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Supplemental Security Income (SSI)

HIV Infection Not Automatic Reason for SSDI Approval

Jun 12

Posted by Hal LaPray in Diseases And Conditions, HIV / AIDS, Supplemental Security Income (SSI)

Although not always, most people who have HIV or AIDS do qualify for Social Security Disability Insurance (SSDI) benefits, but not because of their HIV itself. Here’s why.

When a person is infected with HIV, their immune system is weak and compromised, making them vulnerable to opportunistic infections. An opportunistic infection is caused by pathogens that normally would not make a healthy person with a strong immune system ill. Since a person with HIV has a weakened immune system, these types of pathogens have the ‘opportunity’ to infect. Some examples of opportunistic infections that a person with HIV may experience are: bacterial infections, fungal infections, viral infections, diarrhea and other conditions that affect the mucous membranes as well as they body’s blood supply.

Because HIV affects everyone differently, there are no hard and set rules when it comes to which conditions will qualify or disqualify a person for SSDI benefits. Eligibility depends much more on the severity and the frequency of the opportunistic infections than the type. The Social Security Administration (SSA) does keep a list of all known associated conditions that could potentially affect a person with HIV and maintains a separate list for women and children.

Or course, applicants that have HIV must also follow the same guidelines as other applicants do and they also must meet the same criteria. HIV claims have a history of being given preference during the application process and are usually processed much more quickly than other types of claims. Although with the current backlog situation adding months to what should be relatively short waiting times, one should not assume their case will be given preference over another.

Sometimes the SSA does offer what are called “presumptive benefits” to people who have the HIV virus while their application is being processed. These benefits are paid one a six month basis under the “presumption” that the present HIV infection is going to be sufficient to qualify them for regular SSDI benefits once their case is reviewed. In order to apply for “presumptive benefits”, the applicant must get form SSA 4814 from their local SSA office and have it filled out by a doctor, detailing the presences of an HIV infection. If, once their entire claim has been reviewed, it is determined they are not eligible for SSDI benefits, applicants who received the “presumptive benefits” do not have to repay them.

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SSI Recipients in Tennessee Losing Heath Care Benefits

Apr 13

Posted by Hal LaPray in Disability News, Personal Stories - Social Security Disability, Social Security Articles, Supplemental Security Income (SSI)

Tennessee SSI Recipiects May Lose Health Care Coverage

Tennessee SSI Recipiects May Lose Health Care Coverage

Since January of 2009, Tennessee has withdrawn coverage for 100,000 residents who were insured through TennCare, Tennessee’s version of the Medicaid program. These cuts come on the heels of a resolution to a decade’s long court battle involving recipients of Supplemental Security Income (SSI).

TennCare’s eligibility guidelines have always stated that anyone who ever qualified for SSI would also qualify for medical coverage under their program. Due to rising costs and the state’s unstable financial situation, Tennessee wanted this provision overturned to withdraw health coverage from those who no longer qualified for SSI. In 1987, a class-action lawsuit involving SSI recipients was brought against the state. The lawsuit resulted in an injunction barring Tennessee from denying coverage under TennCare to all SSI recipients, both past and present.

"Here I am three-quarters of the way through getting well after two types of cancer and needing surgery and colon tests and CAT scans to see if the lymphoma's come back and here they cut me off. There's nothing I can do until I turn 65 now, except wait and hope I don't get sicker." - Thomas Moore, 64, Woodbury, Tennessee

The state argues that all SSI recipients should qualify for TennCare on their own, taking their current income and assets into consideration. This is the same process that applicants who have never received SSI have to go through to determine their eligibility. State officials say that assuring that everyone follows the same set of rules not only benefits those seeking assistance, but also reduces wasteful spending of state resources by ceasing to pay out benefits to people who clearly are not entitled to them.

TennCare’s spokesperson Kelly Gunderson maintains that SSI recipients are not being unfairly targeted. Gunderson said TennCare is only re-evaluating their eligibility based on income, which is the same process every other TennCare recipient must go through. If their household incomes qualify them for health coverage, they will receive it. However, Social Security is the very income that has put some TennCare recipients over the qualifying threshold in some cases.  Further, the vast majority of those losing TennCare benefits under the new ruling were receiving treatments for live-threatening conditions and are now being forced to discontinue those treatments due to lack of health coverage.

Jessica Pipkin is a Tennessee resident who lost the use of her limb in an accident five years ago. She requires 24 hour nursing care in her home, which was covered under TennCare until the recent ruling went into effect. Her husband makes $19,000 a year at his job. Her disability benefits are $14,400 per year. This combined income puts them well over the threshold to qualify for TennCare coverage, even though Pipkin’s care costs $37 per hour.

Thomas Moore, a 64 year old Tennessee resident and cancer survivor also had his health coverage dropped under the new ruling. In 2008, Moore began receiving SSI benefits because of a hip fracture, but was required by the state to move to the Social Security program when he reached the age of 62. The change in programs put his income at too high a level to qualify for TennCare coverage, which he subsequently lost. Moore was still undergoing follow up treatments for his cancer and had a hip surgery scheduled at the time he lost coverage.

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Laws Make Understanding Social Security Qualifying Process Difficult.

Apr 7

Posted by Hal LaPray in Social Security Articles, Social Security Disability, Social Security Disability Denials, Supplemental Security Income (SSI)

Social Security laws are written in such a way that it is often confusing for disabled applicants to know whether they will qualify for benefits.

Social Security laws are written in such a way that it is often confusing for disabled applicants to know whether they will qualify for benefits.

The rules involving Social Security benefits are confusing at best. The Social Security Administration (SSA) denies sixty five percent of claims the first time they are filed. With so many different criteria to meet, regulations to follow and red tape to get tangled up in, it’s no surprise that most applicants resort to hiring an attorney to manage their application for them.

There are two types of benefits which a disabled person may apply for. One is for people who are recently disabled with a solid work history. The other is for people who do not have a recent work history or may not have accumulated enough qualifying “quarters”.

The first type of benefits are called Title II benefits (SSDI). These benefits are for people who have a recent work history and that have worked at least five of the past ten years. Each year is divided into four quarters so this means that in order to qualify for Title II benefits, a person must have worked for twenty of those forty quarters.

Disabled applicants who fall into this category are eligible to receive benefits for five years. During that time, their children are eligible to receive benefits on their behalf as well. The benefits for minor children will be one half of those awarded to the disabled parent. This amount increases to two thirds of the disabled parent’s benefits if the disabled parent dies while receiving benefits. Workers who qualify for benefits under the Title II guidelines will become eligible for Medicare two years from the onset of Social Security benefits.

The other kind of Social Security benefits is called Social Security Supplemental Income (SSI). In order to qualify for benefits under the SSI guidelines, the applicant must have very a limited income and very limited financial resources at their disposal. For a married couple, the value of their assets cannot exceed $3,000 – excluding necessities such as the home itself and vehicle. As of 2010, the maximum benefit amount for a person qualifying for SSI could receive is $674 per month. Under the umbrella of SSI benefits, there are no benefits granted to dependents or minor children.

If your original claim to the SSA for benefits has been denied, you are given sixty days in which to file for what is known as a “reconsideration”. This means you ask the SSA to reconsider your application for benefits, based on current information and any other new and supporting information you can provide. If turned down a second time, the SSA allows another sixty days for the filing of a second appeal.

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California SSI Recipient Starts Online Petitition to Protest Decreased Benefits

Aug 10

Posted by Hal LaPray in Disability News, Social Security Articles, Social Security Disability, Supplemental Security Income (SSI)

california-economyFran Cannon, a Californian who depends on Supplemental Security Income (SSI) benefits for her livelihood, has started an online petition to protest the recent reduction in Social Security disability benefits for SSI recipients in California.

"A key characteristic of a mature political society is the willingness and ability of that society to support those who cannot otherwise support themselves"

With California being faced with a budget crisis, steps have been taken to reduce payments of benefit recipients in that state.  While SSI is a federal program, many states supplement the monthly income benefit checks from their own budgets.  Recently the amount supplemented by California has been reduced two times, to levels that were extant four years ago.

This is such a shame.  A key characteristic of a mature political society is the willingness and ability of that society to support those who cannot otherwise support themselves.  People who live on Supplemental Income Benefits (SSI) are already faced with financial difficulties that few Americans truly understand.  These are people who have been declared wholly disabled and unable to earn a living, including people who are blind, elderly, or mentally disabled.

While economic downturns and budget shortfalls can be expected from time to time, one would certainly hope that our civic leaders and public officials would weigh very carefully all options, alternatives and consequences of such a decision, considering the social and economic ripple-effect impact across the spectrum.  Decisions like this should be made after all other solutions have either failed.

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