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ENDOMETRIOSIS & SSDI BENEFITS

WHAT IS ENDOMETRIOSIS?

Endometriosis is a chronic, painful condition that affects women. The condition occurs when the endometrium, which is the lining inside the uterus, begins to grow outside the uterus. The endometrial cells then implant on the ovaries, Fallopian tubes, and other organs in the pelvis. This causes pelvic pain, heavy menstrual bleeding, and pain during sex. It can also cause infertility.

Endometriosis affects almost 10% of women of reproductive age around the world. This means that  around 190 million women and girls have this condition. Despite being a common condition, endometriosis is often misdiagnosed.  Therefore, many women don’t get the treatment they need.

Endometriosis usually causes severe pain, especially during menstruation. This can cause missed days of work and also make it difficult to attend work on a regular basis. Treatments like surgery and medication can ease some of the symptoms. However, there is no cure for the condition. If you cannot work due to your symptoms, then you should apply for SSD benefits with the help of our law firm.

one in ten women has endometriosis illustration of different women one with abdominal pains

WHAT CAUSES ENDOMETRIOSIS?

There are several theories about the exact cause of endometriosis, but the exact cause is not known. Below is a list of some of the possible causes:

  • Retrograde Menstruation: This occurs when menstrual blood flows backward through the Fallopian tubes into the pelvic cavity instead of leaving the body.
  • Embryonic Cell Transformation: Hormones such as estrogen transform embryonic cells into endometrial cells that implant during puberty.
  • Surgical Scars: After surgery, such as a hysterectomy or C-section, the cells may attach to the scar site.
  • Immune System Disorders: Issues with the immune system may make the body unable to recognize and destroy endometrial tissue growing outside the uterus.

Even with research, the exact cause of this disease is still unknown, making it difficult to create specific treatments and prevention methods. The potential causes, like backward blood flow and immune system problems, each offer clues but don’t fully explain this condition. That is why it is important to keep studying to understand it. Encourage your doctor to understand your condition. By figuring out the real causes, we can improve how we diagnose and treat this chronic condition.

THE SYMPTOMS OF ENDOMETRIOSIS

Symptoms of endometriosis can vary widely, but the most common symptoms include chronic pelvic pain, especially during menstrual periods. The pelvic pain is often more intense than typical menstrual cramps. Many women experience heavy menstrual bleeding or bleeding between periods. Pain during intercourse and during bowel movements, particularly during a period, are also frequent complaints.

Women with endometriosis may experience internal bleeding and pelvic pain. Other common symptoms include bloating and nausea. Beyond these symptoms, the disease can cause infertility, making it a common finding among women seeking treatment. Around 40% of patients become infertile. However, infertility can be treated with surgery and hormone therapy. But it is not always successful.

Other symptoms may include fatigue, diarrhea, and nausea, particularly during periods. The symptoms are not necessarily in line with the extent of the disease. This means that even minimal endometriosis can cause significant pain. Some women also suffer from mental issues, brought about by chronic pain and struggles with infertility.

ENDOMETRIOSIS CAN CAUSE OVARIAN CYSTS

Women with endometriosis can develop ovarian cysts known as endometriomas or “chocolate cysts.” These cysts form when endometrial tissue grows in the ovaries and causes a cyst filled with blood to develop. Over time, the blood within the cyst darkens, giving it a chocolate appearance. Which is how these cysts got their nickname.

Endometriomas can cause various symptoms, such as severe pelvic pain, especially during periods. They can also cause heavy bleeding or irregular periods, pain during or after sex, and infertility due to their impact on ovarian function. Additional symptoms may include nausea, fatigue, and pain during bowel movements and your period.

These cysts can be detected through imaging tests like ultrasounds or MRIs. The reason to have imagine is to evaluate the size and position of the cysts. If a cyst is attached to the Fallopian tube it can cause the tube to twist. When this happens, you will have terrible pain and you need surgery to not only remove the cyst, but also the ovary.

If endometriomas cause significant pain or problems, then treatment options might include medication to manage symptoms or surgery to remove the cysts. Medications such as birth control pills, can help reduce pain and prevent the growth of the cysts. In more severe cases, surgery may remove the cysts. Removal of the cysts can help relieve symptoms. However, after surgery you need to continue using birth control pills or other hormone therapy or the cysts will return.

TREATMENT FOR ENDOMETRIOSIS

There are treatments for endometriosis that can help manage your symptoms. Treatment options aim to reduce pain and manage symptoms. Pain management often begins with drugs like Ibuprofen. Hormone therapy, including birth control pills, can reduce or stop your period. Stopping your period slows the growth of endometrial tissue and reduces painful symptoms.

If medication isn’t enough, then surgery can remove endometrial implants and scar tissue. Surgery can provide significant pain relief and improve your chances of getting pregnant.

For women struggling with infertility, technologies like in vitro fertilization (IVF) can be helpful. IVF can increase the chance of pregnancy because it eliminates issues like Fallopian tubes filled with scar tissue. However, IVF is an expensive option.

Work with your doctor to use a combination of approaches to achieve the best results. Along with medical treatments, habit changes like regular exercise, a healthy diet, and stress management can also support your health and symptom management.

CAN YOU GET SSD BENEFITS FOR ENDOMETRIOSIS?

Endometriosis is not on SSA’s list of conditions that qualify for SSD benefits. However, even if there is no listing for endometriosis, you can still win benefits.  You can win by proving that your symptoms impact your residual functional capacity (RFC). Your RFC is a description of what you can physically do during the course of an eight hour work day.

In terms of physical limits, the SSA uses your medical records to define your ability to sit, stand, walk, and lift, during the course of an 8 hour day at work. Likewise, the SSA will include your ability to carry, pull, and push. In terms of mental limits, the SSA will consider any memory and concentration issues. Likewise, they will consider your pain level and how it impacts your ability to follow instructions. Find out more about how the SSA defines work.

In order to define your physical RFC, the SSA will examine your medical records. They will take into account what your doctor says about your ability to work. Additionally, the SSA has their own doctors review your medical records and make statements about your RFC. Unfortunately, even though these doctors will never meet or examine you, their opinion may carry more weight for the judge than your own doctor.

The SSA will also consider descriptions of your symptoms from your family and friends. Find out more information about what types of evidence the SSA must consider. For example, your family or friends could write a statement how your pain symptoms impact your energy level. Find out more about how your RFC and the GRID rules can help you win SSD benefits.

ENDOMETRIOSIS QUALIFIES FOR SSDI BENEFITS

The SSA doctors work for DDS, the state agency who reviews all cases. The SSA will take the medical opinion of their own doctors into account. If the SSA needs more information, then they may send you to a medical exam. Learn more here about what to expect at SSA’s doctor exam.

If your endometriosis symptoms limit you so much that you can no longer do your job, then the SSA will determine if there is any other job you can do. In addition to your medical records, the SSA will consider your age, education, work experience and job skills, and your physical and mental abilities. The older you are, the more likely it is that you will win SSD benefits. Because if you are over 50 years old, the SSA does not expect you to go back to school or obtain a job that requires you to learn new job skills.

To help in the five step SSA review process, the SSA will use the “GRID rules.” The GRID rules are a framework that takes into account your age, education, work experience, and RFC. When the SSA applies the GRID rules to your case, it can help them determine whether you can adjust to other types of work. For example, if you are over 50, then the SSA will determine whether you have skills from your past job that transfer to other work. As you age, your skills and education may no longer help you get a new job. Learn more about the GRID rules and winning SSD benefits.

DOES SSA CONSIDER THE EFFECTS OF TREATMENT ON YOUR ABILITY TO WORK?

When they define your ability to work, the SSA considers the effects of your treatment for endometriosis. Because treatment can cause severe symptoms. For example, the SSA will consider the effects of the drugs you are taking for pain. The SSA will request a description of the problems or adverse effects of the medications from your doctor. Learn more about how the SSA evaluates pain.

Additionally, they will review your medical records to find out whether you are having pelvic symptoms, pain and fatigue . They will also look at whether or not you are experiencing mental illness, like anxiety. Many people suffer from mood swings, anxiety, and other mental issues, when they have endometriosis.

Likewise, the SSA will consider the impact of surgery. Many women have surgery to help their pain symptoms or to try to get pregnant. The SSA will consider whether surgery keeps you from working.

To determine the adverse effects of treatment, the SSA will allow enough time must pass to see the treatment result. The SSA believes the effects of treatment are temporary in most instances. However, the effects of treatment may keep you from working for a period of at least 12 months in a row.  In those situations, the SSA may determine that your medical condition prevents you from working for over one year. If so, then the SSA should pay you SSD benefits.

HOW TO APPLY FOR SSDI BENEFITS IF YOU HAVE ENDOMETRIOSIS

If you cannot work due to endometriosis, then apply for Social Security Disability Insurance (SSDI) benefits. This is a benefit that pays a portion of your former monthly income, because you are unable to work due to illness. To apply, you must submit an application to the Social Security Administration. You can apply online on the Social Security’s website. Next, you will need to submit medical evidence to the SSA that proves you cannot work for at least one year. This evidence should be from your treating doctor.

Another option is filing for Supplemental Security Income (SSI) benefits. The SSI program provides benefits based on financial need. Therefore, you can qualify for benefits even if you have no work experience. The SSA will look at your income and assets and decide if you qualify for SSI benefits. Next, they will look at your work credits to see if you qualify for SSDI benefits. If the amount of your SSDI benefits are below $943, then you may qualify for concurrent benefits.

The easiest way to file for benefits is online on Social Security’s website. However, you can also apply by phone by calling Social Security at 800-722-1213. Or, you can apply in person at your local Social Security office.

Filing an application for benefits in person will usually involve a long wait in line. But, if you want to meet with the SSA in person, then this is your only option. Try to call and make an appointment at your local SSA office before you go in and wait in line.

Winning SSD benefits can be a difficult battle, but you don’t have to fight the battle alone. Hire our law firm with no money up front to help you win SSD benefits.

GIVE A COPY OF YOUR MEDICAL RECORDS TO YOUR SSD LAWYER

Having a copy of your medical records helps the SSA understand your endometriosis and any other medical conditions. If you don’t send them a copy of your medical records, then they will have to request them. We suggest you request a copy of your progress notes every time you visit the doctor.  You should be gathering these records as your case goes through the appeal process, because it is wise to have a copy of all of your medical records.

Please also remember that the SSA and your attorney are not automatically aware of every time you visit a doctor, counselor, or hospital.  You are responsible for giving that information to the SSA and to your attorney.

Unfortunately, attorneys aren’t mind readers. They need your help to collect your records.  Make sure you provide your attorney with a copy of your full medical record or a list of all of your doctors. This list should include counselors, programs, ER visits, and any mental or physical testing.

Also, you will need a copy of everything that is in your SSA file and any records you gave to the judge before your hearing. It can be very expensive for your attorney to obtain medical records for you.  If you already have a copy of your records, then you avoid that expense by giving your records to your lawyer.  Additionally, it is helpful because your file will be complete when the time comes for your hearing.

When you speak to your attorney, you should also include the address, phone number, and fax number of your doctor. Without a complete copy of your entire medical record, you cannot prove you deserve SSD benefits.

IS IT WORTH THE ATTORNEY FEE TO HIRE AN SSD LAWYER?

It isn’t easy to get Social Security benefits and the application process can be frustrating for most people. But, having an attorney throughout the review process can help. It is our belief that when you have a law firm with experience handling your Social Security case, the SSA makes sure that they follow their own procedures.

Additionally, when you have an attorney with legal experience, they will have access to Social Security’s decisions. They can also submit medical evidence that may be missing from your case. Also, your attorney can work with your doctor to obtain the medical evidence you need to win your SSDI and SSI benefits.

There is evidence that hiring an attorney with the proper experience raises your chances of winning your SSD benefits by 30%. It is also smart to hire an attorney to help you at your hearing. After all, you are the star witness at your hearing. If you hire an attorney with experience, then they can prepare you to testify. Learn about how to prepare for your hearing.

Another thing your attorney can do is help you obtain the medical records you need to win your benefits. Medical records are the most important evidence in your SSD case. They are even more important than your hearing testimony. There are specific forms that your doctor can fill out to help your case. We provide those forms to our clients, so that they can give them to their doctor. Also, we encourage our clients to have regular visits and treatment with a supportive doctor. Learn about how to collect your medical records for your SSD case.

YOU ONLY PAY ATTORNEY FEES IF YOU WIN YOUR BENEFITS

The SSA has capped attorney fees in Social Security cases at 25% of your past due or back benefit or $7200, which ever amount is less. This is the most your attorney can charge when they win your case. Your lawyer cannot charge an attorney fee if you do not win benefits.

For example, if your attorney wins your SSDI case and your back benefit is $10,000, then the attorney fee will be 25% of the back benefit, or $2500. In such a case, you would not pay the $7200 cap. Instead, the attorney fee is 25% of the back benefit, which is less than the cap. This is what happens in most SSDI and SSI cases.

In another example, if you attorney wins your SSDI case and your back benefit is $100,000, the attorney fee is not $25,000, which is 25% of the back benefit. Instead, the attorney fee would be $7200. Because $7200 is the most your attorney can charge you after winning your case at the hearing level or below. That is true even if 25% is higher than the $7200 cap on attorney fees.

Additionally, your attorney can only charge an attorney fee if they win your case. In other words, if you do not win your benefits, then you do not pay an attorney fee. This means that your attorney has worked for up to two years on your case for free. So, if you don’t win benefits, then your attorney doesn’t get paid. Obviously, your attorney has a good reason to win your case.

WHAT WE DO TO HELP YOU WIN SSD & SSI BENEFITS 

You do not need to try to win benefits for endometriosis on your own. Our law firm can help file your application for SSD benefits. Also, we can help you file an appeal after every SSA denial. That way, you can focus on your health. Our attorneys and staff can:

If you file your application for benefits online at Social Security’s website, then you have 6 months to complete it. It is wise not to take that long. Once you submit your application online, the SSA sends you an application summary in the mail. You must sign the summary and mail it back. Otherwise, they will not process your application.

HOW OUR LAW FIRM HELPS YOU WIN SSD BENEFITS

The SSA benefits application and appeal process can be long and complex. If you have endometriosis, then worrying about SSD benefits is the last thing you want to do. Contact our law firm to give you legal advice and walk you through the application process.

If you want to learn more about our lawyers and staff, then read our About Us page. For example, you can learn about Andria Summers, who has over 22 years of experience working at our law firm. She can also help you with your Medicare advantage plan.

Dianna Cannon has been helping her clients win benefits for over thirty years. Ms. Cannon has years of Federal Court experience. She has also taught law school and written a book on SSDI benefits. Brett Bunkall also has years of legal experience helping people obtain their SSI and SSD benefits.

Together, over the last 30 years, we have won over 20,000 SSDI and SSI cases. Additionally, we have won over $100 million in ongoing and past due SSD benefits for our clients. Many of our clients, due to our work, do not have to attend a hearing. Instead, they win their case at an earlier level of appeal.

Make sure that you hire an attorney with the experience to win your benefits. Too much is at stake to attempt to win benefits on your own. We are Social Security law experts. You can trust us to help you win your benefits for endometriosis. We want to make the difficult process of winning SSD benefits as easy as possible for you. For help, contact us today.

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