SSDI Review question

[shoegirl1020]

My son has been receiving SSDI or maybe SSI (he's 8 and disabled) since Dec. 2004. Actually I applied in Dec and probably was approved in January. I was very surprised becaues I'm told that everyone is denied the first time. In any event, on Friday I received a letter stating that I needed to come in on such and such a date for a regular review to see if ds is still disabled. Then, the following day I get the same notice, but for a different date. My taxpayer dollars at work I tell you

The letter does not give any information so:

1. Should I bring DS with me? He is functionally unable to effectively communicate, but will put on quiet a show if pressed to do anything meaninful; and

2. Should I bring any documentation from his treating doctor?

Is there anything that I should be aware of before going in?

 

[kathyk2]

I would definately bring as much medical documentation as you can. I would also bring a copy of his IEP since it may contain test results to help back up your claim. I wouldn't take your son to the review the Social Security office isn't a kid friendly place. Just be honest with the reviewer and know that you can appeal an unfavorable decision.

 

[SueM in MN]

I agree with Kathy.
When we applied for my DD, we were also prepared that she would probably be turned down the first time. She was not, but the SS reviewer sid I was the best prepared person she had ever met.

So, bring evidence and medical documentation of everything as you can.
My DD has not actually ever been to the SS office because it is just barely handicapped accessible. I called and was told I did not need to bring her as long as I had all the documentation.

 

[mechurchlady]

All they want is documentation. It was 8 years after getting SSI before they finally asked me to see a doctor and psychiatrist/mental health/whatever that they assigned. This was because I do not have a regualr doctor. That was all I needed to continue on SSI. If I had had a regular doctor then I could have just sent in the info.

It took many many tries, a lawyer and finally after getting SSI so in debt that I had to file bancrupcy. There are documented cases of people obviously ill who do not get SSI.

Good luck.

 

[MightyMom]

I guess things are done differently in different states.
Neither my son or I have ever been in the SSI office. Okay... I take that back...... I did go in once to update some information because I needed to do it in person.

My son qualified the first time based on his disability. I filled out the application and I've had numerous phone interviews over the years to review his case.

When they do review his case to see if he's still disabled..... it's always been done with a boat load of paperwork that is sent to me. I fill it out at home and send it back. Other requests for information are sent to the doctors.

I've never ever had to take any information into the office.

I'm glad to do the phone interview. Prior to the date of the interview I'm sent a letter detailing the time and date of the phone interview. It's always been pretty easy.

Now.... I know that information doesn't help you. Sorry. But perhaps you can bring it up and ask if it's an option for you in the future.

Do you have a copy of your initial application? If so.... I would take that to the appointment along with the corresponding information it requests. That might help you.

 

[pcparamedics01]

I have a question. I thought SSI was based on need, and you need to be very unfortunate to receive it for your child. At least that is what I have heard from other parents. SSI is federally funded so I know it is not a Ga thing. Any input on this? We have put out thousands of dollars on biomedical treatment this sure could help us.

 

[SueM in MN]

I have a question. I thought SSI was based on need, and you need to be very unfortunate to receive it for your child. At least that is what I have heard from other parents. SSI is federally funded so I know it is not a Ga thing. Any input on this? We have put out thousands of dollars on biomedical treatment this sure could help us.

My DD is over 18, so it went on her income only (and she has none).
SSI-Disability is based on first on the person being disabled, the person applying for it (or a parent) paying in enough quarters to qualify and also on income. I don't remember what the limits are, but you can find it on the SS website. We did not apply for DD until she was over 18 because our income was too high and we knew she would not qualify.

 

[pcparamedics01]

My DD is over 18, so it went on her income only (and she has none).
SSI-Disability is based on first on the person being disabled, the person applying for it (or a parent) paying in enough quarters to qualify and also on income. I don't remember what the limits are, but you can find it on the SS website. We did not apply for DD until she was over 18 because our income was too high and we knew she would not qualify.

Thanks Sue. So does all the other posters qualify with small children? Unless they are needy.

 

[pcparamedics01]

Thanks Sue. So does all the other posters qualify with small children? Unless they are needy.

I meant so does "how" does...

 

[SueM in MN]

i don't know, but I can tell you it is a pretty thorough process (and I, at least was pretty intimidated by it).

 

[pcparamedics01]

i don't know, but I can tell you it is a pretty thorough process (and I, at least was pretty intimidated by it).

I heard the same thing! I would love to know if there is something I am missing..... We have spend upteen dollars on uncovered expenses that is not covered under insurance daily!!!

 

[MightyMom]

I have a question. I thought SSI was based on need, and you need to be very unfortunate to receive it for your child. At least that is what I have heard from other parents. SSI is federally funded so I know it is not a Ga thing. Any input on this? We have put out thousands of dollars on biomedical treatment this sure could help us.

Well... that's what I thought too.....and without sharing any financial information with perfect strangers..... I will tell you about our situation.

Initially I knew my son would not qualify based on our income. We didn't even bother applying. The stress took an unfortunate toll on our marriage and my husband and I separated. We lived apart for several years and my son then qualified for SSI. I did not work and they counted only child support.

When my husband and I decided to work things out I knew my son would no longer qualify.

That is when I went to the SSI office to report my husband moving back in.

My husband's income was over the guidelines and my son no longer qualified.

Fast forward a few months........ We had been on a Medicaid Waiver Program waiting list for 4 years. My son's name finally came up. This program is called the Medically Dependent Child Program in Texas. My son qualified based on his disability. This program does not count parents income... only the child's and he has none.

Around this same time I got a letter from SSI saying my son now DID qualify for SSI. But only by the skin of our teeth. During the months when there are 5 weeks.... he does not qualify for SSI..... but he still has medicaid through the Medicaid Waiver Program.

By no means are we "very unfortunate" and I'm quite surprised my son still qualified for SSI.

Now... also keep in mind the cost of living and what our income might be compared to yours. We live in deep south texas. My home is 1900 square feet. It was only 3 years old when I purchased it and we only paid $72K. Our dollars get stretched pretty far down here...... and while we do live comfortably....we are by no means well off.

Do other states not have medicaid waiver programs? You might want to look into it. It's worth a shot.

 

[SueM in MN]

Do other states not have medicaid waiver programs? You might want to look into it. It's worth a shot.

They do, but each state does things somewhat differently. They all have to go by the child's income to determine eligibility, but some states have a 'family co-pay' that is based on the family income. In our case, we would have paid in more per month than DD would have used and, if whatever money you don't use, you lose at the end of the year. So, we opted not to have DD in that program.
You can google your state to find out how to apply and what the requirements are. It might be called "Medicaid waiver" or "Katie Beckett program."
You would also be able to find out about it from your county Department of Health or Human Services.

 

[barkley]

My DD is over 18, so it went on her income only (and she has none).
SSI-Disability is based on first on the person being disabled, the person applying for it (or a parent) paying in enough quarters to qualify and also on income. I don't remember what the limits are, but you can find it on the SS website. We did not apply for DD until she was over 18 because our income was too high and we knew she would not qualify.

not to contradict, just to clarify a bit-

there are 2 types of disability benefits paid by the social security administration-ssi and ssd. ssi eligibility is based on disability, income and resources-if it is a minor applicant, the parent's income and resources are considered. ssd eligibility is based on disability and having enough contributing 'quarters' in the ss system (some types of income count, not all, and there is no resource limit)-ONLY adults qualify for ssd (although if a minor, disabled or not, has a parent in receipt of ssd, there is usualy an allotment for them as well). the only time 'quarters' come into consideration regarding 'children' is when an 'adult child', unmarried, between 18 and 22, disabled (by social security's criteria) prior to age 22, who has a parent in receipt of either retirement or disability benefits, or has a parent who is deceased applies. in that case social security will look to see if the parent has enough work quarters in which case the child may get a higher benefit by drawing from their parent's earning record.

be aware-social security excludes from consideration some types of income and resources (you can check their website for a listing).

as for medical assistance-check with your local health and social services department as well. there are more programs than you can imagine-and some have VERY high income and resource caps. if you find you are eligible but with a high 'soc' (share of cost-it's not a premium you pay, it's like the deductable on standard insurance but it's done on a monthly vs yearly basis) consider the following-in most programs the share of cost is NOT something you pay every month. you only pay as you go-so if you/child has med costs of $100 one month and your soc is $900 you still only pay $100 to the providers, pharmacy (whatever). BUT-it can be a godsend when you have a month where the bills are in the thousands (or tens of thousands)-you will only have that set 'soc' to meet (and 'technicaly' you only have to have 'obligated' yourself to meet it in most programs-so you indebt yourself to the provider for it and if necessary set up a payment plan).

one other suggestion-if you have a minor child whose disability/illness is orthopedic, burn, spinal cord injury (and some others) in nature-consider exploring a referral from your doctor to shriner's hospital. they will take patients if a doctor does a referral indicating that a child will likely benefit from their care. they do not take income or resources into consideration nor will they accept ANY form of payment or even bill any insurance you may have for any care provided in their facilities. an absolutly AWSOME organization (dd is having orthopedic surgery through them thursday ).

 

[SueM in MN]

if you find you are eligible but with a high 'soc' (share of cost-it's not a premium you pay, it's like the deductable on standard insurance but it's done on a monthly vs yearly basis) consider the following-in most programs the share of cost is NOT something you pay every month. you only pay as you go-so if you/child has med costs of $100 one month and your soc is $900 you still only pay $100 to the providers, pharmacy (whatever).

That depends on how the state works it. In Minnesota, it is a monthly payment. They tell you what your share is and you pay that same amount each month, whether or not you had any claims that month. That is for the "Katie Beckett" or "Medicaid Waiver Program" in Minnesota. So, you pay a wset amount each month and at the end of the year, if you have paid in more than you used, the 'extra' money goes to the state general fund (not back to you and not credited to the next year). In MN it is an obligation to pay it and you can get into trouble as with any other 'debt' if you don't pay it.
Other states might handle it differently and different programs, even in the same state, may work differently.

one other suggestion-if you have a minor child whose disability/illness is orthopedic, burn, spinal cord injury (and some others) in nature-consider exploring a referral from your doctor to shriner's hospital. they will take patients if a doctor does a referral indicating that a child will likely benefit from their care. they do not take income or resources into consideration nor will they accept ANY form of payment or even bill any insurance you may have for any care provided in their facilities. an absolutly AWSOME organization (dd is having orthopedic surgery through them thursday ).

Shriners is a very good suggestion. They have many hospitals; some specilize in different things (mostly burn vs orthopedic), but IMHO they all have excellent care.

 

[pcparamedics01]

They do, but each state does things somewhat differently. They all have to go by the child's income to determine eligibility, but some states have a 'family co-pay' that is based on the family income. In our case, we would have paid in more per month than DD would have used and, if whatever money you don't use, you lose at the end of the year. So, we opted not to have DD in that program.
You can google your state to find out how to apply and what the requirements are. It might be called "Medicaid waiver" or "Katie Beckett program."
You would also be able to find out about it from your county Department of Health or Human Services.

Yup we were on the Katie Beckett and were cancelled. It paid for my son's speech and other co pays, extra blood work not covered for biomedical and such. It was not based on need but I got a letter one day and got cancelled. I should try to reapply.

 

[pcparamedics01]

Do other states not have medicaid waiver programs? You might want to look into it. It's worth a shot.

I think our medicaid waiver is called Katie Beckett that Sue had said. My son got cancelled from that.

 

[barkley]

That depends on how the state works it. In Minnesota, it is a monthly payment. They tell you what your share is and you pay that same amount each month, whether or not you had any claims that month. That is for the "Katie Beckett" or "Medicaid Waiver Program" in Minnesota. So, you pay a wset amount each month and at the end of the year, if you have paid in more than you used, the 'extra' money goes to the state general fund (not back to you and not credited to the next year). In MN it is an obligation to pay it and you can get into trouble as with any other 'debt' if you don't pay it.
Other states might handle it differently and different programs, even in the same state, may work differently.

Shriners is a very good suggestion. They have many hospitals; some specilize in different things (mostly burn vs orthopedic), but IMHO they all have excellent care.

that's the 'trade off' when your medicaid is operated under a waiver. you in essence are waived of one or more of the standard criterias for eligibility but it can end up in a trade off that people receiving the same services but not waived of that criteria are not subject to (i think with 'katie beckett' the monthly co-pay is because of the elimination of considering the parent's income or assetts-looking only to the child's to get them eligible in the first place, but then there's a sliding scale that uses the parent's income to determine the co-pay). when i administered these types of programs in the state i retired from we always tried to get kids covered by the program that offered the most benefit with the lowest fee to the parents (or idealy no fee).

it does def. vary state to state. in order for a state to get fed funding they HAVE to provide at least the minimum standards of care the feds mandate. some provide much more-those that don't can't receive fed funding. some states do this because they look to what their state funding would cost if they just offered a bare bones program and it would be cheaper than their share (with fed help) providing all the elements of the fed mandate. SOME don't for purely 'ethical' reasons (read-political)-one of the primary ones being over the issue of the fed requirement of covering certain types of abortions (that state may not permit any or not as liberal as the fed's allow-the feds say 'you at least cover them or no fed funding-then the client can at least search out a doctor in an adjacent state to perform it'). unfortunatly this can cause a disservice to and disadvantage people from qualifying for other services that opting for the fed share would help provide

again-i suggest people check with their local dhss. it can even vary in services from county to county in an individual state. some counties have programs that only thier residents qualify for that are independantly funded (the one i worked for had one specifically for people with pending ssi or ssd applications-we knew it could take forever to get approved so it was a safety net to try to prevent a person from either going bankrupt or not seeking the med. services they desparatly needed).

one other thing to look at if you (or your child) is on a medicaid type program and get notified of ending eligibility-see if the county or the state you are in offers any kind of 'transitional' program. these can be programs that continue to cover some types of services for a set period of time despite not meeting the normal eligibility criteria (we had one that provided for 9 months of coverage to give people a chance to try to secure other coverage or qualify under a different program).

 

[OKWMom]

Not to hijack this thread, but I have a question about a child qualifying for SSI or SSDI. Assuming the child did not qualify because she is a minor and her parents' (not married) income is higher than the limit, what effect does it have on the child's eligibility if one of the parents retires and is drawing social security? This also assumes the other parent continues working and her income is higher than the limit.

Will the income of one parent keep the child from being eligible or will she be eligible upon the retirement of one parent?

Thanks for any assistance.

 

[barkley]

Not to hijack this thread, but I have a question about a child qualifying for SSI or SSDI. Assuming the child did not qualify because she is a minor and her parents' (not married) income is higher than the limit, what effect does it have on the child's eligibility if one of the parents retires and is drawing social security? This also assumes the other parent continues working and her income is higher than the limit.

Will the income of one parent keep the child from being eligible or will she be eligible upon the retirement of one parent?

Thanks for any assistance.

retirement of one of the parents won't make her become eligible. but if the parent is retired, she should at least be getting (as a minor child) a social security payment also. minors who have a parent receiving social security disability or straight social security retirement get a payment as well. it goes until they are 18 (or 19 if they are still in highschool and will graduate within a certain time frame). unfortunatly no medical benefits come with that.