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Do you know someone who had an SSA Consultative Exam?
mitodi2009
Posted: Monday, March 20, 2017 5:50 PM
Joined: 3/4/2017
Posts: 16


Hi, I am new to this forum and so glad there is support out there, even if online.

Today my husband had his SSA consultative exam - the one with a psychologist for memory, etc., but they could not tell me anything about its outcome and they do not release reports to the patient, only to a doctor that you specify. We do not have a diagnosis from a doctor, so the SSA is relying on their own exams and the functional reports. I am so curious about what went on in the exam. They said it was supposed to take 2 hours. He was only there for about an hour and change, so I am wondering why was it so short? What do they ask? 
When I tried to ask my husband immediately afterward, he already forgot what went on. That is how much his short-term memory is shot. He could not even fill in the date on a form he was given to sign - he did not know the month, even when I told him it was March, he forgot March was '3' when you write a date. 

I guess I am worried about a consultative exam not giving a good picture of how he is functioning. They don't take a history of what he can do, they just give tests. I know of his decline and it is clear to me for the past 2-3 years how he has changed. Does anyone have a LO that had an exam of cognitive/memory given by the SSA that remembers what they were asked?  Thanks in advance.


elainechem
Posted: Monday, March 20, 2017 6:12 PM
Joined: 7/30/2013
Posts: 4672


My hubby never had one, but our 25 year old son who has autism has had two. Some people say that the purpose of these exams is to deny claims. That's not true. The doctors who perform them are licensed to practice and they must abide by certain ethical standards. My son's first exam was when he was 17. I was allowed to be present for it. That one was actually silly and a complete waste of the government's money and our time. My son already had comprehensive neuropsychological testing and a definitive diagnosis. The doctor just rubber stamped what the neuropsychologist wrote and gave my son a talk about personal hygiene because he had to do something for that hour to justify his time. 

The next exam was this past summer because our son doesn't see a psychologist anymore and they needed new information. The visit was brief. I gave her a copy of his original neuropsychological report and she just confirmed that it was all the same. I was allowed to be present for that too because our son can't give a good account of his medical history. 

I suspect that your husband's visit was short because his deficits are so obvious that it didn't take long to confirm it. They may have asked him basic questions about his living situation and any of his history that he could remember. It sounds like he can't remember much. How come he doesn't have a diagnosis of dementia yet? 

Are you your husband's power of attorney for healthcare and finances? If not, you should be. See an elder care attorney to take care of that. 

Crushed
Posted: Monday, March 20, 2017 6:40 PM
Joined: 2/2/2014
Posts: 1958


DW had hers, it lasted 1 1/2 hour and she was approved IMMEDIATELY after.
la36
Posted: Monday, March 20, 2017 6:43 PM
Joined: 3/2/2017
Posts: 7


Gee...my husband had one very recently..new to this too...his lasted about 3 hrs...then we were called back to discuss the results after about 3 weeks! They gave me the diagnosis right there with all the details! Although my husband was not there...My stepdaughter and I were...she just graduated from law school so she wrote up a paper with consent from him...Wish I could help you more...But I would contact them and just ask outright...I dont know! Sorry
mitodi2009
Posted: Monday, March 20, 2017 7:01 PM
Joined: 3/4/2017
Posts: 16


Thanks for your reply. It helps a lot.

We just don't have a true "doctor", yet - my husband was into natural health and refused to see anyone but Naturopaths, and they don't diagnose like doctor's do. That was his "normal" life some time ago...so there was no doctor to do testing. He was also in heavy denial - thinking that he was going to beat dementia or Alzheimer's because he could just eat healthy and not "get what his father and brother got" - his father passed away from Alzheimer's and he swore he could have saved him "if only"; his brother has it and is about a little over a year older than him. So we are crossing that battle of getting him to agree to do SSA. Every week he does not even remember we applied and agreed to it, so I have to remind him and he was aggressive/angry weeks ago when he refused to go to today's appointment.  So I wondered if in the exam today he could have told the doctor "I want to work, nothing is wrong with me".

We also just got approved for Medicaid due to the decrease in income from his inability to work, but too late to coincide with the SSA application submission to go to a true doctor prior to their needing the Consultative Exam.
I also just saw another forum post about "Anosognosia" where the patient has an 'impaired ability to perceive his illness', so there may be that going on where he believes nothing is that wrong. Each week he just says, "I want to go on a cleanse and everything will be okay". But it has been 2 years of that and still a decline, not saying I am against eating healthy to support the brain, but it is complete denial of something more serious.
Anyway, thanks again. We will just have to see what SSA determines. He is 57 years old, what else can he do for work if he can hardly function...

 


elainechem
Posted: Monday, March 20, 2017 7:12 PM
Joined: 7/30/2013
Posts: 4672


mitodi2009 wrote:

So I wondered if in the exam today he could have told the doctor "I want to work, nothing is wrong with me".  

 

It doesn't matter if he said that to the psychologist (I assume that he saw a psychologist). Psychologists are smart enough to know that many people with brain disorders or diseases are not aware of how bad off they really are. They don't take a patient's word for things, they know that they have to test them to find out the truth. 
mitodi2009
Posted: Monday, March 20, 2017 7:25 PM
Joined: 3/4/2017
Posts: 16


Yes, it was a psychologist - good to know. I hope they would not take his word for it. He really has hope he will go back to work.
Iris L.
Posted: Monday, March 20, 2017 8:26 PM
Joined: 12/15/2011
Posts: 13919


Mitodai, here is an article about anosognosia that will explain more about it to you.

http://alzonline.phhp.ufl.edu/en/reading/Anosognosia.pdf 


Iris L.


mitodi2009
Posted: Monday, March 20, 2017 9:16 PM
Joined: 3/4/2017
Posts: 16


Iris L. wrote:

Mitodai, here is an article about anosognosia that will explain more about it to you.

http://alzonline.phhp.ufl.edu/en/reading/Anosognosia.pdf 


Iris L.

 

Thanks. This is very interesting. 
meg7544
Posted: Tuesday, March 21, 2017 12:08 PM
Joined: 1/21/2013
Posts: 136


Yes. DH had one.  He was 50.  He already had a dx from his doctor and had been approved for disability retirement from work.  He was approved by SSA shortly after the psychologist interview.
mitodi2009
Posted: Tuesday, March 21, 2017 5:04 PM
Joined: 3/4/2017
Posts: 16


meg7544 wrote:
Yes. DH had one.  He was 50.  He already had a dx from his doctor and had been approved for disability retirement from work.  He was approved by SSA shortly after the psychologist interview.

 

Meg7544, do you remember if your DH mentioned what his interview asked him?


mitodi2009
Posted: Tuesday, March 21, 2017 5:07 PM
Joined: 3/4/2017
Posts: 16




Are you your husband's power of attorney for healthcare and finances? If not, you should be. See an elder care attorney to take care of that. 




I do need to consult with an attorney, except that he is not elderly, but he has nothing really that would need financial power of attorney. I do everything and own everything already. All I can really see is doing Healthcare directives for my state. Or guardianship if they already think he is incapacitated and cannot sign power of attorney docs. But I will check. Thanks.

elainechem
Posted: Tuesday, March 21, 2017 5:38 PM
Joined: 7/30/2013
Posts: 4672


mitodi2009 wrote:
 
I do need to consult with an attorney, except that he is not elderly, but he has nothing really that would need financial power of attorney. I do everything and own everything already. All I can really see is doing Healthcare directives for my state. Or guardianship if they already think he is incapacitated and cannot sign power of attorney docs. But I will check. Thanks.

 

It doesn't matter if he is elderly or not. My hubby started down this road when he was only 57. It's just that elder care lawyers are accustomed to working with clients who have dementia, so they know what steps need to be taken to protect the spouse when her husband with dementia needs full time care and after he passes. Estate planning needs to be done now. If he needs to spend a long time in a nursing home, there are two choices, Medicaid and self-pay (unless he has long-term care insurance). You don't want to be a bankrupt widow, so you need to see someone now. And you need to get the POAs in place now. You'd be surprised how many institutions and medical practices will not talk to you without it. 

mitodi2009
Posted: Tuesday, March 21, 2017 7:35 PM
Joined: 3/4/2017
Posts: 16


elainechem wrote:
mitodi2009 wrote:
 
I do need to consult with an attorney, except that he is not elderly, but he has nothing really that would need financial power of attorney. I do everything and own everything already. All I can really see is doing Healthcare directives for my state. Or guardianship if they already think he is incapacitated and cannot sign power of attorney docs. But I will check. Thanks.

 

 
It doesn't matter if he is elderly or not. My hubby started down this road when he was only 57. It's just that elder care lawyers are accustomed to working with clients who have dementia, so they know what steps need to be taken to protect the spouse when her husband with dementia needs full time care and after he passes. Estate planning needs to be done now. If he needs to spend a long time in a nursing home, there are two choices, Medicaid and self-pay (unless he has long-term care insurance). You don't want to be a bankrupt widow, so you need to see someone now. And you need to get the POAs in place now. You'd be surprised how many institutions and medical practices will not talk to you without it. 



 

Oh Gee. I did not know that is what POA is also used for. I thought it was for banks and houses owned. Thanks. I will seek some eldercare lawyer to help me.  So much. And as he is in this silly denial still, it could make it hard to get him to comply to do the paperwork with me and the lawyers, etc. But I have to try.
elainechem
Posted: Tuesday, March 21, 2017 7:59 PM
Joined: 7/30/2013
Posts: 4672


Anosognosia means that he UNABLE to understand that he has a problem. It isn't denial, it's part of the disease. It isn't likely to change. Yes, it makes it very difficult to get him to go along with things. I know all about it, my hubby has anosognosia big time! It's frustrating, but you have to find ways to work around it. 
Crushed
Posted: Tuesday, March 21, 2017 9:42 PM
Joined: 2/2/2014
Posts: 1958


mitodi2009 wrote:
elainechem wrote:
mitodi2009 wrote:
 Oh Gee. I did not know that is what POA is also used for. I thought it was for banks and houses owned. Thanks. I will seek some eldercare lawyer to help me.  So much. And as he is in this silly denial still, it could make it hard to get him to comply to do the paperwork with me and the lawyers, etc. But I have to try.

There is a difference between a health care power of attorney that allows the POA to make health care decisions and and ordinary  POA which can include the power to have access to any and all medical data and medical professionals.   Many health care powers do not include the specific right to  access to all records .  This can cause lots of problems 

The  Maryland advance directive does have the appropriate language

http://www.marylandattorneygeneral.gov/Health%20Policy%20Documents/adirective.pdf

I routinely insert it into standard DPOA

 


meg7544
Posted: Wednesday, March 22, 2017 12:42 AM
Joined: 1/21/2013
Posts: 136


mitodi2009 wrote:
meg7544 wrote:
Yes. DH had one.  He was 50.  He already had a dx from his doctor and had been approved for disability retirement from work.  He was approved by SSA shortly after the psychologist interview.

 

Meg7544, do you remember if your DH mentioned what his interview asked him?

Hi mito,,

It was 13 years ago but this is what I remember.   As background, DH has genetic EOAD.  We were getting a run-a-round by SS.  This was before EOAD was really known about by many of the SS offices and before EOAD was on the fast-track list.  DH's application was denied.  So we appealed and were scheduled to meet with an administrative law judge. In the interim, I called my state senator's office and spoke to an aide.  The next thing I knew, we received a notice from SS that we had an appointment scheduled with a psychologist. 

I was concerned how the meeting would go because DH’s limitations were not easily discernable.  He was in with the psychologist for a long period of time.  When he was finished, I asked DH what they talked about.  DH said they talked about his family history with regards to the genetic mutation.  He said the doctor was interested in the historical details that caused his family to immigrate to the U.S. in the late 1800’s.  He said they spent a lot of time talking about history.  DH always loved history and had a great memory for the who, what, when, where and how.  So I think what happened is the psychologist could tell that DH had a great long-term memory but his short-term memory was lacking. I don’t remember getting a write-up from the psychologist, but his SS application went through right away and our court date was cancelled.  

 

 



Dede57
Posted: Wednesday, March 22, 2017 1:44 PM
Joined: 7/18/2016
Posts: 96


DH had one recently, then he had to go back for further testing. So he was been seen twice in about 3-4 months by the same dr for the SSA. He has dx from testing that his DR sent him for. Now my DH is early stage and just to talk to him he seems fine and he can do some of the little tests decently. But he can not drive as he doesn't remember to look before backing or changing lanes. And he forgets things and misplaces things.  The SSA determined that even though he could no longer do the job he had been doing he could do some other job and denied him disability. We now will have it go before a judge.
mitodi2009
Posted: Wednesday, March 22, 2017 7:36 PM
Joined: 3/4/2017
Posts: 16


Thanks everyone.

So it may be hit or miss, depending on the SSA case worker or decision makers. No real way to tell what they will decide even if I knew what the psych report has in it. I will certainly appeal if it gets denied. I always wonder what they could possibly think someone can do for work if they cannot do their old job. My husband cannot even fill in a job application much less know what date it is. What employer will hire him is beyond me how the SSA thinks. I know there are various 'handicapped' workers out there in the workforce, so maybe SSA thinks they can lump dementia under a handicap...who knows. I am tired now of guessing what the outcome will be. Can only sit tight...

We are getting our POA and AHDirectives completed from our state downloadable forms. Thanks for that advice. 


elainechem
Posted: Wednesday, March 22, 2017 8:18 PM
Joined: 7/30/2013
Posts: 4672


mitodi2009 wrote:

I always wonder what they could possibly think someone can do for work if they cannot do their old job.

The Social Security Administration doesn't care whether someone can still do their old job. They only care whether the person is capable of "substantial gainful activity" (SGA). That means, are they capable of earning the modest sum of $1,170.00 per month? They look at how the person's disability affects their ability to work, their level of education, previous work history, etc. to decide if they can perform SGA. Let's say a person was once an electrical engineer. They may not be able to do that work anymore, but they might still be capable of cleaning toilets. Yes, it can be that ridiculous. If your husband is as impaired as you say, I wouldn't worry about him being approved. 

When my hubby went through neuropsychological testing, I explained SGA to the doctor. She was shocked. She said, "What's he gonna do? Be a greeter at Wal-Mart?" The answer to that was "no". I had stopped him from driving shortly before we got his results. The caregiver is under no obligation to provide transportation to work for the person with a disability. 

Our 25 year old son is also on disability due to his autism. He is intelligent, physically strong, and he can drive. But the mere thought of applying for work can send him into a panic. He has very poor socialization and communication skills. 


mitodi2009
Posted: Thursday, March 23, 2017 12:46 PM
Joined: 3/4/2017
Posts: 16


I cannot imagine how they could think a caregiver would transport to the job and know their work schedule and fill out the job application and paperwork, etc. Those are the things I would need to do for DH because he cannot drive, nor take a bus, nor ride a bike, nor complete a job application or the numerous forms they have you fill out on hire day(W4, etc.), remember his work schedule, etc. None of these things. I wrote a lot in the third party functional report which I hope is weighed in to the decision.

It is funny that you mention "A greeter at Walmart" because when I picked up DH after his exam, he was chatting away with someone in the waiting area. He can sometimes be congenial enough to do only that - a greeter - but would he remember where he is after a few hours, or remember when to take his lunch break, or when his shift ends, or how to get home...

Also, next week's exam is the physical one and he cannot bend, lift, reach, has Parkinsonian shaking, etc. So cleaning toilets is not going to happen either, unless they plan to put him in a wheelchair to do the cleaning. They will test his walking, gait, and other physical things pertaining to performing job related things because of all the pain/movement symptoms we listed.

Oh thank you guys for your posts. I am feeling a little less stressed.


dayn2nite2
Posted: Thursday, March 23, 2017 1:03 PM
Joined: 6/20/2016
Posts: 609


mitodi2009 wrote:

I cannot imagine how they could think a caregiver would transport to the job and know their work schedule and fill out the job application and paperwork, etc. Those are the things I would need to do for DH because he cannot drive, nor take a bus, nor ride a bike, nor complete a job application or the numerous forms they have you fill out on hire day(W4, etc.), remember his work schedule, etc. None of these things. 

They don't care about that.  Not the logistics, but only "can" the person do any job that provides the $1,170/month.  

elainechem
Posted: Thursday, March 23, 2017 1:20 PM
Joined: 7/30/2013
Posts: 4672


Well, if they can't figure out a way to get to a job, then they can't do the work, can they?
dayn2nite2
Posted: Thursday, March 23, 2017 2:17 PM
Joined: 6/20/2016
Posts: 609


Not being able to get to a job they feel you can do is another oppotunity to deny the claim.  It's all a game, and we poor folk aren't ever supposed to "win" (not that claiming disability is ever a win for anyone)
elainechem
Posted: Thursday, March 23, 2017 3:10 PM
Joined: 7/30/2013
Posts: 4672


I believe that they do take into account whether your disability prevents you from even getting to this alleged job they say you can do. When hubby was approved, he could no longer drive. I don't think it would have been a stretch to prove that it was unsafe for him to walk the mile and a half to the nearest alleged job. We had no public transportation where we lived. 

It's like if your disability is chronic migraines. Yes, you can work when you feel okay. But, half the time, you can't even get out of bed. No employer would even hire you. I think such a case could be won on appeal, at least.

When you're talking about a person with a diagnosis of dementia, their condition will only decline. That's why dementia is on the fast track list.  


mitodi2009
Posted: Thursday, March 23, 2017 7:24 PM
Joined: 3/4/2017
Posts: 16


I hear ya - it is not about a "win" for having a disability. But it is about getting some support if the disability truly exists. I would love for there to be a magic cure so he could go back to playing with his son and working and doing other things he loved. But I do not know that a cure exists. As caregivers we are exhausted on top of trying to figure out how we are going to make ends meet. We know the difference in their abilities before the disability. We are not [all] lying or trying to cheat the system by applying. There are days when I wish it was a mistake and that he is just so stressed that it is causing temporary memory issues. I am going to keep moving along in the process to figure out the type of dementia, etc., but it has been too many years and I and other family members saw the decline that goes beyond mere stress. Case workers do the best they can (we hope) with all the evidence, but they do not see the everyday behaviors, they did not personally experience the disabled person's history.
banter
Posted: Saturday, March 25, 2017 6:55 AM
Joined: 12/24/2015
Posts: 1


My husband had the exam and it was so short, maybe a half an hour, I didn't know what to think. A couple of weeks later they had put the  ssdi money into our bank account before we even knew the answer was yes. It was six months from the last day he worked  He is not diagnosed with dementia. He was asked about current events and daily living .She asked him questions and he didn't have to write anything or read. He did not know who the President was.She couldn't believe it so she asked "You don't know who the President is?" He said "No we don't have cable tv anymore."
mitodi2009
Posted: Thursday, March 30, 2017 1:43 PM
Joined: 3/4/2017
Posts: 16


I just wanted to thank everyone for your feedback. This past Tuesday(28th) was DH's Physical exam. The doctor needed me to be in the room because DH could not remember anything to answer his questions. So as I was in the exam...it was so sad..DH has some parkinsonian/neuro issues going on along with his other memory/cog symptoms. He could not walk a straight line - like when you get pulled over for possible DUI and you have to put one foot in front of the other. He could not touch his hand to his nose and had noticeable tremors. Possible Parkinsonian dementia?

Anyway - I just called the case worker today to ask a simple question about getting the Tuesday Physical report sent somewhere and guess what - she said his case left her office and they decided on it because there was enough evidence in the psych exam. The case worker did not even need to wait for the physical report to come in. So if that means that the psych exam showed clear signs of decline(etc) then maybe DH is approved? SSA will be writing/calling soon, she said. 

Will see...


elainechem
Posted: Thursday, March 30, 2017 5:31 PM
Joined: 7/30/2013
Posts: 4672


I think it sounds like a definite approval. A similar thing happened to me. Hubby had one neuropsychological exam which was paid for by his employer, but it took me about six months to get a hold of the thing! Very non-responsive doctor! While waiting, I scheduled him for a second exam. Months later, I called SSA to ask if they had gotten a copy the second report (I had sent them a copy of the first exam after they initially denied his application because they never got a copy from that doctor). I was told that they didn't need the second one, the first one had enough information. Hubby was soon approved. He got his first check six months after being forced to retire early on disability. 

I don't think you have anything to worry about. 


 
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