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Old 04-29-2008, 07:12 PM #1
thursday thursday is offline
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Question My CA people, a Medi-CAL question!

Did I do something bad by applying on my own for Medi-CAL before I was asked to apply for SSDI by my LTD provider??

I'm really hazy on who belongs to what... I thought that Medi-CAL was a state department.
My concern is, when I told the Social Security Department (for SSDI) that I have never applied before did I accidentally tell them a falsehood?

I applied back in February (?) and they just told me this week I have a disability determination appt next week. And I don't want to do anything wrong- especially since I still haven't started the process for my LTD's offer for the Social Security Advocate to help my SSDI claim.

p.s. what do they do at a Medi-CAL disability examination anyway?

thank you guys!!!!
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Old 04-29-2008, 07:59 PM #2
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Don't worry. Medi-cal is the State and SSDI is the Federal Govt. They very rarely talk to each other but you are entitled to both if you are approved. Call the State for more info regarding their programs. I have both.

Good luck
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Old 04-30-2008, 01:58 AM #3
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Quote:
Originally Posted by Curls47 View Post
Don't worry. Medi-cal is the State and SSDI is the Federal Govt. They very rarely talk to each other but you are entitled to both if you are approved. Call the State for more info regarding their programs. I have both.

Good luck
Phew!!! Thanks so much Curls I plan on calling them during buisness hours tmrw for sure. What should I expect with this exam? Are they gonna draw blood??? (please no~ I'm a huge baby about needles!!)
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Old 05-01-2008, 01:44 PM #4
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Smile Feel free 2 share experiences about Disability Determination Exams

I called today- it seems this exam will be of use to SSDI as well. I believe they said it meets the same requirements.
(sidenote- a QME does not meet the requirements although it sounds like the same type of examination )
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Old 05-01-2008, 09:53 PM #5
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Default Medi-Cal/Medicare

Hi - others are right - are separate programs.... however, lots of people dont know that you can qualify for both - and at least in the state of Cal gives you special rights...... one rarely gets SSDI on their first (or much longer) try - even with their own doctor's reviews.... plus, you are not eligible for Medicare coverage until 18 months after the date SSDI determines you were disabled and if the determination is not made by then - its 28 months... in any case - you will have to be able to afford to pay for COBRA for 18 months, and if there is a gap until 28, high risk insurance, which is outrageous in cost....

Medi-cal right away would give you some insurance... further, when you get SSDI and are eligible for Medicare - there is a prgram where Medi-Cal pays your monthly premium on Part A and B for Medicare, and although many state Medi-Cal workers are not aware of this - also a portion of your Plan D monthly premium - Medicare Prescription Plan (if the program isnt cut this year along with everything else) - and if you are on Medi-Cal and meet the financial requirements. You would be considered a "dual-eligible" and need to be really persistent if you do get SSDI so follow up with the program.....

Another tip - you mentioned your LTD - unforutnately theses companies have a tendency to appear to try to help you get SSDI to save them money - when in actuality they do nothing in court and you loose (thus making it easier for them to deny you LTD) - you are required to apply for SSDI however - be sure that you dont have the right if nessary to get your own attorney that THEY will have to pay that works only in your interest (they often will not reveal you can use any attorney and they must pay them).... and if you must work with them that the person from the LTD company has credentials to represent you - shows an interest in your case - meets with you etc.... if they dont - ask for another rep from the LTD company.

Back to the exam - they used to be very inadequate actually - Medi-Cal is apt to tentatively approve you until your SSDI is approved, a much more difficult process, so at least you'd have some coverage.

Hope all goes well.

Last edited by BEGLET; 05-02-2008 at 12:11 AM.
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Old 05-01-2008, 09:54 PM #6
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Default Medi-Cal/Medicare

oops = posted twice!
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Old 05-02-2008, 12:39 AM #7
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I can't thank you enough!! This is great information!

Quote:
Originally Posted by kmeb View Post
Hi - others are right - are separate programs.... however, lots of people dont know that you can qualify for both - and at least in the state of Cal gives you special rights...... one rarely gets SSDI on their first (or much longer) try - even with their own doctor's reviews.... plus, you are not eligible for Medicare coverage until 18 months after the date SSDI determines you were disabled and if the determination is not made by then - its 28 months... in any case - you will have to be able to afford to pay for COBRA for 18 months, and if there is a gap until 28, high risk insurance, which is outrageous in cost....

Medi-cal right away would give you some insurance... further, when you get SSDI and are eligible for Medicare - there is a prgram where Medi-Cal pays your monthly premium on Part A and B for Medicare, and although many state Medi-Cal workers are not aware of this - also a portion of your Plan D monthly premium - Medicare Prescription Plan (if the program isnt cut this year along with everything else) - and if you are on Medi-Cal and meet the financial requirements. You would be considered a "dual-eligible" and need to be really persistent if you do get SSDI so follow up with the program.....

Another tip - you mentioned your LTD - unforutnately theses companies have a tendency to appear to try to help you get SSDI to save them money - when in actuality they do nothing in court and you loose (thus making it easier for them to deny you LTD) - you are required to apply for SSDI however - be sure that you dont have the right if nessary to get your own attorney that THEY will have to pay that works only in your interest (they often will not reveal you can use any attorney and they must pay them).... and if you must work with them that the person from the LTD company has credentials to represent you - shows an interest in your case - meets with you etc.... if they dont - ask for another rep from the LTD company.

Back to the exam - they used to be very inadequate actually - Medi-Cal is apt to tentatively approve you until your SSDI is approved, a much more difficult process, so at least you'd have some coverage.

Hope all goes well.
I really wish I had a diagram of SDI, SSDI, WC, LTD and Medi-CAL. They all are there to help- but getting there isn't easy. They also tend to want the "other guy's" benefits to help you so they can stop and/or take back the safety net they have provided you. Its like a benefit stand-off!!
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Old 06-26-2008, 04:01 AM #8
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Shocked

I just received a denial for Medi-Cal for my poorly executed disability determination eval. nice.
"We have reviewed all information available to us about your circumstances and find that your application for Medi-Cal.. has been denied. Your disability has been disallowed by the State Disability Evaluation Division.
The applicant's condition is not of such severity as to interfere significantly from all work activity.
Based on the evidence, the applicant's condition is not severe enough to be considered disabling."


Questions:
a) Which is it? Am I not considered disabled at all- or just not enough to be considered unable to EVER work again, thus being inelligible? (I know the answer should probably be in the Medi-Cal fine print on their website, going there right now.)
b) I am scared about requesting a hearing over this matter. Anybody ever gone thru this?
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