Hypothetical SSDI question....

Fearless_One

So tell me if I understand this correctly.   If a single person living alone who works full-time and makes around 24K a year gets diagnosed with mets - would not be eligible for SSDI for 6 months?    Expedited cases are only if you are given a year or less, right?   

I do not have mets, but this really concerns me, if it ever does happen.   I don't know what I would do.   I would lose my car, the roof over my head, etc.    I can't just not work for 6 months.

I thought if you were stage IV, it was automatic.   I didn't realize you don't get approved unless you have been out of work for 6 months.

Do I understand all this correctly?

AnneWisc

Please ask for an appointment with your hospital social worker, or your state or county human services office.  Most localities have stopgap coverage that would kick in before SSDI does. Also, knowing the ropes for SSDI makes a huge difference, vs. going it alone (even with attorney).

If you are sitting on a big bank account, many of these programs expect you to "spend it down" before you draw any support, but they don't normally force you to lose your car or housing.  

You may also want to canvass your family/friend network to see what assistance, if any, you could count on there.  I don't mean in terms of financial handouts but rather a place to live, rides, and so on. 

I would hate to see you stressed unduly by these worries.  The "social safety net" is not what it used to be, but I think your fears may be feeding themselves due to lack of information.  

Fearless_One

Anne, I was unaware of stopgap coverage.   Thank you...

No, no big bank account.   I pretty much go paycheck to paycheck, which is why I worry so much, even though I don't have mets.   My onc said my tumor was "very aggressive" including perinodal tissue invasion, and I just worry, even though I have a good bill of health right now.

Chickadee

You don't have to be out of work for 6 months to get approved, but sadly, you still have to wait 6 months to start receiving benefits.  Your approval is expedited due to the Stage IV diagnosis but the checks still don't start for 6 months.  Below is a copy/paste from the SS website.....maybe there is a different definition of "the date we find that your disability began", but my understanding and what is true in my case is that it is the last day I worked.  I don't think you have to wait to that day to apply but it will figure into when your checks begin.   I agree with Anne, you would be doing yourself a favor to talk directly to SS.  However, I have enough experience with them to find that they often give out bad information and I always back it up with lots of reading and research, on their website and on other disability sites.  I've been through this process twice now, once with my disabled son and now for myself.

Here is what is on the SS website:

If your application is approved, your first Social Security benefit will be paid for the sixth full month after the date we find that your disability began.

For example, if your disability began on June 15, 2010, your first benefit would be paid for the month of December 2010, the sixth full month of disability.

Social Security benefits are paid in the month following the month for which they're due. This means that the benefit due for December would be paid to you in January 2011, and so on.

Fearless_One

Thank you, Chickadee.   But it also says on their site that if you are working at the time you apply, they will most likely disqualify you.   So I think no matter what, it's 6 months of no work before you would even be approved.  

Where do they get this random number?   It's so unfair.   If I broke both my legs tomorrow, I would have to wait 6 months.

Chickadee

It's not approval that takes 6 months, it's the arrival of the first check.  My approval took only about 5 weeks from online application.  

Don't know how the 6 months was determined, whether procedural or legislative.  You could also review the SSI program that provides benefits based on low income.  I've never looked at the process of qualifying for that one but it might be a bridge of sorts given the loss of income while applying for SSDI.  SSI is administered by the states and also qualifies you for Medicaid, but I don't know the time frame for approval and check disbursement. 

I can understand the frustration but I also understand the need to make the program requirements stringent to try to ensure that limited Social Security funds go to those most deserving.

Your bio says that as of now you are Stage IIA.  Small comfort but at least you aren't IV and I pray you never reach this scary place.  Of course none of us wants to be any Stage, but you are wise to start asking these questions and looking for all the probabilities that might occur.  If your employer is large enough, start looking at all the possible benefits from work and then start researching any state and local programs as well as Cancer organzations that may be able to help bridge the gap.   I agree, those 6 months can be devastating financially for many of us.

I'm already retired and living off savings so the SSDI will help me stretch those savings out longer........and I hope for longer.

petjunkie

In my case, the date of my disability was not the date I was diagnosed stage IV, but the date I stopped working. So for me, that was Nov 1. I was eligible to receive benefits starting in May, so my first check arrived in June. It only took about 3 weeks for my application to be approved-- but if I had been working, they wouldn't have approved me. You have to be totally disabled-- unable to work-- and then there is the waiting period before benefits begin.

I think that SSI is supposed to help bridge the gap for people who qualify. I had savings and a retirement account, so I didn't qualify for SSI, so I don't know much about it.

The other bummer is that there is a 2-year period before you are enrolled in medicare. So I had no income for 6 months, then got only social security income (which in my case was about 20% of my former salary), and with my small social security income I'm paying a ton for COBRA coverage and in copays for medical stuff. It's crazy.

The only way I could do it was to get help from family and also to cash out my 401K to pay off bills and cover me for that 6 months. Even now, I would be struggling terribly if my parents weren't helping me out. I'm 36, single, and hadn't paid into the system long enough to have my Social Security payments be very high. I can't get insurance through a spouse. It's hard on single folks, for sure.

I did get my student loans forgiven because of permanent disability. If you can plan now, try to get the best handle you can on current expenses and sock away every dime for an emergency fund that i hope you never have to use. I cut down as much as possible on my spending and am now trying to learn how to get good deals through coupons, etc. It's a whole new life, for sure... 

hopeful34

Just out of curiousity.....when you ladies have to wait six months, do they give you a check for 6 months, or do you only get a normal monthly check when the grace period is over?  Sorry if that sounds confusing.

Fearless_One

I disagree it's for those who most need it.   I know people who have gotten it for back ache, depression, etc.   If I got stage IV cancer, I would not be approved because I currently work.   It is designed for people who are able to quit their jobs - and not every ill person can just walk away from their jobs.   I don't have a 401K or a spouse to support me or disability through my workplace. 

Chickadee, were you not working when you applied?   I do believe you will not be approved if you are working.    I do not expect to be getting paid while working.   But it's unfair one should have to be unemployed for 6 months to be considered.  

Chickadee

I had stopped working and two months later got my progression report which turned my world upside down.  That's when I applied.  I've been a temp worker when I can for the last 2 years, so technically I'm still employed, but I won't seek or accept any work until I see where this progression is going.  It just made sense for me to secure the benefits now in case this beast decides to take me to the mat.

Fearless_One

Chickadee, that is good you had stopped working.   Even at stage IV, if you had been working full-time, they would have denied you.   Assuming that income had been more than 1K a month, which is their cut-off.

reesie

Fearless One, I don't know about Florida, but New Jersey has a 6 month short term disability through unemployment - that takes care of the 6 months here.  I haven't had to go out on LTD yet, but I have used the STD (in the beginning of my DX).  If (when) I feel the need for LTD I would again qualify for the 6 month STD before the SSDI started.

Either way, the maximum benefit under either the NJ STD or the Fed SSDI is nowhere near my net pay so we would still still have financial difficulties (although on LTD I do have LTD coverage to get me to a better monthly position) - we are in the process of getting rid of as much debt as possible right now for this future probability.

Unfortunately, the Life Insurance I have doesn't have accelerated benefits or I might be considering LTD now.

Fearless_One

Reesie, thanks - I will look into that.   I do not know if Fla has something like that....if so, that would help to ease my mind some. 

Chickadee

I forgot about Workers Compensation.  You should check out the qualifying factors for that.  It's when you are out of work due to illness or injury and might bridge the gap to SSDI.

Fearless_One

I think workers comp is only if you are sick or injured from or on the job.....but I am not 100% sure....

I guess in a worse case scenerio, I would have to live with relatives for the 6 months.  I would lose my car, so would be unable to get to doctors appointments, but I think there are organizations that offer free transport.   Of course, I probably woudn't be going anyways, since I would not be able to afford Cobra with no income coming in.  

I shouldn't even be worrying about this stuff - I may never need to.   But I still worry.

Chickadee

I've always been almost obsessively practical, but I would say to anyone who is employed and younger that no matter how difficult you think it is or even impossible, divert some portion of your income to an emergency fund or savings.  If your company offers any kind of disability insurance, look into it and see if it would be helpful.

I saved from the time I started working as a telephone operator 40 some years ago, at first just $10 a paycheck and then when I could I boosted it and boosted it.   I know it's damn hard in today's economy but we can see why it's so important to try.

Fearless_One

Not possible on my income.   It's just enough to make my expenses, and I do not have the energy to work a second job right now.    If I get mets, I guess I will have to live with relatives, that's all.  

No, I had no disability.    They offered it when I started, but I never signed up (stupid me).   Needless to say, I am ineligible now.

3katz

Fearless_One - hopefully this is something you'll never have to worry about. But I do understand that you're trying to get all the information you can just to prepare. But please don't worry yourself too much.

SS will be approved if one is stage IV and not working. In my case I was approved in about 3 weeks and received my first check after 5 months. I know that's a long time to wait - especially if you are just supporting yourself.

You say you have no disability insurance. When your sign-up begins for next year's benefits, can you get it then? Even though you have a pre-existing condition, you may still be eligible. Check during the next annual enrollment. You should be able to change/add/remove benefit options at that time. Good luck.

Fearless_One

Hi 3Katz, yes, I know stage IV is approved if one is not working.   So for those of us who are working at the time of stage IV diagnosis, we would have to quit our jobs, be unemployed for 6 months, and then (I think this is correct?) wait another 6 months for our first check.  

No, I am no longer eligible for any disability through my employer, even at next open enrollment.   However, I believe I would be eligible with a new employer.  Not 100% sure....

reesie

Fearless_One, there is only one six month wait - the day you quit working you could apply for SSDI. Stage IV is fast tracked so once approved you would start receiving checks at the end of the first 6 months (it's really 5 months not covered with the check at the beginning of month 7 for month 6 - the checks are retrospective).

For automatic coverage (STD, LTD, Life) at your employer it would depend on the type being offered and if the employer is large or small.  Large employers may have some coverage that is offered to all employees and has no individual underwriting with automatic approval for everyone that applies, small employers don't have this requirement. 

However, any coverage through companies like AFLAC are individually underwritten so your eligibility would be determined based on health questions (this is not Employer offered coverage, just Employer sponsored if that makes any sense).

I used to be at a company that offered life insurance up to 2 x pay without underwriting but anything over that you had to get individually underwritten.  And you can bet when our open enrollment happens in December at my current employer I will be adding any coverage I automatically qualify for that may be offered (I work in a "large" company).

Have you had the opportunity to find out if Florida has a state STD yet?

3katz

That's too bad you can't elect disability at the next open enrollment. You could get private disability insurance such as AFLAC. My friend has it and it was a god-send when she injured herself, needed surgery & was off work for 6 weeks (she lives alone, worked for a small company that didn't offer disability). I do believe it's expensive though. If you changed employers, most likely you could get disability insurance but it all depends on the company. Usually the larger the employer, the better the selection of benefits. I am very fortunate to work for a global company because we have fantastic benefits. Expensive, yes. Worth it, you bet. Even though I'm out on disability, I have not separated from the company. One of the perks. Don't know how long that will last, though, since I'm exhausting my company's LTD time.

Fearless_One

Thank you ladies, for all your responses.   I guess the bottom line is you really have to have about 6 months salary saved up.   SSDI does not care what your future holds.   You have to have not been employed for 6 months (or made less than 1K a month, (like a single woman can live off that). 

And you absolutely cannot get life or disability insurance with a cancer preexisting - EXCEPT with group coverage through a large employer (i.e. over 50 employees). 

Medigal

Fearless:  I am confused about your post that one has to have about 6 months salary or other income saved up.  SSDI seems to be tied into SSI for the 5 months one has to wait to collect SSDI "if they get approved" and the rules for SSI indicate one cannot have over $2000 of savings.  This blows my mine because how is one to pay rent, food, medical etc. with only $2000!  If anyone in your family or friends help you out with support or food, it is counted against you!  SSI cuts you down before you have a chance it seems to me.  If you refuse SSI then you lose the 5 or so months of payments it would pay you while you wait for SSDI  from what I was told and read.  This entire thing can make one sick if one isn't already disabled!  My head is spinning from trying to figure this one out so if any one knows I am wrong about this, please advise.  Thanks!

Fearless_One

Medigal, sorry, but I don't know the answer.   I am 46, so I don't know anything about SSI, never researched it.   If you are correct, my head is going to explode.    So not only would they expect you to be out of work for 6 months, but they would not allow to have more than $2000 in the bank?  

I am confused though, because I know some ladies on here said they went through all their savings while waiting for SSDI.   I am assuming their savings was more than 2K...

Medigal

Fearless:  Maybe those ladies opted out of the SSI part.  We had no idea SSI was involved at all until recently.  The rules for SSDI are more reasonable but we were told SSI kicks in for the months you have to wait to be paid the SSDI (usually about 5 or 6) and it is basically a welfare program so you have to abide by the same rules people who apply for it due to "needs" based.  Maybe it is different for terminal cancer patients since they usually get approved immediately.  I just thought they had to also go through the "waiting period" for SSDI payments and that is where SSI kicks in.  Didn't any of you who got approved have to agree to sign up for the SSI?  My head has already exploded concerning this.  It certainly isn't something anyone would want to do unless they really needed it, imo!

Fearless_One

Medigal, thanks - I was not aware of this.   If my cancer were to progress, maybe I would be eiligible for SSI as a stopgap measure until SSDI.   Something I would have to research further.....

Hopefully won't happen, but I like to know my options...

Medigal

veggiegal:  From our experience, she should give them the names, addresses and phone numbers of "any" and all medical professionals who have treated her condition.  Even tho the person is negative against her, they will have to consider any negative information against the postitive info her other doctors are stating.  Her medical reports about her condition will be the deciding factor, imo.  This is very sad that a PT person thinks they are qualified to decide if someone is disabled or not.  What they ask for is names of all people who have treated her and any other treatments she has had to have for her condition.  This is where the PT person will have to be disclosed, imo.   They will all be sent special forms for info and their records and if the PT creep downs her, it doesn't necessarily mean they will just go by what PT says.  Worse comes to worse, they can send her to be checked out by one of "their" doctors (at their expense) and make up their own minds about her being disabled or not.  It can be a very nerve wrecking process especially for someone who does not have all the treatment people in their corner. 

Just tell her to remember that even if she gets turned down and has to appeal it, the lawyer can find ways to get around the PT creep's accusations.   Everything will not be determined by what "one" person says.  He may end up having to show proof for his  negative accusation.  He's not living in her body so how can he know what she is really feeling?  Sorry your question was missed when we got off on other concerns with SSDI.  Do hope we all end up victorious in this very frustrating ordeal.  Best of luck to your friend!

Chickadee

Veggiegal, your friend does not have to provide information on the physical therapist.  This PT, by the way behaved in a very unprofessional manner if you ask me.  She has no training or standing to decide whether or not someone would or should qualify for SSDI.   Your friend should provide information from her primary physicians who sound as if they are familiar with the process and would know how to represent her disability accurately.  If the information is not complete enough, the SSA may make an appointment with an independent Dr. to evaluate your friends situation.

Your friend should research as much as possible the kind of information that is favorable to a positive decision in terms of her unique disability and provide as much supporting documentation and references to support that. 

Fearless_One

Veggiegal, what specifically is wrong with your friend ?  

Fearless_One

If 3 doctors said it was a good idea, I would disregard the PT's comment.  

Medigal

Veggiegal:  I read something researching this SSDI that it it easier for people over 50 years old (for some reason).  They didn't go into details.  Your friend does have a better chance since she is almost 62.  I think it has something to do with the fact that they know she is getting closer to the age where she can opt for regular Social Security.  I don't know if one can get it at 62 any more since they have changed the rules so much.  But yes, tell her to be grateful she is up in age at this time.  Good luck to her and you for caring about her so much!