Law and People with Disabilities

21 November

• Public benefits includes a wide variety of stuff: fuel assistance, foodshare, etc.
• We're going to work on income eligibility stuff today.
• SSI and disability insurance (SSDI)
• "EBD:" Elderly, blind, and disabled.
• Interesting wrinkle: SSDI income could be garnished for stuff like child support.
• SSI comes bundled with medicaid. SSDI - medicare (after 29 months).
• 5-step sequential evaluation
  1. Working under SGA ($1000/month in 2011)
  2. Severe impairment
  3. Meet or equal a medical listing
  4. Can't return to previous work:
     • Previous Relevant Work
     • Within the last 15 years
     • At or above SGA level
     • Done long enough to learn the job
     • As the job is done in the national economy
     • Residual functional capacity
     • Physical/mental
     • Standard exertional standards
  5. Can't do other work available in the national economy
     • This is where the grid factos in age, RFC, education, past work
• All claimants must satisfy 1 & 2. Then you need either 3 or 4 and 5
• There can be exceptions to the SGA standard: vacation/sick leave pay, benevolent employer, subsidies, impairment-related work expenses
• So one strategy as an advocate is to try to get people approved earlier. Your chances improve at an ALJ hearing, but that takes a long time, so if you can help a client get approved at stage 3, that's a major help. So there are some timeline exceptions (presumptive disability, compassionate disability, terminal illness, etc.) that are available, so spot those if your claimant can get access to them.
• A disability determination can unlock a lot of other things: housing, foodshare, DVR, etc.
• Medicare parts:
  • (A): hospitalization, etc.
  • (B): basic medical, doctor visits, equipment, etc.
  • (C): privatized medicare - HMOs/managed care
  • (D): prescription drugs.
  Long-term care is pretty much not covered. There are co-pays, deductibles, etc.
• The majority of people accessing medicare are elderly, not people with disabilities.
• You can be on medicare and medicaid simultaneously; medicare is less comprehensive, but will be the first like of defense, and the medicaid picks up what is left.
• Medicaid is joint state/federal (medicare is entirely federal).
• Badgercare is the family medicaid program.
• Four categories of medicaid: