Navigating Social Security Disability: COVID, Chronic Illnesses, and Invisible Conditions

Welcome to Season 2, Episode 2 of Winning Isn't Easy: Navigating Your Social Security Disability Claim. In this episode, we'll dive into the complicated topic of Navigating Social Security Disability: COVID, Chronic Illnesses, and Invisible Conditions.

Many people applying for or receiving Social Security Disability benefits are surprised by how difficult it can be to prove conditions that aren’t always visible. While obvious physical impairments are easier to recognize, chronic and invisible conditions like Long COVID, Parkinson’s, Chronic Fatigue Syndrome, dizziness, or immune system disorders often face closer scrutiny from the Social Security Administration. Symptoms such as brain fog, fatigue, cognitive impairment, and recurring flare-ups can be just as disabling - but they require careful documentation to meet the SSA’s rules. In this episode of Winning Isn’t Easy, we explain how the SSA evaluates invisible and chronic conditions and why these claims are often challenged. We break down the medical evidence the SSA looks for, how functional limitations are assessed, and why detailed treatment records and residual functional capacity forms are critical. We also discuss how these conditions are analyzed under SSDI and SSI and what can strengthen a claim. By the end of the episode, you’ll have a clearer understanding of how to present invisible and chronic conditions to the SSA and how to improve your chances of securing the benefits you deserve.

In this episode, we'll cover the following topics:

One - Understanding Social Security Disability for COVID-19 and Related Conditions

Two - Chronic Conditions and Neurological Impairments

Three - Dizziness, Immune Disorders, and the Five-Step Evaluation

Whether you're a claimant, or simply seeking valuable insights into the disability claims landscape, this episode provides essential guidance to help you succeed in your journey. Don't miss it.


Listen to Our Sister Podcast:

We have a sister podcast - Winning Isn't Easy: Long-Term Disability ERISA Claims. Give it a listen: https://wiedisabilitypodcast.buzzsprout.com


Resources Mentioned In This Episode:

LINK TO YOUR RIGHTS TO SOCIAL SECURITY DISABILITY: https://mailchi.mp/caveylaw/your-rights-to-social-security-disability-benefits

FREE CONSULT LINK: https://caveylaw.com/contact-us/


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Need help with your Social Security Disability claim? Have questions? Please feel welcome to reach out to use for a FREE consultation. Just mention you listened to our podcast.

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Please remember that the content shared is for informational purposes only, and should not replace personalized legal advice or guidance from qualified professionals.

Transcript

Nancy Cavey [00:00:00]:
 Foreign. Hey, I'm Nancy Cavey and I want to welcome you back to Winning Isn't Easy. Social Security Disability Benefits this is a podcast where we break down everything you need to know about navigating the Social Security system. But before we get started, I've got to give you a legal disclaimer. This podcast is not legal advice. The Florida Bar association says I have to tell you that. But now that I've said it, nothing will prevent me from giving you an easy to understand overview of the Social Security disability claims process, the games that are played, and what you need to know to get the disability benefits you deserve. So off we go.
 
 Nancy Cavey [00:00:50]:
 Now I'm going to take a closer look today at something that surprises a lot of people applying for and receiving Social Security disability benefits. Benefits how invisible or chronic conditions like long Covid, Parkinson's, chronic fatigue syndrome, dizziness or immune system disorders can impact your eligibility for benefits. Now, most people know that severe physical limitations can qualify for Social Security benefits, but many don't realize that some of the symptoms of these various diseases are symptoms that you can't see. For example, chronic fatigue, brain fog, cognitive challenges, dizziness, or immune dysfunction if you can't see it. Sometimes people don't believe that you actually have these problems, such as doctors or even the Social Security Administration. So we've got to have careful documentation and the right approach to prove that you are disabled under Social Security rules. So let's say you've been struggling with Long Covid after weeks or months of illness and you have just, in quotes, fatigue or brain fog. Maybe you've got Parkinson's and your condition hasn't progressed to the point where there are obvious physical symptoms, but you've got chronic fatigue or brain fog.
 
 Nancy Cavey [00:02:08]:
 Or let's say you have an immune system issue that has flares. And when you're not having a flare, you're not necessarily having any problems. But but when you're having flares, even simple tasks become overwhelming. Now, I think that these various medical conditions, particularly as they wax and wane, or particularly in the early stages of diagnosis, are just as disabling as visible conditions. Now, Social Security, I promise you, is going to scrutinize these closely. They're going to ask for detailed medical evidence, functional assessments, and even specialized forms prepared by your doctor. And that's where it gets complicated. Now, I will tell you that having represented individuals for many years with these types of diseases, I find that proving invisible or chronic conditions requires significant documentation and potentially testing.
 
 Nancy Cavey [00:03:04]:
 We as Social Security disability lawyers have created many Forms we call residual functional capacity, forms that try to capture not only the objective basis of the diagnosis, but an objective basis for the subjective complaints and the restrictions and limitations. And that documentation, including these forms, can make the difference between winning and losing your claim. So I'm going to start in this episode with Long Covid and talk about what you need to document, how claims are evaluated and what it takes to win a claim. Then I'm going to move on to chronic conditions and progressive conditions like Parkinson's and chronic fatigue syndrome. And then I'm going to dive into immune system disorders, try to explain to you step by step the process that Social Security uses in these cases and what documentation is crucial. My goal here? Well, by the end, I want you to have a clear understanding of how to present invisible and chronic medical conditions in a way that Social Security understands what evidence matters, how to quantify your limitations, and. And how to give you your best chance of securing the benefits you deserve. So I am going to talk about three things.
 
 Nancy Cavey [00:04:15]:
 One, understanding Social Security disability for COVID 19 and related conditions. Two, chronic conditions and neurological impairments. Three, immune disorders and the five step sequential evaluation process. Now, I'm going to take a break. I want you to come back with a pad and a pencil so you can take great notes. We'll be back in a minute.
 
 Speaker B [00:04:34]:
 Are you considering filing for Social Security disability or has your claim been denied already? Either way, you require a copy of your rights to Social Security disability benefits, which will cover everything you need to know about the Social Security disability claims process. Request your free copy of the book@kvlaw.com today.
 
 Nancy Cavey [00:05:13]:
 Welcome back to Winning Isn't Easy Understanding Social Security disability Benefits and a claim for COVID 19 and related conditions. I'm going to give you the insider guide to getting Social Security benefits for Long Covid. And I'm going to do so by telling you a story. You may know that there's an estimated maybe 2 to 4 million people in the United States who are out of work because of COVID and the complications of Long Covid. Now, I will tell you that Social Security, quite frankly, for a long time, just did not understand how to approach Long Covid cases, particularly those that have respiratory, cardiac, pulmonary, neurological and cognitive symptoms. And at the beginning, they didn't even have any directives for physicians about how to document a Long Covid case. So let me tell you the story of Espy, who is a police officer that I was honored to represent. She was employed in South Florida and in the course of her employment was exposed to A person with COVID she developed shortness of breath, fatigue and cognitive problems that you can imagine just impaired and made it impossible for her to work as a police officer.
 
 Nancy Cavey [00:06:30]:
 Her claim for Social Security benefits was denied not only once, but twice. And we ended up in front of a hearing or in a hearing in front of a judge. Now, by the way, Social Security has flagged about 44,000 Covid claims to try to give them some degree of quote, unquote priority. And I use that word very loosely, but I want to explain what happened the first time that I or a judge tried a first Covid case. A number of years ago. The judge confessed to me that it was his first Covid case. And since Social Security had no guidelines and don't really have guidelines for evaluating Covid claims, he asked me how I should proceed. And I suggested to the judge that we evaluate each one of her symptoms, her respiratory symptoms, her fatigue symptoms, her cognitive symptoms, and to do so individually, but then to do so in combination.
 
 Nancy Cavey [00:07:33]:
 And part of this was having a well prepared client and having the right residual functional capacity forms. And ultimately we won. But let me tell you how we won. And I use this approach today, even though there are more directives, if you will, about COVID cases for the Social Security judges and physicians. Social Security uses a five step sequential evaluation test. And at step three, the question is whether a person meets a medical listing based on the severity of their impairments. Remember when we studied high school biology, we studied the body in terms of body systems. So we studied the pulmonary system, the respiratory system, if you will.
 
 Nancy Cavey [00:08:23]:
 And we studied the cardiovascular system, we studied the neurological system, we studied the kidney system, if you will. So we studied all of the body systems that have been in fact impacted by Covid. Unfortunately, Social Security does not have a listing for Covid. So my approach, and my approach today is, is to look at the applicable listing level for the person's impairment. Do they have a respiratory impairment, do they have a cardiac impairment? And I'm pulling out the listing. Now what I'm trying to do also is to pick out the right residual functional capacity form. So we have created residual functional capacity forms for different issues. Cognitive issues, pulmonary issues, kidney issues, neurological issues.
 
 Nancy Cavey [00:09:25]:
 And we have also, with time now created long Covid residual functional capacity forms. So I'm looking at my clients medical records and I'm trying to determine one, is there disabling documentation in the medical records by body system? So for example, if my client has pulmonary issues, I want to see pulmonary function tests. And secondly, I want to have the doctor complete the appropriate pulmonary residual functional capacity form. But I also want them to fill out a long Covid form. If my client, for example, has cognitive issues, I want to again make sure that the medical records are documenting the disabling cognitive symptoms and have the cognitive residual functional capacity form or even have my client undergo a CPET exam to document not only cognitive issues, but fatigue issues. And the third thing is I want my client to have a working knowledge of what they have to prove. Because my client was one of her own best advocates. When I explained to her what it is we had to prove and our strategy of doing it by body system and then by the entire long Covid presentation, she got it and she and I really became a team in developing the history in her medical records of her symptoms and functionality by body system complication, if you will.
 
 Nancy Cavey [00:10:58]:
 And we had the right residual functional capacity form. That really was the key. Now the other key, of course, was a brief that we did. We did a five page brief, which is all we can do in the Social Security world. But I did a brief explaining to the judge why my client met the five step sequential evaluation. And I was referring in the record page and verse to the medical records as to why she potentially met a listing or why she had symptoms that would prevent her from doing her past work as a police officer and other work in the national economy. Now, my client was also well prepared because I showed her a video about the preparation process, what was going to happen. I showed her another video that went through all the questions she would ask and in fact gave her the questions.
 
 Nancy Cavey [00:11:50]:
 She wrote out the answers we practiced. So she was very, I mean, she had testified in trial as a police officer, but now she was testifying as a witness. So I gave her a framework for testifying. We practiced that. And she had a comfort level. And she was able to use that documentation preparation in the hearing because she had some cognitive issues. And of course, I was ready to cross examine the vocational evaluator who was going to testify that while she couldn't go back to her past work, she could do other stupid work like being a surveillance system monitor or addressing envelopes or sorting nuts and bolts. So we had a.
 
 Nancy Cavey [00:12:30]:
 Well, I had a well prepared cross examination of the vocational evaluator to weave in to the judge's hypothetical and my hypothetical. All of the symptoms that would impact our ability to do those kinds of work. Shortness of breath, the need to take breaks, fatigue, inability to deal with change, absenteeism. So you can see we were able to Weave all of this in starting with the medical records, the history of the symptoms, the the documentation of the objective basis of her restrictions, the residual functional capacity forms, a well prepared client, a well prepared brief, and a well prepared cross examination of the vocational evaluator. Now, not all these cases have to go to trial, but I will tell you, I treat every one of these as if Social Security is going to deny it. Not only once, not only twice, but they were going to end up in front of a hearing. Got it. Takes a team approach.
 
 Nancy Cavey [00:13:25]:
 Let's take a break. Welcome back to Winning isn't Easy. I want to talk about chronic conditions and neurological impairments and specifically to talk about Parkinson's disease. Now, Parkinson's impacts the nervous system and can cause both movement and cognitive impairment. Social Security isn't really interested in why you have pd. You might have been involved in a past work in an occupation that created exposures to toxins or chemicals like tce. Or you may have developed part Parkinson's disease for no known reason. It really doesn't matter why you've got the Parkinson's.
 
 Nancy Cavey [00:14:21]:
 What matters are the symptoms and functionality. Now certainly at step four, the issue is going to be can you go back to the lightest job you held in the five years before your claim has been adjudicated? And certainly if you've been involved in a job that created exposure to toxins or chemicals, you know that's a no brainer, you shouldn't be going back to that work. But probably your symptoms that you have as a result of the PD are going to preclude you from doing your past work. Now you need to understand that these cases are decided at step five and the issue is whether you can do other work in the national economy in view of your age, education, skills and restrictions, it is really crucial that your medical records are discussing all of your disabling medical symptoms. You may have cognitive issues, visual issues, balance issues, problems with spasm, you may have fatigue, you may have all sorts of other different symptoms. But when you see your physician, it's important in my view that you have a list of your symptoms sort of by problem, and then draw a line across that piece of paper and give examples of the problems that you're having because of that symptom. Because your medical record should be discussing not only your disabling medical symptoms, but but how those symptoms impact your functionality. And better yet, we want your doctor to complete a PD residual functional capacity form to document and quantify your physical restrictions, limitations and your cognitive impairments.
 
 Nancy Cavey [00:15:53]:
 But you know this isn't the only sort of invisible medical condition that we can deal with. Particularly, you know, PD can be disabling in the early stages without a lot of visible symptoms, but certainly as that disease progresses, it becomes more obvious. But another condition that I have a lot of experience with is chronic fatigue syndrome. And I will tell you that, again, you've got the burden of proof here, but there are some policy regulations that I think are important. So Social Security has Social Security Regulation 14 1, and this regulation clarifies the Social Security Administration's policy on developing evidence to establish that you have a medically determinable impairment and how they evaluate the impairment. Why is that important? Because one of the first things that Social Security is looking at, particularly in a chronic fatigue case, is do you have what's called a medically determinable impairment that's established by signs, symptoms, and laboratory findings? Now, that can be really hard to prove since there's no gold standard for a diagnosis of chronic fatigue. And that's where I think SSR 1411 comes in. Now, Social Security has acknowledged that CFS is a systemic disorder and that it's a complex of symptoms that can vary in terms of frequency, duration, and severity.
 
 Nancy Cavey [00:17:25]:
 This regulation reviews the history of the diagnostic criteria over years and looks to the CDC criteria for the diagnostic criteria that Social Security expects to be seen in your case. So what is it that Social Security wants to see? Well, they want to see one or more of the following signs clinically documented over a period of at least six consecutive months in your medical records. Probably, number one, swollen or tender lymph nodes. On physical examination, they want you to have evidence of pharyngitis. They want persistent reproducible muscle tenderness on repeated exams, including the presence of positive tender points. They want to see any other medical signs consistent with medically acceptable clinical practice and other evidence, such as acute infections or inflammatory events that preceded the onset of cfs. They're looking at causation. They were looking for laboratory findings, signs, and other documentation in your medical records.
 
 Nancy Cavey [00:18:35]:
 And quite frankly, you're not always going to see this, because in some instances, CFS is a diagnosis of exclusion. And certainly your medical record should document how the doctor went through the diagnostic studies, lab findings. And while they may not be positive or only mildly positive, you still have a diagnosis of cfs. The other thing that I think is really important is that the doctor prepare and complete a residual functional capacity form that we Social Security lawyers have prepared called a chronic fatigue syndrome. Residual functional capacity forms. Now, I know that most doctors who do CFS work are familiar with the form because they're routinely asked to complete it. But again, what's really important here is some history of exposure that predated the CFS potentially objective findings of the diagnosis, but just as important are an objective basis of the restrictions and limitations. Social Security doesn't like claims that are based on subjective presentations, so they want to see some objective basis for the restrictions.
 
 Nancy Cavey [00:19:48]:
 And that could be a CPET exam. That could even be a functional capacity evaluation. It could be some neuropsychological testing, though I'm not really a proponent of that in the context of a chronic fatigue claim. But the one thing that is really important, I think, is having that CF residual functional capacity. Got it. Hopefully this will have given you some insight in cases like PD and cfs. But let's take a break before I move on to immune disorders and the five Steps Sequential Evaluation.
 
 Speaker B [00:20:21]:
 Struggling with your Social Security disability case? The right attorney can make all the difference. Get our booklet the key to hiring a Great attorney for your Social Security disability case. Discover how how to find an experienced attorney who will fight for your rights and navigate the process with ease. Don't leave your future to chance. Request your free copy@kvlaw.com today and ensure you have the expert support you deserve.
 
 Nancy Cavey [00:21:01]:
 Foreign. Welcome back to Winning Isn't Easy. I want to talk about dizziness, immune disorders, and the five Step Sequential evaluation process. Now, why do I want to start out with dizziness? I find that some invisible medical conditions, including immunological issues, do involve symptoms of dizziness. And this is important to understand because everybody, regardless of whether you have a case involving an immunological issue, dizziness, or a herniated disc, is going to be required to prove that you have a medically determinable impairment established by medical evidence consisting of signs, symptoms, and laboratory findings. Now that's pretty easy. If you've had a back condition, you've had an mri, a CT scan, you've had surgery. But it becomes more problematic in cases involving dizziness and certainly even more problematic in immunological issues.
 
 Nancy Cavey [00:22:01]:
 So let's first talk about dizziness, because I think it sets the stage for some of the problems that we have in immunological cases. It's hard to prove that you are dizzy. There's no gold standard case test necessarily for dizziness. Now the Social Security administration wants to understand the cause and source of your dizziness, and it can be related to different things like Meniere's disease, neurological disorders, tumors, metabolic disorders, vestibular dysfunction, and even the side effects of medication. And while there may be gold standard tests to prove, for example, that you have a tumor, you may not have that gold standard test for the diagnosis of dizziness because really, in my view, it's more of a symptom than a diagnosis. But your medical record should be documenting what's the diagnosis that is the cause of your dizziness? Is it Meniere's? Is it a neurological disorder? Is it a vestibular dysfunction? The second thing you need to document is the average frequency of your dizziness episodes per week and per month, how long the episode lasts, whether you have warning signs of impending dizziness, how long it is between the warning and the episodes of dizziness, whether you can take safe precautions when you're feeling an episode, and if so, what those are. Whether there are any precipitating factors such as stress or exertion. What are the symptoms associated with your dizziness episodes? How long do they last? And of course, what are the after effects and how long do those after effect episodes last? What's the degree to which the dizziness interferes with your daily activities? Have you sustained any injuries during these episodes? What's the type and response to medication? Do you require more supervision at work than an unimpaired worker? Are there any safety issues working at heights with power machines operating motor vehicles? Do you have any mental problems associated with the dizziness? Do you have good days and bad days? Would you have to be off task or need unscheduled breaks because of the dizziness? And are your impairments demonstrated by signs, clinical findings and lab results consistent with your symptoms and functional limitations? So the Social Security administration expects some correlation.
 
 Nancy Cavey [00:24:20]:
 And of course, what are the functional limitations that affect your ability to work on a at a regular job on a sustained basis? And would there be any additional testing that would clarify the severity of the dizziness and limitations? Now again, that's a lot of information. The way we try to get at this is with a residual functional capacity form called a dizziness residual functional capacity form. But we also quite frankly want to try to get at the underlying cause of the dizziness and have your doctor complete a residual functional capacity form for that underlying condition, which I think is a good segue into immunological issues. Now, unlike dizziness, there is in fact a listing of impairments for immunological disorders. Now that isn't to say that there is aren't listing level conditions for conditions that cause dizziness like a brain tumor. There are, but you're not going to see a listing for dizziness. But in the immunological issue we're going to start out with the immunological system disorder listing section 14.0. 14.10.
 
 Nancy Cavey [00:25:39]:
 And that can include systemic lupus, scleroderma, polymyositis, undifferentiated and mixed connective tissue disorder, immune deficiency disorders, HIV infections, inflammatory arthritis and sodern syndrome. Now, each one of those disorders have elements and symptoms that have to be established to qualify as a listing conditions. Now, there's an alternative criteria. You must have at least two of the constitutional symptoms, such as severe fatigue, fever, malaise or involuntary weight loss, and a marked functional impairment in maintaining activities of daily living, maintaining social functioning and completing tasks in a timely manner due to deficiencies in concentration, persistence and pace. Regardless of whether we have a symptom of dizziness, we want to try to plug it in to a listing for that underlying condition, like a brain tumor. Or if we have an immunological issue, we want to try to plug it in to one of these listings in listing 14.0 dash 14.10. But even in those listings, the symptoms are really, really crucial. If we don't meet step three for any of these diseases or conditions, we go on to steps four and five of the five step sequential evaluation process.
 
 Nancy Cavey [00:27:03]:
 And the key here is having your medical records tell the story of your symptoms and your functionality combined with an appropriate residual functional capacity form. We have to prove at step four that you can't go back to the lightest job you held in the five years before this claim was decided. And at step five, where these cases are generally decided, that you can't do any other work in the mythical, hypothetical, not real world national economy in view of your age, education and skills and those restrictions and limitations. Or Alternatively a step five if you're over 50 that you grid out now, again, it really comes down to proof. It comes down to understanding what it is you have to prove. Understanding if there is a listing, understanding how to tell your story to your doctor in a way that documents your symptoms and functionality. Making sure that there is an objective basis of the diagnosis, if possible, making sure that there is an objective documentation of the basis of the restrictions and limitations supported and consistent with the forms you're filling out your medical history and of course those residual functional capacity forms. This isn't easy and it's not for the faint of heart, but I'm hoping that you now have a better understanding of how going about proving a Social Security disability case.
 
 Nancy Cavey [00:28:25]:
 Got it. Now, thank you for listening to this episode. If you found this episode helpful, please take a moment to like our page, leave a review and share it with your family and friends. And please subscribe to this podcast. By the way, I want to hear from you at the beginning of each episode description. You're going to find a link where you can send us questions or comments, and I'll feature those in a future episode. So please, let's interact. Join us next week for another insightful episode of Winning Isn't Easy.
 
 Nancy Cavey [00:28:55]:
 And thanks for listening. Sa.