Heat and Some Ranting
It's too darn hot. 90 degrees outside and inside the trailer. The lack of humidity does make an enormous difference, though. It's much easier to tolerate this kind of heat when there's a tiny bit of a breeze and the air is dry enough to immediately evaporate any sweat from the surface of the skin. Staying hydrated is the challenge. It also feels much cooler in the shade.
At home in Maine where the humidity is much higher, I can't tolerate temperatures over 80. The demyelinated nerves in my brain malfunction and I get confused, irritable, dizzy, and exhausted. They used to test patients for multiple sclerosis by submerging their bodies in hot water since high body temperatures cause the communication between damaged nerves in the brain to go awry.
We've had the air conditioning on every day for the last week or so, given the temperatures. Mostly it's for the dog's sake. He doesn't seem to be able to tolerate the heat as well as us. When we first get up around dawn, we have some windows open and it's a little chilly. The sun comes up and as the outside temperatures rise, we close up the windows and shut all the blinds where the sun would otherwise come in. We also put out the awning to partially shade one side of the rv. By mid morning, temps in the trailers are reaching 80 so we turn on ceiling fan in the main living area. That's enough to keep us cool for awhile but once the temperatures hit 84 or so, we turn on the air conditioning.
The dog's mid-day walk is short. He wants to go outside but doesn't want to move much so most of the walk is at a very sluggish pace. The blacktop is also pretty warm around mid-day though it hasn't yet reached the point of serious discomfort for his feet.
By around 3:30, the sun's angle is low enough that it's not as intense on the sides on the rv and I open some of the blinds. I hate feeling closed in and I want to open the blinds and windows as soon as possible. But the afternoon sun from the West is still pretty hot shining on the windows on that side so I keep the blinds and windows there closed and open only those on the East. I turn off the air and open the door. Today, I'm alone in the trailer since Mike is working at a job site so I shut off the air earlier than I would normally. But 3:30 was too early; it's now 90 in here; the dog is panting hard and I'm sweating even though we're both idle. I grit my teeth and bear it. I'd rather be hot, and be able to look out the windows and feel the fresh air circulating, than shut myself up in this metal box.
Even though I don't have a lot of tasks on my plate right now, I've been stressing about the one major task I do have: providing Social Security with evidence that I am still disabled. The letter requesting this information came in the mail last week. They want to know if I've been seen by any medical professionals between March 2014 and the present and if I continue to be unable to work.
These letters terrify me since so much is at stake. I know that I'm unable to work a full time job in any field but it's intimidating to have to prove that to someone else and what if they don't think my evidence is sufficient. It should be easy, you might think, to show whether or not someone's disabled, once you adequately define criteria of being disabled. They either are or are not disabled. But doctors aren't robots; they have attitudes and beliefs that influence how they evaluate patients, and they engage in faulty reasoning just like ordinary people. For example, just this past week I read a blog entry written by a cardiac surgeon who voiced the opinion that too many people these days are receiving Social Security Disability Insurance and that many of those receiving these funds are malingerers who are not actually disabled. No evidence was given to support his claim, beyond his assertion that he sees many people who appear to be healthy who claim to be disabled.
Many ordinary people engage in the same armchair assessment: they learn that some person they are acquainted with is receiving SSDI and because they don't see anything immediately wrong with that person, they think that the person and many others are defrauding the system. They conclude that anyone can get SSDI, that you don't have to have anything really wrong with you. Similarly, they see a middle-aged or younger person park in a handicapped spot and because that person can walk, they assume that the person is faking and misusing the privilege. Doctors, like anyone else, are subject to prejudices and bad reasoning. Because a person is a doctor, we might assume that he or she is qualified to determine whether a person is legitimately disabled. But this assumes not only that they aren't allowing their prejudice to influence their assessment, but also that they both have expertise in the relevant areas and that they are familiar with a person's entire medical record.
A cardiac surgeon is not qualified to make the assessment that many people who have been determined by their doctors to be disabled are in fact not disabled and are defrauding the Social Security System. Just as none of us can look at a person getting out of a car with handicapped plates and assess whether that person is or is not disabled, a cardiac surgeon can't make that assessment. He or she can assess a specific patient's cardiac health, but beyond that, we have no reason to listen to or believe what this doctor has to say.
And obviously, doctors aren't infallible in their judgments of their individual patients. To use a personal example: I had to include documentation in my initial application for Social Security Disability Insurance from all my doctors; that included a psychiatrist that I normally saw in Maryland once each year for fifteen minutes to reauthorize some of my prescriptions. I had seen her one year ago and since I had last seen her, I'd left my job because I was too sick to work and then moved to New Mexico because the weather was better for my health conditions and I couldn't afford to stay in Maryland. I was also seeing new doctors who had assessed me and taken over authorizing my prescriptions. When she asked me to come in to her office and pick up the materials, I told her I was now living in New Mexico. Her response: "It seems like if you're really disabled, how could you move like that?" Huh? In her opinion, moving meant that I wasn't disabled, and therefore she didn't want to provide any documentation that I could use as part of my case to document disability.
There are some problems here. First, most obviously, moving doesn't indicate that a person isn't disabled. The fact that I had re-located doesn't tell you anything about my capacity to work. In fact, in this case, I moved because I was disabled.
Second, the only things she was qualified to speak to were the specific psychiatric symptoms I had described to her in her office and the signs she had observed during those times. She could speak to the drugs she had prescribed for me, their doses, changes in doses, and the frequency of my refills. And while she could report the symptoms of fatigue and depression I reported to her, and the reported effects of the drugs she had prescribed for those conditions, she was not qualified to assess whether I had autoimmune diseases, which diseases I had, and their likely impact on me (beyond being possible causes of my fatigue and depression).
Knowing that there are doctors out there like this psychiatrist and the cardiac surgeon, as well as a few others I've encountered over the years, I worry every time I see a doctor and every time I'm asked for documentation of my disability. Because I'm aware of the skepticism that exists in our society, of the popular belief that anybody who's willing to claim disability can get away with it regardless of whether or not they're disabled, I'm always afraid that I won't be believed.
So my latest worry has been: what if I can't sufficiently show the people at Social Security that I continue to be disabled? They're looking for evidence that the original conditions and limitations I reported continue. Judging by the information they request on the form, the evidence they use is whether I continue to be regularly assessed and treated for those conditions and limitations.
I've had forty-four doctor appointments over the last two years--with a neurologist, an orthopedic specialist, an opthomologist, a hematologist, a dermatologist, my primary care doctor, a holistic health doctor for pain management, and my good old rheumatologist. And this number is only for doctors directly relevant to my disability; it doesn't include the appointments I've had with therapists, a mammogram, a hospital visit when the pharmacy messed up my prescriptions, or gynecological/reproductive health care appointments.
It's not easy to be awarded Social Security Disability benefits. And for most conditions, it's not a once and for all evaluation. It's necessary to provide adequate documentation by the appropriate medical professionals documenting that the patient has been diagnosed not only with specific conditions but that these conditions limit the person's daily activities and thus their capacity to engage in full-time work.
Are there people who are not disabled who are wrongly awarded benefits because they somehow game the system by finding doctors who are willing to repeatedly lie to the federal government about their patents' health and risk losing medical licensure? Maybe. But until I see evidence that this is the case, I'm not justified in making any kind of claim about fraud being committed by people who receive Social Security Disability Benefits. And neither is anyone else.
Here's an irony. While I've been stressing about having to prove to Social Security that I continue to be disabled and whether I'll continue to have money to pay for basic living expenses, I'm also paying $700 a month to the IRS for taxes. The story behind these taxes: When I became disabled and had to stop working, I couldn't afford to pay living expenses, never mind my student loans. Thankfully, in recognition of this, the federal student loan program allows those who become permanently disabled to have their loans forgiven. When someone applies for forgiveness and documents disability (which requires documentation from one's doctors, much like Social Security Disability), forgiveness is not immediate. Documentation of disability must be provided for three years. Only then are the loans forgiven.
However, at the end of the first tax year that a person applies for forgiveness of student loans, the student loan administrations sends out a 1099 form that reports the amount of student loans as forgiven debt that must be reported to the IRS on that year's taxes. Essentially, what happens is that when you tell the student loan people you're permanently disabled and unable to pay your debt, the amount of that debt immediately becomes a form of taxable income. Surprise! And all it's due by the normal tax filing deadline that year.
There's a caveat: If you can show the IRS that you have essentially no assets or if you have other significant debt, you can reduce the amount of forgiven debt you are required to pay taxes on. But if you have equity in your home, money in your retirement account, or any savings, those things count against you for tax purposes. The IRS considers these assets to be liquid and says that if you have these assets, you can be expected to use them to pay off your forgiven debt.
So there you are, newly disabled and unemployed, most likely not yet receiving Social Security Disability benefits since that process takes so long to get through, unable to pay your student loans--and suddenly you're expected to report as income and pay taxes on money that you did not receive that year (money that was spent in some cases decades ago on tuition).
In my case, I applied for forgiveness at the end of 2013. I was required to report those loans as income when I submitted my taxes in the Spring of 2014, and to pay in full the taxes owed. That year, I supported myself with payments from SSDI (payments are low because I was forced to retire at age 45, not 66 or 67), and private disability insurance payments through my previous employer (which pays me less than one-third of my previous salary). Yet because I applied for student loan forgiveness that year, my tax bill, due that April 15th, was over $20,000.
That debt has not yet been and may never be forgiven, even though I was legally required to pay taxes on it. Will my student loans eventually be forgiven? I don't know. That's dependent upon the assessment of the student loan administration and my continued documentation of disability.
If you don't or can't pay your income taxes, the IRS can put a lien on your property, including your primary residence. I sent them several thousand dollars at the time the taxes were due which wiped out my safety net, and requested to pay the remainder through their payment plan. While they processed my application and I continued to make monthly payments to them, I got several registered letters threatening to place a lien on my home. At the time, that home was the primary residence of two disabled people (me and my elderly mother).
After six months, they granted me permission to pay off the remainder of the debt (now plus interest and penalties) in installments. If I miss or am late on a payment, they can begin the process of placing a lien on the house again.
So now I'm paying the government each month for debt that was not forgiven, so that I don't lose my home. Those payments are substantial, and come out of my disability insurance payments, since I can't work and don't have an income. In fact, they're bigger than the monthly payments I would have been making to the student loan administration if I hadn't applied for student loan forgiveness, forgiveness I had requested because I couldn't afford to make the loan payments in the first place.
So here I am: making payments to one part of the government (the IRS), on the assumption by them that my student loan debt has been forgiven by another part of the government (the student loan administration) due to disability, using money that yet another part of the government (Social Security Disability Aminstration) sends me because I've shown them that I'm disabled.
I expect another letter this spring from the student loan administration similarly requesting further evidence of continued permanent disability, threatening that unless I provide this evidence, I must begin making payments again on the student loans. In the meantime, I'll continue to make payments to the IRS using my Social Security Disability Insurance so the IRS doesn't place a lien on my home.
And while this drama unfolds, I spend my time going to doctors and documenting once again to SSDI through forty-four more doctor appointments that I continue to be permanently disabled (sic), lest they cut off my disability insurance payments, rendering me unable to pay the IRS (since I'm too disabled to work), ineligible for my current medical insurance (which I really need because I'm disabled and need a lot of treatment), with massive student loan debt (which I can't pay because I'm disabled).
Fuck.
At home in Maine where the humidity is much higher, I can't tolerate temperatures over 80. The demyelinated nerves in my brain malfunction and I get confused, irritable, dizzy, and exhausted. They used to test patients for multiple sclerosis by submerging their bodies in hot water since high body temperatures cause the communication between damaged nerves in the brain to go awry.
We've had the air conditioning on every day for the last week or so, given the temperatures. Mostly it's for the dog's sake. He doesn't seem to be able to tolerate the heat as well as us. When we first get up around dawn, we have some windows open and it's a little chilly. The sun comes up and as the outside temperatures rise, we close up the windows and shut all the blinds where the sun would otherwise come in. We also put out the awning to partially shade one side of the rv. By mid morning, temps in the trailers are reaching 80 so we turn on ceiling fan in the main living area. That's enough to keep us cool for awhile but once the temperatures hit 84 or so, we turn on the air conditioning.
The dog's mid-day walk is short. He wants to go outside but doesn't want to move much so most of the walk is at a very sluggish pace. The blacktop is also pretty warm around mid-day though it hasn't yet reached the point of serious discomfort for his feet.
By around 3:30, the sun's angle is low enough that it's not as intense on the sides on the rv and I open some of the blinds. I hate feeling closed in and I want to open the blinds and windows as soon as possible. But the afternoon sun from the West is still pretty hot shining on the windows on that side so I keep the blinds and windows there closed and open only those on the East. I turn off the air and open the door. Today, I'm alone in the trailer since Mike is working at a job site so I shut off the air earlier than I would normally. But 3:30 was too early; it's now 90 in here; the dog is panting hard and I'm sweating even though we're both idle. I grit my teeth and bear it. I'd rather be hot, and be able to look out the windows and feel the fresh air circulating, than shut myself up in this metal box.
Even though I don't have a lot of tasks on my plate right now, I've been stressing about the one major task I do have: providing Social Security with evidence that I am still disabled. The letter requesting this information came in the mail last week. They want to know if I've been seen by any medical professionals between March 2014 and the present and if I continue to be unable to work.
These letters terrify me since so much is at stake. I know that I'm unable to work a full time job in any field but it's intimidating to have to prove that to someone else and what if they don't think my evidence is sufficient. It should be easy, you might think, to show whether or not someone's disabled, once you adequately define criteria of being disabled. They either are or are not disabled. But doctors aren't robots; they have attitudes and beliefs that influence how they evaluate patients, and they engage in faulty reasoning just like ordinary people. For example, just this past week I read a blog entry written by a cardiac surgeon who voiced the opinion that too many people these days are receiving Social Security Disability Insurance and that many of those receiving these funds are malingerers who are not actually disabled. No evidence was given to support his claim, beyond his assertion that he sees many people who appear to be healthy who claim to be disabled.
Many ordinary people engage in the same armchair assessment: they learn that some person they are acquainted with is receiving SSDI and because they don't see anything immediately wrong with that person, they think that the person and many others are defrauding the system. They conclude that anyone can get SSDI, that you don't have to have anything really wrong with you. Similarly, they see a middle-aged or younger person park in a handicapped spot and because that person can walk, they assume that the person is faking and misusing the privilege. Doctors, like anyone else, are subject to prejudices and bad reasoning. Because a person is a doctor, we might assume that he or she is qualified to determine whether a person is legitimately disabled. But this assumes not only that they aren't allowing their prejudice to influence their assessment, but also that they both have expertise in the relevant areas and that they are familiar with a person's entire medical record.
A cardiac surgeon is not qualified to make the assessment that many people who have been determined by their doctors to be disabled are in fact not disabled and are defrauding the Social Security System. Just as none of us can look at a person getting out of a car with handicapped plates and assess whether that person is or is not disabled, a cardiac surgeon can't make that assessment. He or she can assess a specific patient's cardiac health, but beyond that, we have no reason to listen to or believe what this doctor has to say.
And obviously, doctors aren't infallible in their judgments of their individual patients. To use a personal example: I had to include documentation in my initial application for Social Security Disability Insurance from all my doctors; that included a psychiatrist that I normally saw in Maryland once each year for fifteen minutes to reauthorize some of my prescriptions. I had seen her one year ago and since I had last seen her, I'd left my job because I was too sick to work and then moved to New Mexico because the weather was better for my health conditions and I couldn't afford to stay in Maryland. I was also seeing new doctors who had assessed me and taken over authorizing my prescriptions. When she asked me to come in to her office and pick up the materials, I told her I was now living in New Mexico. Her response: "It seems like if you're really disabled, how could you move like that?" Huh? In her opinion, moving meant that I wasn't disabled, and therefore she didn't want to provide any documentation that I could use as part of my case to document disability.
There are some problems here. First, most obviously, moving doesn't indicate that a person isn't disabled. The fact that I had re-located doesn't tell you anything about my capacity to work. In fact, in this case, I moved because I was disabled.
Second, the only things she was qualified to speak to were the specific psychiatric symptoms I had described to her in her office and the signs she had observed during those times. She could speak to the drugs she had prescribed for me, their doses, changes in doses, and the frequency of my refills. And while she could report the symptoms of fatigue and depression I reported to her, and the reported effects of the drugs she had prescribed for those conditions, she was not qualified to assess whether I had autoimmune diseases, which diseases I had, and their likely impact on me (beyond being possible causes of my fatigue and depression).
Knowing that there are doctors out there like this psychiatrist and the cardiac surgeon, as well as a few others I've encountered over the years, I worry every time I see a doctor and every time I'm asked for documentation of my disability. Because I'm aware of the skepticism that exists in our society, of the popular belief that anybody who's willing to claim disability can get away with it regardless of whether or not they're disabled, I'm always afraid that I won't be believed.
So my latest worry has been: what if I can't sufficiently show the people at Social Security that I continue to be disabled? They're looking for evidence that the original conditions and limitations I reported continue. Judging by the information they request on the form, the evidence they use is whether I continue to be regularly assessed and treated for those conditions and limitations.
I've had forty-four doctor appointments over the last two years--with a neurologist, an orthopedic specialist, an opthomologist, a hematologist, a dermatologist, my primary care doctor, a holistic health doctor for pain management, and my good old rheumatologist. And this number is only for doctors directly relevant to my disability; it doesn't include the appointments I've had with therapists, a mammogram, a hospital visit when the pharmacy messed up my prescriptions, or gynecological/reproductive health care appointments.
It's not easy to be awarded Social Security Disability benefits. And for most conditions, it's not a once and for all evaluation. It's necessary to provide adequate documentation by the appropriate medical professionals documenting that the patient has been diagnosed not only with specific conditions but that these conditions limit the person's daily activities and thus their capacity to engage in full-time work.
Are there people who are not disabled who are wrongly awarded benefits because they somehow game the system by finding doctors who are willing to repeatedly lie to the federal government about their patents' health and risk losing medical licensure? Maybe. But until I see evidence that this is the case, I'm not justified in making any kind of claim about fraud being committed by people who receive Social Security Disability Benefits. And neither is anyone else.
Here's an irony. While I've been stressing about having to prove to Social Security that I continue to be disabled and whether I'll continue to have money to pay for basic living expenses, I'm also paying $700 a month to the IRS for taxes. The story behind these taxes: When I became disabled and had to stop working, I couldn't afford to pay living expenses, never mind my student loans. Thankfully, in recognition of this, the federal student loan program allows those who become permanently disabled to have their loans forgiven. When someone applies for forgiveness and documents disability (which requires documentation from one's doctors, much like Social Security Disability), forgiveness is not immediate. Documentation of disability must be provided for three years. Only then are the loans forgiven.
However, at the end of the first tax year that a person applies for forgiveness of student loans, the student loan administrations sends out a 1099 form that reports the amount of student loans as forgiven debt that must be reported to the IRS on that year's taxes. Essentially, what happens is that when you tell the student loan people you're permanently disabled and unable to pay your debt, the amount of that debt immediately becomes a form of taxable income. Surprise! And all it's due by the normal tax filing deadline that year.
There's a caveat: If you can show the IRS that you have essentially no assets or if you have other significant debt, you can reduce the amount of forgiven debt you are required to pay taxes on. But if you have equity in your home, money in your retirement account, or any savings, those things count against you for tax purposes. The IRS considers these assets to be liquid and says that if you have these assets, you can be expected to use them to pay off your forgiven debt.
So there you are, newly disabled and unemployed, most likely not yet receiving Social Security Disability benefits since that process takes so long to get through, unable to pay your student loans--and suddenly you're expected to report as income and pay taxes on money that you did not receive that year (money that was spent in some cases decades ago on tuition).
In my case, I applied for forgiveness at the end of 2013. I was required to report those loans as income when I submitted my taxes in the Spring of 2014, and to pay in full the taxes owed. That year, I supported myself with payments from SSDI (payments are low because I was forced to retire at age 45, not 66 or 67), and private disability insurance payments through my previous employer (which pays me less than one-third of my previous salary). Yet because I applied for student loan forgiveness that year, my tax bill, due that April 15th, was over $20,000.
That debt has not yet been and may never be forgiven, even though I was legally required to pay taxes on it. Will my student loans eventually be forgiven? I don't know. That's dependent upon the assessment of the student loan administration and my continued documentation of disability.
If you don't or can't pay your income taxes, the IRS can put a lien on your property, including your primary residence. I sent them several thousand dollars at the time the taxes were due which wiped out my safety net, and requested to pay the remainder through their payment plan. While they processed my application and I continued to make monthly payments to them, I got several registered letters threatening to place a lien on my home. At the time, that home was the primary residence of two disabled people (me and my elderly mother).
After six months, they granted me permission to pay off the remainder of the debt (now plus interest and penalties) in installments. If I miss or am late on a payment, they can begin the process of placing a lien on the house again.
So now I'm paying the government each month for debt that was not forgiven, so that I don't lose my home. Those payments are substantial, and come out of my disability insurance payments, since I can't work and don't have an income. In fact, they're bigger than the monthly payments I would have been making to the student loan administration if I hadn't applied for student loan forgiveness, forgiveness I had requested because I couldn't afford to make the loan payments in the first place.
So here I am: making payments to one part of the government (the IRS), on the assumption by them that my student loan debt has been forgiven by another part of the government (the student loan administration) due to disability, using money that yet another part of the government (Social Security Disability Aminstration) sends me because I've shown them that I'm disabled.
I expect another letter this spring from the student loan administration similarly requesting further evidence of continued permanent disability, threatening that unless I provide this evidence, I must begin making payments again on the student loans. In the meantime, I'll continue to make payments to the IRS using my Social Security Disability Insurance so the IRS doesn't place a lien on my home.
And while this drama unfolds, I spend my time going to doctors and documenting once again to SSDI through forty-four more doctor appointments that I continue to be permanently disabled (sic), lest they cut off my disability insurance payments, rendering me unable to pay the IRS (since I'm too disabled to work), ineligible for my current medical insurance (which I really need because I'm disabled and need a lot of treatment), with massive student loan debt (which I can't pay because I'm disabled).
Fuck.
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