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I found out right after my SSI hearing from my lawyer that the judge was in my favor. What happens now?

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Dear Biblitz,

Ok after fighting my SSI case since April 2008, getting denied, and apealing my case. I was appointed a lawyer through Social Services. Because i'am on full social services. Welfare got a lawyer for me abd he started the appeals process. Well after waiting more than a year for my hearing, D-day arrived. I was in the hearing room for about 5 minutes in front of a judge. Got asked a few dumb questions. Then i guess they were done. And i was told to wait outside. During this whole ordeal my paralegal, who prepped my case, and lawyer said not to worry, that they have so much medical stuff on me and my doctors deemed me permently disabled. That i would more than likely win my case! Well when i was in the hearing room, the judge and lawyer kept smiling at each other and smiling at me, after i answered the judges questions! When we first went in there the judge more or less made that beginning speal how he listens to my case and etc.. and that it would take him 2 to 4 weeks to make a decision! Now mind you i was only in the hearing room 5 minutes. Now the few questions i was asked, a 5 year old could answer in a very good way! hehe Judge only asked me about 4 questions and that was it. And i was told to wait outside. Well about 3 minutes later my lawyer came out and told me that the judge was in my favor and that i won! I thought i wouldnt find out for a few weeks for the judges decision. Well anyways i guess i won my case! The way it looked to me in the hearing room. The judge and lawyer allready knew i was going to get approved. Just by the way they were smiling at each other and me, answering questions! That was weird, questions were even dumber. So what happens now. Do i get back money from when my application was dated, When do i find out how much i will be getting a month and when will this will all start! This is my first time Getting SSI and hopefully i never have to go through this again!

Biblitz replies:

Congratulations!

It's not so much that judge and atty colluded somehow mysteriously. It sounds simply as if atty did his homework and you did yours, culminating in a good, complete dossier fully supporting your claim with the relevant medical info. Tho it might seem arbitrary, doesn't sound like it was at all. You just jumped through the hoops.

Forget the judge's questions and all the smiling. Quite often people smile when they're nervous. Or maybe they were smiling to make you feel more comfortable. Maybe they know one another and have been through the procedure a thousand times already. Who cares? The substance of your claim is in the documents contained in your medical file.

You will receive formal notification of the decision w/i the period judge suggested which will likely contain info/procedures necessary to obtain the actual payments if they don't start automatically. Read everything carefully and keep it together with everything else you've got in the file.

Again, good fortune smiled on you. Celebrate when the first check arrives in the correct amt. And do notify atty when this happens. There may be last-minute advice on what to do if payment is late and so on.

Tell Biblitz your story!
teaman90
How has the system treated you so far in your application for disability benefits? Gotta' question? Gotta' comment? We'd love to hear from you! Blast me, blast you, and give us the skinny. Also, if anyone knows the whereabouts of the trucker from the South in Doug Pray's film, Big Rig, with Grave's disease who was denied disability benefits, wrongly in my view, please ask him to get in touch. I think I can help. As David Bowie and the good people at the IOM remind us, you're not alone! Update Feb. 7/10 Thanks to everyone who spread the word about the trucker in Big Rig. I'm pleased to report that we've now found one another. Happily, his condition is so improved he no longers requires advocacy! Yay!

'You're not alone!'

Here's a fairly representative sample of the SSI/SSD adjudication process from Erie County, New York Social Services Legal Advocacy for the Disabled:

SSI/SSD Application Process

The Social Security Administration provides benefits to persons who meet its definition of disability through their Supplemental Security Income [SSI] and Social Security Disability [SSD] programs.

The Social Security Administration develops and applies its own rules and regulations for disability determinations. The process begins with an application for benefits. Several documents are required, including:

Reports detailing work history and doctors providing treatment
Releases to obtain records
Proof of birth or resident documentation.

Patience is key:

Initial applications are often denied for various reasons such as: not enough work quarters, failure to co-operate or immigration status.

Level 1 Appeal:

A written request for a hearing with an administrative law judge is the first level of appeal. It can take up to one [2] years for a hearing to be scheduled. Typically, the administrative law judge will issue a decision two - six months after the hearing.

Level 2 Appeal:

The hearing decision is appealed by submitting a request for review to the Appeals Council.

Typically the Appeals Council issues decision within two months on current appeals. However, they have an existing backlog of appeals dating back more than two years.

Final Appeal:

If review is denied, or an otherwise unfavorable decision is issued by the Appeals Council, the federal courts must then be petitioned for appeal.

The Outcome:

The Social Security Disability process can be long and frustrating. Depending on the number and level of appeals filed, a final determination could take several years. Claimants often abandon the process and their claim, before their appeals are exhausted:

However - patience, persistence and adequate information are often the keys to a favorable decision. (Accessed online Feb. 3/10)

Could you give me some idea, at least, of the kind of money I'm looking at if I qualify for benefits?

leJournal

I have to go down my list of medications and choose which pills I can take and which ones I can't... Some months, I have a little extra money and I can take it, and other months I can't... I've just been picking and choosing... . I haven't done myself any favors by doing that, but you have to do what you've got to do. Maggie (woman with multiple sclerosis waiting for Medicare coverage) Quoted by Williams et al. (2004)
teaman90
Maggie had to make decisions about which medications to take and which to forego, which is a dangerous dilemma. In her case, these hard choices are necessary because she has just started receiving Social Security Disability Insurance (SSDI) benefits but will not become eligible for Medicare for 2 more years. In the interim, she has no health insurance. (emphasis added) For others, the complexities of the Medicare prescription drug program or the state-federal Medicaid program can lead to interruptions in access to services or medications as program rules change or individual circumstances fluctuate. Yet others lose coverage when they lose their job or their employer stops offering health insurance. Although people with disabilities are somewhat more likely than other people to have insurance (especially public insurance), the consequences of a lack of insurance can be more severe for them because they often have more needs for health care (DeJong and Sutton, 1998). (From The Future of Disability, Chapter 8, Access to Health Insurance and the Role of Risk-Adjusted Payments to Health Plans, p. 222)

redWire

When applying for disability benefits, get used to life 'on the wire.' When you're on government dime, you're on government time, so use it wisely to ensure your file of complete, up-to-date medical reports fully supports your claim. There are a variety of advocacy groups in most jurisdictions to give your application a good first pass before submission. Ask Biblitz if you need help locating one near you. Also, keep a careful record of each development regarding your application from the date of illness/injury and diagnosis. Create a timeline that shows each medical event as well as each exchange with benefits provider, including outcome. If you're new at this, prepare to wait as long as two years just to find out if you qualify. And for what, exactly? Note how difficult it is to discern the actual paltry amount applicants receive if they prevail in what is often the fight of their lives. Don't imagine it's much better in Banana Canada, either! Spin the wheel at B.C.'s Income Assistance Estimator. Yes, and see the Ontario class action against the cruel administration of its disability benefits scheme! See an excellent overview of the battle currently raging in B.C., Complaints of Unfairness Shoot up from Welfare, Disability Recipients/Independent government tribunal had budget cut as appeals rose 46 per cent by Andrew MacLeod in TheTyee.ca Feb. 1/10.

The Future of Disability in America

Committee on Disability in America Board on Health Sciences Policy Institute of Medicine of the National Academies

Hardcover
Edited by Marilyn J. Field and Alan M. Jette

Our conclusions, as detailed in this report, entitled The Future of Disability in America, document the sobering reality that far too little progress has been made in the last two decades to prepare for the aging of the baby boom generation and to remove the obstacles that limit what too many people with physical and cognitive impairments can achieve. Disturbingly, many of the major recommendations contained in the two earlier reports have received little or no serious consideration, and they remain as germane today as they were in 1991 and 1997. This report therefore reiterates several still pertinent goals from the earlier reports and offers new recommendations that, if enacted promptly, could create a future in which Americans of all abilities and ages can participate fully in society. ... (From the Preface by Alan M. Jette, Chair, pgs. xiv-xv)

... The trade-offs or choices that Americans make about future spending will reflect their fundamental values about the balance between community and individual responsibility. Still, it should be recognized that health, social, and other policies that assist people with disabilities do not only represent current transfers of resources from those without disabilities to those with disabilities - or from mostly younger people to mostly older people. Over their life spans, the majority of Americans will experience disabilities or will have family members who do. People may not realize it, but the support that they give today for policies that affect future funding for disability-related programs is a statement about the level of support that they can expect at later stages in their own lives. (emphasis added)

This report underscores the growing evidence that disability is not an unavoidable consequence of injury and chronic disease but is substantially affected by the actions that society takes-in the public arena and in commerce and other private domains. Ultimately, the future of disability in America rests with Americans. (Summary, pgs. 9-10)

Harper's

On Spectrum

My daughter, her autism, our life

By Sally Tisdale
April, 2010

More on Financial Assistance for Caregivers of U.S. Vets.

About 65 million Americans are caring for ill or disabled family members in any given year, according to the National Family Caregivers Association. For many people this is a brief period in midlife when they help care aging parents. About 20 percent of the population have some kind of defined disability, but exactly how many live where, how many people are providing daily care for spouses or parents or siblings, no one really knows. The Census Bureau has just begun tracking the number of grandparents rearing their grandchildren, but they don't follow parents caring for their disabled adult children.
hands
Eighty-three-year-old Mrs. Christina Doherty of Namurkah, Victoria, has taken care of her 62-year-old son, Les, all his life. He was born physicaly handicapped. Approximately 100,000 Australians are handicapped in ways which require special care. (From A Day in the Life of Australia, March 6/81, edited by Rick Smolan, p. 204)

These numbers are going up. Better health care means that disabled and chronically ill people live longer. Disabled people who once would have been institutionalized in childhood now stay home with their families and attend local schools. (The list of disabilities that can pin a child to his or her parents for the long haul is quite lengthy - Down syndrome, glaucoma, congenital heart defect, porphyria, cystic fibrosis, leukemia, epilepsy, head injury, stroke, fetal alcohol syndrome, cerebral palsy, muscular dystrophy, spina bifida, and an array of rare genetic disorders most people have never heard of.) Decades of government policy and a Supreme Court decision, Olmstead v. L.C., have established that public services for all disabled people must be provided in the least restrictive and most integrated environment possible. States are required to create community-based services, but the broad vision of disinstitutionalization - a new society of supervised or modified places to live and a network of support services - has never materialized. The community-based alternatives that do exist - group homes and respite centers, social work, skills training, and assisted-living facilities - are overwhelmed. The system strains and shrinks. For a good many people, the least restrictive environment is the family home.

In spite of (and sometimes because of) policies that mandate community-based care, it is easier to find services for some disabilities than for others, easier in one year than in aother. The the family is often the best caregiver can lead to the belief that the family doesn't need help. Parents, writes researcher Nancy Breitenbach (see her six-page article, The Lost Generation, on developmental disabilities), find that they must "demonstrate without a doubt that they are unequal to the task and that they need help. Doing one's duty in difficult circumstances is seldom enough to merit aid. Parents may have to present an image of defeat if they wish to gain anything." A parent adds, "You shouldn't have to break down in order to get services." (-- p. 61)

We applied for Supplemental Security Income, the form of Social Security meant for disabled people. According to SSI criteria, Annie is fully disabled, and she now receives a small but reliable monthly check. (Her condition is reviewed every three years, in case she improves and becomes more independent.) In turn, SSI made her eligible for Medicaid, a blessing for which I am more grateful than for any other help we've received. But in one of the more maddening moments I experienced, she was denied services by the county on the grounds that she has no "adapted impairment" - in other words, she can manage life just fine - and because her diagnosis wasn't established by the time she was eighteen years old - in effect, because she hadn't been labeled.

Being denied county services is no small thing, for she has been denied money for skills training and access to most opportunities for supported employment or housing. I recently called a private non-profit charity in Portland that offers residential and employment support for people with developmentally disabled adults. They wouldn't even accept an application without county eligibility. (-- p. 63)

So how long before I receive an actual payment? ... Dave?