A question about Social Security Disability

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Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 5/6/2011 7:57 PM (GMT -6)   
If you qualify and get approved for Social Security Disability, does that mean you automatically get approved for Medicare, regardless of your age?  I couldn't find that answer even on the Social Security web page.
 
I was turned down on the first pass, as expected, and as I was warned.  I did it all on-line, as well as a visit to my local SS office as requested.
 
I got turned down on the 2nd pass, not expected, doing it on my own, following all the SS rules to the letter of the law.  My rep in Baltimore had me convinced I had been approved even 2 days before I got the official reject letter.
 
Then I did what I should have done in the first place, I got a very good dedicated SS lawyer.  Last word, my name is now on top of the list for her to take my case to the judge.  She said under my circumstances, I shouldn't even have to be there in person.  Hoping to have approval finally at last.  It has been a full 2 years now.
 
For anyone considering it, my advice is to get a SS lawyer from day one, I could have saved months and months of needless waiting.  They all work for continency, and there's a mandated cap on how much they can take when they back pay you once you are approved.
 
I am still not cleared to be able to work by any of my doctors.  It's interesting, that in the SS disability process, they absolutely will not talk directly to any of your doctors, which I find absurd.
 
When I went to the local SS office for the required meeting, they told me that I was 100% vested for the maximun amount, as I have paid into the SS system heavily every year since 1968.  It's not a handout as some think, its an entitlement, one, that as a taxpaper and one  that has paid into the system for 43 years is entitled to.  The red tape and double standards  they apply are aggervating.
 
David in SC
 
 

Post Edited (Purgatory) : 5/6/2011 8:03:21 PM (GMT-6)


North Alabama
New Member


Date Joined Jan 2010
Total Posts : 18
   Posted 5/6/2011 9:15 PM (GMT -6)   
My wife went through the same routine that you did about ten years ago for her back problems. She got rejected twice and then we got an attorney to go to fed court and then got approved. It took about a year and a half all total, but she got back pay starting from the time the judge ruled that the disability started (about three years back). She was 43 years old at the time and we signed her up for Medicare part A and B. Because I still work and have insurance for the both of us, Medicare is secondary payer for her which just pays copays and anything else that might not be covered by my insurance at work. Either part A or B payment (I don't remember which one) is deducted from her social security check. The reason that I keep her on medicare even though we have good insurance where I work is because under the Cobra law, if I get laid off Cobra only allows me to continue with the company insurance (you pay the employers rate). A spouse that is "eligible" for medicare is not covered by Cobra. She would have to wait for the medicare anniversary date to get on medicare, so would have a period with no insurance. Also you must pay more monthly if you do not accept medicare at the time you first become elligible.

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 5/6/2011 9:22 PM (GMT -6)   
North Alabama,

Thank you kindly for the good info on my question. The SS office did say, when I am approved, I will be back paid all the way to January of 2009. Seems to me that the lawyer's cut is limited to around $5,000, which will still be worth it to me.

Hope you and your wife are doing ok. Were you spared from the terrible tornado damage in your state?

David in SC
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06, 2/11 1.24, 4/11 3.81
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/10

North Alabama
New Member


Date Joined Jan 2010
Total Posts : 18
   Posted 5/6/2011 9:53 PM (GMT -6)   
We live a little south of Huntsville and we were not in the path of any of the tornadoes. One hit a few miles south of us. We only lost electricity for a day compared to Huntsville where I work which lost electricity for about five days, so we got off easy. The four grand children stayed with us until electricity was restored in Huntsville so I had a great time with them (ages 4 weeks to 7 years old).

By the way, going to court was no big deal. Just let the attorney and the judge do the talking. Don't say anything unless the judge specifically asks you something and you should have no problem. I learned everything I know about court from watching Judge Judy.

Atmosphere
Regular Member


Date Joined Mar 2010
Total Posts : 220
   Posted 5/7/2011 12:33 AM (GMT -6)   
I am in Baltimore, but I am not your rep ;)

You will become automatically Medicare eligible AFTER 2 years with SSDI or if over a certain age- i have SSDI. Meaning, i qualify on grounds that i am disabled. (a lot of ppl. are ignorant and don't know the difference b/w SSDI & SSI).

SSDI Folks pay into the system. SSI Folks don't need to do squat, it is all based on income.
I too was declined first time, went the lawyer route, and everything has been fine since. Trust me on this.

And SS takes an odd amount out of my SSDI monthly check for Medicare.

Fyi, You can pick certain aspects of Medicare you want, aside the basic bare bones A/B that is what you are given. Part A/B is Medical and Hospital. Or pay Extra for Dental and Vision. An RX Plan etc. Other components blah blah.
For instance, I have a separate Dental plan, cause I didn't want to go to some podunk dentist and that is what worked out best for me..

I never have had to set foot in a court room. My lawyer has done everything for me. I have seen him once but I keep in contact with the attorney office often. I gave him the attorney my rejection papers and he handed me medical assessment papers FOR ME TO GIVE TO MY DOCTORS to complete. I directed my Drs. once they completed the paperwork, to mail it back to me, and I mailed the paperwork to my lawyer.

Sometimes SS will send you out to see one a Private Doctor they pay if they lack enough information about a special medical condition that you are filing disability for. I was ordered by Social Security (SS) to go see a Psychologist for an assessment. For instance, I claimed or filed for anxiety or GAD (Generalized Anxiety). SS wanted more proof than what was in my filed apparently. So they sent me to a private doctor. No sweat though.

True Facts.
It is indeed very long, slow process too. Paper work gets moved about the pace of molasses. So don't let it get you too worked up or aggravated.

Bear in mind, you won't be getting a whole lot of moolah from SS. In the end, it will be better than the $0 you're getting now, but don't think it be enough to go buy a new car, buy a day at the spa etc. That $700 or so will be mostly for expensive medicine and house bills. At least so I find. Since you're not working anymore. You need to be very wise with how you spend your monthly check. Save a few dollars if you can.

I learned and continue to learn everything I know from real-life experiences. Get in touch if you want to ask me anything. Hope you feel better.

Post Edited (archiestyles) : 5/7/2011 2:39:08 AM (GMT-6)


rcroller
Regular Member


Date Joined May 2011
Total Posts : 326
   Posted 5/7/2011 8:29 AM (GMT -6)   
My wife was a Medical Disability Examiner for Social Security for five years and I was a Vocational Rehabilitation Counselor for several years often dealing with that system. All of the above comments are sad but true. Those of us who work and pay into this system our entire lives are usually rejected twice and faced with a two year process to receive our entitlement through an Administrative Law Judge's overturning of the two SS decisions, original application denial and one appeal. I can't tell you how many times my wife determined that an applicant met the Federal listing and attempted to accept the applicant for the benefits for which they clearly qualified only to be slapped down by a supervisor or higher up because they are strictly denial oriented. The more hoops they set up to jump through the less likely one is to be successful in collecting anything, especially those with a dire prognosis. I hope I won't need to go that route, but if it becomes necessary I will absolutely retain a SS Lawyer from day one. Best of luck to you.

Post Edited (rcroller) : 5/7/2011 8:33:22 AM (GMT-6)


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 5/7/2011 8:43 AM (GMT -6)   
Thank you, both, that was great information, and I hope it will help others here if they need to go the SS route. Again, if I were starting it all over, I would have had my current attorney first.

I am hoping, now that my name is on top of the list here locally to go before the judge, there will be settlement soon.

Thanks again for you all's great input.

david in sc
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06, 2/11 1.24, 4/11 3.81
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/10

NutmegCT
Regular Member


Date Joined Mar 2011
Total Posts : 46
   Posted 5/7/2011 1:10 PM (GMT -6)   
Just to clarify something said in an earlier post here: Once you've been eligible for SS Disability payments for 24 months - even retroactively - you're eligible for Medicare.

Example: you file for disability in January 2003 and are turned down. You appeal the denial and are again turned down in 2005. You appeal again and finally get the original 2003 denial overturned in 2008. Since you were retroactively found eligible as of 2003, your Medicare eligibility begins January 2005. So your medical bills are eligible for Medicare reimbursement as of January 2005 - a whole three years back from when you had the denials overturned in 2008.

Tom
Age 62, Biopsy September 2010.
PSA 4.8, Gleason 3+3, Stage T1c, 4/12 positive cores at 10-40%.
Palladium 103 implant February 1, 2011.

lifeguyd
Veteran Member


Date Joined Jul 2006
Total Posts : 677
   Posted 5/7/2011 3:03 PM (GMT -6)   
 
I learned that workmen's compensation, SS disability, and private insurance are at best CAPRICIOUS AND UNPREDICTABLE.  When  was working and just a young 56 years old, I finally succumbed to a long time back weakness. I found myself out of work and in extreme pain.  I was granted a workman's compensation grant.  When that ran out I applied for SS Disability wiithout thinking that I had chance to collect.  Within a very short time I was notified that I qualified, I colllected full disability and early Medicare for the life of my elgibility.
 
To this day, I think that I qualified because I rejected all of the strange possible reasons and answered the questions with straight forward and honest responses.  I told the examiners that yes I had high blood pressure, allergies, asthma and pherpheral neurapathy and doo da doo da day.  But none of those prevented me from working.  However, yes I had a total melt down of the spine (MRI's included to prove it) and that made life a painful and unchanging challenge.  I was approved within months.  In most cases the people who read your application are honest hard working government employees.  Tell the truth and take your chances.  I think there is a real chance that you would be approved if you were fighting advanced prostate cancer.
PSA July 2006 4.7 , Nodule found
biopsy 10/06 very agressive gleason4+4=8 identified
DaVinci surgery, January 2007
Post Ob confirms, gleason 4+4=8 with no extension or invasion
no long term continence problems
post surgery PSA continues to be undetectable at 4 years
ED problems continue, using bimix
born 1941
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