Doctor says "don't work" but finances say otherwise

July 28, 2011 4:57 PM

My doctor doesn't think I should work, but our family finances are dire. Everything I've heard says that disability is not likely for me. Now what?

For the past 10 or so ears, I've worked part-time in my profession. This was good for our family when the kids were younger, and we were able to survive. During this time I suffered from the depression that has plagued me since childhood, so a limited schedule was good for me too.

About a year ago, we decided to move to a more expensive house in a nicer town. I was the driving force behind this and agreed with my husband that I would seek a job with more hours in our new area to help with the mortgage.

The move went fine, I had a ton of interviews but nothing came of them. I became more depressed. Changed meds, felt a bit better and finally got a job...then the position was cut after 3 months for budget reasons.

The next 2 months were the worst of my life. I barely moved out of bed. I continued to apply and interview, but my heart wasn't in it. Finally I checked myself into a psych hospital where I was diagnosed with bipolar disorder. I stayed there a week, and then did a partial hospital program for 3 weeks.

For the most part I am feeling better, however my med regime is still in flux. My new outpatient psych does not want me to work while I am getting stable. My husband, however, is freaking out about our finances, since we've now had to add in all these hospital bills, weekly appointments and blood tests.

We've tightened up our budget as much as we can, but it's still clear we need more income. I have two jobs to apply for, and one seems to be perfect for me, but it's full time. The last thing I want is to take a job in my field and then have another breakdown, especially since I generally work with kids. I could apply for an hourly retail job, but I'm not sure how much I'd have to work in order to make up the shortfall in our budget.

All of this stressing is taking a toll. I've caught myself sliding into a mixed state a few times, and my daytime napping has increased. Today I had the first inklings of the kind of paranoia I used to experience. My doc is on vacation, but I will call his office tomorrow to see if I can see someone else.

In the meantime, I don't know what to do. Is it true that it is a very long and difficult process to get on disability for mental illness? Do I need a lawyer? How much does that cost?

I know this is a randomly composed tl;dr, but my mind is all over the place right now. Thanks for reading and for any insight you have.

posted by Biblio to health & fitness (22 answers total)

Start out by applying for EDD. It's a relatively fast process (a couple of weeks). Go to your state's webiste and see what you need to do. You'll need your doctor's help, but from what you're saying, I really don't think that you're going to have a problem and that will tide you over for a while.
posted by puddinghead at 5:06 PM on July 28, 2011 [1 favorite]

Me again. Sorry, I should clarify. In California the webiste is for the Unembloyment Development Departmen (EDD). Try a search for Disability Insurance for your state. I was just exactly about in your shoes a while ago, and had no trouble qualifying.
posted by puddinghead at 5:14 PM on July 28, 2011

Unemployment Department. You know what I meant.
posted by puddinghead at 5:16 PM on July 28, 2011

Yeah, I'm unfortunately in MA, and we don't seem to have a similar program. Thanks, though.
posted by Biblio at 5:21 PM on July 28, 2011

Have you considered reducing your hours and cost of living to match?
posted by rr at 5:29 PM on July 28, 2011

Don't worry what "everyone" says about who gets accepted for disability. What I heard is that they make everyone apply a few times just so they can make sure you really need it. My dad got accepted on his first application. So you never know. If your doctors are adamant about it, then I think you have a chance that's good enough to try for. Especially if it's just temporary while you're recovering.
posted by bleep at 5:30 PM on July 28, 2011 [2 favorites]

Are you against moving into a place that's cheaper? You say you have cut your budget, but does that include getting rid of a car, cell phones, cable, expensive rent?
posted by TheBones at 5:30 PM on July 28, 2011 [1 favorite]

Seconding don't worry about qualifying for disability in MA. Thanks to Facebook, I know everyone's business and I unfortunately know of a lot of people with lesser problems that are on SSDI. And not only are they on disability, but their minor children pull a check for some reason as well. I don't understand the latter part, but apply.
posted by jerseygirl at 6:00 PM on July 28, 2011

Work and see how it goes.
posted by thorny at 7:01 PM on July 28, 2011

Any chance that working might cheer you up? I know that not working makes me really depressed. Working, while tiring, tends to make me feel needed. It's really, really difficult to deal with totally unstructured time.
posted by sully75 at 7:05 PM on July 28, 2011 [1 favorite]

At what point does moving to a cheaper house start to make sense? I mean, to a certain extent you're being asked to choose between your health and the box you live in. I think everyone will agree that your health is more important, right?

Were it me, I'd radically reduce your cost of living in the short term while also trying out some basic work. Even something barely part time in the service industry, maybe? Just something low stress to begin with. If it doesn't work for you, at least you'll be a bit ahead financially by preemptively tightening your belt. If work doesn't work, start looking to move.
posted by pjaust at 7:24 PM on July 28, 2011

sent you an email.
posted by orangemacky at 7:31 PM on July 28, 2011

We've done the belt tightening, cut cable, phones, groceries etc. I'm biking around town more and making more meatless meals. We've even cut the kids' allowances. Selling the house is not on the table right now. Hopefully it won't need to be.

I'm certainly open to hourly work, and there is something to be said for getting out if the house, but I'm concerned about if I do apply for disability....should I not be working? This is so confusing.
posted by Biblio at 8:22 PM on July 28, 2011

In Tennessee, you can work while on disability up to a certain point. You're only allowed to make X amount. It works out to a part-time retail or secretarial job, that sort of thing.

If you don't mind the underhanded way, you could supplement with cash projects--make jewelry, clean houses, take in sewing projects, mow lawns, walk dogs, do nails, babysit/eldersit, rent out a room. I believe this is illegal, but people do it, so proceed with caution.
posted by thinkingwoman at 9:58 PM on July 28, 2011

The SSDI is a federal level thing. So, it shouldn't vary from state to state. For example, my sister is on SSDI because of being intellectually disabled and she was able to work part-time and did so for years (like nearly 20). The birth mother of my soon-to-be adopted kiddo is also on SSDI and is allowed to work part-time as well. These two ladies are in NM and VA respectively. Speak to someone at the Social Security Administration. They can better advise you.
posted by onhazier at 6:36 AM on July 29, 2011

It would help to have assistance in deciding whether to apply for Disability Insurance and then in applying if you decide to. Ask your physician for a referral, or contact the Disability Law Center of Massachusetts for assistance or a referral. Good luck.
posted by Mr.Know-it-some at 6:38 AM on July 29, 2011

I am in a similar situation - large medical bills, had already cut everything that could be cut, worried that some decisions in the past (that were good for the family) may be causing some trouble now. I believe that you have cut everything you could.

My husband and I are working in parallel - he is searching for a job and I am searching for a higher paying job (he is a SAHD). We are networking through our professional organizations and other "meet ups" to find work. I have found networking has helped to keep my spirits up.

Have you considered putting yourself on a schedule? Here is an idea - Get up at the same time everyday, job search, exercise, lunch, downtime, get dinner on? Maybe going to the library to job search would be helpful. Getting out of the house also helps keep your spirits up and it is free.

Best of luck to you. The only thing that gets me through these valleys in life is knowing "this too shall pass".
posted by BuffaloChickenWing at 7:41 AM on July 29, 2011

One thing you haven't said...do you want to work? Not what your husband wants, not what your doctor wants, what do you want?

You know better than anyone how working is going to affect your mental state. Tell your husband that his "freaking out" is negatively affecting your stability at this difficult time, and he needs to tone it down, and tell your doctor that financial stress is negatively affecting your stability, and you need a strategy to deal with that. Then, make the decision that you believe will be best for your health, long-term, and figure out your options from there.
posted by psycheslamp at 1:14 PM on July 29, 2011

The only suggestion I have besides things that have already been mentioned is to try to regulate your sleep cycle as much as possible. I'm not a doctor, but my understanding is that sleep can play a large role in the recurrence of bipolar symptoms.

(I know this isn't always easy to do though, so try to be as kind to yourself as possible.)
posted by parakeetdog at 1:50 PM on July 29, 2011 [1 favorite]

Hi there! My work involves Social Security disability, so maybe I can help explain the process. (I am a lawyer, but I am not your lawyer, and this is not legal advice.)

There are 2 types of federal disability benefits – you have to qualify for at least one type, but some people qualify for both. The first is disability insurance benefits. Per SSA: “As you work and pay taxes, you earn credits that count toward your eligibility for future Social Security benefits. You can earn a maximum of four credits each year. Most people need 40 credits to qualify for benefits. Younger people need fewer credits to qualify for disability or survivors benefits.” The second type is supplemental security income disability, which is for people with very limited income and resources.

You can apply for disability benefits online, or in person at your local SSA office (or over the phone, too). You can give them your medical records, or the agency can request them from your doctors/hospitals/other treatment providers. Then local (state level) disability examiners look at your claim/medical records and determine whether you’re disabled under agency rules. This could take 3 to 4 months. If you're approved, you can start getting benefits in the sixth full month following the date you became disabled.

If your claim is denied, you can appeal for reconsideration and eventually a hearing in front of an administrative law judge. (Some states skip the reconsideration step and go straight to the hearing level.) Because of the agency's heavy workload, you may wait up to a year or two before you get to a hearing. This is the point where people typically get lawyers. These lawyers generally work on a contingent fee basis, meaning you don’t pay anything up front, but they get a chunk of your benefits of you win your claim (currently 25% or $6,000 – whichever is less).

Anyway, the agency uses a 5-step process to determine whether you are disabled:

Step 1: How much are you earning right now? If you are earning more than a threshold amount per month ($1,000 a month in 2011), SSA won’t consider you disabled. (It's called substantial gainful activity, and there are different threshold amounts for different years.) The agency also look into the past – have your monthly earnings have been below the threshold since the date you became disabled? There are some exceptions where it’s okay that you earned more than the threshold amount for a few months. If your earnings are low enough, you go on to step 2.

Step 2: Do you have a “severe” impairment? SSA needs medical records proving that you have a medical/psychological impairment that significantly affects your ability to perform basic work activities. You have to prove that you've had these limitations for at least 12 months (or that they can objectively be expected to last for at least 12 months). Medical records are very (very!) important – in short, the agency can’t just take your word for it. You can also submit letters or functional assessments from your doctor discussing your condition or why they think you cannot work. If you have a “severe” impairment, you go on to step 3.

Step 3: Does your severe impairment meet the criteria for an impairment that SSA considers automatically disabling? Basically, there's a giant list that says you are automatically disabled if you have condition A with symptoms/limitations X, Y, and Z. If you don’t meet the list, you go on to step 4.

Step 4: Can you do your past work? SSA will look at the work you’ve done in the past 15 years and consider whether you can still do the type of work you used to do, even with the limitations you have due to your illness. If you can’t do your past work, you go on to steps 4.5 and 5.

Step 4.5: What exactly are you still able to do, even with your illness? SSA looks at the limitations related to your impairment (along with your age, education, and work experience) to get an overall picture of your functional abilities since the date you say you became disabled.

Step 5: Can you do other work? SSA uses the functional picture it got in step 4.5 to see whether you can adjust to any other type of work. “Other” work can include entry-level unskilled work. If the agency finds that - even with your impairment - you can do other types of work besides your past work, it will consider you not disabled.

The Social Security disability planner site has more info. I hope that helps a little bit. (And by the way, there is no agency policy that says you have to apply multiple times just to show you're really disabled - you can be approved on the first application.)
posted by the littlest brussels sprout at 1:44 AM on July 30, 2011 [7 favorites]

IANAD You do, in fact, have a disabling condition. You need some time to stabilize your condition, and learn how to manage it and cope with it. Bi-polar disorder is eminently treatable for most, and you should be able to return to work at some point.

What would you and your family do if you found out you had serious diabetes, or MS, or some other disease that affected your energy, general health, etc.? You'd make arrangements. That's what you have to do now. You may have to accept some debt while you learn to manage your illness. I think staying home can make mental health disorders worse, so I recommend part-time or volunteer work for the time being. If you aren't able to get up and go to sleep at appropriate times, your meds may not be correct. Many posters recommend keeping a regular schedule, regular exercise, getting outside (vitamin D, as well as general goodness) and omega/fish oil supplements. Riding your bike is likely doing you a lot of good.

SSI Disability has lots of rules. I suspect you don't need it for the long term. Does your husband's job have an Employee assistance Program(EAP)? They're often helpful in a difficult scenario like this.

parakeetdog's comment "be kind to yourself" is so, so right. You didn't choose this, it takes time and effort to manage, and it causes genuine pain and suffering. But it is treatable, and you can be happy and healthy again.
posted by theora55 at 8:58 AM on August 2, 2011

Just read brussel sprout's comment, which is incredibly useful. thanks
posted by theora55 at 9:00 AM on August 2, 2011