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Anonymous
Please please help

Hello I need help with my function report adult form. I filled it out, but needed an additional page due to needing more room. Does this look okay, or is to much. Please help. I was told this is the time for them to see your real issues.

Function report- Adult

Section B-Information about your illness, injuries, or conditions
5. How do your illnesses, injuries, or conditions limit your ability to work?
Due to my fibromyalgia my muscles and nerves hurt all the time. I am extremely tired and have no energy at all. I have to take several naps. My muscles are stiffed and my body aches, as if I have flu like symptom’s all the time. I have major headaches, and have recently been diagnosed with migraines. My eyes are always blurry and watery and due to this I am always depressed and moody. My fibro flare ups upset my stomach, in which flare up my H.plyori. I have tested positive again for H.ployri ones again. My stomach pains cause me to curl up like a baby, and just cry. I have memory issues, such as remembering to take my meds, get lost, forget where I parked- lose my debit, and visa cards. I have rib pains, and feel as if I am being hugged by a bear. There are days I just can’t breathe and feel that I am having a heart attack. I can’t sit for more than 30 minutes at a time, as my nerves and muscle hurt so bad. All these pains cause me so much anger and depression.
I am on Fibromyalgia meds, which are Escitalopram Oxalate 10 MG three times a day. This medicine causes me to have rashes, headaches, blurry vision, dry mouth and upset stomach. I also will state this meds gave me suicidal thoughts. Due to this reasons, I have recently been prescribed something else-“Amitriptyline HCL 25 mg. Right now it’s been a little over 5+ days that I have been on this, and am not likely the feeling to this meds as well. I am having continuances bowel movement and still major headaches. The meds seem to hurt more than help, but at this point I am desperate for some pain reliever. Because I have a history of H.ployri (ulcer infections) I have to be very careful as to what types of meds I take.
My PTSD which is from prior sexual, psychical and mental abuse has made my life a NIGHTMARE. I come from a history of sexual abuse by my uncle (this is when I was only 5). I then grew up with a very strict (cultural Hindu father) that treated me as his personal punching back. I was beaten as a child to the point where I was locked into the closest and starved as a punishment. My mother was beaten on a daily bases, and we were all on pins and needles with my father. After many years of psychical abuse, and the threat of being forced to an arranged marriage at the age of 16 I tried to commit suicide. I stopped and thought about it and that night I ran away from home. Due to my running away, I was homeless. At the age of 17 I was raped by an unknown party and became pregnant. I choose to keep this child (the child of my rapist) and never disclosed to anyone(not even as of today) how my child came about. Shortly before delivering my child I married, and kept the secret that my child is of a rapist. I have ever since then lived a secret and even today my own flesh and blood has no idea how she has come about. I am always scared- scared my rapist is looking for me, and will find me. Will he attack me again, and living this nightmare over and over is killing me. I am living a nightmare that is killing me mentally. I relive this event on a daily bases, and have constant flashbacks. Due to this my self-esteem is very low, I have no interest in life, I have negative feelings, I have no hope, I have a hard time holding on to relationship, holding on to jobs, and keeping a relationship with friends and family. I fear that I have AIDs, and have had over 30+ HIV test (due to me being raped years ago), but I can’t get over it. I am paranoid. My PTSD causes me so much anxiety. My anxiety causes me upset stomach, such as I live on an elevator, as my stomach is always up and down up and down. I have so much anger and just blow up so easily. I am always on guard as I never know something bad will happen to me. I can’t sleep (during normal hours) and am very easily freighted. Due to all this anxiety, I am now *picking* my skin to the point I caused scars (quarter size hole) in my face. I don’t’ understand how or why this picking would help me, but it takes my mind to a different place. My picking has gotten so bad that in May of 2013 I went in and saw a dermologist(Susan Denman) in which I cried for help. I told her that I am picking my skin, and needed help. In return she asked me to see a psychologist as things were getting so bad for me and I threated suicide.
I then went in and started counseling, and now along with PTSD I have been diagnosed with “borderline personality” and my doctor believes my picking is related to my PTSD and borderline. My anger has gotten so bad that I have been in so many escalated situations (fighting with loved ones, and strangers) that I don’t’ know when I am going to “lose it”. I feel my life is a pressure cooker. My picking is so severe that I have had to have major cosmetic work done. Due to my picking I have become very suicidal. I don’t do any shopping, and choose to stay home all by myself. I am not able to relate to people, and feel everyone is out to get me. My mind is always racing, and heart is always pounding. I have disfigured my face and now I am severely depressed on how I look. I am so depressed that I have missed out on my daughters graduation, my sons school event’s, my brothers baby shower, my cousins wedding, and my uncles funeral. How can I show my disfigured face? I have to be in certain lighting, and always think everyone is judging me. When I pick I pick for hours and hours. I use tweezers for my picking and have caused so much scars on my face. My stomach is always in a knot, so I go hours, even days without eating, but when I eat I binge eat. I am not sure what is causing me to gain weight- is it the meds, or my depression as I can go on for days without eating. Due to my PTSD, Depressions, anxiety, and Borderline I am on these meds.
Alprazolam 0.25mg -3 times a day. This meds makes me dizzy, sleeping, nauseous, and dry mouth. I also have speeding thoughts with this meds, but since I am on so many meds, it’s hard to pin point which one is doing this. I am feeling down when I am on this meds, but have been informed I must continue to take, or things can get way worse for me. I am always sleeping, so I usually can take up to 5 naps a day. I am always dizzy and tired therefore I am not able to operate my car.
Lamotrigine 100mg- 1 time daily- this meds me dizzy, and blurry vison, and very sleepy. This meds makes me so sleepy. I am so tired that I need to nap all the time. At least 5 naps a day are required. I have gained 15 pounds, so major weight gain.

I have severe headaches to the point there was a limp found on my right side of the temple. I recently had a MRI done to rule out cancer, and my doctors states I have migraines. My migraine headaches causes me to have throbbing headaches, pain in the eye socket, neck pain, nauseous, vomiting, scalp pains, and vertigo. I am not able to look at the computer, light, tv, books, articles or anything. I need to close my eyes, lay down and stay in a dark quiet room. The headaches can last up to several days.
I am on two meds for my headaches
Amitriptyline HCL 25-1 times a day. This meds make me very drowsy (again I am on 4 others meds, so unclear which one to really pin point out).

Sumatripan Succinate 25 mg- this meds are very good, but gives me dry mouth, upset stomach, and blurry vision.
Due to all my mental and psychical conditions I am on 5 different meds. 5 meds all at the same time. I am always tired, and need to nap several times a day. I am not able to drive myself, my child, or anyone else, as I never know when I might fall asleep while driving. I am always in pain, and due to my depression I have no care to dress, put make up on and do anything as my life, and future seems hopeless. But I need my meds, as I am scared what might happen if I stop taking these meds. I can’t bare the pain of my fibromoyia, which make my nerve’s twitch. Even though this meds are somewhat of a help, they make me very helpless and tired. I am not productive, and always tired, sleeping, and depressed. I always forget things, and even get lost. When I use to drive I would forget where I parked, and would request for security guards to find my car. I forget to pay bills, which has upset my husband so badly that I no longer pay bills, or do any managing of our funds. Due to my confusions I have had NSF on our bank accounts, when that didn't need to happen.

Date
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Address City –State- Zip Code
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Name of person tying (completing) this form
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Hi there,

Hi there,
I am so sorry to hear about all of your troubles. I think that this is a very convincing way to fill out your additional information form. I do have a couple of thoughts and suggestions however.
For every issue that you have, I would note how it affects your daily living. You do a very good job of this for the most part, but I would double-check and be sure that there is always a limiting reason for mentioning the disability or mental illness. For example, when you talk about how you were raped and have become anxious, be sure to mention how that limits you. I would imagine that you're horrified and afraid to leave your house, making travel, working, shopping, etc (whatever personally limits you).
My other note would be to keep in mind that the more information you put in, the more likely the a judge will try to question you on how you're disabled if your claim goes to an ALJ hearing. You ABSOLUTELY want to put in a ton of information, but expect the judge to ask you questions about what you did for fun the last weekend, what you did the past evening, etc. If you say you went to a restaurant or something like that, which would contradict you saying you cannot go outside due to the picking, you would not be approved for benefits. I do not doubt that your anxiety is horrible at all, I just want you to keep in mind that the judge will try to catch you "slipping up." Very sad but true. Good luck with your claim!

Akin ireland
How do your illnesses,

How do your illnesses, injuries or conditions limit your ability to work?

Hi Akin,

Hi Akin,
Generally someone would not be able to perform the job functions necessary for work they have been doing, would be able to do, or could be trained to do.

Anonymous
Can sciatic nerve how would I

Can sciatic nerve how would I put that down

Hi There,

Hi There,

If you expect to be out of work for 12 months because of that, you could be able to qualify for SSDI benefits. https://www.disability-benefits-help.org/form/free-disability-evaluation

Emuly
How would I answer about my

How would I answer about my coronary heart disease and having diabetes.

Hi There,

Hi There,

You may be able to qualify with heart disease. You can fill out our Free Disability Evaluation to find out more: https://www.disability-benefits-help.org/form/free-disability-evaluation

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