1

Fully disclose all your symptoms and limitations.

I advise all my clients to fully disclose all symptoms and limitations, whether talking to the doctor or the assistant (who likely spends more time with you and has better handwriting!). Ideally, I want anything to which you would testify in a hearing to be found in the medical evidence. It is much more difficult for a judge to discredit your testimony if there is supporting medical documentation. You are the only person who can impact reported symptoms and limitations. It is even more vital that you report everything if you have limited insurance coverage or can only see the doctor once every few months. Taking advantage of every appointment to fill the record with your description of your symptoms and limitations gives your doctor a much better basis upon which to provide a professional opinion of your ability (or inability) to work.

2

What are symptoms?

Just to be clear, there are many different symptoms you can report of which you may not be aware. Here are some examples: Pain; nausea; vomiting; diarrhea; weight loss/gain; stiffness; headaches; increased/decreased appetite; constipation; frequent urination; trouble falling/staying asleep; irritability; mood swings; general malaise; fatigue; drowsiness; anxiety; depression; panic attacks; paranoia; auditory/visual hallucinations; tremors; slurred speech; stuttering; ringing in the ears; racing heart; shortness of breath; dizziness; lightheadedness; swelling; weakness; restlessness; crying; withdrawal; trouble staying awake; loss of interests; easily angered; physical/verbal aggression; cough; sore throat; black-outs; near-fainting; itchiness; redness; congestion; limited range of motion; lack of concentration or focus; confusion; forgetfulness; and many, many more.

3

Frequency, Intensity and Duration of Symptoms

The frequency, intensity and duration of your symptoms says a lot about the severity of your condition. Frequency: Experiencing back pain once every two weeks isn't as severe as daily pain. For conditions such as asthma or epilepsy, the frequency of attacks or seizures is the key factor: 4 petit mal seizures in a month isn't disabling, but 5 is. Intensity: Mild symptoms are much more tolerable than extreme symptoms, which means your ability to work isn't as restricted. Experiencing mild pain daily isn't as limiting as experiencing moderate to extreme pain 2-3 times week. Duration: The longer your symptoms last the more impact they have on your ability to work. Migraine headaches that last 4 - 6 hours clearly have a greater impact than those that last 15 - 20 minutes.

4

Medications and Side Effects

Tell your doctor if the medications that are being prescribed are relieving your symptoms and to what degree. It is also very important to report any side effects of the medications that may impact your ability to work as well. For example, your pain reliever may significantly reduce your pain, but if it causes extreme sleepiness requiring regular naps, you're no more able to sustain work than without the medication.

5

What triggers your symptoms?

Specific activities or circumstances that trigger the onset of your symptoms are an indicator of restrictions on your ability to work. If your back hurts after lifting heavy objects, you would only be restricted from lifting heavy objects. But if your back hurts even with only limited activity, your restrictions would be much broader and have a much greater impact on your ability to work.

6

What relieves your symptoms?

Specific activities and circumstances that relieve your symptoms are also an indicator of restrictions on your ability to work. The need to alternate between sitting and standing due to back pain would eliminate work that requires you to be on your feet for extended periods of time. If you must regularly elevate your feet to at least waist level due to swelling ankles, the types of work you could sustain would be very limited.

7

Sustainability and the cumulative effect

Although you may be able to make it through a full day of work or even a few weeks, the cumulative effect of your activity may make it impossible for you to sustain working on a regular and full-time basis. If you could work through the back pain for 2 full days but then required a full day to recuperate, you would likely not be able to continue working for very long. Similarly, if during your manic episodes of bipolar you're able to maintain a set schedule with high energy but during your depressive episodes you can't even get out of bed most days, you wouldn't be able to maintain a consistent work schedule.