SSI Expedited Payments

Posted January 19, 2018 by Premier Disability Services, LLC®

Expedited SSS Payments

The Supplemental Security Income (SSI) program provides monthly income to individuals who are low income and do not have the requisite working credits for Title II Social Security Disability Insurance benefits. The Social Security Administration (SSA) can start payments more quickly than usual in four different types of situations:

1.Presumptive Disability (PD) or Presumptive Blindness (PB) payments.
If your claim is for SSI benefits for disability or blindness, the SSA may make PD or PB payments for up to 6 months while you are waiting for the Disability Determination Services (DDS) to make a final decision. The decision to grant PD or PB payments is based on the severity of your condition and the likelihood that your claim will be ultimately approved, and is not based on your financial need. If you are later denied SSI benefits, you do not have to repay your PD or PB payments; however, if you received an overpayment for other reasons then you may be asked to repay some of the PD or PB payments.

2.Emergency Advance Payments.
The SSA may be able to make an emergency advance payment to new applicants who face a financial emergency (meaning you need money right away due to a threat to health or safety, such as not enough money for food, clothing, shelter or medical care) and who are due SSI benefits that are delayed or not received. The SSA can only pay one such advance payment. The maximum emergency advance payment you may receive is the smallest of: the SSI Federal benefit rate (plus any federally administered State supplement); the total amount of the benefits due; or the amount requested for the financial emergency. These payments are later recovered when the SSA subtracts your emergency advance from the payments already due to you. If you are not due past payments, the amount is subtracted form your current monthly benefits in up to 6 monthly installments.

3.Immediate Payments.
The SSA may be able to make an immediate payment to new applicants and those already receiving SSI whose benefits are delayed or not received and who face a financial emergency (see above). The immediate payment cannot be higher than $999.00. Immediate payments are entirely discretionary on the part of the SSA and you do not have formal appeal rights if the SSA determines you are not eligible for an immediate payment. Immediate payments are later subtracted from the first regular payment due to you.

4.Expedited Reinstatement cases.
If your benefits ended because you worked and had earnings, you can request to have your benefits started again without having to complete a new application. This process is called “expedited reinstatement”. You can request that your benefits start again if you: stopped receiving benefits because of earnings from work; are unable to engage in substantial gainful activity because of an impairment(s) that is the same as or related to the impairment(s) that allowed you to get benefits earlier; and make the request within 5 years from the month your benefits ended.

The SSA can give you provisional benefits for up to 6 months while they determine whether you can get benefits again. These benefits include Federal payments and Medicaid coverage. If the SSA decides that you cannot get benefits again, they usually will not ask you to repay the provisional benefits.

If you or someone you know is unable to work due to a medical condition, please contact us for a free evaluation of your claim!

Source: SSA.gov/ssi/text-expedite-ussi.htm

By: Joyce Trudeau of Premier Disability Services, LLC®

Social Security Disability with End-Stage Renal Disease

Posted January 12, 2018 by Premier Disability Services, LLC®

End Stage Renal Disease

End Stage Renal Disease (ESRD), or kidney failure, is an irreversible condition most often caused by Chronic Kidney Disease (CKD), though it can occur suddenly or from other disorders. The National Institutes of Health estimates that over 26 million people have CKD, and many don’t realize until the damage to the kidneys is severe. According to the latest U.S. Renal Data System Annual Report, ESRD affects over 660,000 Americans of all ages.

The United States Renal Data System also found that Medicare spent over $500 billion on kidney disease, making it one of the most expensive disorders. On ESRD alone, Medicare spends $32 billion annually, along with an estimated additional $15 billion for non-Medicare patients.

Because ESRD puts a whole organ out of commission, the treatments are very costly. Most of the costs are from inpatient and outpatient medical care. Individuals waiting for a kidney transplant must often undergo dialysis. The National Kidney Foundation found that dialysis costs $83,000 each year for the average patient. When a kidney becomes available, the transplant will cost over $30,000.

Because the condition requires so much time at the hospital, ESRD is a leading cause of lost productivity. Dialysis requires three days a week for about four hours, which puts a toll on those trying to work, both on their physical abilities and available time.

The Social Security Administration (SSA) has several Adult Listings regarding CKD and ESRD. If you are out of work or earning less than SSA’s current substantial gainful activity amount, and if you meet or equal one of these listings, you will be found disabled. However, even if your CKD does not meet or equal any of the listings, you can be approved another way. The SSA may also award benefits based on a medical-vocational allowance.

To determine whether or not you can work, the SSA will determine your maximum Residual Functioning Capacity (RFC). The examiner takes into account your limitations, education level, and work history to first put you in a category of work (sedentary, light, medium, heavy, or very heavy), and then find jobs you’re qualified for with your work history. If the SSA can’t find a job you can do or decides you can’t even do sedentary work, you may be approved for benefits.

ESRD is a permanent and very debilitating condition, so it can cause many limitations that would keep you out of work. The National Kidney Foundation reported that CKD patients had an average of 10 doctors’ visits a year, second to only cancer. Additionally, dialysis patients need to spend at least 12 hours a week in the hospital for their necessary treatments. Fatigue, mental confusion, sleep problems, and chest pain can make normal tasks hard to complete. Bone pain, swelling of the lower extremities, and impaired motor skills can make it hard to walk, stand, and perform fine movements.

If you or someone you know is unable to work due to a medical condition, please contact us for a free case evaluation.

CKD Listings: SSA.gov/disability/professionals/bluebook/6.00-Genitourinary-Adult
SSA Publication on ESRD: SSA.gov/pubs/EN-64-107

By: Joyce Trudeau of Premier Disability Services, LLC®

Manipulative Limitations in a Disability Claim

Posted January 5, 2018 by Premier Disability Services, LLC®

Representative Payee Program

Nearly every job requires a full and complete use of the hands. Anyone who has “manipulative limitations” caused by injury or pain needs to be aware that this can be an important component of a disability claim. While more obvious in situations involving a condition such as carpal tunnel syndrome or a specific hand injury, this limitation can also be important even when it is not the major disabling condition.

Social Security law says that in order to do even unskilled, sedentary work a person must have good use of both hands and the fingers – this is called “bilateral manual dexterity” in the regulations. Any significant limitation in a person’s ability to handle, pick up and finger small objects is important in the disability decision. Many claimants have conditions that restrict the amount of lifting they can do. Anyone person who can lift and carry even 10 pounds for most of the day may still be found capable of sedentary work, under Social Security regulations. The addition of a manipulative limitation, particularly of the dominant hand, can be enough to tip the scale in favor of the claimant.

More general medical conditions such as arthritic impairments, fibromyalgia, and chronic fatigue may also include hand, arm, and/or shoulder pain. Often when Social Security is collecting information on these illnesses from a claimant, the entire focus is on lifting, standing and sitting limitations. Careful medical record development of limitations on use of the hands is very helpful in the decision-making process. Soliciting this information from treating medical sources can be extremely important. These limitations may sometimes be viewed as a minor problem in the context of some larger disease process. As such, medical case records often do not specifically mention them.

When the right questions are asked of the medical provider, however, a clearer picture may emerge. Does the person have pain in the dominant hand? Does stiffness prevent full use of the hand, particularly for small motor tasks such as writing? Is the pain increased by repetitive use? Although someone may be able to lift five pounds, or use the painful hand for a task once or even five times, can this be done on a continuous, repetitive basis for an 8-hour work day, five days per week? What is the effect of such an activity level on the person’s ongoing condition?

Think of a manipulative limitation in combination with all other impairments. Often it can be overlooked, for example, when the presenting problem is psychiatric. When a condition such as anxiety or depression is not severe enough on its own to qualify a person for benefits, the claim can be strengthened by considering this and other physical limitations.

If you or someone you know is unable to work due to a medical condition, please contact us for a free evaluation of your claim!

By: Thomas A. Klint of Premier Disability Services, LLC®