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Archive for the ‘Supplemental Security Income’ Category

Fall update 2011: Creating a trust; role of DDS in Texas

Friday, September 30th, 2011

Establishing a trust can greatly aid special-needs individuals

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OK, everybody…one last roundup of “Things to Know.”

From a Sept. 26 piece entitled “Government Benefits for Special-Needs Individuals,” a good look benefits’ programs and a great idea for helping special-needs individuals–set up a trust for them:

Planning is paramount

[Although it is crucial] to ensure that you have adequate planning in place to preserve your child’s eligibility for government assistance, it is important for individuals to know what government benefits are available to a special-needs child and when these benefits are available. Because government programs can be confusing and . . . they change often, anyone seeking to learn more about receiving government benefits for a special-needs child should consult an attorney or review current documentation on eligibility from each individual government program.

Four programs for special-needs families: two not means-based

There are four relevant government benefit programs available to special-needs families. These are Supplemental Security Income (“SSI”), Medicaid, Medicare and Social Security Disability Insurance (“SSDI”). [Neither] SSDI [nor] Medicare are… means-based programs. In other words, there is no investigation into your finances to determine if you qualify for the program based on your income or your resources. Medicare is a form of sponsored health insurance available for the elderly and the disabled and SSDI is available to individuals and minors or special needs children of an individual who has died, retired or become disabled.A special-needs child who is under age 22 and who is not working can obtain SSDI benefits based on his or her parents’ prior earnings.

SSI, Medicaid are means-based

SSI and Medicaid are both means-based programs. Eligibility for those programs is based on financial need and strict requirements must be met prior to receiving benefits. Medicaid can provide in-home care, cost of hospitalization and nursing-home care as well as some housing benefits to recipients. A special-needs child can receive SSI, SSDI, Medicaid and Medicare all at the same time.

Creating a supplemental-needs trust

The distinction between means- and nonmeans-based programs is important to understand. [Because] these benefits add greatly to a disabled person’s ability to receive care, and given the expensive cost of long-term medical and nursing care, anyone seeking to give a special-needs child assets may disqualify him or her from receiving means-based program benefits. However, setting up a supplemental-needs trust for your special-needs individual can help provide for their care without disqualifying him or her from SSI or Medicaid benefits.

Medicaid, SSI linked

Although the requirements should be reviewed periodically for changes, currently, to qualify for SSI benefits, a disabled adult cannot own more than $2,000 of assets. There is a link between eligibility for Medicaid and eligibility for SSI. Eligibility for SSI makes a disabled person eligible for food stamps and Medicaid, which pays medical expenses, nursing home care and mental health services. Given the very low poverty threshold, setting up a supplemental-needs trust can help provide for extra care over and above that which the government may provide.

All in all, a thoughtful piece and well worth reading the entire article. Even though slanted toward New Jersey residents, the info is relevant to all special-needs families in the U.S.

The following is slanted toward Texas residents, but, again, good information for those in states with similar systems. From a Sept. 29 press release at Digital Journal:

DDS plays pivotal role in SSI/SSDI claims

Whether a Texan wants to make a claim for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), the application process begins and ends with the Social Security Administration (SSA). However, after a Texan applies for benefits, their claim is forwarded to an intermediate governmental body.

The Division for Disability Determination Services (DDS), part of the Texas Department of Assistive and Rehabilitative Services (DARS), makes disability determinations for all SSDI or SSI applicants in Texas. SSDI and SSI Benefits When Texans have physical or mental disabilities severe enough to hinder regular work activities, they can apply for federal SSA benefits to help restore a portion of lost income. The SSDI program covers disabled workers, and sometimes their family members, who have earned benefits by paying Social Security taxes during their employment.

DDS acts as SSA’s agent

The SSI program considers an applicant’s means and resources when determining coverage. Lower income adults and children typically qualify, but some people may be eligible for both programs. Application Process The application process, and how a person is determined as disabled, is the same in all U.S. states. Applicants fill out forms, either in person at a local Social Security office or online, providing information about their medical conditions, treatment and why working is difficult. They must also explain their work duties before the injury or disability and agree to release their medical records to the SSA and DDS. Once the Texas DDS receives the completed application, it can act as the SSA’s agent to determine whether the applicant is disabled.

Again, lots of good info here, and well worth the time to study it and make notes so you can ask good questions when consulting with your disability attorney.

 

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Syracuse-related study raises serious questions about fairness of SSA disability judges

Saturday, July 30th, 2011

TRAC finds wide disparity among ALJ  rulings

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No study about SSA Disability in recent memory deserves more attention than the one recently released (and subsequently pooh-poohed by the SSA) from Syracuse University’s Trans­ac­tional Records Access Clear­ing­house (TRAC), a non-profit research orga­ni­za­tion.

Don’t let the system beat you down

If you (or a family member or friend) are one of the unlucky minions to feel trapped and ignored by the federal government’s program to aid disabled persons, please don’t let the findings of this admittedly bleak report stop you from pressing forward with your claim. If anything, this report should legitimize the idea that disability judges can be arbitrary in their rulings and therefore a trained, experienced disability attorney could be your best ally in this notoriously time-consuming process.

Huge disparity among judges’ approval rates

The following is from a Baltimore news site called Baltimore City Paper Blogs; it begins with a district centered in San Antonio, Texas–but the grim numbers apparently apply across the nation:

In San Anto­nio, Texas, peo­ple hop­ing to get Social Secu­rity dis­abil­ity pay­ments could see their cases assigned to any of 17 judges. The luck of this draw mat­ters a lot. One of the judges grants ben­e­fits in just 14 per­cent of cases. Another judge hands over benefits—which range from about $700 per month to about twice that—92 per­cent of the time.

That 78 per­cent dis­par­ity rate makes San Anto­nio the sec­ond most lottery-like sys­tem in the Social Secu­rity Administration’s arch­i­pel­ago of hear­ing offices, accord­ing to a data analy­sis by the Trans­ac­tional Records Access Clear­ing­house, a non-profit research orga­ni­za­tion housed at Syra­cuse Uni­ver­sity. (Dal­las is num­ber one, with 83 per­cent disparity).

“To a sur­pris­ing extent the records on dis­abil­ity deci­sions show again and again that even within the indi­vid­ual offices there is not a clear con­sen­sus among the judges about which claims should be awarded ver­sus which should be denied,” the authors of the report , David Burn­ham and Sue Long, write. “The prob­lem today is some­what worse than it was four and a half years ago.”

This study is from a group aligned with Syracuse University

In case you missed the in-line link, here it is again, the link to the report summary by TRAC, the research outfit aligned with Syracuse University, which reports studying nearly two million claims filed with the Social Security Administration. The report starts thusly:

A court-by-court analysis of close to two million Social Security Administration (SSA) claims has documented extensive and hard-to-explain disparities in the way the administrative law judges (ALJs) within the agency’s separate hearing offices decide whether individuals will be granted or denied disability benefits.

These findings — discussed in detail below — suggest that in many SSA hearing offices today, the chance a disability claim is granted or denied is often determined more by the particular judge assigned to handle it than by the facts and circumstances presented in the case. The findings further document that the problem is not simply the result of a few judges whose decisions are far out of line with those of other judges on the bench. Rather, the agency’s own case-by-case evidence demonstrates that the problem is systemic. To a surprising extent the records on disability decisions show again and again that even within the individual offices there is not a clear consensus among the judges about which claims should be awarded versus which should be denied.

Systemic.

That doesn’t sound good, as anyone with a systemic disease knows and understands. That means whatever the problem is, it’s not localized but instead spread throughout the entire system.

USA Today reports on ‘disparity’

Following is an excerpt from a recent USA Today report, illustrative of the perception of the status quo in such matters:

Congress and the agency’s inspector general have begun looking at the disparity. Yet both Social Security officials and advocates for the disabled say they are reluctant to interfere with the judges’ independence.

“Congress has been pretty enthusiastic about the idea of ALJ independence,” said Social Security Commissioner Michael Astrue, adding that only “a handful” of judges have approval ratings above or below average.

“They can’t tell an ALJ how to decide cases, but they can make sure they follow the agency’s policies.” said Ethel Zelenske, government affairs director for the National Organization of Social Security Claimants’ Representatives.

The Social Security Administration reports about 8.4 million disabled workers nationwide get an average monthly benefit of $1,069. Another 8.1 million low-income disabled people with little work history get about $500 a month in Supplemental Security Income. More than 2.9 million people applied for disability-worker benefits in fiscal year 2010, up 38% over the past five years, agency figures show.

To cope with the increase, Social Security has added about 200 judges in the past five years and streamlined the process of reviewing claims. The average wait time for a decision has steadily dropped, from a peak of 532 days in August 2008 to 354 days last month, agency data show.

TRAC responds to SSA’s response

To be fair, the SSA did respond to TRAC’s study-report, and TRAC’s response to that can be found here.

Just remember, we can help connect you with a compatible, trained attorney who can help you with your case–if nothing else, it’s possible that an experienced attorney might be able to steer your case toward a more reasonable outcome.

 

 

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Posted in Cancer, Cardiovascular, Connective Tissue Diseases, Digestive, disability, Endocrine, Genitourinary, Hematological, Immune system, Impairments that Affect Multiple Body Systems, Mental Disorders, Musculoskeletal, Neurological, Respiratory, Skin, Social Security, Social Security Disability, Special Senses and Speech, Supplemental Security Income | Comments Off

Three recent books address ‘mental health epidemic’

Thursday, June 30th, 2011

Numbers of reported afflicted great cause for concern

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A disturbing trend

A June 23 review of recent books at The New York Review of Books begins with this startling observation:

It seems that Americans are in the midst of a raging epidemic of mental illness, at least as judged by the increase in the numbers treated for it. The tally of those who are so disabled by mental disorders that they qualify for Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI) increased nearly two and a half times between 1987 and 2007—from one in 184 Americans to one in seventy-six. For children, the rise is even more startling—a thirty-five-fold increase in the same two decades. Mental illness is now the leading cause of disability in children, well ahead of physical disabilities like cerebral palsy or Down syndrome, for which the federal programs were created.

The review, entitled “The Epidemic of Mental Illness: Why?,” addresses three new works:

 

‘Astonishing 46 %’ meet criteria

You’ll have to read the whole thing to decide whether these books might be useful to you or someone you’d like to help, but we’ll leave you with one more passage from the review, before more commentary on the same:

A large survey of randomly selected adults, sponsored by the National Institute of Mental Health (NIMH) and conducted between 2001 and 2003, found that an astonishing 46 percent met criteria established by the American Psychiatric Association (APA) for having had at least one mental illness within four broad categories at some time in their lives. The categories were “anxiety disorders,” including, among other subcategories, phobias and post-traumatic stress disorder (PTSD); “mood disorders,” including major depression and bipolar disorders; “impulse-control disorders,” including various behavioral problems and attention-deficit/hyperactivity disorder (ADHD); and “substance use disorders,” including alcohol and drug abuse. Most met criteria for more than one diagnosis. Of a subgroup affected within the previous year, a third were under treatment—up from a fifth in a similar survey ten years earlier.

If any of this is close to the target, these are trends we can not ignore. The stats on children have to be particularly disturbing, even for the most hard-hearted among us.

Skepticism: ‘Researchers come up empty-handed’

However, what may be most disheartening for those whose loved ones suffer from these ailments is that all the modern hoo-haw about science and pharmacology might be just that: hoo-haw. Writing about the same three books, and the review itself, Jacob Sullum writes June 13 at Reason.com:

As those questions suggest, Angell seems to share the skepticism of the authors whose books she reviews: University of Hull psychologist Irving Kirsch, who in The Emperor’s New Drugs shows that antidepressants are only slightly more effective than placebos, so slightly that the difference may be attributable to stronger expectations of improvement primed by the drugs’ side effects; the journalist Robert Whitaker, who in Anatomy of an Epidemic argues that the “astonishing rise of mental illness in America” can be understood largely as an outgrowth of the desire to sell psychiatric drugs; and Daniel Carlat, a Boston psychiatrist who confesses his profession’s shortcomings in Unhinged: The Trouble With Psychiatry. Angell notes that “none of the three authors subscribes to the popular theory that mental illness is caused by a chemical imbalance in the brain.” She adds that “the main problem with the theory is that after decades of trying to prove it, researchers have still come up empty-handed.”

None of this can be comforting to anyone connected to a friend or loved one affected by mental illness. Imagine being stuck “in the system” trying to get SSI or SSDI benefits for someone so afflicted.

Delays in system back in the news

The system in general is infamous for its delays and backlog, although some announced efforts we’ve covered here have been targeted at reducing the wait times, which can linger from many months to years. Sadly, recent reports indicate those efforts are losing headway. According to a June 22 report in Baltimore City Paper:

The Social Security Administration (SSA) may be losing its battle against the backlog of disability cases, according to an analysis of its data by a New York-based nonprofit.

“In particular, the data show that while progress had initially been made, the hoped for reduction in backlogged matters ground to a halt in the last 12 months,” a report by the Transactional Records Access Clearinghouse (TRAC) says. “Since then the number of pending cases grew by 5 percent. More success has been achieved in reducing average wait times.”

We can help find an attorney

That’s good news about reducing wait times, but the backlogged cases is definitely not improvement. If you’re feeling “stuck in the system” after having trying to make a go of it by yourself, we understand. And we can help. Perhaps it’s time you reach out to a trained, experienced attorney who can guide you through the maze of federal bureaucracy. If so, please scroll down and, under the heading “Need Help With Your Disability Case?” please complete the online form to get a personal response to your case.

 

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SSA touts advantages of online disability application

Saturday, April 30th, 2011

The Social Security Administration reports in a Webinar filmed in October 2010 that “Last year SSA received almost half a million more disability applications than [in] the previous year. 70 % of those applications were filed online.”

Watch ‘Webinar’ for basics of online application

Click here to watch the Webinar; it’s about 40 minutes long, covering these topics:

  • Advantages of doing business with Social Security online;
  • Who can file online;
  • Getting started;
  • Applying for benefits;
  • Recent enhancements to online applications, and
  • What happens after you submit.

The SSA encourages those with the following qualifications to apply:

  • Individuals applying for Social Security benefits who are 18 or older;
  • Those with a mental or physical condition that
    1. has prevented work for at least 12 months, or
    2. is expected to prevent work for at least 12 months, or
    3. is expected to end in death
  • Residents of the U.S. or its territories/commonwealth.

Why apply online?

The SSA describes the ease of submitting an online application:

Applying online for disability benefits offers several advantages:

  • You can start your disability claim immediately. There is no need to wait for an appointment
  • You can apply from the convenience of your home, or on any computer; and
  • You can avoid trips to a Social Security office, saving you time and money.

What’s needed to do the application?

To the question, “What information should I gather before I get started?” the SSA says:

For the Disability Benefit Application, you should have:

  • Your Social Security number;
  • Direct deposit numbers (from a check, or ask your financial institution for the numbers) to have your monthly benefits deposited automatically;
  • Your W-2 Form from last year or, if you were self-employed, your federal income tax return (IRS 1040 and Schedules C and SE);
  • An original or certified copy of your birth certificate and, if you were born in another country, we also need proof of U.S. citizenship or legal residency;
  • Information about any workers’ compensation claim you have filed, including date of injury, claim number, and proof of any payments made to you; and
  • If you were in the military service, the original or certified copy of your military discharge papers (Form DD 214) for all periods of active duty.

For the Adult Disability Report, you should have:

  • The name, address, and phone number of someone who knows about your condition and can help with your claim;
  • Information about your illnesses, injuries, and conditions, including dates of treatment, and patient ID numbers; and the names, addresses, and phone numbers of the medical providers who treated you;
  • Names of medicines you are taking and who prescribed them;
  • Names and dates of medical tests you have had and who requested the tests;
  • Medical records that you already have; and
  • Types of jobs and dates you worked for your last five jobs.

Other frequently asked questions

Here’s some other common questions and the answers from the SSA:

Do I have to finish all the questions in one session?

No. If you need more time, you can save the information you entered and then stop. We will give you separate numbers for the Disability Benefit Application and the Adult Disability Report that you can enter when you want to return to answer the rest of the questions.

What if I can’t answer everything?

Even if you are unable to answer all the questions on the Adult Disability Report, you may still submit it to us. We will help you get the missing information.

However, make sure you complete the Disability Benefit Application and select the “Sign Now” button to submit it.

What happens next?

We will ask you to print and sign a medical release form that allows us to get information from your doctors. If you do not have a printer, we will send a medical release for you to sign.

You also will print a cover sheet that you can use to send us the signed medical release and any medical records you already have in your possession.

We will contact you if we need more information about your claim.

Once we have all the information we need to make a decision about your disability claim, we will send you a letter.

Availability

The online forms are available to you seven days a week during the following hours (Eastern time):

Monday-Friday: 5 a.m. until 1 a.m.
Saturday: 5 a.m. until 11 p.m.
Sunday: 8 a.m. until 10 p.m.
Holidays: 5 a.m. until 11 p.m.

How to get started

Follow these 4 easy steps to apply online

Step 1. Review the Adult Disability Checklist for details about what you will need before starting the online process.

Step 2. Fill out the online Disability Benefit Application to provide us with information regarding eligibility for payment.

Step 3. Fill out the online Adult Disability Report to provide us with medical and work history.

Step 4. Fill out, sign and mail or take the Authorization to Disclose Information to the Social Security Administration Get Adobe Reader to your local Social Security Office.

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SOAR’s anecdotal successes may pave way for co-operation among state, federal programs

Monday, February 28th, 2011

By Mike Hinshaw

Howard Long is a testament to the possibilities of the SOAR program, so named because it’s an acronym for SSI/SSDI Outreach, Access and Recovery, a program administered with states and various agencies by the Social Security Administration to help reduce homelessness and provide SSI and SSDI benefits for qualified applicants. The homeless community is particularly difficult to enroll, assess and reliably contact, hence the outreach.

According to a Feb. 22 story at StarNewsOnline, “One year ago Howard Long, 50, was homeless, had no income, and was living outdoors. He had been to the emergency room at least twice and had been arrested for sleeping in public.

“Today Long rents an apartment, pays for groceries and utilities and has health insurance from Medicare.

“What changed Long’s life is an innovative program called SOAR, which last year helped get 31 chronically homeless people in New Hanover County into housing.”

Chronic homelessness

The story says it’s all part of a 10-year effort mounted in concert with United Way to reduce “chronic homelessness” in the Cape Fear region of North Carolina.

According to the local program director, Dan Ferrell, the benefits accrue way beyond the individuals who get help:

” ‘Communities like those in the Cape Fear region have become increasingly aware of the high costs of homelessness in terms of law enforcement, emergency room care and social services,’ Ferrell said. ‘SOAR is one of our major initiatives to reduce the costs of homelessness.’

“SOAR-acquired benefits bring taxes back to state and local communities.”

Local authorities say benefits outweigh the costs

The story says the 31 recipients will split nearly $270,000 this year and indirectly quotes Ferrell as indicating the benefits back to the community will “significantly exceed” the costs.

A specific benefit cited is that the beneficiaries’ lives improve enough to get out of the emergency-room cycle of using hospitals for health care. The thrust of the story is that addressing the essential cause of homelessness pays off better than the fragmented approach of an endless repetition of street sweeps, lockups, and a life of bouncing between temporary shelters and blowing in the wind.

Applying for benefits ‘very complicated, difficult and somewhat adversarial’

But without a concerted effort involving inter-agency cooperation–from federal to local communities–local authorities have few choices besides traditional responses. “Applying for the benefits is ‘very complicated, difficult and somewhat adversarial,’ [Michael] Hosick said. ‘Homeless people in particular can quickly get frustrated and give up.’ ”

Hosick is the local executive director for Triangle/Coastal Disability Advocates.

The case that Jack built–over 30 years

More insight–and another success story–comes from a program in Florida, the Bridgeway Center: “SOAR (SSI/SSDI Outreach, Access and Recovery) is a highly effective process that works within the system to assist disabled individuals in obtaining Social Security benefits.  SOAR has proven to be a successful addition to the array of strategies in the prevention and alleviation of homelessness.”

The example case that Bridgeway has on its site concerns the story of  Jack, “who had exhibited emotional and behavioral problems since childhood; anger, mood swings, inability to hold a job, and difficulties completing tasks of daily living.  Growing up, his mother would get so frustrated with him she threw him out of the home many times.”

The cycle would be repeated many times, for decades.

On one of these occasions he was introduced to alcohol and realized that it made the voices in his head go away.  Jack did not like being on the street so he would beg his mother to let him come back home.  When Jack was found wandering the streets extremely drunk at age 16 he was taken to a hospital and admitted under a Baker Act.  Jack stayed in the hospital until he was 18, then he was released to his mother, stabilized on medication.

This living arrangement lasted for around 6 months before again he was on the streets.  This pattern continued for six years, in and out of hospital, staying with his mother, becoming homeless and back to hospital, until his mother passed away.  Then Jack had no place to go; he truly was homeless.  He stopped taking his medication and began to use street drugs. At 25 he was arrested for possession of drugs, and then hospitalized again.

When he was released and admitted to a group home, his Bridgeway Center Case Manager, Donna Morgan took him to apply for Social Security Insurance. He was denied.  Ms. Morgan attempted to assist him in the appeal process but by that time Jack had left the group home. Ms. Morgan then had difficulty maintaining contact with Jack to complete the process. The Social Security Office would not provide her with information on Jack’s appointments schedule, doctor’s visits or paperwork requirements since she was not Jack’s representative. Jack was denied Social Security benefits three times in one year, without proper documentation, and with no one to stand up for him they would not consider his application.

For Jack? SOAR came through

Finally, Jack crossed paths with the system again, when Morgan ran across him, according to the Web site–and by that time, he was 30. However, this time “This time she used the SOAR strategies. Ms. Morgan became Jacks representative, completed the narrative and obtained reports from the many doctors Jack had seen over the years. After compiling all of the evidence as directed in the SOAR training, she submitted the documentation to the Social Security Office. Jack received full benefits within 3 months following application including benefits retroactive for the previous one and a half years.”

It takes a village, they say. In this case, the “village” is federal-state-city-local agency co-operation.

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Colorado ‘medi-pot’ issue splits SSDI from SSI; New Jersey voters nix mixing jobless, disability funds

Friday, November 12th, 2010

by Mike Hinshaw

Today we start a two-part look at a smorgasbord of  topics, from serious but surprising to surprisingly serious.

According to an October blog in Denver’s alt-paper/online site, medical marijuana has become a sore spot between state officials and  indigent patients, including those with AIDS. Some patients receive Social Security Disability Insurance (SSDI) benefits; some receive Supplemental Security Income (SSI); and some receive neither.

MMJ = medical marijuana: Indigents’ costs hotly contested

In Colorado, part of the medicinal pot eligibility process involves getting the original prescription–about which, more later–and another part is paying an annual $90 registry license fee in order to make purchases. The Cannabis Institute maintains the license fee is too high for all patients–not to mention the poor–and sent a letter to the state Board of Health demanding a reduction from $90 to $10 on the license-fee for all patients who have received proper prescriptions.

At this point, let’s back up for a second to explain that according to various reports, Colorado’s med-pot system has already brought in significant revenue for the state.

Governor wanted ‘to steal’ from registry fund to cover General Fund

Significant enough that the governor proposed transferring a significant portion of licensee-fee revenues to cover shortfalls in other areas of the state budget, even though a state amendment seems to make that illegal. Here’s how it was written at another DenverWestword blog: “In August, Colorado Governor Bill Ritter expressed his intention to steal $9 million out of the patient registry fund and transfer it to the state’s General Fund to help alleviate budget shortfalls in other areas of government.” (For attribution’s sake, the blog cites this link to an Aug. 24 post by CTI: Governor Wants to Steal Patient Registry Fees to Balance Budget: Has Ritter Become Addicted to Cannabis Revenues? )

Widespread examples of revenue increases

This is, perhaps, not yet background enough on the money involved. Besides the patient registry, various Colorado communities have seen revenue boosts not only from dispensary and grower fees but also from sales taxes, warehouse rental/lease space and associated construction (including permits, inspections and often specific, custom build-out requirements). Even newspaper advertising has benefited.

OK, so here’s the lede from that Oct. 21 blog in Westword: “Yesterday, the board of health considered lowering medical marijuana license fees for indigent patients — and wound up eliminating them for those who qualify.

“Problem is, the criteria used to determine indigency leaves out many people in need — including AIDS-patient Damien LaGoy, who says he can’t afford to renew his license, which expires in two days. ‘This may be my last interview,’ he says.”

AIDS patient reportedly mispeaks

LaGoy waited to testify while the committee discussed procedures for ongoing rulings of conditions that qualify for medical marijuana licenses, ultimately deciding to shelve that discussion until January. By mid-afternoon when he got his turn, the weary AIDS patient says he was worn out, “out of breath” and “couldn’t talk very long.” Confused and trying to speak quickly, he “told the board he collects $917 each month — $14 more than the amount that would have qualified him as indigent by an estimate he shared with the Denver Post. He subsequently realized that he’d transposed the numbers and actually gets $719 a month. But he still doesn’t qualify, he says, due to the way the board decided to determine indigency.”

As explained in both the blog and in that Denver Post article, the crucial factors that emerged made distinctions among SSDI, food stamps and SSI program recipients. And it wasn’t only the advocates who were upset–even some board members were chagrined. From the Post: ” .  . . the standard the board approved for determining who is poor enough to qualify for the program upset medical-marijuana advocates, who said some indigent patients will still be stuck with a bill. And even some board members expressed frustration that the health department — which has received millions of dollars in application fees since the medical-marijuana program began — couldn’t put together a program that includes more patients.

” ‘I just think with however many millions of dollars, we could have done a better job,’ said board member Joelle Riddle.”

This is such a complex issue that much more space would be needed to cover all the points and counterpoints. However, for anyone seriously interested, enough links have been provided herein to allow further research into the rapidly changing developments for those affected in states where “MMJ” has become a hot topic. Be assured, though, we will continue to monitor and report on this emerging issue.

New Jersey voters reject funds transfers

Now we turn to a related topic: Similar to the attempt to transfer Colorado MMJ funds to cover shortfalls in other parts of the state budget, New Jersey voters on Election Day slammed attempts to “Rob Peter, Pay Paul” at the expense of unemployment and disability funds.

First, let’s look at a Nov. 2 post at nj.com, from the state house correspondent: “New Jersey voters today overwhelmingly approved a constitutional amendment that will ensure the money workers pay into the unemployment and temporary disability funds can’t be used to plug future holes in the state budget.

“The vote on the sole statewide ballot question will prevent the governor and the 120-member legislature from using the funds for anything other than their intended purpose: to help people who can’t find a job or who physically cannot work.”

Wall Street Journal: ‘mealy-mouthed’ wording

To get an idea of how big a deal this vote was –and how confusing the wording was on the ballot– consider this pre-election piece from a blog at The Wall Street Journal: “New Jersey voters are being asked whether to prevent state politicians from dipping into unemployment, disability and other funds to balance the budget. But the mealy-mouthed wording of the ballot question appeared to puzzle voters.

“The question reads:

Shall the amendment to Article VIII, Section II of the State Constitution, agreed to by the Legislature, which: prohibits collection by the State of assessments based solely on employee wages and salaries for any purpose other than providing employee benefits; dedicates all employer and employee contributions collected for any employee benefit fund, and all returns on investments of those contributions, to the purpose of that fund; and prohibits any transferring, borrowing, appropriating or using of those contributions or returns for any other purpose, be approved?

“Voting yes would tie politicians’ hands and prevent them from dipping into the funds for other purposes.”

Problems with wording–and the ‘help text’

Well, as the nj.com post attests, voters did indeed figure it out, with help from various sources, but the WSJ post also includes this quote from a retired engineer and an attorney: ” ‘The interpretive statement was harder to understand than the question,’ said Mike Mastro, 73 years old, a retired engineer in West Windsor.

“ ‘I’m an attorney and I didn’t understand it,’ says Mike Meduski, a father of two. ‘I didn’t understand the ballot question or the interpretive statement. They made no sense to me.’ ”

Too often, such is life with unemployment and disability issues. Way too often.

Surprisingly serious and seriously surprising: Hollywood? Really?

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Billions in SSDI payments questioned in subcommittee, GAO report–including an employee of the SSA itself

Tuesday, August 31st, 2010

[Editor's note: This is the third of three installments examining the need for legal counsel and improved legislation for those needing help with disabilities–and against those who game the system. Part One is here; Part Two is here.]

The Government Accountability Office (GAO) released a disturbing report in late June that contends the Social Security Administration (SSA) may have made fraudulent or improper disability payments to thousands of individuals, including more than a thousand federal employees.

As reported Aug.4 in The Washington Post, the SSA disputes the audit:

“Almost 1,500 federal workers might have received improper or fraudulent Social Security payments in the past several years, according to a government audit disputed by the Social Security Administration.

Payroll records vs. benefits data link nearly 70,000 others

“Government Accountability Office investigators matched civilian federal payroll records with benefit data from the Social Security Disability Insurance program and the Supplemental Security Income program to yield their estimates.”

Beyond the 1,500 federal employees, the GAO audit (see the summary here) finds questions about “62,000 individuals [who] received or had renewed commercial driver’s licenses after SSA determined that the individuals met the federal requirements for full disability benefits” and another “7,900 individuals with registered transportation businesses who were receiving SSA disability benefits.”

A tiny fraction?

WP columnist Joe Davidson, writing a day later, at first tries to downplay the significance of the numbers, saying that 1,500 of the millions of federal employees represents a tiny fraction. That’s not “many out of a current federal workforce of 2 million” Davidson writes. “And even that comparison overstates the problem.

“Sen. Carl Levin (D-Mich.), chairman of the investigations panel under the Homeland Security and Governmental Affairs Committee, put the numbers in a more precise context.

” ‘GAO matched a database of Social Security disability recipients against federal payroll databases covering about 4.5 million persons who worked for government agencies for varying periods of time from October 2006 to December 2008,’ he said as he opened the hearing.

“Fifteen hundred out of 4.5 million ‘represents a very small percentage,’ he accurately noted, ‘only three-hundredths of 1 percent.’ ”

“If only all rates of fraud or improper activities were so low.”

Larger questions for endangered SSDI program

We catch his drift, but can’t co-sign for such a forgiving attitude. In the first place, it overlooks the nearly 70,000 other folks who may have received improper payments. More important, such forbearance downplays the threat to a disability program that is running out of funding.

Davidson does recover a sense of accountability, though, when he says, “Yet any improper activity is too much, particularly by federal workers who are trusted to safeguard tax dollars, not abuse them. And every penny of the $1.7 million that the GAO found in improper monthly payments to federal workers is too much.”

Let’s see– $1.7 million x 26 months … on my calculator, that comes to $44.2 million in possible overpayments. And, remember, that’s only for the 1,500 federal folks, for the period Oct. ’06 to Dec. ’08.

It gets worse. According to the WP article, nearly $11 billion is stake for a longer period:

“The SSA made $10.7 billion in overpayments to disability beneficiaries from 2004 to 2008, according to Senate aides. [Senator Tom Coburn (R-Okla.)] is especially concerned and familiar with fraudulent payments from his time as a practicing medical doctor and as part of his service on President Obama’s bipartisan debt commission, aides said. The Oklahoma Republican also is a fierce critic of the salaries and benefits earned by federal workers and other spending for government operations.”

Coburn and Senators Thomas R. Carper (D-Del.) and John McCain (R-Ariz.) requested the GAO audit, which was featured at the Aug. 4 subcommittee hearing,  “Social Security Disability Fraud: Case Studies in Federal Employees and Commercial Drivers Licenses.”

Another $3 billion

Other incidents of overpayment have been found, too. For example, this is not the GAO’s first probe of the SSDI or SSI systems. According to the printed version of Coburn’s opening statement for the hearing, a previous GAO investigation found “nearly $3 billion in overpayments from 1999 to 2003 in the DI program alone.”

Regardless the fractional amount overall, this is simply too much money to be wasted, period–and especially for a program in such dire straits, as we wrote here: “The Social Security Disability Insurance (SSDI) fund, however, is in trouble. And fixing it requires way more than Band-Aid legislation in the next few years. In short, the fund is financed mostly by a 1.8 per cent payroll tax and at current rates will be in serious trouble in only five years. And by 2018, a short three years later, it will be broke, according to a recent study by the Congressional Budget Office (CBO), which makes a brief available here.”

Here’s an excerpt from Coburn’s statement:

“We cannot afford to allow healthy people to waste our money. Nor can the Disability Insurance Trust Fund afford it. The Congressional Budget Office recently concluded that the Trust Fund will be exhausted by 2018.

“GAO’s investigation into fraud in the Social Security disability programs is not its first. In 1997, they designated the SSI program as “high risk” due to years of mismanagement and overpayments. GAO also previously identified nearly $3 billion in overpayments from 1999 to 2003 in the DI program alone. In today’s report, GAO found $10.7 billion more in overpayments from fiscal years 2004 to 2008.

“In response to these numbers, SSA’s disappointing reply was that ‘overpayments are unavoidable.’ This is unacceptable. It is also in direct contradiction with the President’s mandate that overpayments in government programs be eliminated.”

SSA Commissioner objects

SSA Commissioner Michael J. Astrue vigorously disagreed with the GAO report, quoted in the WP piece, calling the report ” ‘fatally and hopelessly flawed,’ and said auditors improperly compared payroll data with SSA data.”

In his printed statement for the hearing, Astrue said:

“Of the 20 cases that GAO reviewed, GAO investigated only one problematic CDL case and only one problematic case involving a commercial vehicle company. GAO did not conclusively prove fraud in any of these 20 cases and has referred only 5 of these cases to our Office of the Inspector General (OIG).

“We do not intend to minimize the importance of the issues raised in this investigation, and we take our stewardship responsibilities very seriously. Nevertheless, the results apply to only these 20 non-representative cases, and after reviewing these 20 cases, we found that we had already detected overpayments for half and believe that we would have identified the remaining cases through subsequent enforcement activities if earnings were reported on the W-2 or as self-employment income to the IRS.”

Gregory Kutz, managing director of GAO’s Forensic Audits and Special Investigation division acknowledges the preliminary nature of the findings. From the main report itself:

“Thousands of federal employees, commercial drivers, and owners of commercial vehicle companies received Social Security disability benefits during fiscal year 2008, though we could not determine the extent to which beneficiaries improperly or fraudulently received payments. Because further investigation is required to determine whether these individuals are entitled to receive payments, our analysis provides only an indicator of potentially improper or fraudulent activity.”

Curiously, one of the disputed cases was for an employee who works for the SSA, and SSA officials had no idea until informed by the GAO. According to the WP story, “And in an ironic twist, a Social Security Administration worker from Arizona received $11,000 in overpayments after she was hired by the agency in 2007/ The SSA did not have information about her disability in her files, the GAO said.”

Stay tuned–these questions aren’t going away anytime soon.

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Disability planning and programs: Part 2

Tuesday, June 29th, 2010

[Continued from here, discussing links and references from this CDA Web page.]

Step 3 is where we get into “the meat” of disability finance:

  • Employer sick pay
  • State benefits
  • Disability insurance benefits
  • Workers comp
  • SSDI/SSI

Employer sick pay, or sick leave, may be generous in one industry, lean in another. At a small company, nothing may be available other than wishes for good luck. Some large and even mid-size companies offer long-term disability policies. Where ever you work, you should learn the specifics of the policy because it may be your first line of defense, even if it runs out long before a health problem is resolved.

According to the Insurance Information Institute, “In some states, such as Hawaii, New Jersey, New York and Rhode Island, state law requires employers to provide disability benefits for up to 26 weeks.” (Don’t confuse this with workers compensation.)

Over at CostHelper.com, we see that “Disability insurance provides income to help pay your living expenses if you are unable to work for a significant length of time because of injury or illness. Generally benefit payments are 60 percent of your total salary.”

The CDA page explains that “[d]isability insurance can be an invaluable lifeline for disabled workers and their families:

  • If your employer offers disability insurance make sure you fully understand what benefits are available to you and how your company’s disability insurance program works.
  • If disability insurance is NOT provided by your employer, it can be purchased individually at affordable rates. Contact your insurance agent for more information.
  • Self-employed individuals can also benefit greatly by having disability insurance. Consult your financial advisor or insurance agent for assistance.”

The CostHelper.com page says to “[e]xpect to pay between 1 percent and 3 percent of your annual salary for a good disability plan, according to DisabilityQuotes.com. That works out to $600-$1,800 for someone earning $60,000 a year.”

Earlier, we cautioned not to confuse state disability benefits (if available) with workers comp benefits. In the usual sense, workers comp addresses workers who are injured on the job. However, if work-related, an illness and subsequent disability may be covered by workers comp, too. As the CDA page says, “After a short waiting period, workers’ compensation generally pays a portion of your former wages or salary. Benefits vary significantly by state and are restricted to a specific maximum and minimum amount.” Here’s a link to programs in each state.

As mentioned in our preceding post, SSDI is a form of  federal “insurance” that workers qualify for by having paid enough funds into Social Security (from paychecks) by working long enough at jobs with employers who make the payments (including self-employed). Here’s the link to the main disability information page of the SSA, including topics such as basic program information, who is eligible, how to apply and so forth.

In your planning, count on at least a six-month wait before receiving SSDI payments.

SSI is not funded by paycheck contributions but by general tax revenue; it provides cash to meet basic needs for food, clothing, and shelter. The program is designed to help aged, blind, and disabled people, who have little or no income and few resources.

Here is a link to the SSA’s page outlining eligibility requirements for SSI.

Here’s the bracing news: If you don’t have access to any of the preceding resources, you’re pretty much left to your own devices and social-family network. For the “average” long-term disability, you’ll need to cobble together some method to make it for 2 1/2 years.

The first fallback position is personal savings. Then you’re looking at such drastic measures as using credit cards, dipping into a mortgage or retirement funds. Here’s how the CDA page lays it out:

  • “Personal savings
    A small percentage of Americans are lucky enough to have savings, investments or other financial resources that can supplement or replace their income during a prolonged disability. The rest of us, unfortunately, are not so lucky. Any disability, especially one lasting more than 90 days, would quickly drain our savings. After all, Americans’ savings rate is at an all-time low. A full 1/3 of Americans have no retirement savings and no pension, according to the Social Security Administration. Talk about stress!
  • “Last Resort” income sources
    If all else fails, you can begin paying expenses with credit cards, get a second mortgage, take out a home equity line of credit, withdraw money from your retirement plan, and ask family and friends for assistance.”

As you can see, maintaining one’s health is the best option. Of course, no one can do that indefinitely, so financial planning is the next priority. If you’re still healthy, look for ways to promote an even healthier lifestyle. Then, begin your financial planning process.

If you or a loved one needs disability help now, you can use the links provided to contact SSA officials or advocates and disability attorneys.

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Applying for disability benefits from the Social Security Administration can be a daunting and frustrating challenge. For more on the basics of disability, SSI, and SSDI, please click here.You will also have the opportunity to click on information about attorneys who can help you and a link for a free case review.

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Posted in disability, Social Security, Social Security Disability, Supplemental Security Income | Comments Off

Disability benefits explained from square one: Part 1

Thursday, June 24th, 2010

OK, we’re going to cover a lot of ground in the next few installments, so let’s start with a quick review of the basics.

The acronyms SSDI and SSI refer to the most well known programs that help people who develop long term disabilities. Both are administered by the Social Security Administration (SSA), and each is notorious for being cumbersome, slow, and difficult for the average person to deal with–which is why many who need disability help turn to professional advocates and attorneys who specialize in the field.

SSDI = Social Security Disability Insurance, which pays benefits to workers (and some family members) who qualify; the basic qualification to receive these insurance payments is that you have:

  1. worked long enough to have paid
  2. enough Social Security taxes through payday deductions

to fund your “insurance account.” In other words, if your work history comprises jobs that did not pay–or pay enough–into Social Security, in most cases you won’t qualify for SSDI.

In that case, however, you may qualify for SSI, which stands for Supplemental Security Income–this program is not based on payments made from jobs but does award benefits based on financial need.

Together these two programs account for the bulk of what most of us consider the disability program for Americans. However, as mentioned, jumping through the hoops can be maddening, and the built-in delays can result in a payments arriving so slowly that the claimant has already died.

For a quick example of how slow the SSA acts, have a gander at its disability front page. As of post time, you can look to the top, upper right of the page and see a link to a press release with the following headline:

Social Security Administration Attacks Disability Backlog

Which sounds like a good thing, right? Well, it is–always good to catch up on a backlog.

But notice the dateline  ===> Tuesday, October 9 , 2007

Shoot, we have more recent, more accurate info right here, toward the end of a May 2010 post in which we discuss delay issues among the various states.

That being said, SSI/SSDI remain the most publicly known disability programs. But they’re not the only alternative.

The Council for Disability Awareness (CDA) is a nonprofit organization that says its purpose is to inform and educate “the American public about the widespread and growing frequency of disability, and the financial impact it can have.”

However, judging from its “members page,” one might infer the group has an interest in selling disability insurance. That being said, however, the Web site does indeed offer a wealth of information.

For one thing, here’s a page about “reducing your chances” of becoming disabled. Pretty standard stuff: wellness tips such as “quit smoking, get regular checkups,” and so forth. Of course, most people don’t think about disability until a family member or they themselves become disabled.

But the statistics suggest that all adults should be aware of at least the basics of disability. For instance, it seems to be a common misperception that “events” cause most disabilities: a car wreck, an accident at work or home, etc..

But according to CDA, which claims to base its figures on the latest available census data and on info from the Centers for Disease Control, the most common causes of disability are injuries or accidents but rather:

  • “Illnesses like cancer, heart attack or diabetes cause the majority of long-term disabilities. Back pain, injuries, and arthritis are also significant causes.
  • “Most are not work-related, and therefore not covered by workers’ compensation.
  • “Lifestyle choices and personal behavior that lead to obesity are becoming major contributing factors.”

Oddly enough, this CDA page is quite contradictory, both in overall tone and in these specific statements (emphasis added):

  • “It strikes like a bolt from the blue: unwanted, unexpected, unwelcome. Unfortunately, many of us are totally unprepared for the financial hit that disability can bring.
  • “Most Americans live paycheck to paycheck. There’s little or no money left for unexpected emergencies like an injury or illness – the primary causes of disability.

Perhaps the intention was to say something like, “unless you injured in an accident or taken with sudden illness, disability can creep up on you, until there’s a sudden realization that your condition leaves you in financial peril.”

At any rate, the CDA’s suggestions are sound as far as how to think about finances in the event of a disability, including:

  • Your sources of income, monthly expenses and lifestyle
  • The impact a long-term disability could have on them
  • Preparing a plan of action to address the crisis

Step 1 is, basically, preparing a budget. (The page has a link to a “calculator” routine.)

Step 2 is to, as may be expected, isolate and trim unnecessary expenses.

Step 3 is where we get into “the meat” of disability finance:

  • Employer sick pay
  • State benefits
  • Disability insurance benefits
  • Workers comp
  • SSDI/SSI

That is where we will continue the discussion in Part 2.

****************************************************************************************************
Applying for disability benefits from the Social Security Administration can be a daunting and frustrating challenge. For more on the basics of disability, SSI, and SSDI, please click here.You will also have the opportunity to click on information about attorneys who can help you and a link for a free case review.

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Posted in disability, Social Security, Social Security Disability, Supplemental Security Income | Comments Off