Interviewer:  Good Day.  This is Brian Therrien.  It's my pleasure to have Jonathan Ginsburg with us today.  Jonathan, how are you?

Interviewee:  I'm doing fine, Brian. 

Interviewer:  Great.  I’m well.  I’m well.

Interviewee:  Good. 

Interviewer:  For those of you who don't know Jonathan, he is a very prominent attorney that lives and works in the Atlanta , Georgia area.  And the reason why I am excited to have him on the line today is he is one of the most successful people that are attorneys helping individuals get benefits.  Got a great percentage.  He’d been doing it for a long time.  Really understands the system.  So today, Jonathan is willing to spend some time with us to talk about disability, disability benefits specifically related to fibromyalgia.  So, I don't want to steal any of your thunder, but there are a lot of people that are out there affected by this.  It’s very difficult for people to understand and they find it difficult to get benefits.  So we’re just very eager to hear what you have to say.

Interviewee:  Absolutely.

Interviewer:  Great.  So, let's start at the top.  You have worked for around 10 years in the Social Security Disability area.  Correct?

Interviewee:  I have.

Interviewer:  Okay. And can you share with us your experience with fibromyalgia patients and, you know, disability claimants that you've had.  Are they getting benefits?  Are they being awarded benefits?  Is it recognized?  Let’s start with that.

Interviewee:  Yeah.  I think fibromyalgia is becoming more and more recognized.  Certainly, 10 years ago, it was less well known.  I think judges were less inclined to grant on fibromyalgia to recognize what it is.  I think for the last 10 years, as more and more press has been issued about fibromyalgia.  More people read about it, know about it.  Judges become more educated.  I think a lot of that and certainly the Social Security Area is because attorneys have brought more of these cases in front of judges and you know, when you see a case is once every three years.  That’s one thing.  But if you see, you start to see these cases, you know 5, 10, 15 a month then obviously the judges have to recognize that something is up.  So, I think that certainly at this point in time, you know we’re – recording this in 2006, fibromyalgia is pretty well recognized by most social security judges, at least that I have been in front of,  part of it unfinished all over Georgia and even in the states around it.  So I think it’s pretty well known situation.

Interviewer:  Well, good.  Here’s one of the common challenges that I hear from our members is, “I don't feel good.  I have no energy.  I'm in absolute pain but my doctor does not believe me and he won't fill out the paperwork.  What do I do?”

Interviewee:  What do I do?  Yeah, that’s a real issue because, just as judges have become more educated, you still have out there a lot of doctors who don't recognize fibromyalgia.  They don't believe that it exists.  It is very hard to test for.  It’s usually diagnosed as elimination which you found out when something is -- if somebody has certain conditions and they are -- certainly, there’s a checklist the doctors could use.  But, again, sometimes it’s misdiagnosed.  Again, some doctors think it is all psychological.  So, yes, you can have the situation where your doctor doesn’t believe you.  And what I would say at that point is as a patient, you cannot accept that the doctor -- the doctor doesn’t expect it and doesn’t believe in it,  I think you want to ask your doctor, “Do you believe this exists?”  If the doctor tells you “no”, then it's probably the time to get another doctor.  Ultimately in social security, you have to have support from your treating doctor.  And if you don't have support from your doctor, it's a major uphill battle, because social security -- you realized judges all day long see people coming in and saying, “I can't work.  I'm disabled.”  And if they accepted everybody’s word at face value, then they would all be approved.  So obviously they don’t do that.  So more and more I think especially since the numbers have increased.  As you know, the numbers are going up every month.  I think the Social Security judges, in particular,  are looking more and more for medical support for any type of allegation especially one like fibromyalgia which is depending on subjective evaluation.

Interviewer:  Great point.  So, doctor doesn’t believe you.  You ask him if he believes or her, if they believe.  And they believe in the condition in general, that would be the first up, right?  

Interviewee:  I think so.  I think I would add -- again, I think its part of a -- just a general discussion that one would have with his or her physician.  What is your take on fibromyalgia?  Do you believe that it exists?  Do you think it is a psychological impairment?  I mean, feel the doctor out.  What do you think?  Do you think it's physical?  Do you think it is on a cellular level?  Do you think it is a problem with energy transport?  What exactly do you think it is?  And, try to get a read on what the doctor thinks it is and what in his mind would make somebody or would leave somebody disable because of it.  Again, I think sometimes you have to really ask the question of the doctor, what his philosophy about this whole area is.  Because again, that’s how you find out whether this doctor’s going to be helpful to you.  Maybe very compassionate and a good doctor, someone you really like.  But again, if you have a -- if you’re applying for Social Security, you’ve got a mission, you’ve got a, you know, that’s your job now, is to find support for your allegation that you’re not able to work.  So, I think you need to be very forthright, don’t beat around the bush and then talk to your doctor to find out what he says.

Interviewer:  Yeah.

Interviewee:  And if he doesn’t believe it and if he doesn't -- if he’s a real wishy-washy not trained in it, and of course that’s a lot of trouble, too.  Doctors are not trained in it so, they’re not willing to go out on a limb and diagnose it or support you with it.  You know, turn to support the fibromyalgia support groups out there and these -- of course, doing your own research.  Find people who will support you.  

Interviewer:  And, also people need to be aware, from my understanding, from reviewing your work that there are doctors that, in general, do not support a disability and are not in favor of it.  So, you also have to be conscious about that.  Correct?  

Interviewee:  Absolutely.  There are doctors, and I’ve spoken  a couple of them just in social settings.  And I remember one doctor; this is probably about two or three years ago.  And he said, “You know, really I don't think, I really find it hard for me to believe that anybody is really disabled.  I think anybody can work if they really, really wanted to.”  Well, you know, that’s a pretty cynical attitude.  But again, this is a pretty well-known guy and he treats people.  I guess he gets some business from insurance companies.  So he’s biased, that there’s no such thing as complete disability.  And, of course, you know the other way I approach disability physicians is I don't ever ask a doctor, “Is my client disabled?”  I asked the doctor to identify specific activities that a person can or cannot do.  So, again, if you say, “Am I disabled?” that is umbrella term.  It could mean a number of things.  For social security purposes, you could be unable to do certain functions.  For example, you can't lift more than 5 pounds.  That would, theoretically disabled in certain types of jobs, but wouldn’t disable you from others.  So the term “am I disable” doesn’t really mean anything if you’re looking at lifting restrictions.  So, again, what we try to do is encourage our clients to identify the very specific limitations that they cannot perform and get the doctor on board with that.  So you don't force the doctor, you know, try to pin-up that as scientific -- as blanket conclusion that this patient is completely disabled, because, you know, if someone is completely disabled, can't move or do anything.  Of course, those people who are deserving disability claimants, are able to function in their house.  They may have good days and bad days.  But the question or the definition of disability is can you function in a competitive workplace.  So that’s what we try to focus on.  You have to -- you have to kind of know where you’re headed with this, so that you can -- you can devise a game plan that will get you there.  

Interviewer:  That’s great advice.  Now, I'm wondering, do you find in the cases, in your experience that people that are subject to or unfortunately have fibromyalgia have other conditions or it may cause other conditions?  In a lot of your work I have seen that there are multiple conditions that are addressed like fibromyalgia and depression, et cetera.  

Interviewee:  Absolutely.  I think that fibromyalgia, again, is something that, you know, certainly can cause depression.  One of the things that you’ve asked me before and I didn’t really comment on this.  But, you know, one of the common characteristics I see from claimants is just an ongoing desire to find treatment.  Most of my fibromyalgia cases are identifiable by the size of the file.  What I mean by that is that the claimant usually is going to be -- I would say all the time or most of the times can be a female, usually come in a type A, hardworking type of female.  Somebody who’s maybe worked, you know, in pretty high-level job or working maybe even, you know, with the job that they’re not, let’s say, trained for but they’re picked up because they’re such good workers.  And they will go to 15, 20 doctors sometimes, trying to find relief.  And fibromyalgia is one of these things where it kind of moves around body.  The common threat would be mild facial pains where they’re very sensitive to the touch.  Maybe digestive issues, balance issues, things like that.  But the pain may move around, maybe in the upper body for a couple of months.  And then move to the lower body.  So as the symptoms change, they may seek treatment with different doctors.  Then they’ll go to an orthopedist or neurologist.  And then they go all around trying to find things and treat the symptoms.  And, of course, the treating physician maybe trying different types of medications or bio feedback.  And so, I think  ultimately, sometimes the claimant will have multiple diagnoses even if fibromyalgia is probably the overriding one.  But maybe at any point time, there maybe a specific symptom that impair that person’s ability to perform certain types of activities.  I think depression is always a factor.  Again, these are  folks who have worked real, real hard.  They’re usually over-achieved.  They’re high-energy type of people and all of a sudden they can’t do anything.  They sleep.  They’re just, you know, fully different person.  They feel that they are trapped in their own body and who wouldn’t be depressed by that?  

Interviewer:  Yeah, absolutely.  Let’s talk about -- let’s talk about how to win, some strategies.  

Interviewee:  All right.  

Interviewer:  Now on a separate part of our site, you know, we have spent, I don’t know, 90 minutes or so going through the entire social security system.  So many can enjoy that as well as understand how they could use your guide to go through and start the process and follow the process and use it as kind of a tutorial to assist and pursue their benefits, right?  

Interviewee:  Absolutely.  

Interviewer:  So, is there any other tools, tips, tricks, things that you have, Jonathan, in addition to the guide that would be helpful for somebody who has with fibro to win?  

Interviewee:  I tell you, one of the things I always tell my client when I meet him early on is I say, “You know, keep a pain diary.”  This fibromyalgia, obviously, is a condition that is characterized by pain in various forms.  And I think that sometimes it’s hard to remember especially since the process can now take two to three years to get from initial application to a hearing decision.  I’d say go up and get a calendar and it could be just a drugstore calendar.  It doesn’t need to be fancy.  And keep a pain diary.  So that if you’re having a really bad day, Thursday the 14th, let’s say, then write it down.  So that you’ve got this calendar and then two years later if you’re in a hearing, you can refer back to it and testify from that calendar that I had a really, really -- you know, looking at this month, you know, 20 days out of the month, I had a really, really bad day and I typically measure pain using a 1-to-10 scale.  So 1 be kind of a mild headache, 10 being the worst pain you could imagine.  And the best diary are ones that might have 4 or 5 all day long.  You know, 4 to 6 I was in an 8.  And again this has to be something everyday.  But in fibromyalgia the claimants oftentimes are pretty type A sorts, so they can keep this up for awhile.  That can be very helpful in making arguments with the judge especially in remembering what went on because fibromyalgia can also affect the memory.  And, certainly, it’s very hard to think back two or three years ago, what you’re feeling like March of 2004, let’s say.  But if you have that little diary that can help a lot.  So that’s one thing I always recommend that they do.  

Interviewer:  Great advice.  Okay, anything else that you can think of?  

Interviewee:  Well, certainly, these folks are many times going to many different doctors.  To keep track of all the doctors they are going to, I think that, again, you know, this is part of the memory thing that are even for anybody who certainly go to a lot of different doctors, write down the names and addresses of all the doctors.  I think that, you know, you have to just be really, really focused on what, you know, the type of treatment you’re getting and be -- as we talked about before, be very aware if you have a doctor who is helpful or not.  I used various form, if that’s where you are heading with this.  But I use various forms to track this.  That’s, basically, what I use to win my cases.  I list the help of the doctors who identify these very specific conditions, specific limitations that will convince the judge.  And that’s kind of what I do as far as my practice.  

Interviewer:  Well, that is where I was going.  I did not want you to reveal your secret to everybody but --  

Interviewee:  Okay.  You know, it’s not as much of a secret.  I think that that is part of what lawyers do.  

Interviewer:  Yes.  

Interviewee:  That’s what I do in my little own way.  I think those people -- most other lawyers do it their ways as well.  What I try to do is, I know ultimately when I get in the hearing I’m going to be in front of the judge, I’m going to be in front of a vocational witness.  And for those who are not aware of this, most social security hearings involved the testimony of an independent vocational witness, somebody who’s there to talk about the past work the claimant has done and what the claimant might be able to do.  But really, the vocational witness’ job is to help the judge translate the medical findings into very specific work limitations.  So ultimately at the end of the day, what we try to prove is that my client cannot function either the past work or any other kind of work.  That way I have to do that is that I’ve got to convince the judge that my client’s impairments are so severe that the vocational witness will conclude that given the -- hypothetical is what they do.  They do it to cover, to pretend a person given the profile the judge comes up with, there’s no way the person could possibly work.  The best way to do that, my view, is to come up with a list with the help of a doctor to translate the medical findings for you.  So, all the judge has to say is, “Mr. Vocational witness or Ms. Vocational witness, assumed that I find that the claimant’s past year for work is as described by the Doctor A, B, C in this form, would he be able to work?  Would she be able to work?”  And that, to me, is I won’t call a trick.  But that is sort of the practice that I use to form -- the forms that I’ve developed are usually pretty good about doing that because, again, it’s basically able to derive from a lot of hearings where I watched this vocational witness because I know that we’re going to testify and I know which answers are going to win cases.  

Interviewer:  Okay.  So documenting -- the properly documenting documentation with the forms?  

Interviewee:  Well, properly identifying the specific limitations that the claimant is dealing with.  And, again, those limitations might be, as I said before, balance issues, digestive issues which could cause issues going to the bathroom too frequently or something like that.  That could cause interference with a person’s capacity to work.  Certainly fatigue would be a reliability factor, unscheduled absences in the worksite, too many absences, just a general during the course of a month or a week.  Those are type of things that I really like to focus on.  I’m all about reliability when it comes to social security.  But if the judge sensed that the claimant is not going to be a reliable employee, the vocational witness is going to testify that there’s really no job this person can do.  

Interviewer:  Okay.  Okay, good.  Great.  So the forms, can somebody request them from your office or with the guide, they could get them?  

Interviewee:  It has to be able to be available to folks.  

Interviewer:  Okay.  

Interviewee:  And what we’re trying to do is we’re trying to create forms for really many or as many listings as I can, listing areas.  Basically, again, what that means social security has kind of divided the body up into a number of different body systems.  Some of which are things we see a lot.  Some of which we don’t see very much.  Fibromyalgia happens to be something I see a lot of.  So I have to develop forms specific to fibromyalgia.  And when somebody purchases the “How to” guide, the disability guide, then I’ll make available for that person, if they wish, the forms that are specific to that condition, in this case fibromyalgia.  

Interviewer:  Okay.  So just a heads up, if somebody wants the guide to further their case and their education level and they go through the order process to make a note to, you know look for the condition specific forms.  How is that sounds?  

Interviewee:  Absolutely.  I think that -- and I want to make clear, I mean I’m still -- you know, this is something that’s a process because we take a lot time to put these forms together.  And some of them -- all of these are ones that I used in practice.  So we’re rolling them out, you know, little at a time to make sure that they’re clear.  You need the people to understand because you also, besides the form, I like to make available to my clients as well as to the people who buy the disability guide, the cover letter, so they can take it to the doctor, they can explain to the doctor what they’re looking for.  Because, again, you got to realize that doctors are in the business of treating people, making you better.  They deal with your symptoms and hopefully making you more comfortable.  I am in the business of winning a case and those are two things that don’t always go on the same track because, again, the doctors are not creating notes for me, he is doing for his own benefit, to trace the person’s history.  I need those notes to really talk about something that is a legal conclusion, which is disability.  

Interviewer:  Yes.  

Interviewee:  So that’s why I set and translate the record that’s exactly what I mean.  And sometimes the translation, what the doctor is really trying to say, what is he going to say about, you know, disability or with the term “disability”, what he can say about the person’s functioning, the capacity to function in various settings.  That is not something that’s going to be on a lot of medical notes unless you ask for it.  

Interviewer:  Okay.  I sensed that I am hearing here and correct me if I am wrong, is that somebody can collect this information that you put together in the guide format and they can use these to enhance their effort, whether they are pursuing benefits on their own or they want to use the assistance of an attorney.  There is still an application for this wealth of information you put together, is that --  

Interviewee:  I’d like to think so.  I think that, certainly, the guide is really beneficial when somebody is starting out, because usually they’re not going to be able to get an attorney in the outset.  Most attorneys don’t take cases really early on.  And they might not see a need for an attorney in the early stages don’t get the forms.  Hopefully, if they get the guide, the forms will be filled up correctly so there won’t be things left out, that’s number one.  I think that, you know, if you got a functional capacity forms that we’re talking about that is done early on, that’s going to help.  I will convince the judge down the road that your condition was at this level of severity early on with the process.  Again, you got to look at it as if you may not be at a hearing for two years.  The process can take some time from two to three years.  And if you walk in there with the forms that’s filled out last week, there are some judges who will concluded that well that means your disability began last week.  Well, if you’d been at home with no money and really nothing for two years.  You know, you paid into the system and you’re looking to get your pass-due benefits.  You work two years on pass-due benefits, you’re going to have evidence in that file to suggest that you’re condition was at this level two years ago.  And since doctor’s notes don’t always talk about like that, the forms that we used are ways to get that into the record early on to really help cement the argument that your disability began at the perfect onset, which might be a couple of years; two, three or four years ago.  

Interviewer:  So, I think I've got it now.  When somebody comes down with a condition and we’re discussing fibromyalgia today, the general strategy should be that they need to start, if they think this is going to be a debilitating condition that they need to start formulating their case, like right away, and that’s --  

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Interviewee:  That’s absolutely correct.  

Interviewer:  Yeah.  

Interviewee:  You want to -- you know, you cannot -- unfortunately, most people are so optimistic and they like to think that they’re going to get better.  But I think you have to take a worst case scenario and look at it and say, “Okay.”   If I end up in the disability process; I need to have a case strategy starting day one.  

Interviewer:  Yeah.  Okay, great, great, good point.  Now that we’re on the case strategy topic, this was something that came out from our members the other day.  Somebody sent me a note for me to follow-up conversation.  And they were suffering from fibromyalgia.  And they said to me, they said, “Brian, I’m really struggling with how to go about this process.”  You know, they have all the symptoms and the fatigue and the pain and that.  And they were saying that, you know, thinking about, you know, from swinging -- taking a swing and going through the process on their own.  And they said that really this thing that is going through and bothering me about this is they had listen to the interview that we had done.  The general overall interview.  And they have done a bunch of studies and know the process well.  They said, “I just don’t feel right because I don’t think because of my condition and the fatigue that I have and everything.  That if I go through and end up representing myself, I have to go in front of the judge and I'm presenting myself, it doesn’t look good for me because if I can do that as complex as this system is, the judge is probably gonna think I could work.”  And I said --  

Interviewee:  Well, yeah, that’s certainly something I hear.  In fact, one of the thing I have to deal with, with a lot of my fibro cases is I'll have -- and I've seen this two or three times during the last year.  My client will come in with this notebook that is, you know, perfectly everything is completely in places.  It is tabbed, it is typed with all the medical records are itemized and really, they're work of art.  And I have got to tell my client you know, you can’t -- I certainly appreciate that makes my life a little bit easier, but, you know that’s absolutely correct .  You go into court and you look like you have been their professional legal secretary.  Yeah, that can certainly hurt the case.  So I think that you have to -- yeah, truth of what the truth is you got to go in and make every effort which is go in by yourself to do it that way.  But, yeah, you have to be very sensitive.  In fact, they could look that way.  Although, in many cases, it may have taken, the individual, a month or two months to produce this beautiful notebook, it certainly looks like something that is a product of a lot of work.  So I think that is something absolutely to be aware of and not to show to a judge, it is not necessarily to do it that way, you can handwrite the forms or could write the form.  But yeah, you got to look the part too at the hearing.  

Interviewer:  Okay, great, great.  Oh, listen this is -- we’ve covered a lot in the short period of time.  Are there any other closing comment or suggestions that you would have for our audience?  

Interviewee:  Well, I think for fibromyalgia, I would tell you that a couple of things that seemed to be common to the cases that we take and winning, one is it seems like digestive problems seem to be a big deal.  I think judges tend to look at that if they see the person is having digestive problems, such a lesser extent in balance problems.  That is something that seems to be a -- this is sign that the fibromyalgia is legitimate.  I think the fatigue, the chronic of fatigue which goes along with it, you know, that’s going to be a little bit harder to document in the medical record.  That is something, certainly, you should tell your doctors you’re experiencing that.  And, of course, the myofascial pain.  And, typically, the words I usually hear from people would be, “It’s so painful, I can’t even have a sheet on.  I’m trying to sleep in bed and have to turn the heat up in the bedroom because I can’t even have anything, any blankets or sheets touching me.”  That’s kind of a term that I keep hearing.  A phrase I keep hearing over and over and over.  So I think that if you’re describing it in the forms which your doctor keep those things in mind, because those are things that the judges are hearing day in and day out.  It doesn’t mean you can’t have other symptoms that wouldn’t be convincing.  But those three or four symptoms are ones that I see all the time and I think that – I’ve seen judges cite in the records as well as things they find credible.  I think the judges talk among themselves.  And when they -- you know, they talk about what they find credible for fibromyalgia patient.  And think that those are something that I think that are common.  

Interviewer:  Okay.  Well, this has been great.  We really want to thank you.  On behalf of everybody out there that is affected by this, for taking the time and helping with the education process and the tips to win the case are really great.  We thank you.

 Interviewee:  My pleasure.  Thank you.