Social Security Disability Update Pg 2

[Boston Tea Party]

Originally Posted by CPT Tripss

Unless she has a work history, very unlikely with Rett's, she won't get SSD. SSI is another matter.

Oh, I thought it was the same. Don't know much about it (Social Security). Just know that the mother of a profoundly disabled child has had an extremely hard time getting any benefits for her child. And that sucks.

[Jedana]

If I remember correctly, there is a 6 month waiting period once you've been approved. DH was approved in May of that year, but didn't get benefits until November. He was approved the first go round, but ESRD is usually an automatic approval .

He couldn't bring in income over a certain amount--I think it was $600 or so a month.

Once he was feeling better, with the dialysis and his levels fixed, he went back to work and stopped receiving SSDI after the 6th month back. He still has Medicare A, B, and a supplemental. The supplemental runs almost $1300 every quarter--if it wasn't for the AKF, we wouldn't be able to pay it, as that is about what we pay for insurance for me, DS and DD. Part B runs about $300 quarterly.

[IheartMickey]

Originally Posted by Jedana

If I remember correctly, there is a 6 month waiting period once you've been approved. DH was approved in May of that year, but didn't get benefits until November. He was approved the first go round, but ESRD is usually an automatic approval .

He couldn't bring in income over a certain amount--I think it was $600 or so a month.

Wow, $600 is low. I'm allowed to make $980 per month.

[sasywtch]

Originally Posted by tvguy

The statement you get just before your birthday from Social Security lists how much your disablity payment would be each month if you qualify.

My MIL worked for a law fire that specialized in SS disability, and, in my opinion, the system is wonky.......it can be hard to get approval without an attorney.....and to be honest, a good attorney can get people who clearly are unqualified ....... qualified. But the process can take 6-9 months.

If he's denied next month, I may be asking you for the name of that attorney. (I'm assuming it was here in town?).

[Tinker'n'Fun]

Regarding working, this is directly from the pamphlet the govt. gives you re: working or returning to work.

Trial work period—The trial work period allows you to test your ability
to work for at least nine months. During your trial work period, you
will receive your full Social Security benefits regardless of how much you
are earning as long as you report your work activity and you continue to
have a disabling impairment. In 2013, a trial work month is any month in
which your total earnings are over $750, or, if you are self-employed, you
earn more than $750 (after expenses) or work more than 80 hours in your
own business. The trial work period continues until you have worked nine
months within a 60-month period. Extended period of eligibility—

After your trial work period, you have 36 months during which you can work
and still receive benefits for any month your earnings are not “substantial.”
In 2013, we generally consider earnings over $1,040 ($1,740 if you are blind) to be substantial. No new application or disability decision is needed for you
to receive a Social Security disability benefit during this period.

Expedited reinstatement—After your benefits stop because your earnings are substantial, you have five years during which you may ask us to start your benefits immediately if you find yourself unable to continue working because of your condition. You will not have to file a new disability application and you will not have to wait for your benefits to start while your medical condition is
being reviewed to make sure you are still disabled.

Continuation of Medicare—If your Social Security disability benefits stop because of your earnings, but you are still disabled, your free Medicare Part A
coverage will continue for at least 93 months after the nine-month trial
work period. After that, you can buy Medicare Part A coverage by paying
a monthly premium. If you have Medicare Part B coverage, you must
continue to pay the premium. If you want to end your Part B coverage, you
must request it in writing. Work expenses related to your disability—If you work, you may have to pay for certain items and services that people without disabilities do not pay for.

For example, because of your medical condition, you may need to take a taxi to work, instead of public transportation, or pay for counseling services. We may be able to deduct these expenses from your monthly earnings before we determine if you are still eligible for benefits. How your earnings affect your Social Security benefits During the trial work period, there are no limits on your earnings.

During the 36-month extended period of eligibility, you usually can
make no more than $1,040 a month or your benefits will stop. But, the
work expenses you have as a result of your disability are deducted when we
count your earnings. If you have extra work expenses, your earnings could
be substantially higher than $1,040 before they affect your benefits. This
substantial earnings amount usually increases each year.

We deduct work expenses related to your disability from your earnings
before we determine if you are still eligible for benefits. These expenses
may include the cost of any item or service you need to work, even if the
item or service also is useful to you in your daily living. Examples include
co-payments for prescription drugs, counseling services, transportation
to and from work (under certain conditions), a personal attendant
or job coach, a wheelchair or any specialized work equipment.

I know it looks complicated, but if you take it paragraph at a time it really is not that bad.

[sasywtch]

I want to thank everyone for your responses.
He's not too worried about insurance as he has Kaiser through his ex wife.
I read somewhere to keep on them at the ss office to make sure everything is there and maybe tomorrow would be a good day for him to drive down there.

[deerhart]

Sasywtch

I am a Social Security Attorney. Feel free to PM me with any questions.

Sadly, many cases seem open and shut until SSA gets ahold of them and twists them all around.

Other times delays occur because doctor's office do not respond in the very short window SSA asks them to. Other times it is just because the doctor does not put the key words in the records or fail to fully explain because they think the disability is obvious.

FOr DIB benefits, there is a 5 month wait period (you are paid starting the 7th months from the month you were found disabled. SSA pays 1 month behind, so they are paying for month 6th in the 7th month). For those with very little assets and no income, who promptly apply right as they go out of work, they can be eligible for SSI for that wait period. This does not happen that often because many people wait to apply.

Medicare eligibility starts after you have recieved 25 months worth of benefit payments (in any combination between a payment each month and/or a lump sum payment). You can only be paid for up to one year retroactive from the date you applied (so if you wait to long you can lose benefits).

Also the rules are different depending on your age and education level and the type of work you have done in the past. If your under 50, the rules are the strictest, they get a bit easier at 50 and then again at 55. If you have worked in ardous manual labor for 35 years, the rules are the easiest for that person.

It sounds like they are trying to get him to meet either a listing or a compassionate allowance.

Consultative exams are extremely common now a days as SSA tries to manufacture, sometimes, negative evidence. I have seen them send people for these exams with 300-500 pages of medical records over the course of the last year and several doctor statements already in the file in regards to their disability. Attorneys are starting to look at them as SSA trying to generate contradicting evidence so they can claim things are not consistent.

It is not supposed to be an adversary system, but over the course of the last 5 years it has become more and more adversary. The sad thing is that most people do not realize that the mindset seems to be deny everything unless you absolutely can't get around it.

[deerhart]

Originally Posted by Boston Tea Party

Oh, I thought it was the same. Don't know much about it (Social Security). Just know that the mother of a profoundly disabled child has had an extremely hard time getting any benefits for her child. And that sucks.

That is probably because they made to much money. SSI is the only option for children benefits (if the child is under 18). And basically if the parents combined income is about 30-35k or they have over 2-3k in assets, the child will not be financially eligible even if the child was medically eligible.

The situation changes quite a bit when they turn 18 and there are several different options depending on the situation. I even had a 20 year old client who earned his way into DIB benefits because he was making just enough at a sheltered workshop to earn the couple of credits he needed to qualify while his SSI claim was pending.

[deerhart]

Originally Posted by AnnaS

What everyone else said. Except that the process here in NY initial and appealing can take years - yes years. From the time my sister applied, was denied, appealed, had two hearings - it took three years - unfortunately my sister passed by then. My mom collected what was owed to her minus the 25% for the attorney (who did not do much in my opinion - but that is another story). Perhaps in other states the process is different? don't know. I hope so.

The years is also based on stories I have heard from more people here. They are supposed to be backed up. Reviews are also taking a lot longer than their projected time - if it's 3 years - it can take 4 yrs. etc.

If you have all the documentation and doctors all agree that he is disabled, I would recommend applying on his own first. If denied, yes, contact a lawyer right away and appeal.

Sadly no, the average wait from initial application to a hearing is about 2.5 years nationwide (6 months for inital app, 6 months for recon, 18 months for hearing). Hearing process times DO vary by hearing office. For example Cleveland is 8-9 months, but the Akron office (a mere 40 miles down the interstate) is 14-15 months.

The 10 prototype states go a bit quicker because they go from initial directly to hearing. Missouri is one and so is PA (I forget the rest off hand).

And this is IMPROVED. 4-5 years ago the average wait for a hearing, only, in North Atlanta could easily run 4 years, and that is on top of the time it took for the initial and reconsideration decisions. A 5 year wait was not unheard of.

Oh the storys to tell, like how SSA said a client who had been in a COMA for 6 months would not meet the 12 month duration requirement because it is perfectly logical that even if he woke up today he would be back in any shape to attempt work within 6 months
Good luck!

[Mskanga]

Originally Posted by Boston Tea Party

Oh, I thought it was the same. Don't know much about it (Social Security). Just know that the mother of a profoundly disabled child has had an extremely hard time getting any benefits for her child. And that sucks.

The first time my daughter had cancer at age 14 I was not able to get any benefits for her. She is now 19 and recently was approved for SSDI after she relapsed cancer last august and she is now collecting on my husband's record , he passed away three months ago.

BTW my husband died seven months into the 24 months waiting period for medicare. Yep , he died without getting what he needed and he paid for all his life , nice huh ?

[sasywtch]

Boyfriend got a call today from Social Security to come in tomorrow to sign papers and to name a beneficiary. They wouldn't tell him on the phone but I'm pretty sure they wouldn't be asking for this info if he wasn't approved. It only took 5 months, not too bad. It came on a good day as he was having a "down" day today and feeling hopeless. Gets those every once in awhile.

I think this calls for celebrating by going to Disneyland in July!
It will be different for me as I'm use to going from opening to close but this time it will have to be slow going with many rests in between.

[sasywtch]

I am so sorry that I did not see your post earlier. I've been working 20 hours a week overtime and skimming when I can.

Originally Posted by deerhart

Sasywtch

I am a Social Security Attorney. Feel free to PM me with any questions.

Sadly, many cases seem open and shut until SSA gets ahold of them and twists them all around.

Other times delays occur because doctor's office do not respond in the very short window SSA asks them to. Other times it is just because the doctor does not put the key words in the records or fail to fully explain because they think the disability is obvious.

He lucked out as his doctor with Kaiser is a top Movement Disorder Specialist and part of the Michael J Fox Foundation so he was familiar with what SS needed.

FOr DIB benefits, there is a 5 month wait period (you are paid starting the 7th months from the month you were found disabled. SSA pays 1 month behind, so they are paying for month 6th in the 7th month). For those with very little assets and no income, who promptly apply right as they go out of work, they can be eligible for SSI for that wait period. This does not happen that often because many people wait to apply.

Out of curiosity because I'm dense on this, when you say when they found you disabled, are you refering to todays date when they approved it or when he applied back August when the doctor said he was disabled? He applied in August and found eligible (I think) today

Medicare eligibility starts after you have recieved 25 months worth of benefit payments (in any combination between a payment each month and/or a lump sum payment). You can only be paid for up to one year retroactive from the date you applied (so if you wait to long you can lose benefits).

Also the rules are different depending on your age and education level and the type of work you have done in the past. If your under 50, the rules are the strictest, they get a bit easier at 50 and then again at 55. If you have worked in ardous manual labor for 35 years, the rules are the easiest for that person.

The one thing the analyst told him was that he had a good case because #1 he had a condition listed in their book #2 Stable work history for 35 years. He had worked with the state for 35 years and even they nudged him to retire due to his condition. He was starting to lose his balance and I think they even thought he was a liability for them. He's also 58

It sounds like they are trying to get him to meet either a listing or a compassionate allowance.

Consultative exams are extremely common now a days as SSA tries to manufacture, sometimes, negative evidence. I have seen them send people for these exams with 300-500 pages of medical records over the course of the last year and several doctor statements already in the file in regards to their disability. Attorneys are starting to look at them as SSA trying to generate contradicting evidence so they can claim things are not consistent.

It is not supposed to be an adversary system, but over the course of the last 5 years it has become more and more adversary. The sad thing is that most people do not realize that the mindset seems to be deny everything unless you absolutely can't get around it.

The funny thing is, he worked for the state agency they contract to in CA (but a different area) and his now ex-wife worked for the exact agency that ss contracts with------ which has the exact same initials I just noticed!

Thank you so much for answering my questions and I apologize to everyone on here that I was off/on and not coming back to it. 10 hour days 6 days a week is wearing me down.

[sasywtch]

Originally Posted by Mskanga

The first time my daughter had cancer at age 14 I was not able to get any benefits for her. She is now 19 and recently was approved for SSDI after she relapsed cancer last august and she is now collecting on my husband's record , he passed away three months ago.

BTW my husband died seven months into the 24 months waiting period for medicare. Yep , he died without getting what he needed and he paid for all his life , nice huh ?

That stinks and it iritates me to no end. I am so sorry. (I will leave it at that as to not get political).

[sasywtch]

He went in today and is approved however, he has to set up a beneficiary to ok the money monthly. This will cause a rift but hopefully, he chooses wisely. He cannot choose me because we aren't legally married yet but he can choose his ex wife or his adult son. I'm guessing you can imagine where the conflict would come in on his choices.

This is necessary for the medication he is on and being weaned off of as it causes addictions (gambling). Once he has been off the medication for a year, he can petition for a change with no beneficiary to divvy out the funds monthly.

Payments will start in March--he had filed in August