SSD update for March 2009!

[brendapals]

Greetings friends,

Here is my latest adventure on SSD for you-

Yesterday, 1030am appt at SS office, with my lawyer, to file an appeal, based on the denial I rec'd on 1/14/09. Claimed I had made too much money from 6/08 to 12/08. Since I have learned so much from this forum, I cut my hours down beginning 1/1/09 so that I would be within their SGA (income limitation).

THREE AND ONE-HALF HOURS LATER..............................


We ended up filing a completely new claim, the worker said she knew that ALS fell under compassionate allowances, but NOT SURE IT FELL UNDER "TERI" list. So I tried telling her, in my best slurred speech ever, but she said that the people who reviewed my app would decide if it was "teri".

So, let's cross our fingers, I should be approved, I think, for ssd pymts to start in June 09. My lawyer/friend also is putting together another appeal, based on how I reduced the work I did in 10/08, 11/08, 12/08, but my employer still paid me the same. I'm not sure about all the specifics. Big thing-my lawyer is not charging me anything-so no one taking advantage of the ole girl here!

All I know is, what an exhausting process! And my family wants to know why I'm still in pj's a 3pm?

Don't worry-I'll keep you posted on "the rest of the story"
Never give up,
Never let up,
Never lose faith,
brenda

[rose]

Do you ever feel like you just stepped into a surrealistic dream??? The TERI designation has been around a lot longer than compassionate allowances. I think the good news is that they did not question what you've earned, and as ALS is a TERI condition,whether or not this lady was "sure" (sheesh!!!) that should mean that you won't have any more snags. I'm happy for you that your lawyer friend did this for you, its reassuring to have friends that come through.

The bureaucracy of the Social Security Admn. still amazes me. A good example being that they took the payment for the month of December Medicare premium from my first SSD pay, which was in January, (they also deducted January's payment) so, even though they retroactively covered me for my medical in December, there was no way for me to use it, because (1) I didn't know I had it (which seems important, call me crazy) and (2) I really DIDN'T have it yet, because my SSD claim at that point was still being appealed. So, in reality what I "got" to do, was pay my $400 COBRA + $96.40 for my non existent Medicare for December. Don't get me wrong, I'm happy to just be done with it, even started getting my LTD checks.

Anyway, my intent was not to use your thread to vent on, I actually wanted to point out to you that one month from when you will receive your first SSD check, you will have Medicare coverage if you so desire to use it. It will be the original plan, does not include dental or prescriptions.

[vickster]

Wow Brenda!
Sounds like you have been threw alot with SSI. I especially like how you used your "best slurred speech!!" I too have bulbar with the slurred speech and can relate. When I don't feel like talking to someone, I use my best slurred speech.

My story relating to disability and work:
My fatigue and slurring was increasing and I finally took a leave in Jan 2009. I went on Short term disability through work. I can't believe how many times I could have screwed myself over. My manager was sympathetic with my condition and suggested I go part time; I was reluctant to do this thinking it might mess up my benefits (it would have). Yesterday I got a message from Human Resources where I work that I should send in a written resignation. This didn't sound right to me although the gal said this would not jeopardize my health benefits or Long Term Disability Plan. :confused: I asked my husband to call an attorney specializing in employment and the attorney said "definitely not - do not resign." I don't know much about this - but I see how people can go down the wrong path by people giving wrong info.

Vicki

[brendapals]

rose-bless your heart-vent anytime!

vicki-
I don't know about the hr people asking for your resignation?:confused::confused Sounds like you'll get all the right answers before doing anything though.

Yeah-my slurred speech, nothing to drink for the first hour, 1 bathroom break the whole time, BUT......................
my emotional lability never showed its ugly head!
yippee:razz:

[crystalkk]

Brenda,

I will keep my fingers crossed for no problems this time. It's great that you have a friend that is helping you.

[Felicia38]

Hello, I was wondering can you sign up for disabiliy while you are getting short term disability from were you work? How does the Cobra benefits work? My husband is going to Emory next Tuesday to confirm the als diagnosis. I am just wondering if/when they diagnose him does someone lead you by the hand and explain your financial options or is this something i have to research? This is confusing because I have no experience with any kind of government assistance such as medicaid, ssi, etc. Me and my husband want to make sure we handle this correctly. Any advice on this would be apprectiated. Thank you.

[brendapals]

hey Felicia

I'll try my best to help you with what info I have. It is my understanding that the government (social security administration) will begin paying benefits under disability after a 5 month waiting period., with a dx of ALS. That's after your husband is approved of course.the amt that they allow you to make is $980 per month. It's called SGA-I can't remember what it stands for though.

I'm not sure if they have to factor in short term dis. payments or not.

Now, if for that 5 mo, he can't work, he would be eligible for SSI pymts if, and only if, your total assets are at or below $2000.

And then there's the part where they factor in if he has enough credits paid in over his yrs of working to be eligible for ssd. From my experience, the ALS Assn patient advocate tried to help all she could, she got the letter from my neuro and all of my office notes. She also tried to tell me there was a max that a person could make while waiting, but wasn't sure of the amt.

My employer got a 6 pg form from them yesterday, wanting to verify that I had worked in 08 and 09, and what the difference was from yr to yr. In my case, I think they are going to be able to go back at least 2 months from my official date of 1/1/09 that I gave them this past Tues. Something about taking only a % of my income as earned. It's such a mess.

I would strongly suggest you find someone, either at the clinic, or maybe a friend of yours-to help you muddle thru it all. It's not a piece of cake that's for sure. I'm sure someone other than myself has a lot more info for you too,
take good care,
let me know if I can help,
brenda

[jimmybob]

first and foremost, retain an attorney that specializes in SS benefits. the cost is worth it! make copies of your employers benefits packet that covers short and long-term disability. make copies of the dx with the doctor's recommendation that this disease will prevent the pt from performing work. remember, you're dealing with the federal government, they need everything explained like talking to a 5 year old.

if your company has a short-term disability program, take advantage of it immediately after confirmed dx of ALS. simultaneously begin the process of applying for SS benefits.

side note: my company offered 6 months short-term disability, with full pay and benefits, plus the legal counsel specializing in SS disability benefit litigation that started the week after my dx. it still took 6 months, after my short-term disability expired, to get my first SSDI check, retroactive of course.

[Felicia38]

Thanks for responding. I am still confused. If my husband gets diagnosed tomorrow he can then take his short term disability here at work and while on the short term disability he can go ahead and file for ssdi check? Am i understanding that part right? Does my income get factored into the equation? Will the ss benefits start right away? What is SGA?

[rose]

OK, there are some forum members that have a better grasp on this, but I will start. If your husband's employer paid into the state short term disability program he will qualify for this, but probably ONLY after he runs out of any sick pay he has accumulated at work. And, only if his company contributed to the state for their employees. (there would be a deduction out of his pay stubs, you can find this out easily enough)

Long term disability policies differ. We talked about this fairly recently on the forum. One contractual part of seemingly anyone's I've heard of, is that whatever % of his gross pay it is worth will be actually be that total MINUS any other compensation he receives. By any, I mean any! social security payments, retirement, other policies, whatever. When he will be eligible to start with payments from LTD is also dependent on the policy he has.

Using my policy as an example, I qualified to start receiving compensation after I had been out of work for 5 months. Not all policies say 5 months, some are 6, some may be less. There was a mandatory 45 day wait period from the date that I applied for benefits. So, for example, if I had waited 5 months to file, even though I'd be eligible for payments to start right then, I would still have had to wait the 45 days, and then receive the first check, which would include the approximately 6 weeks of back pay.

My payout amount was based on an average of what I earned (not my pay rate, but what I actually was paid) for the previous 12 months. This is not universal, there seems to be quite a variation between insurance companies/policies when it comes to this. One of the forum members said his rate was based on what he earned the last day that he worked.

The paperwork is almost as extensive as that for applying for social security.

Your husband should put the medical code for ALS on absolutely every form he fills out, whether it be short term, long term, or social security. Also spell out the words Amyotrophic Lateral Sclerosis, don't abbreviate, don't use the terminology Lou Gehrig Disease.

The code number is 335.20.

Social Security has some specific terminology that is used as well. The term "TERI" that Brenda was talking about stands for terminal disease. ALS, along with end stage renal disease and a few others, officially are TERI qualified.

Recently, Social Security implemented a new program to help speed up the process. It makes provision for those proper documentation, to have their their claims approved in as little as a few days. This is is called the Compassionate Allowances Program. Irregardless of how quickly your husband's claim would be approved, he would still not be eligible for any payments before the 6 month mark from when he left work, or his hours were so greatly reduced that he earned little enough to satisfy them (what Brenda was doing battle over)

Social Security has a website that is helpful to an extent. All of the social security information I was just discussing, is only for social security disability, there is a supplemental disability program, it has strict parameters, such as no more than $2,000 in assets, and a very small monthly income (I do not know what the amount is)

All three of these, the std ltd and ssd all have to do with what your husband earns/earned. Whether or not your income impacts this is not known to me, BUT, some other forum members, such as georgia, are well versed in it, and should see this thread (hopefully)

I am not sure of what SGA stands for, I think I need to see it in context... if I figure it out, I'll amend this post.

I was advised by the director of the ALS clinic that I attend, not to employ an attorney. I did not check into using one, as she had said they take almost half. Whether or not this is true, I don't know. Often times, if there is a snag, getting your state legislator involved can speed things up tremendously. It did for me, and for others here.

I do know the amount he will receive from any of these resources is not negotiable. They are all formula driven, based on his earning history.

Hope this gets you started, and all the best of wishes and hopes for your husband.

[Marjorie R. Wilcox]

While Rick was on temporary disability from work, he applied by telephone interview for the permanent disability, which is Social Security benefits before the age of retirement. He went automatically from one to the other, with no time lapse in between. We considered ourselves fortunate because we had heard that it could take a very long time.

[Felicia38]

Thanks everyone, as of right now don't know which diagnosis he will have, but the information you have given is appreciated.

[brendapals]

Hope this is good news, maybe someone will let me know.


I emailed my friend the lawyer, and asked her to please see about the status of my ssd claim. I re-applied on 3/10/09, and my employer completed and mailed her paperwork on 3/17/09.

Well, she tracked my claim down, and it was with the "DDDS", all they could tell her was that a decision was made on 4/1/09. And I should get a letter in a week or two.

So, now we wait and see I guess,
brenda

[crystalkk]

Brenda,

Good luck with the letter, I'll be praying for you that it is approved.

[DgtofTNfan]

Brenda,
Hope there is good news coming in your mail and this hassle is over for you!

Felicia
I think the only thing that would factor in your income to decrease his amount that you mentioned is SSI which is what people receive when approved for disability but who have not paid enough into the system for SSDI. SSI is household income based.

The SGA is the Substanital Gainful Activity. The best I understand it is if you are still working while receiving disability or applying for disability, your earnings and working capacity are evaluated. I am not really versed in SGA and the social security website is not helpful.

[brendapals]

yes, I think that's what SGA stands for. I know in my case, my SGA amt is $980/mo GROSS earnings that I can do.

Makes things a little tight at my house, but hey, we've made it 3 months now, so as my dear father used to say...

I could walk around with a nail in my foot that long!

take care all,
brenda

[rose]

Brenda,
That's good news! (I hope) ... if you signed up for direct deposit, check your account for a deposit, mine went in before any official letter from SSD arrived, in fact it was in there before the congressman's aide had called me to tell me it was approved. (but I was unaware) When the payment is made is based on where your birthday falls, so, because mine is on the 5th, it means the deposits is supposed to be for the first Wednesday after the 5th of each month. ~ I think.... don't take that as gospel though.

[brendapals]

thanks rose,
I surely hope it's good news. And don't you worry, I call and balance my checkbook every other day, and it's about as low as it can go right now...on the limbo scale!:lol::lol::lol::lol:

I'll keep you posted,
-b