By Angela

Request for Part-Time Work

(Note: Events are real, names have been changed, and photos are not real professionals described in the story.)

In November 2007, Angela received the staggering news regarding the jury’s award which did not cover the legal fees. This meant that she did not receive any money at all. There was no money to cover past, present or future medical costs. No money to cover her monthly expenses just to get by. No money to help her with her every day living challenges resulting from the accident.

As she slowly recovered from feelings of distress and hopelessness, her advocate, Estelle engaged her and people in her support network in some problem-solving. Angela knew of a person at Cantor School District who had been on disability and was allowed to work, so she and Estelle began to explore if she might be able to work part-time. Estelle called SERS who in turn sent Angela a letter saying that she needed to obtain approval to work from them. They stated: “Disability retirees are permitted to work while receiving disability, with SERS’ approval; however, employment is restricted as follows:

· seeking employment in any school system within the state where I had worked,

· taking a position that is similar to the one you held with the school system,

· taking a position that is conflictive with the medical basis in which disability was granted, and

· if disability benefit includes service credit from STRS/PERS, seeking employment that is covered under their system.”

Fortunately, one of the people in Angela’s support network who was familiar with her situation and challenges offered her part-time work. The job would involve working from her home 10 hrs./week providing assistance in the form of coming up with ideas for web pages, videos and web marketing regarding brain injury. In January 2008, she submitted the required information to SERS for their approval: name of employer, contact person, contact phone number, number of hours working per week, and a brief job description.

At the end of the month, she received a letter from SERS rejecting her employment request stating: “After review of this request, we find that the duties required for this position would conflict with your disability. Disability retirees are permitted to work while receiving disability, with SERS’ approval; however, employment is restricted as follows… They list the information above and underline “taking a position that is similar to the one you held with the school system.”

This letter was a surprise and difficult to understand in terms of their reasons for rejecting the request. Just how would this job conflict with her disability when it contained necessary accommodations for her medical challenges? And how could helping someone by coming up with ideas for web pages and such which were not related to early childhood/parent education be too similar to her school position as a program coordinator/parent education specialist?

At her next appointment with her psychiatrist, Dr. Pemberton, Angela asked what SERS had listed as the medical basis of her disability. In the report from the SERS psychiatrist, Dr. Knutman, he had listed “Depression.” In a space which asked what measures could be taken to speed recovery, he had written “In litigation.” Litigation was finished and Angela was still no better. In Knutman’s review of her medical records, he did not review any of the additional medical documentation she and Estelle had taken during her 2007 re-evaluation from her neurologist, oto-neurologist, or neuropsychologist which detailed difficulties she was having from her brain injury and problems from her damaged vertebrobasilar artery. How could SERS and their doctors simply ignore this information and choose “depression” as the only medical basis of her disability?

Estelle phoned SERS and spoke with them regarding their assertion that this part-time job offer was too similar to her school job. They said Angela had written a newsletter as part of her job and, therefore, it would be similar. She told them that Angela was a program coordinator and had more duties than just a newsletter. Their obvious lack of understanding was abundantly apparent when they asked, “Is it like a teacher’s assistant?” After Estelle tried to explain the duties required in her previous work, they said to re-submit the application and describe how the proposed job differed from the one previously held with the school district. The following was submitted in addition to her job description:

Differences between the 2 Jobs

· Proposed job is up to 10 hrs/week not 40 hrs.

· Proposed job has nothing to do with parent education/early childhood education.

· Proposed job does not entail supervising other staff or multi-tasking.

· Proposed job can be done from the home and would not entail driving thus making accommodations for difficulties and dangers related to driving.

· Proposed job can be done at a slower pace to make accommodations for problems with slow processing speed due to brain damage. Also can rest as needed when experiencing migraine, neck & shoulder pain, fatigue, vertigo, etc.

· Proposed job entails assisting in the form of sharing ideas and/or doing some writing. Does not involve being responsible for producing something as a complete finished product.

· Proposed job does not entail lifting, transporting materials from one location to another, doing a lot of walking and moving around (making accommodations for problems with balance, gait, vertebrobasilar insufficiency), doing work-related activities in environments which are have too much visual and auditory stimulation.

At the end of February, SERS once again denied her employment request stating: “We are in receipt of additional information regarding your previous request for employment. After review of the additional information, we find that the duties required for this position would conflict with your disability. Disability retirees are permitted to work while receiving disability, with SERS’ approval; however, employment is restricted as follows:

· seeking employment in any school system within the state of Ohio

· taking a position that is similar to the one you held with the school system

· taking a position that is conflictive with the medical basis in which disability was granted

· if disability benefit includes service credit from STRS/PERS, seeking employment that is covered under their system.”

Sometimes Angela had difficulty understanding things because of her brain injury. This time, it wasn’t just her. Other “normal” people couldn’t make sense of SERS’ decision. In March 2008, Estelle phoned and asked them to explain their rational behind their denial. They said they would phone Angela and speak with her.

When a Miss Hawthorne from SERS phoned, Angela told them she didn’t understand how this proposed job conflicted with her disability. The woman said something about the fact that the proposed job would require computer work and looking up research and that since Angela used a computer in her job with the school district, the proposed job was too similar. She didn’t specifically tell her how this job would conflict with her disability. Perhaps there was something about using a computer and looking up articles that conflicts with depression since that was the only problem they acknowledged, but this has yet to be explained.

The one thing that could be said for Estelle, was that she could not stand to see injustices done to people, especially to her clients, people with disabilities. First, she wrote the following letter and sent it to SERS. Then, determined to find some kind of assistance with this matter, she contacted the state Office of Legal Rights.

March 18, 2008

To Whom It May Concern:

I’m writing to again ask you to reconsider your decision to deny Ms. Cramer the opportunity to work for a brain injury attorney in a part time capacity.

Ms. Cramer’s initial request to take this position was denied on the basis of the work being “too similar” that which she performed when working for Cantor School District. When I called to inquire on what basis that decision was made, Ms. Hawthorne informed me that because she’d printed a newsletter in her former job, the proposed job (conducting limited research regarding brain injury websites and support groups) the committee thought the jobs were similar. She requested we submit detail regarding how Ms. Cramer’s former and proposed jobs differ, which we did in February, 2008. Her request was again denied, this time based on the committee’s opinion that the proposed job would be contraindicated by her disabling condition.

Please consider the following facts again in relation to Ms. Cramer’s proposed job:

1. Her job with the school system and her proposed job are in very few ways alike. Aside from working on a computer, I can find no similarities between the two positions. The topics are different, the demands (cognitively, emotionally and physically) are different, and the hours and specific tasks are vastly different, all of which is readily apparent when reviewing the material we’ve already submitted.

2. Despite SERS’s insistence that she is “depressed,” Ms. Cramer suffers from many common symptoms associated with traumatic brain injury. She has vast medical documentation that supports this diagnosis. As such, it’s virtually impossible for her to take a job outside of her home. She experiences ready over stimulation leading to confusion, disorientation, balance difficulties, speech disruptions, and migraines. She’s unable to drive long distances or frequently. If she were placed in a community oriented job, she would last approximately 15 minutes before shutting down in a manner that is consistent with someone who has suffered a brain injury. She’s simply unable to work in any environment that is the least bit noisy, full of visual distraction, or that demands even minimal social interaction. A job working at home for two hours a day (scheduled when she’s feeling well) to me represents little in the way of being “conflictive with the medical basis in (for?) which the disability was granted.” The proposed job actually represents one of the only ways that Ms. Cramer can re-enter the workforce at this time.

3. Even if (as SERS contends) Ms. Cramer’s disabling condition is “depression”, the proposed job is still not “conflictive with the medical basis in which the disability was granted”. Ms. Cramer IS depressed: Who wouldn’t be after facing such life altering circumstances? Working in the job she proposes would actually do her a world of good in terms of alleviating depression. She longs to contribute in ways she formerly did through work. Working from home for two hours a day is a way she can use her creativity, passion for helping others, and limited cognitive energy to benefit others. Since becoming disabled, she has struggled with feelings of being “worthless” and a burden to others. Please allow her this opportunity to contribute to her community again in a way she can actually manage.

4. This is a job tailor made for Ms. Cramer because she can accomplish its objective in ways that will be genuinely helpful to her employer. She also needs the money. She’s still in danger of losing her home because she can’t manage her monthly bills on disability income. While I know that’s not your problem, it does lend urgency to your reviewing this request again. If she can’t work, she’s headed to a nursing home for long term care (at the age of 48). In her mind, THIS is the option that is contraindicated, given your contention that she’s “depressed.”

5. You’ve provided us very little information regarding why you’ve decided how you have. Your decisions, frankly, seem capricious and arbitrary and are not in any way understandably explained. If you cannot see a way to grant Ms. Cramer the opportunity to become employed in the proposed job, perhaps you could provide us with ideas of what sorts of jobs would be allowed, according to your rules. Clearly, we have a difference of opinion regarding what constitutes “similar jobs” and “contraindication,” so perhaps you could provide us with examples of jobs that you would find suitable for Angela given her current medical status. This would at least give us some clue regarding what you would regard suitable and allowable.

6. Each of Angela’s medical providers agree that this job is something she can manage and at which she can excel. All are in agreement that the proposed job is not contraindicated given either her medical or psychiatric status. We can provide letters of support from such providers if it would help Ms. Cramer’s case.

We look forward to hearing from you regarding this further appeal,

Estelle A. Corbin, Ph.D.

Executive Director

Creative Solutions

Estelle was able to find a lawyer with the Office of Legal Rights willing to help Angela. The lawyer sent documentation of her official job description from Cantor School District as well as a letter from her psychiatrist, Dr. Pemberton, which is listed below:

May 18, 2008

To Whom It May Concern:

It is her understanding that if Ms. Cramer accepts a part-time position which was recently offered to her, SERS (School Employees Retirement System) would likely terminate her disability benefits. I am hoping to provide information in hopes of convincing SERS to reverse their decision.

As I am sure your knowledge of Ms. Cramer would indicate, she as been unemployable since an auto accident in July of 2004 which resulted in permanent functional impairments. In the early part of 2005, I became involved with Ms. Cramer providing psychiatric psychopharmacological and supportive care in collaboration with her individual therapist. I have also collaborated with several of Ms. Cramer’s ongoing health care providers and I have tried to integrate the findings of numerous neurological, neuropsychological, vocational, physical medicine, occupational therapy evaluation, and have tried to provide Ms. Cramer with crisis support to the numerous tragic issues of her loss of her previous occupational abilities due to her traumatic brain injury and its subsequent numerous cognitive, emotional and physical sequela.

In addition to this, I have had the opportunity to integrate into her understanding of Ms. Cramer’s neuropsychological presentation the results of very helpful evaluatory insights made available by Dr. Nelson Harvey, a neuropsychologist.

Ms. Cramer’s history is well known and consists of the fact that prior to her disability beginning in 2004, she had been employed for 12 years as a masters level trained coordinator of a preschool program that monitored the development of preschool children in an extremely large school system. This job required her to be highly mobile and to be highly flexible working in numerous locations. This employment also required her to demonstrate high levels of personal organizational skills, to be highly flexible, to display substantial levels of stamina, and as she worked to multi-task by doing simultaneous public relations. At this time, the complications of Ms. Cramer’s traumatic brain injury includes difficulty completing daily living tasks, pain syndromes to her neck and back, intermittent slowed and praxic speech, episodic migraine headaches, coordination and balance problems, labiality and easily being overwhelmed, hyper-reactivity and flooding to auditory and visual stimuli, an episodic tremor, episodic blurred vision, substantial cognitive and physical fatigue, intermittent weakness on the left side of her body, short-term memory problems, decreased mental speed and efficiency, emotional labiality, major depressive symptoms, marginal abilities to live independently, and moderate social isolation.

I understand that the position that has been offered to her is one that would not require Ms. Cramer to leave her home. The essence of this position, I understand, would require her to function as a copy editor who would proofread blogs and monitor news developments. Of crucial importance, her “hours are totally flexible.”

Since, at this time, it is clearly not possible for Ms. Cramer to participate even in a minimal part-time position outside her home, I fail to under the logic of the School Employees Retirement System’s threat to terminate her benefits if she would accept this minimal part-time position that does not require her to leave her home because of her traumatic brain injury induced deficits. This potential position does not require her to work in multiple locations. The content of her work is not a focus on child development or the problems of early childhood or primary education. The job requirements have nothing to do with the assessment of developmental accomplishments in preschool children and, most importantly, make it possible for her to work as she is capable and rest if fatigued, which makes it possible for her to the complications of cognitive fatigue which escalate her physical difficulties. Most importantly, this opportunity would elevate her very low sense of personal efficacy which would help lessen her sense of helplessness which would then decrease her personal sense of failure which exacerbates her depression and exacerbates suicidal ideations.

Sincerely,

H. Pemberton, M.D.

Diplomate American Board of Psychiatry & Neurology

Angela was contacted by the lawyer saying that he was told by SERS that she could choose to work if she wanted to. If she did so without SERS’ permission, however, she would likely be more closely scrutinized. Although Angela needed the additional money to meet her monthly expenses, she could not afford to jeopardize her disability payments. In spite of choosing not to work, she was notified by SERS in June that she was to be evaluated by a neuropsychologist, a neurologist, and psychiatrist.

—————————

By January 2009, Angela still had not heard the determination of her disability status resulting from the re-evaluations done in 2008. She wondered if she had received the results in the mail and misplaced the letter telling her she had 60 days to sign the acknowledgement that usually accompanied SERS correspondence. She panicked thinking that maybe she had received something and 60 days had passed.

She asked Estelle if she would call SERS. Angela hated talking on the phone in situations like these. Though she could write things in an organized, well-thought out fashion, organizing her thoughts and communicating them verbally was a different matter. When she wrote things, she could take all the time she needed and juggle them around on the computer until it looked right. Conversations on the phone or in person happened too quickly. She couldn’t put her thoughts in front of her to see what she was thinking and juggle them around until they made sense.

Towards the end of January, Angela received a call from Mrs. Leadbeater with SERS saying that she had received a call from Estelle Corbin asking about the permission to work issue. She said that she would not return her call because she did not want to break attorney-client confidentiality. “But I’ve given my permission for Estelle to call on my behalf several times,” said Angela, confused about why this was an issue since Estelle was her case manager/advocate.

Mrs. Leadbeater continued with her unimpressed manner, “I thought all of this was resolved last summer.” She paused for Angela’s response. “Well, did your attorney talk to you? What did he say?” she demanded.

This is precisely why Angela hated talking on the phone to these kind of people. She tried to recall what her lawyer had said. That was so long ago. She tried to remember what she could, pull it all together and organize her thoughts. She came out with “Well, he said that first you said I had to have permission, and then you changed your mind and said I didn’t.”

With a bit of a huff in her voice, she responded, “I didn’t change my mind; we changed our policy. Every March or April, we will send out a questionnaire asking whether you have worked or not the previous year. Depending upon that, we may decide to evaluate a person more closely.”

“You already evaluate me every year,” said Angela confused about how they might evaluate her any more than they already were.

“Yes, we do for people like you, but we don’t evaluate everyone every year,” replied Mrs. Leadbeater. “Some people we evaluate every 2 years.” She asked if there was some other reason why Estelle had called them.

Angela explained that it had been a long time since she had gone through their evaluations and wasn’t sure if they had sent a letter about the determination. She thought perhaps she had misplaced it.

“Oh, no, you’re fine, dear,” said Leadbeater in a sugary sweet voice. “We haven’t made a determination yet.”

After hanging up, Angela immediately called Estelle to tell her about the phone call. While Angela was under the impression that SERS had refused to speak to Estelle, they had in fact told her that Angela’s disability status was to be reviewed at the February board meeting. Estelle said that while she was asking about the disability status, she also decided to ask for a meeting before the board to ask them to change the medical basis of Angela’s disability, as well as revisit the permission to accept last year’s job offer if it was still available.

Estelle reminded Angela that it wasn’t until Estelle had contacted an organization made up of retired school employees and had told them about what SERS was doing with Angela’s case, that SERS suddenly changed what they had been saying about needing SERS approval. They said that Angela was free to do any kind of work she wanted to, but needed to realize that would open her up for re-evaluations. It was Estelle’s understanding that there would be less cause for concern if she did have approval from SERS.

The truth of the matter to realize when dealing with SERS is that nothing is ever in writing, and they seem to change their minds upon a whim. And, it will ALWAYS be to their advantage.

© Angela Cramer, 2008-2009

Clipart and photos are the property of Jupiterimages made available through subscription:
© Jupiterimages Corporation, 2008-2009 www.clipart.com


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