgery12:00 PM7/2/2003angela-county visit 01:30 PMMeds8350 S River PkwyTempe, AZ 85284(877) 250-5823Confid

38、ential Patient InformationPrescription Profile05/01/2002 through 05/24/2003 Patient Info: Vanessa HandBeard810 South 8th StreetLaCrosse, WI 54601(608) 796-2495Date of Birth: 06/15/1961 Gender: Female Allergy Conditions: CODEINE SULF 30MG TABLETS Health Conditions: ARTHRITIS DEPRESSION FIBROMYALGIA H

39、YPERTENSION MIGRAINE Date of Service Prescription NumberMedicationRPh Prescriber Insurance Plan Quantity Price 01/27/2003 1039217-3498 TOPROL XL 50MG TABLETS FWW ROWAN-KOENEN, K PERX 30.00 $15.00 01/26/2003 1076116-3498 EFFEXOR XR 150MG CAPSULES SDK BRODRICK, PETER PERX 60.00 $15.00 01/20/2003 10864

40、35-3498 TOPAMAX 25MG TABLETS SDK HUTTER, R PERX 120.00 $15.00 01/18/2003 1085879-3498 AMBIEN 10MG TABLETS CWH BRODRICK, PETER PERX 15.00 $15.00 02/25/2003 1039217-3498 TOPROL XL 50MG TABLETS FWW ROWAN-KOENEN, K PERX 30.00 $15.00 02/25/2003 1102211-3498 MAXALT-MLT 10MG TABLETS HAW ROWAN-KOENEN, K PER

41、X 6.00 $15.00 02/22/2003 1101071-3498 SKELAXIN 400MG TABLETS CWH ROWAN-KOENEN, K PERX 45.00 $30.00 02/22/2003 1101072-3498 CLONAZEPAM 0.5MG TABLETS CWH ROWAN-KOENEN, K PERX 45.00 $7.00 02/22/2003 1101073-3498 PROPOXYPHENE-N 100 W/ APAP 650 TABS CWH ROWAN-KOENEN, K PERX 60.00 $7.00 02/22/2003 1101074

42、-3498 AMBIEN 10MG TABLETS CWH BRODRICK, PETER PERX 15.00 $15.00 02/22/2003 1101076-3498 EFFEXOR XR 150MG CAPSULES CWH BRODRICK, PETER PERX 60.00 $15.00 03/25/2003 1039217-3498 TOPROL XL 50MG TABLETS FWW ROWAN-KOENEN, K PERX 30.00 $15.00 03/25/2003 1101076-3498 EFFEXOR XR 150MG CAPSULES FWW BRODRICK,

43、 PETER PERX 60.00 $15.00 04/30/2003 1131014-3498 EFFEXOR XR 150MG CAPSULES SDK BRODRICK, PETER PERX 60.00 $15.00 03/22/2003 1114015-3498 METHOCARBAMOL 750MG TAB MAM FIOCCO, S PERX 90.00 $7.00 01/07/2003 1080767-3498 PROPOXYPHENE-N 100 W/ APAP 650 TABS SDK ROWAN-KOENEN, K PERX 45.00 $7.00 03/19/2003

44、1101072-3498 CLONAZEPAM 0.5MG TABLETS SDK ROWAN-KOENEN, K PERX 45.00 $7.00 03/19/2003 1101073-3498 PROPOXYPHENE-N 100 W/ APAP 650 TABS SDK ROWAN-KOENEN, K PERX 60.00 $7.00 03/19/2003 1112864-3498 TOPAMAX 100MG TABLETS SDK HUTTER, R PERX 60.00 $15.00 04/25/2003 1039217-3498 TOPROL XL 50MG TABLETS FWW

45、 ROWAN-KOENEN, K PERX 30.00 $15.00 04/25/2003 1101072-3498 CLONAZEPAM 0.5MG TABLETS FWW ROWAN-KOENEN, K PERX 45.00 $7.00 01/06/2003 1039219-3498 WELLBUTRIN SR 150MG TABLETS MAM ROWAN-KOENEN, K PERX 60.00 $15.00 01/06/2003 1053136-3498 ALBUTEROL INHALER (COMPLETE) 17GM MAM ROWAN-KOENEN, K PERX 17.00

46、$7.00 01/06/2003 1066302-3498 ADVAIR DISKUS 250/50MCG 60S MAM ROWAN-KOENEN, K PERX 60.00 $15.00 01/06/2003 1074312-3498 CLONAZEPAM 0.5MG TABLETS MAM ROWAN-KOENEN, K PERX 45.00 $7.00 04/24/2003 1102211-3498 MAXALT-MLT 10MG TABLETS SDK ROWAN-KOENEN, K PERX 6.00 $15.00 04/23/2003 1128234-3498 PROPOXYPH

47、ENE-N 100 W/ APAP 650 TABS SDK ROWAN-KOENEN, K PERX 60.00 $7.00 02/11/2003 1039219-3498 WELLBUTRIN SR 150MG TABLETS MAM ROWAN-KOENEN, K PERX 60.00 $15.00 03/14/2003 1102211-3498 MAXALT-MLT 10MG TABLETS SDK ROWAN-KOENEN, K PERX 6.00 $15.00 03/14/2003 1110574-3498 WELLBUTRIN SR 150MG TABLETS SDK BRODR

48、ICK, PETER PERX 60.00 $15.00 05/22/2003 1141666-3498 OXAPROZIN 600MG TABLETS WEE ROWAN-KOENEN, K PERX 60.00 $7.00 04/14/2003 1102211-3498 MAXALT-MLT 10MG TABLETS SDK ROWAN-KOENEN, K PERX 6.00 $15.00 04/14/2003 1124126-3498 WELLBUTRIN SR 150MG TABLETS SDK BRODRICK, PETER PERX 60.00 $15.00 05/17/2002

49、988237-3498 PROPOXYPHENE-N 100 W/ APAP 650 TABS KXS HOEFERT, J PERX 15.00 $5.00 08/26/2002 1026335-3498 PROPOXYPHENE-N 100 W/ APAP 650 TABS CWH ROWAN-KOENEN, K PERX 30.00 $5.00 08/26/2002 1026341-3498 TOPROL XL 50MG TABLETS CWH ROWAN-KOENEN, K PERX 30.00 $15.00 05/16/2003 1102211-3498 MAXALT-MLT 10M

50、G TABLETS MAM ROWAN-KOENEN, K PERX 6.00 $15.00 10/31/2002 1053734-3498 MAXALT-MLT 10MG TABLETS HAW ROWAN-KOENEN, K PERX 6.00 $15.00 05/15/2003 1066302-3498 ADVAIR DISKUS 250/50MCG 60S PDH ROWAN-KOENEN, K PERX 60.00 $15.00 05/15/2003 1124126-3498 WELLBUTRIN SR 150MG TABLETS PDH BRODRICK, PETER PERX 6

51、0.00 $15.00 05/15/2002 987250-3498 CYCLOBENZAPRINE 10MG TABLETS MAM ROWAN-KOENEN, K PERX 30.00 $5.00 10/30/2002 1053136-3498 ALBUTEROL INHALER (COMPLETE) 17GM HJH ROWAN-KOENEN, K PERX 17.00 $5.00 10/30/2002 1053137-3498 PREDNISONE 20MG TABLETS HJH ROWAN-KOENEN, K PERX 14.00 $5.00 10/30/2002 1053138-

52、3498 ZITHROMAX 250MG TABS (Z-PAK) HJH ROWAN-KOENEN, K PERX 6.00 $15.00 09/26/2002 1039215-3498 CELEBREX 200MG CAPSULES KJU ROWAN-KOENEN, K PERX 30.00 $15.00 09/26/2002 1039216-3498 PROPOXYPHENE-N 100 W/ APAP 650 TABS KJU ROWAN-KOENEN, K PERX 60.00 $5.00 09/26/2002 1039217-3498 TOPROL XL 50MG TABLETS

53、 KJU ROWAN-KOENEN, K PERX 30.00 $15.00 09/26/2002 1039218-3498 FLUOXETINE 20MG TABLETS KJU ROWAN-KOENEN, K PERX 90.00 $5.00 09/26/2002 1039219-3498 WELLBUTRIN SR 150MG TABLETS KJU ROWAN-KOENEN, K PERX 60.00 $15.00 11/27/2002 1064970-3498 EFFEXOR XR 150MG CAPSULES PDH BRODRICK, PETER PERX 30.00 $15.0

54、0 12/27/2002 1039217-3498 TOPROL XL 50MG TABLETS CWH ROWAN-KOENEN, K PERX 30.00 $15.00 12/26/2002 1076116-3498 EFFEXOR XR 150MG CAPSULES MAM BRODRICK, PETER PERX 60.00 $15.00 03/06/2003 1029974-3498 CYCLOBENZAPRINE 10MG TABLETS HAW ROWAN-KOENEN, K PERX 30.00 $7.00 01/02/2003 1053734-3498 MAXALT-MLT

55、10MG TABLETS FWW ROWAN-KOENEN, K PERX 6.00 $15.00 03/06/2003 1086435-3498 TOPAMAX 25MG TABLETS HAW HUTTER, R PERX 120.00 $15.00 04/07/2003 1101073-3498 PROPOXYPHENE-N 100 W/ APAP 650 TABS CWH ROWAN-KOENEN, K PERX 60.00 $7.00 12/20/2002 1074312-3498 CLONAZEPAM 0.5MG TABLETS MAM ROWAN-KOENEN, K PERX 4

56、5.00 $5.00 05/07/2003 1112864-3498 TOPAMAX 100MG TABLETS HAW HUTTER, R PERX 60.00 $15.00 12/11/2002 1039216-3498 PROPOXYPHENE-N 100 W/ APAP 650 TABS CWH ROWAN-KOENEN, K PERX 60.00 $5.00 12/11/2002 1053734-3498 MAXALT-MLT 10MG TABLETS WEE ROWAN-KOENEN, K PERX 6.00 $15.00 06/04/2002 291873-4533 PROPOX

57、YPHENE-N 100 W/ APAP 650 TABS RLP ROWAN-KOENEN, K PERX 45.00 $5.00 02/01/2003 1074312-3498 CLONAZEPAM 0.5MG TABLETS MAM ROWAN-KOENEN, K PERX 45.00 $7.00 02/01/2003 1080767-3498 PROPOXYPHENE-N 100 W/ APAP 650 TABS MAM ROWAN-KOENEN, K PERX 45.00 $7.00 09/04/2002 1029974-3498 CYCLOBENZAPRINE 10MG TABLE

58、TS CWH ROWAN-KOENEN, K PERX 30.00 $5.00 12/02/2002 1039217-3498 TOPROL XL 50MG TABLETS MAM ROWAN-KOENEN, K PERX 30.00 $15.00 12/02/2002 1053734-3498 MAXALT-MLT 10MG TABLETS MAM ROWAN-KOENEN, K PERX 6.00 $15.00 12/02/2002 1066302-3498 ADVAIR DISKUS 250/50MCG 60S HAW ROWAN-KOENEN, K PERX 60.00 $15.00

59、11/01/2002 1039217-3498 TOPROL XL 50MG TABLETS HAW ROWAN-KOENEN, K PERX 30.00 $15.00 Total: Total Scripts: 35 $805.00 Daily Life ExampleEach one of these comes with, a set of problems and diagnosis. Write it down.And, as I said. After you list all these. On a separate paper write how it all effects

60、your daily life. Go into detail.Always write down what you can. But, add see attached paper work.Send a letter of what your life is like with all your problems. How you wish you could work, but just cant anymore. That you spend most all your time, in bed. you have to think of your worst dayIt also,

61、helps to list every single doctor you have seen in the last 5 years.Get lab and xray reports on your own, to send with your paper work to ssd!Always make a copy of everything you send to ssd! Everything!If they ask you again about something.send it again! You have a copy.I hope this helps a little.And, do not think you are complaining. Or whinning.This is YOUR Body.YOUR life!OK?Fibromyalgia Syndrome (FMS) Disability ChecklistThe primary keys to receiving the disability benefits you deserve are documentation and persistence. Use the information on this page to prepare for the David versus G