Thanks msdrea83! I'll will say age does play a role, the younger the tougher. My wife is close to 52, college educated and a professional and worked nearly 30 years. In her case there was no lawsuits, WC etc...it was a fall and a broken wrist that started her nightmare. SS screwed up soon after she applied in 06. She called SS 3 months after she applied only to be told they've made no decision as yet. About 3 weeks later I told Suzy to call again only to be told they made a decision 3 months ago and that she was denied. This put a halt to an appeal because you only have 60 days to appeal in which she missed that window. We appealed that and won because they never sent us a letter of refusal from the beginning. So, to see another screw up even worse than the one way back is unforgivable and extremely incompetent to say the least. My thinking leans toward a unwritten policy of depriving Americans. It seems to be on purpose. But what amazes me is the stop they put on her altogether in seeing this judge, and by this judge who never met Suzy ever.

Jim,
I am sooo sorry to hear this...why do we pay into SS and then get denied for what we have worked for our whole lives? I am in my first round and I have 2 appts next week, so I am very unfamiliar with the whole process, but thanks for the update....the more I read about everyone's experience, I am expecting my SSDI in about 5 years.

Welcome to the gates of hell known as SSI. Here you are 4 years into the process and still getting the run around. Well I'm sorry to say, you're far from done with it and one of the areas is regarding Medicare.

Even after you finally do get your SSI through, I think you'll find that your local state Medicaid program will be your only medical insurance solution for no less than the first 2 years. Only after being on disability for 2 years does a person qualify for Medicare and then you'll have the $110 payment for Part B coverage plus if you don't buy a supplement during the brief 7 month window (3 months before Medicare kicks in, the month Medicare kicks in and 3 months after it kicks in) you have no guarantee of ever being able to get any kind of Medicare supplemental from then on which you're going to need badly since Medicare is usually 80/20, meaning you'll still owe 20% of the bill. Actually after January the 1st, because of Medicare dropping down the amount they're paying the doctors, the supplement also kicks down meaning most patients now owe an additional 3rd bill for the difference the first two insurance plans didn't pay. In other words, once you're on Medicare you can plan on paying $110 for Part B, plus a supplement for around $150 plus Medicare Part D that costs around $35 a month with a $310 deductible (averaged out together that means most are now paying around $65 a month for Part D drug plan coverage). There's a lot of people who now have both Medicaid and Medicare together. If you want more info, contact either SHIP (a nationwide Medicare help organization that's simply wonderful) or me and I'll help you through this part of your challenges at hand.

The average person is paying around $300 just for their insurance and there's still things that Medicare won't pay for which you'll be left financially on the hook for. The fact that Medicare won't kick in till after you've been on full disability for 2 years is the other thing that hurts most people the most.

On a positive note, even without SSI, you might be able to qualify for Medicaid right now.

As far as why you were denied one more time, I'd like to think it's just another slight accident on their part, but I've become to cynical in my old age. The reason you've had so many roadblocks is not because your wife isn't disabled, it's because of there being so many people who've abused the system to death and now they've run out of money plain and simple.

I'm so sorry that you couldn't apply for SSD instead of SSI because it would have made a world of difference in both the amount your wife will eventually get plus there are so many restrictions regarding assets and total monthly income for those who are on SSI.

Best of luck. Contact me if you need more info on the insurance side of your problems. Bob.

Thanks for the response Bob. I'm a little confused with the terminology. In my state when filing for SSDI one has to apply for both SSDI and SSI at the same time. We knew going in that she would not qualify for SSI or medicaid because we have too many assets. She worked nearly 30 years, and paid into the system. Our monthly out of pocket monthly health insurance bill was around $150 per month through my wife's company. When she was terminated I picked my insurance from my work at $1000 per month out of pocket. With the ecomomy slowly crumbling my kind of specialty work was being outsourced more and more the last 5-6 years, my income dropped 40%. Soon my employer went chapter 7. My wife and I have worked our butts off for decades, we lived the american dream. Within a couple of years we now live the modern american nightmare because it is only here in the states that if a member of a family, where it takes two now to sustain a home in expensives areas where we were born and raised, when a company goes bankrupt COBRA coverage is not and never will be available. My only choice was to cover her through Hipaa at $2600 a month or $1600 per month through BCBS with no coverage for 10 months. We could not afford this. Our savings are gone and selling the house is very difficult with this economy.
So, my point Bob is even with those medicare co-pays and suplements its much better than what my wife has now which is no insurance. I'm employed and cover her out of pocket which is less out of pocket costs than picking up traditional insurance. To me an extra $400 per month through medicare is a bargain.
As far as the two year wait for medicare, I've been led to believe by my wife's representitive is the two year wait is retroactive. Another words if one applys for SSDI over two years ago then is approved, its retro, you'll qualify immediately.

Dear Jim,

I understand what you are talking about in regards to the "working before the onset". I was approved not for SSDI but for regular SS Benefits which comes with medicare and benefits for my minor children and back benefits for my 18 and older chilren up until they became 18, just to clarify what I actually got approved for. When they mentions "working before the onset" SS gave my attorney a complete list of the part time work I had done prior to my approval and to make a long story short, I did work a litlle to much on year and it was not hours it was the dollars they are looking at. So, in order to settle I had to give up about 3 years of back benefits. I got 4 years instead of seven, but to me it was worth it. I had waited long enought and suffered financially because of this whole mess and just wanted it over so I gave up 4 years of earnings. I was told that if Iwent in front of a judge I could possibly lose because of the slight overage and I mean it was really a small amount of money I went over for a short, short peroid of time . So, I settled.

I hope this helped.....

Gabbycakes

Just one other possibility, Identity Theft. There is a chance someone worked under her SS# without her knowing. While the odds are it's just a mistake, remember you don't want to be confrontational with the ALJ's office. Bees, honey, vinegar, whatnot...

FYI....

Our newspaper this morning reported that there is a record backlog in SSDI claims nationwide - in some states it exceeds 2 years. The backlogs are partly attributed to the increase in unemployment. Apparently disabled individuals who have worked in the past and are finding it difficult to find work now are instead filing for SSDI, increasing the number of filers.

So sorry for your troubles Jim. I hope things get resolved soon for you and Suzy. XOXOX Sandy

i read the story too...

http://news.yahoo.com/s/ap/20100510/...bility_backlog

make sure they(last job) did not cash in her sick pay, vacation, 401k loans etc.. as income that would look like she worked.



i was told that you cant work part time or even volunteer for free because this would prove that you can work a little. they can take your disability away or not approve it.

i have a bad headache somaybe this isnt making much sense, hopefully you understand what i am trying to say.

good luck,

I worked PT almost the whole time I was waiting for my decision. You can make up to $980 per month before they start to deduct from your monthly benefits. A matter of fact when I first applied and got denied the first time in the deniel letter from the SS Office they stated I should try and work PT, which I did exactly what they said. When I got an attorney to do the appeal and then got a "Fully Favorable" decision he felt it worked to my benefit that I at least tried and continue to work PT on the books. I get my s.s. check every month without any deductions...Please check with your attorney or you local SS Office before you change anything if you are fighting a deniel.
You do have to be very carefull when yo do work PT not to go over that $980 per month. My previous post on this subject explains what happened to me.

Good Luck to all,

Gabbycakes

Good Luck to all.