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Friend in Texas has SS and Medicaid questions. Login/Join 
Page late and a dollar short
posted
Here’s the background, anybody have any suggestions where to go from here?

A friend in Texas has a 39 year old son. Multiple physical problems caused by arthritis gout. Both knees, ankles, one wrist (needs to be fused) both elbows. Under doctors care, also IIRC one wrist was broken and that’s the one that need the fusing. Last I knew he works as a route salesman.

His mother has tried to get him SSI and Medicaid and retraining for something he can do that is less physical. Apparently he has enough credits for SSI but has been denied assistance, that being alluded to his being a single male with no dependents and living (not by choice)at home. His mother was told that if he was homeless for one year he would qualify for assistance but that’s not an option. According to his mother SS alluded to his being retrained for a less physical job but offered no assistance. He wants to work, not just sit home and collect checks but something less physically demanding.

Both of his parents are frustrated, they’ve both been friends for well over forty years.They are both getting up there in age too.

Any ideas will be appreciated. If you want I can put them in direct touch with you, probably better than being in he middle.


-------------------------------------——————
————————--Ignorance is a powerful tool if applied at the right time, even, usually, surpassing knowledge(E.J.Potter, A.K.A. The Michigan Madman)
 
Posts: 8585 | Location: Livingston County Michigan USA | Registered: August 11, 2002Reply With QuoteReport This Post
Oriental Redneck
Picture of 12131
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If they haven't consulted with one, I suggest they contact a SSI attorney in the area. They will know the ins and outs of his eligibility. Sorry, but I'm of no help.


Q






 
Posts: 28734 | Location: TEXAS | Registered: September 04, 2008Reply With QuoteReport This Post
His Royal Hiney
Picture of Rey HRH
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Or a social worker who works for the county. They would know the ins and outs.

I'm not trying to skirt the law but it's not like he's a minor living "at home."

Here's the link to SUPPLEMENTAL SECURITY INCOME (SSI) ELIGIBILITY REQUIREMENTS

It says nothing about "living in your parent's home.

One thing though perhaps, is that his parents aren't claiming him as a dependent on their tax returns.



"It did not really matter what we expected from life, but rather what life expected from us. We needed to stop asking about the meaning of life, and instead to think of ourselves as those who were being questioned by life – daily and hourly. Our answer must consist not in talk and meditation, but in right action and in right conduct. Life ultimately means taking the responsibility to find the right answer to its problems and to fulfill the tasks which it constantly sets for each individual." Viktor Frankl, Man's Search for Meaning, 1946.
 
Posts: 20438 | Location: The Free State of Arizona - Ditat Deus | Registered: March 24, 2011Reply With QuoteReport This Post
If you see me running
try to keep up
Picture of mrvmax
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I agree with what has been stated, pay for an SSI attorney. Years ago I knew a guy who ended up being bound to a wheelchair due to an illness. SS kept refusing to pay SSI to him and it took years of fighting it before they granted it.

I have family members living in poverty stricken areas who are physically able but lazy. Yet SS in their area grant SSI left and right. I could not figure that one out.

Also my business law instructor told of a case he took on pro bono for someone SS kept refusing, saying there was nothing wrong with them. They had been fighting for it for a while. By the time he met with the SS people, that person had passed away. He did get the family back benefits.
 
Posts: 4395 | Location: Friendswood Texas | Registered: August 24, 2007Reply With QuoteReport This Post
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Worked for SSA for 43 years so I'll try to pass along a few things I think may be helpful. SSA runs two disability programs that are often confused. Both programs have the exact same definition of disability. Rey HRH's link to SSI eligibility requirements has a definition of disability for adults. Take a look at it. The definition can be summarized this way. A disabled adult would have a medical problem that prevents them from working. It's not enough to show that you have a medical problem. You have to show that the medical issue prevents you from working. This is important when you answer questions if you appeal your case up to the hearing level. Keep that in mind.

There is regular Social Security disability benefits and also SSI disability benefits. Regular Social Security disability benefits have the disability requirement and also a work requirement. The SSI program has the same disability requirement but you also must have a very limited income and resources. See Rey HRH's link above regarding SSI. Here is the link for qualifications Social Security disability.

https://www.ssa.gov/benefits/disability/qualify.html

If the claim is denied, you can appeal it. You have 60 days (actually 65 because you are given an extra 5 days for mailed in appeals). Make sure you submit a timely appeal. If you get an attorney, understand that the attorney gets 25% of the retroactive benefits. Should you get an attorney? It's an individual choice but I would say - it depends. If you appeal with no attorney make sure you complete the forms and the medical part completely. List all of the medical sources and all of the hospitals. Once you file, realize this. The medical sources you list will be contacted for medical evidence. Doctors and hospitals get many requests for evidence. Some sources respond quickly. Other medical sources don't respond at all. If a source takes too long, the adjudicator may make a decision with just the medical evidence submitted. Since there is incomplete medical evidence, it increases the likelihood of a denial. So you should let your doctors know that you filed for disabiity and ask for their help in responding to evidence requests timely. Another option is to submit medical evidence yourself. You can submit it with the appeal, or any time after that.

If you decide to use an attorney, here are some things to remember. Every attorney wants you to win your case. After all, they don't get paid unless your claim gets approved. The large majority of attorneys are ethical. But a few are not. The longer your case takes, the higher their fee. Some unethical attorneys may slow walk your case to delay it to jack up their fees. Their was one attorney in my area that would drop off an appeal on the last (60th) day it could be filed. Every time. Plus other attorneys do a better job of following up with medical sources or the case adjudicator to insure that they have all the evidence they need. So how do you get a good attorney? You can ask around. But if you don't know anybody who could be helpful with recommendations, you could do this. Every town has a local township page on facebook where you could post miscellaneous items. You can ask for recommendations there.
 
Posts: 1121 | Location: New Jersey  | Registered: May 03, 2019Reply With QuoteReport This Post
More light than heat
Picture of Milliron
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quote:
Originally posted by Fed161:
Worked for SSA for 43 years so I'll try to pass along a few things I think may be helpful. SSA runs two disability programs that are often confused. Both programs have the exact same definition of disability. Rey HRH's link to SSI eligibility requirements has a definition of disability for adults. Take a look at it. The definition can be summarized this way. A disabled adult would have a medical problem that prevents them from working. It's not enough to show that you have a medical problem. You have to show that the medical issue prevents you from working. This is important when you answer questions if you appeal your case up to the hearing level. Keep that in mind.

There is regular Social Security disability benefits and also SSI disability benefits. Regular Social Security disability benefits have the disability requirement and also a work requirement. The SSI program has the same disability requirement but you also must have a very limited income and resources. See Rey HRH's link above regarding SSI. Here is the link for qualifications Social Security disability.

https://www.ssa.gov/benefits/disability/qualify.html

If the claim is denied, you can appeal it. You have 60 days (actually 65 because you are given an extra 5 days for mailed in appeals). Make sure you submit a timely appeal. If you get an attorney, understand that the attorney gets 25% of the retroactive benefits. Should you get an attorney? It's an individual choice but I would say - it depends. If you appeal with no attorney make sure you complete the forms and the medical part completely. List all of the medical sources and all of the hospitals. Once you file, realize this. The medical sources you list will be contacted for medical evidence. Doctors and hospitals get many requests for evidence. Some sources respond quickly. Other medical sources don't respond at all. If a source takes too long, the adjudicator may make a decision with just the medical evidence submitted. Since there is incomplete medical evidence, it increases the likelihood of a denial. So you should let your doctors know that you filed for disabiity and ask for their help in responding to evidence requests timely. Another option is to submit medical evidence yourself. You can submit it with the appeal, or any time after that.

If you decide to use an attorney, here are some things to remember. Every attorney wants you to win your case. After all, they don't get paid unless your claim gets approved. The large majority of attorneys are ethical. But a few are not. The longer your case takes, the higher their fee. Some unethical attorneys may slow walk your case to delay it to jack up their fees. There was one attorney in my area that would drop off an appeal on the last (60th) day it could be filed. Every time. Plus other attorneys do a better job of following up with medical sources or the case adjudicator to insure that they have all the evidence they need. So how do you get a good attorney? You can ask around. But if you don't know anybody who could be helpful with recommendations, you could do this. Every town has a local township page on facebook where you could post miscellaneous items. You can ask for recommendations there.


SS lawyer here. This is good information except for the bit about attorney fees. Attorney fees is a SS case are 25% of past due benefits. However, the fee has to approved by SS and is subject to a maximum. The current maximum, which was increased in November, (it is increases only occasionally), is $9200. So that is the most a claimant will pay in standard SSDIB application no matter how much the accrual is. Trust me there isn’t much incentive to “slow walk” anything, and it’s not like SS moves quickly anyway. If you’re going to a hearing, you’re going to hit the maximum.

A claimant has to be off work or projected to be off work for one year in order to file. Your friend’s son’s biggest problem is that he is 39. At that age, he would have to be functionally illiterate and limited to sedentary employment, or have a significant non-exertional impairment (i.e. psych impairment). Below age 50, getting on SSD is quite difficult. The requirements loosen at 50.


_________________________

"Age does not bring wisdom. Often it merely changes simple stupidity into arrogant conceit. It's only advantage, so far as I have been able to see, is that it spans change. A young person sees the world as a still picture, immutable. An old person has had his nose rubbed in changes and more changes and still more changes so many times that that he knows it is a moving picture, forever changing. He may not like it--probably doesn't; I don't--but he knows it's so, and knowing is the first step in coping with it."

Robert Heinlein

 
Posts: 8900 | Location: West Chester, Ohio | Registered: April 06, 2007Reply With QuoteReport This Post
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^^^^^^^^^^^^^^^^^^^
Thank you Milliron. I will defer totally to your superior knowledge about attorney fees. So we are in complete agreement. Just as a side note, from my experience I would say that most people who have received a medical denial are better off getting a good attorney (such as you!)
 
Posts: 1121 | Location: New Jersey  | Registered: May 03, 2019Reply With QuoteReport This Post
Page late and a dollar short
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Thank you to all here that have answered, I’ve forwarded all these posts to them.


-------------------------------------——————
————————--Ignorance is a powerful tool if applied at the right time, even, usually, surpassing knowledge(E.J.Potter, A.K.A. The Michigan Madman)
 
Posts: 8585 | Location: Livingston County Michigan USA | Registered: August 11, 2002Reply With QuoteReport This Post
Page late and a dollar short
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Now if anyone has a suggestion for an attorney in the Amarillo area?


-------------------------------------——————
————————--Ignorance is a powerful tool if applied at the right time, even, usually, surpassing knowledge(E.J.Potter, A.K.A. The Michigan Madman)
 
Posts: 8585 | Location: Livingston County Michigan USA | Registered: August 11, 2002Reply With QuoteReport This Post
Oriental Redneck
Picture of 12131
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Three came up in Brave search. Just a search. I don't know any of them. Btw, typing in SSDI showed the same results.



Q






 
Posts: 28734 | Location: TEXAS | Registered: September 04, 2008Reply With QuoteReport This Post
Page late and a dollar short
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Thank you 12131.

I’ll forward this to him tomorrow.


-------------------------------------——————
————————--Ignorance is a powerful tool if applied at the right time, even, usually, surpassing knowledge(E.J.Potter, A.K.A. The Michigan Madman)
 
Posts: 8585 | Location: Livingston County Michigan USA | Registered: August 11, 2002Reply With QuoteReport This Post
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