Workers World Today Issue 2 - Healthy Family

HEALTHY FAMILY

Healthy Life Welcome to our Healthy Family, Healthy Life Special Section.

Our focus is on diabetes.

Diabetes is the biggest KILLER in our community.

More than cancer. Read on.

Diabesity: A Crisis in Brooklyn

BY CHARLES TABASSO

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uring a recent interview with Workers’ World Today, Minister John Williams, president and CEO of New Creations Ministries (NCM), spoke at length about his personal battle with diabetes as well as his ongoing war against the disease within the borough of Brooklyn.

Diabetes is currently listed as the 7th leading cause of death within the United States.

According to the American Diabetes Association, over 250,000 deaths were linked to the disease in 2015, and the numbers have continued to climb. There are thought to be over 100 million American adults currently living with some form of diabetes. A disproportionate number of those afflicted with the disease live here in Central Brooklyn, on the Island of Flatbush, where a predominately West Indian population has become the epicenter for a potent new form of Type II diabetes.

Williams made it clear that he was no stranger to the perils of the disease: on top of losing several family members to diabetes, he was pre-diagnosed with it himself.

But this was no death sentence, as he explained, “Just because you are genetically predisposed to a condition does not mean

you have to suffer from it.” Williams was quick to point out that diabetes is a reversible condition, citing his HG A1C’s remission to below diabetes level as proof that a path to optimum health is out there for everyone.

This is the idea at the heart of John William’s “crusade” against diabetes. It was also the catalyst for the Central Brooklyn Diabetes Task Force, formed to address the growing crisis of diabetes within the Flatbush area. So endemic, in fact, that a particularly virulent form has been given the name “Flatbush diabetes.”

Flatbush diabetes, or Ketosis-prone diabetes, is defined as a syndrome in which diabetes begins with ketoacidosis, due to the accumulation of the chemical Ketone; ketones are a blood acid that forms when glucose is unable to exit the blood vessels.

The name is not a coincidence, John Williams explains, “It is affecting predominately the West Indian population in the Flatbush area.” But as devastating as this new form of diabetes has been to the Flatbush community, John Williams has faith that his more holistic approach to personal health is up for the challenge.

His strategy is called The Church-Based Preventative Health Center Initiative. It was

designed to turn Brooklyn community’s churches, Muslim and community centers, into spaces for preventative health care to flourish. The NCM plans to train these community centers to eventually join the Diabetes Task Force, working alongside One Brooklyn Health Systems (OBHS), a non-profit corporation, to coordinate separate hospitals and health centers into a quality integrated health system.

OBHS has received significant funding from the Vital Brooklyn Initiative, spearheaded by Andrew Cuomo, and launched in spring 2017. Approximately $750 million has been appropriated by One Brooklyn Health Systems, which is a merger between Interfaith Medical Center, Kingsbrook Jewish and Brookdale Medical Center. The combined focus of this coalition is “20-20 vision,” or a twenty-percent reduction in the cases of diabetes by the year 2020.

OBHS’ approach and strategy to tackling this vision begins with a three-pronged approach: the National Diabetes Prevention Program, sponsored by the Center for Disease Control, the Stanford University Diabetes Self-Management System, and John William’s New Creation’s 12 Weeks to Wellness Program.

At the center of John William’s wellness program is what he calls NEWSTART. “It is the ten commandments of health,” he said. NEWSTART is an acronym for Nutrition, Exercise, Water, Sunlight, Temperance, Air, Action, Rest, and Trust, “The eight laws of health that we use to teach [our method].”

Similar to John William’s own journey through diabetes treatment, NEWSTART is a “lifestyle change program” that pivots away from the potential for overmedicating diabetes’ symptoms. Stressing his belief that “all drugs are a poison,” Williams admonished the seemingly endless cycle of treating a drug’s side effects with more drugs, illustrating how “side effects are a condition that the drug caused, which calls for another drug, that causes another problem that calls for another drug, and thus continued on page 3

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Diabetes and the Blue Book

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ocial Security uses the list of impairments, also called the "Blue Book," as part of the disability determination process.

Most individuals who apply for Social Security disability don't know what disability criteria the Social Security Administration (SSA) uses to determine whether claimants are disabled. In part, disability examiners use a list of impairments known as the "Blue Book" to determine if an individual will meet the Social Security definition of disability.

What Is the Blue Book?

The Blue Book is a list of impairments with detailed requirements for when the SSA should judge a medical condition to be disabling. The official name of this disability handbook is Disability Evaluation Under Social Security. This listing of impairments contain the most common medical conditions considered to be severe enough to keep an individual from working. If you match the requirements of a listed impairment (called a "listing"), you will qualify for disability automatically, regardless of whether you can actually work or not.

The Blue Book Is Divided Into Two Main Parts: Part A is dedicated to adult disability assessments. Part B is dedicated to childhood disability assessments.

Each of these parts is divided into sections

the requirements for how severe the symptoms, clinical findings, and laboratory tests for a particular impairment have to be — to make sure that the condition is severe enough for an automatic approval. (If your condition doesn't match a listing, the SSA goes through a longer determination process to see if you're disabled, but if you can match a listing, the process stops there.)

Here's how to use the listings to see if you should automatically qualify for disability:

(15 for children, 14 for adults), which contain information about different types of disabilities. The major body systems addressed within the Social Security disability handbook are as follows: Musculoskeletal, Special Senses (Vision and Hearing), Respiratory System, Cardiovascular System, Digestive System, Genitourinary System, Hematological Disorders, Skin Disorders, Endocrine Disorders, Multiple Body Systems, Neurological, Mental Disorders, Neoplastic Diseases (Cancer), and Immune System Disorders.

For each major body system, the Blue Book contains a list of disabling conditions.

For instance, you will find fractures and spinal disorders addressed in the musculoskeletal section.

Using the Listing of Impairments to Help Your Case Because illnesses and injuries have varying degrees of severity, the Blue Book sets out

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Is Your Condition In the Blue Book?

You can look at the SSA's impairment listings to see if you can find your medical condition in a listing, or look at our list of illness-specific articles, which will tell you whether the condition is listed.

Does Your Condition Match a Listing?

If your disability is listed, the next step is to determine if your medical condition meets the specific criteria for that condition to automatically qualify for benefits. The listing requirements are often quite complex; your doctor can help you determine if you meet a listing (or again, you can read our illness-specific articles, which attempt to simplify some of the medical jargon in the listings).

If you haven't had the clinical or laboratory tests required in the listing, you can ask your doctor to perform them. (Or you can wait for the SSA to pay for a consultative exam, but this makes your claim take longer, and it's generally better if the test results are already in your medical record.) Then you can check to see if your test results meet the requirements of the listing.

Does Your Condition "Equal" a Listing?

If your impairment doesn't match the requirements of the listing, the disability claims examiner will determine if your impairments can be considered equivalent to a similar listing, in terms of severity. The SSA allows you to "equal" a listing because it can't include every form or variant of a severe disability in its impairment listings. The SSA also recognizes that there are various ways to diagnose and document the same illness. For instance, the listing may require a specific result on a specific lab test, and you weren't given that test, but you did take a test that shows the same results as the test required by the listing.

Another way to equal a listing is by having a combination of impairments that by themselves are not severe enough to meet a specific listing, but combined, their severity equals that of a listed impairment. If the SSA says your impairments are equally as severe as those in the listings, you will be granted disability benefits. If you have to appeal an initial denial of benefits, and you want to argue that your condition is equal to a listed impairment, you would probably need a disability lawyer to argue your case.

Are All Impairments In the Blue Book?

Not all medical and psychological conditions are listed in the Blue Book—it would be impossible to list all disabling illnesses and injuries in a handbook. You can get disability for a condition not listed in the Blue Book if you can prove the condition limits your functioning too much for you to work.u

Source: nolo.com

Did You Know?

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he Americans with Disabilities Act (ADA), which was amended by the ADA Amendments Act of 2008 ("Amendments Act" or "ADAAA"), is a federal law that prohibits discrimination against qualified individuals with disabilities. Individuals with disabilities include those who have impairments that substantially limit a major life activity, have a record (or history) of a substantially limiting impairment, or are regarded as having a disability.

Title I of the ADA covers employment by private employers with 15 or more employees as well as state and local government employers. Section 501 of the Rehabilitation Act provides similar protections related to federal employment. In addition, most states have their own laws prohibiting employment discrimination on the basis of disability. Some of these state laws may apply to smaller employers and may provide protections in addition to those available under the ADA. EEOC enforces the employment provisions of the ADA. This document, which is one of a series of question-and-answer documents addressing particular disabilities in the workplace, explains how the ADA applies to job applicants and employees who have or had diabetes. In particular, this document explains: lwhen an employer may ask an applicant or employee questions about her diabetes and how it should treat voluntary disclosures; lwhat types of reasonable accommodations employees with diabetes may need; lhow an employer should handle safety concerns about applicants and employees with diabetes; and lhow an employer can ensure that no employee is harassed because of diabetes or any other disability.

As a result of changes made by the ADAAA, individuals who have diabetes should easily be found to have a disability within the meaning of the first part of the ADA's definition of disability because they are substantially limited in the major life activity of endocrine function. Additionally, because the determination of whether an impairment is a disability is made without regard to the ameliorative effects of mitigating measures, diabetes is a disability even if insulin, medication, or diet controls a person's blood glucose levels. An individual with a past history of diabetes (for example, gestational diabetes) also has a disability within the meaning of the ADA. Finally, an individual is covered under the third ("regarded as") prong of the definition of disability if an employer takes a prohibited action (for example, refuses to hire or terminates the individual) because of diabetes or because the employer believes the individual has diabetes.

Title I of the ADA limits an employer's ability to ask questions related to diabetes and other disabilities and to conduct medical examinations at three stages: pre-offer, post-offer, and during employment.u Source:eeoc.gov

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Getting Disability Benefits for Diabetes It's difficult to get disability for controlled diabetes, but most diabetic applicants suffer from related medical problems that limit their ability to work.

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n individual may qualify for Social Security disability benefits based on uncontrolled diabetes or related symptoms like peripheral neuropathy or poor vision. While diabetes that is well-controlled with medication won't form the basis of a successful claim on its own, most disability applicants with diabetes also suffer from other medical problems that limit their ability to work. When filing for disability benefits for diabetes, it's important to list all your symptoms and diagnoses, even those unrelated to your diabetes.

Diabetes Mellitus: Type 1 and Type 2 Diabetes mellitus (DM) is a chronic medical condition marked by an inability to process glucose in the blood. When the pancreas fails to produce sufficient amounts of the hormone insulin, which sends signals to other body cells to absorb excess glucose, blood sugar levels rise.

Elevated blood sugar levels often can be controlled through medication and diet, but persistently high blood sugar levels may

give rise to neuropathy (nerve damage) causing numbness, burning, and tingling in the extremities. Other complications of diabetes include cardiovascular disease, kidney problems, skin infections, and visual changes.

Type 1 diabetes, often referred to as insulin-dependent diabetes, typically manifests in childhood and requires daily insulin injections and monitoring continued on page 4

Crisis in Brooklyn continued from page 1

you’re involved in a situation where your body is riddled with these conditions.”

The statistics on NEWSTART’s official website are a testament to the importance of self-care. Nearly 1,800 pounds were collectively lost last year, due to the program’s efforts to not only combat diabetes but its contributors, such as childhood obesity.

And many patients have touted the reviving effects of NEWSTART’S treatment, such as a reversal of their diabetic condition and drops in cholesterol levels.

John Williams’ war on diabetes is far from over but that doesn’t seem to faze him. He is a man who has dedicated his life to saving as many people as possible. When asked about why he gave up his previously lucrative business of gold and diamond mining in South America, Williams said it was the deep and sincere love he developed for the many peoples and tribes of the region. This is what led to a spiritual calling to stop searching for gold, and as he puts it “To start searching for souls.” That search will continue past the upcoming symposium, and into the months and years ahead.u

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Disability Benefits/ continued from previous page of blood sugar levels. Individuals with Type 1 diabetes are unable to produce the insulin which regulates blood sugar levels. Only about five to ten percent of diabetic individuals suffer from Type 1 diabetes.

Type 2 diabetes, also called adult-onset diabetes, occurs when the body's cells become resistant to insulin and thus fail to process sufficient amounts of glucose. Type 2 diabetes is most common in those over 45, and it is strongly associated with obesity, high blood pressure, and a sedentary lifestyle. Genetic factors also play a role in the development of Type 2 diabetes.

Diabetes is generally treated by endocrinologists, who prescribe medication, blood sugar monitoring, and lifestyle changes to control the disease.

Diabetes and Social Security's Disability Listings In 2011, Social Security removed its disability listing for endocrine disorders, including diabetes, from its Blue Book, a list of impairments that automatically qualify for disability. As a result, it's no longer possible to get approved for disability based on a disability listing specifically for diabetes, but you may be able to "meet" other listings in the Blue Book depending on the severity of your symptoms. For example, a person can match the requirements for Listing 11.14 for peripheral neuropathy, when he or she, in spite of treatment, experiences involuntary movements, tremors, or partial paralysis in two extremities that makes it difficult to walk or use his or her hands.

Diabetic retinopathy that causes less than 20/200 vision in the better eye would meet Listing 2.02.

Other complications related to diabetes, from kidney failure to cardiovascular issues to amputation of a limb, could also meet or "equal" one of the Blue Book listings.

Note that diabetic children under 6 who require daily insulin or 24-hour supervision (depending on the age of the child) will be automatically found to meet Listing 109.08 until they reach age 6.

Qualifying for a Medical-Vocational Allowance Based on Diabetes Getting a medical-vocational allowance is by far the more common way to get approved for disability benefits. If the symptoms of your diabetes prevent you from performing your past work or any other jobs in the economy, you can get approved for benefits under a medical-vocational allowance. A medical-vocational allowance takes into account your age, education, vocational history, and Residual Functional

Capacity (RFC) in deciding whether you're capable of meeting the demands of any fulltime work.

Your RFC is an assessment of how much you can still do despite your impairments.

Social Security regulations require your RFC to be based on medical evidence, so you or your attorney should submit copies of your relevant medical records to demonstrate the extent of your functional limitations. What your records should include depends on the specific symptoms involved. For example, an individual with peripheral neuropathy might submit medical evidence mentioning an unsteady gait, poor fine motor control, or numbness and tingling in the extremities. Or an individual with chronic hyperglycemia might submit evidence from a psychiatrist documenting difficulty concentrating and fatigue that interferes with his or her ability to sustain full-time work.

Clinic notes from specialists are generally considered more persuasive than those from family physicians. For example, if you suffer from diabetic retinopathy, you should seek a referral to an ophthalmologist. Those with kidney disease should receive treatment from a nephrologist, while heart disease patients should consult a cardiologist, and so on.

In addition to clinic notes, you should ask your treating physician, preferably your specialist, to offer an opinion as to your work-related impairments. This is most easily done by providing the doctor with an RFC form addressing your abilities to sit, stand, walk, lift, and carry. The RFC form should also include postural limitations (bending, twisting, stooping), manipulative limitations (reaching, handling, fingering), and environmental limitations (noise, dust, extreme temperatures). Also ask your physician to note whether you would be expected to miss more than two days of work per month, a limitation that generally prevents any full-time work.

Finally, note that special SSA regulations known as the grid rules make it easier for older individuals to obtain a medical-vocational allowance. For example, a 50-yearold with a high school education but no transferable skills would be found disabled under the grids even if she is able to perform sedentary work. If this individual were over 55, she'd be found disabled even if she can do light work. The grid rules frequently come into play in cases involving Type 2 diabetes, which generally manifests during adulthood and tends to worsen as one ages.u

Source: nolo.com