Medicare vs. Medicaid: What’s the Difference?

Medicare vs. Medicaid: What’s the Difference?

Do you feel confused when people start talking about the difference between Medicare and Medicaid?

If so, you are not alone. One study found that only 4% of Americans could correctly explain the basic terms of their health insurance policy.

The thought of navigating the world of health insurance on your own may seem overwhelming. This is especially true as you approach your “Golden Years” and the reality of Medicare vs. Medicaid stares you in the face.

In this post, we will look at the difference between Medicaid and Medicare so you can make an informed decision. 

Understanding Medicare

Medicare is the primary health insurance provider for Americans over 65.

It can also provide coverage for those under 65 who receive Social Security Disability Insurance benefits.

Medicare is composed of 4 major parts. Here’s a brief rundown of each one.

Medicare Part A

Part A is what most people think of when they hear the term “Medicare.”

It covers hospitalization for those over 65 as long as they (or their spouse) worked and paid Medicare taxes for at least 10 years.

For most enrollees, this aspect of Medicare is free. However, you still have to pay deductibles and co-pays for certain services.

Medicare Part B

If you are eligible for Part A, you are also eligible for the health insurance benefits offered by Medicare Part B.

Part B offers coverage for services and equipment that are medically necessary. These include doctor’s visits, x-rays, lab work, and outpatient procedures.

This aspect of Medicare is not free. The monthly premiums are usually deducted from your Social Security payments.

Medicare Part C

Many who enroll in Medicare Parts A and B also sign up for supplemental coverage through Part C.

Also called “Medicare Advantage,” Part C works much like a PPO or HMO plan you likely had during your working years. It may also include dental and vision plans.

Medicare Part D

The final piece of the Medicare puzzle is Part D, which covers the cost of prescription drugs.

It includes a combination of monthly premiums and co-pays with a yearly deductible.

Understanding Medicaid

While everyone qualifies for Medicare once they reach 65—regardless of income—Medicaid is open to low-income families of all ages.

Each state has unique (and strict) requirements for Medicaid eligibility.

If you do qualify, you typically pay nothing for most healthcare services. Supplements are available for dental, vision, and prescription drug coverage.

Medicaid may also be used for long-term care funding for those who have no other way to pay for it.

Medicaid planning attorney can provide guidance and help you understand exactly what you might qualify for.

Medicare vs. Medicaid: Which Is Right For You?

In the decision of Medicare vs. Medicaid, your options depend on your personal situation and finances.

Which aspects of Medicare will you need after you turn 65? Will you qualify for Medicaid at that time, or might you already qualify for it?

The good news is you do not have to figure it out on your own.  If you are working hard to figure out the difference between the two programs, or if you qualify, we may be able to help.  Additionally, consider our Social Security disability advocacy, and estate planning services.  There is a good chance you are going to need these.

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Do SSI Lawyers Really Help With Your Disability Claim?

If you find yourself in need of assistance for a social security disability case, it is important to get help from an expert.

Many people make the error of representing themselves. While you may know your rights, it is always advantageous to reach out to one, or several social security disability law firms to increase your overall chance of success.

Follow the tips below to learn more about the importance of hiring the right SSI lawyer for your situation.

SSI Lawyers Increase Your Chance of Success

When you need a payout for your social security disability case, the last thing you want to deal with is personal doubt and uncertainty at each step of your claim. Hiring a competent disability lawyer will help you wipe away a lot of this doubt since you will have professional advocates on the case for you.

A great team of SSI advocates will work to clarify any questions the SSA has about your medical condition, employment status, medication and treatment, and any other concerns that arise. They will be there every step of the way working on your behalf to convince the Social Security Administration (SSA) that your claim is appropriate and should be granted.

A Great Team of SSI Lawyers Can Speak For Your and Explain the Details of Your Case

Knowing the law is one thing, but you also need a professional that can articulate it on your behalf.

When you start shopping around for various SSI lawyers, gauge how each one of them explains your situation to you. You want a lawyer that will explain everything about your claim, and the work they will do for you clearly, and also answers all your questions.

Remember, your lawyer will argue on your behalf that your condition meets the standards of a disability as defined by the SSA. They will further prove that your state hinders your ability to work and earn a living. It is vital that you can communicate with your lawyer if you ever expect them to be able to convey your situation accurately and compellingly for you.

SSI Attorneys Ease the Application Process

With social security disability cases, you are always subject to lulls in claim turnaround time. One of the best things you can do to get your claim approved as fast as possible is to retain a good SSI lawyer. Hiring a lawyer improves your chance of getting accepted in the first wave of the application process – which can help you get your claim approved in months rather than fighting for years over why it was not accepted in the first place.

You will also get another set of eyes on your initial disability application.

You Will Get Paid What You Deserve

In most cases, you can expect your social security lawyer to take up to 25% of your payout (up to $6k). This rate is the maximum rate an SSI lawyer can charge to assist you as an advocate. But there are some ways that firms can slip other fees by you. Even though it seems like everyone charges the same thing, you can still find there is a difference at the end of the day (in your bank account) if you don’t shop around.

Get the Professional Help You Need

We have years of experience and would love to hear from you. We’re passionate about helping you to know more about your claim – you can see this by visiting our blog.

But we can also show you by meaningfully connecting with you beyond this article. Contact us and get advice and help on your disability claim today!

Contact Lilac City Law For Disability Help Today

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Can You Win a Disability Claim for Meniere Disease in Spokane, WA?

Can You Win a Disability Claim for Meniere Disease in Spokane, WA?

If you have Meniere Disease and are finding it hard to work, you may qualify for Meniere Disease Disability Benefits.

In fact, depending on the severity of your symptoms and if you meet the SSA requirements, you may automatically qualify.

What Meniere Disease is

Meniere Disease is a disorder of the inner ear (vestibular labyrinth) which is the area that controls your balance and positional awareness.  If you have Meniere Disease, you do not constantly have symptoms, but rather attacks that come on quickly and without warning.  These attacks include extreme vertigo, hearing loss, and a full feeling in your ear.  Because of vertigo, you are at risk of falling and causing injuries.  With hearing loss, you may be unable to use the phone or verbally communicate because you cannot hear what is being said to you.  These attacks may happen in a short period of time, or they may be isolated incidents that happen every few years.  Most attacks are very debilitating and take several hours to recover from.

How to Automatically Qualify for Meniere Disease Disability Benefits

Meniere Disease is listed in the SSA blue book under SSA listing 2.07– disturbance of labyrinthine-vestibular function as a disability that automatically qualifies you for Social Security disability benefits.  However, to automatically qualify you must:

  1. Have both, disturbed function of vestibular labyrinth demonstrated by caloric or other vestibular tests; and hearing loss established by audiometry.
  2. Be earning less than $1180 per month (unable to engage in Substantial Gainful Activity)
  3. Have symptoms that last or are expected to last at least 12 consecutive months. Because Meniere Disease’s symptoms come and go, it is important to provide medical records from each time your symptoms occur from your primary doctor (or any other doctor that has treated your Meniere Disease) and your audiologist.

What to do if You Do Not Meet the Automatic Qualifications

Even if you do not meet the qualifications to receive Meniere Disease Benefits automatically, you should still apply for Social Security Disability.

SSA will create a residual capacity assessment (RFC) that will detail your ability to perform certain work-related activities.  Additionally, SSA will use the medical evidence that you submit and possibly ask you to see a doctor or audiologist hired by the SSA.

The RFC will look at your ability to perform basic work activities such as:

  • Walking, standing, sitting, lifting, pushing, pulling, reaching, carrying or handling
  • Seeing, hearing and speaking
  • Understanding/carrying out and remembering simple instructions
  • Responding appropriately to supervision, co-workers and usual work situations
  • Dealing with changes in a routine work setting

SSA should take into consideration side effects caused by the medications you take for your Meniere Disease.

For example, your medications may cause sleepiness and fatigue.  This could impact your ability to work around or with heavy machinery.  It may also affect your reliability and productivity.  If you can prove that your productivity is ~20% less than what it was before your Meniere Disease diagnosis, then you may be found disabled.

After your RFC is created, the SSA will use a formula to decide whether your RFC and your vocational factors put you in the disabled category.

You Can Get Help!

If you have Meniere Disease and are not sure if you should apply for Social Security Disability, please contact us.  We want to help!  If you have been denied, you should file an appeal, asap.  We will show you how.

Get Help With Meniere Disease Disability Claims!

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Long Waits for Social Security Disability Hearing Decisions

Are you currently awaiting a Social Security Disability hearing decision?

Has it been months since you asked for a hearing?  You are not alone.

There are many others out there in the same spot as you.

So why is it taking so long to hear back?

The Process of Requesting a Social Security Disability Hearing

When you are denied for SSDI, you have 60 days to ask for a reconsideration.  Typically, it takes around four months to get a decision on your request for reconsideration.  And, only 12 percent of those people who have asked for a reconsideration actually get approved.

When you are denied a second time, you have 60 days to ask for a hearing in front of an administrative law judge (ALJ).  In 2012 the average wait time for a Social Security Disability hearing decision was 353 days.  Now the average wait time is 596 days or 19 ½ months (this is up from 545 days in September 2017)!

Reasons for the Long Wait

So why is the wait time increasing so much?  According to Mark Hinkle, an SSA spokesperson:


“For several years in a row, the agency received a record number of hearing requests, due primarily to the aging of the baby boomers as they entered their disability-prone years. We also received an increase in applications during the economic recession and its aftermath. During this time, our resources to address disability claims did not keep pace with the increase in applications and backlogs grew. Primarily for these reasons, wait times for a hearing, and the number of pending hearings began to rise.”


And regarding the 986,000 hearings pending and the average wait time is 596 days, even after 15 months of reducing the number of people waiting.  Marilyn Zahm, an administrative law judge in Buffalo and president of the Association of Administrative Law Judges (AALJ), had this to say:


“In 2016, the Social Security Administration received over 2.3 million disability claims, 630,000 more cases than in 2002. Unfortunately, the SSA has not added the personnel, technology or efficiencies needed to address this steady surge.  We now face a crushing backlog of cases, adding long wait times and painful uncertainty to a process that should be swift and secure.”


What is Being Done to Decrease Wait Times

Social Security developed a plan in 2015 to help reduce the backlog of unmade hearing decisions.  The plan included hiring 250 more ALJs plus support staff each year in fiscal 2016, 2017, and 2018.  It also increased the use of video hearings.  The goal was to reduce the waiting time from 595 days to 270 days by the end of fiscal 2020.

In 2016, SSA hired 264 judges but only added 132 in 2017 due to hiring freezes throughout the federal government.

How is the Wait Times Affecting People

The increased wait times are further harming those who are unable to work during the time they are waiting for their Social Security Disability hearing decision.  Some, who are facing mountains of accumulating debt due to being unable to work are even having to file for bankruptcy due to having no income.

What You Can Do Today

The timelines are disastrous for everyone! Your best option is to work with a disability attorney early on in your application and appeal process if only to present the best possible case at all stages of your claim.

Contact Us Today for Help With Your Disability Claim

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Short staffing leads to long waits for Social Security disability hearing decisions

Four Examples of Sedentary Work And Why They May Not Apply to You

Four Examples of Sedentary Work And Why They May Not Apply to You

In order to win your appeal for Social Security disability, you must prove that your limitations from injury or illness prevent you from not only doing your recent job but any job that is also less demanding but within your ability to do. 

This is difficult, especially for younger people.  Social Security believes that younger claimants can adjust to sit down jobs even if they have an impairment. 

However, if you can prove that you can do less than sedentary work, you will have a great shot at winning your appeal for Social Security disability. 

Sedentary Work As an Alternative to Social Security Disability

Generally speaking, the following are going to be strong indicators that you can perform sedentary work:

  • You can lift more than ten pounds
  • You can stand or walk for more than a total of 2 hours combined
  • You can sit for 6 hours out of an 8 hour work day

If you can do a minimum of these three tasks on a daily basis, the Social Security Administration is going to be seeking to understand why you are unable to work, even at a reduced rate.  You should start making note of your specific limitations and how they might help you counter these questions.

Limitations That Might Prevent you to Perform Sedentary Work

Physical exertional limitations

  • Inability to do any of the above mentioned skills
  • Need the use of medical devices to help walk
  • Need to have leg elevated
  • Unable to use an arm due to amputation above the elbow

Non-exertional limitations

  • Needing to alternate sitting and standing
  • Need to rest or lie down
  • Cannot stoop or bend
  • Reduced ability to use hands and fingers
  • Need to take frequent sick days
  • Cannot balance (even on smooth surfaces)
  • Visual limitation
  • Cannot work in noise

Cognitive or Behavioral Health limitations that can affect the ability to do Sedentary work

  • Inability to focus and concentrate due to a prescribed pain medication
  • Difficulty performing simple, routine, unskilled tasks
  • Interference with completing tasks on time
  • Cannot get along with others or cannot respond appropriately to authority

In your disability appeal, the SSA will consult with a vocational expert (VE).  A vocational expert knows about job availability and the skills need to perform those jobs.  The VE will most likely be able to find jobs that you can still do, regardless of your condition; however, a seasoned and effective Social Security Disability Attorney will be able to push back and give you a stronger chance for overcoming the appeal than if you decide to do it yourself.

Talk To An Experienced Social Security Disability Attorney Today!

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Four Examples of Sedentary Work

Example 1:

You are a 36-year-old who was a machinist for the past fifteen years.  You were in a car accident that caused a severe back injury, and you are unable to perform your job.  You can no longer lift more than 10 pounds.  When you applied for Social Security, you were denied because they said that you could perform sedentary work.  The vocational expert says that you can work as an administrative assistant.  However, this does not apply to you because you need to change sitting and standing positions every hour or you are in excruciating pain. 

Example 2:

You are a 52-year-old who was a teacher for the past 30 years.  You fell down the stairs and broke your leg in multiple places.  You had to have surgery and now need to take pain medication on a regular basis to function.  You can no longer stand long enough to teach, so you are unable to work anymore.  When you applied to Social Security for disability, you were denied due to your ability to perform sedentary work.  Your pain medications, however, cause you to be unable to focus or concentrate and complete a task in a timely manner. 

Example 3:

You are a 62-year-old woodworker.  You have been building cabinets since you were in your early twenties.  You have no formal education, only a high school diploma. You broke your back in an ATV accident when you were in your forties.  This caused lymphatic damage which turned into lymphodema causing your legs to swell and have poor circulation.  If you bump your leg, it breaks open easily and gets infected, so you can no longer work around wood and tools that can cause injury.  You also have a very difficult standing and lifting.  You applied for Social Security disability but were denied.  You were deemed able to perform sedentary work.  However, the medication that you are taking causes you to become dizzy and at times almost pass out.  You cannot bend without almost falling because you cannot balance. 

Example 4:

You are a 45-year-old, and you were a concrete worker. You hurt your back and can’t work anymore. You help out your wife at your home business by filing documents, answering calls, and responding to emails. You apply for Social Security and get denied.  Even though you do not get paid, Social Security determines that if you were getting paid you would make SGA and you are capable of performing sedentary work.  However, you use a script when answering the phone because your head is fuzzy from medications. You also only work about two hours during the day because you need to lie down and take a break because your back hurts so much.  

In all four examples, you were told that you were able to perform sedentary work, but again in all four examples, sedentary work did not necessarily apply to you.  In these cases, and similar situations, you want to contact a disability attorney asap to help you prove that you are unable to perform sedentary work.

Work With a Social Security Attorney Today

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5 Warning Signs You Might Have a Lousy Disability Lawyer

5 Warning Signs You Might Have a Lousy Disability Lawyer

When you file for Social Security Disability (SSDI), it is a good idea to begin talking to a disability lawyer. Engaging the expertise of a Social Security Disability Lawyer early in your application process can help avoid some of the big reasons claims get denied later on.

One of the big challenges of finding and retaining a disability lawyer, though, is that there are many lawyers to choose from, and not all of them are as good as they could be.

So, when you hire a lawyer how do you know if you have a good lawyer?

Here are five warning signs that you might have a lousy disability lawyer.

Your Disability Lawyer is Not Available

Disability lawyers usually have a lot of cases they are working on so you may not always speak to your lawyer when you call. However, you should always be able to speak with someone at the lawyer’s office (secretary, an assistant, paralegal).

If they are unable to answer your question, your disability lawyer or someone who can answer your questions should return your call in a reasonable amount of time. If this is not happening, you may want to find a lawyer who will be more accessible to you when you have questions or concerns.

Your Disability Lawyer Makes Impossible Promises

Having a disability lawyer does not guarantee that you will win your case. A disability lawyer should never promise that they will win your case. They need to be upfront and tell you what chance you should have. Most disability lawyers will not take your case unless they feel there is a chance of winning, but again that does not guarantee it. A disability lawyer should also never promise you a dollar amount if you should win your case.

Your Disability Lawyer Doesn’t Follow-Through

If your disability lawyer says they are going to do something and they do not follow through, then this should raise some red flags. Their job is to help you gather the medical evidence and statements that will help make your case strong. When they say they are going to contact your medical professionals or third-parties to collect the evidence, they should be following through. You will not have a case if this is not done promptly.

Your Disability Lawyer Doesn’t Meet With You

Your disability lawyer should call you or meet with you in person a month or two before your hearing to prepare you for the hearing. They should review with you questions you may be asked during the hearing and help you prepare answers that will benefit your case not harm it.

Your Disability Lawyer is Not Respectful

A disability lawyer should be respectful of your situation and not make you feel ashamed or embarrassed about. They should be kind and understanding when you explain your situation and help you understand the process. They should also be respectful of your time.

This goes back to number one above (availability) as well as working with your schedule when scheduling meetings or phone calls.

You Deserve Better and It’s Not Too Late

If your disability lawyer is doing any of these, you should probably get a different lawyer. Filing for SSDI is already confusing and difficult enough without your lawyer making it complicated. When choosing a disability lawyer, asking questions before even meeting with them will help you find the right lawyer for you.  Here is an article that will help find a great disability lawyer.

Can You File a Social Security Disability Claim for Pseudoclaudication?

Can You File a Social Security Disability Claim for Pseudoclaudication

Do you suffer from excruciating back pain?  Is it making it difficult for you to work?

You may be wondering if you can file for social security disability if you suffer from Pseudocladication. 

Let’s look at the qualifications of social security disability. 

What Is Pseudoclaudication?

The term pseudoclaudication is used to describe a condition known as lumbar spinal stenosis (LSS), which causes inflammation of the nerves emanating from a person’s spinal cord. This condition occurs when your spinal canal narrows in the lower part of your back. Bone spurs, bulging disks, or a thickening of the ligaments in the back of the spinal canal may all be to blame. The most common symptoms of pseudoclaudication include tingling or cramping in the lower back, the hips, legs, or the buttocks. You may also feel heaviness or weakness in your legs.

The roots of the nerves that control the movement of your legs pass through narrow areas in the spinal canal. If those passages become too narrow, it may put pressure on the roots of those nerves, causing pain. The pain could intensify while standing or walking and can often be relieved by sitting or lying down.

How to Qualify for a Disability with a Spinal Disorder Including Pseudoclaudication

In order to qualify for Social Security Disability benefits related to pseudoclaudication, you first must be diagnosed by a physician with one of the following disorders:

Nerve Root Compression

Nerve Root Compression is usually caused by a herniated disc or a pinched nerve in the back. This condition can result in limited motion in their spine, muscle weakness, or reflex loss; all of which play into the discussion of how the symptoms might prevent you from earning a wage.

Spinal Arachnoiditis

This disorder results from inflammation of the arachnoid – one of the several membranes that protect the nerves of the spinal cord. One of the keys to seeking Social Security Disability when you have this condition is to ensure that you have a confirmed diagnosis by a physician performing; either a tissue biopsy or an MRI scan.

Lumbar Spinal Stenosis

This condition may be caused by degenerative arthritis. To qualify for SSDI benefits with a diagnosis of Lumbar Spinal Stenosis you usually must have limited motor control, muscle weakness accompanied by pseudoclaudication, or spinal stenosis. This condition must typically be documented by a T scan, an MRI scan, or an x-ray.

Lumbar stenosis may be treated with anti-inflammatory medications. However, some doctors may suggest surgical treatment for these types of conditions if other non-surgical treatments have failed to work for the patient.

What Medical Evidence is Required For Pseudoclaudication?

The Social Security Administration (SSA) will request/need your medical records from the doctor that is currently treating you for pseudoclaudication or related conditions. These records should include an imaging test that confirms the diagnosis of spinal stenosis.

The records should reflect that a doctor has done a complete and detailed physical exam; including, testing your reflexes, muscle strength, range of motion, and your ability to walk, bend, squat and rise.

Medical records should also show whether nerve root compression is causing pain, muscle weakness, loss of reflexes, or limited range of motion.

Other Considerations for SSDI Claims for Pseudoclaudication

When filling out an application for disability benefits, you need to include descriptions of how your back pain and impairment affects your ability to work. You also need to describe how it impacts your overall daily life. Do not forget how back considerations may cause you to be experiencing behavioral health conditions, such as depression or anxiety due to chronic pain. Be sure to list all of your symptoms that you are currently experiencing.  For help, here is a step by step discussion about disability claims and appeals.

Clearly, there are many hoops to jump through when back conditions are the basis for a Social Security Disability claim (or appeal). Reading blogs like this can be helpful in gaining a better understanding. We hope it is at least. However, reaching out to a good disability attorney is also something you might want to consider. If you have any of these conditions, pseudoclaudication – etc., send us a message. We will help you figure out how to approach a Social Security Disability claim or appeal.

Lies and Truths About Waste and the Growth of Social Security Disability

Lies and Truth About Waste and the Growth of Social Security Disability

 

In July and August of 2016, we produced a four-part blog series titled:
Social Security Myths.” In Myth #4 we focused on the rhetoric that Social Security disability claims were soaring, and sought to evaluate the sensational assertions using facts that are readily available, for anyone who cared to look anyway.

Recently, this false claim regarding disability was put forth again for the sole purpose of making some hard to understand, and politically charged, points when the President’s budget director stated the following in an interview on CBS:

“Do you really think that Social Security disability insurance is part of what people think of when they think of Social Security? I don’t think so. It’s the fastest-growing program. It grew tremendously under President Obama. It’s a very wasteful program, and we want to try and fix that.”

We called this type of statement, “The Typical Spin,” in our Myth #4. The view expressed above solely identifies SSDI as both the “fastest growing program” and a “very wasteful program.” Let’s keep it simple here, and break down, what’s inaccurate and just plain incorrect about this statement.

 

 

 

Social Security Disability is the Fastest Growing Program?

The rate of claims for disability has gone up and down in recent years, correlating strongly with the economic environment. However, the rate of all the claims that are granted has remained consistent with respect to the total number of workers in the workforce.

 

Social Security Disability Denial Rates 2005-2014
Social Security Disability Denial Rates 1975-2014

 

Approximately 0.5% of all workers are awarded disability benefits per year (about 1 in 200). This rate has been consistent for at least the last ~20 years.

It is important to look at this data as rates and percentages instead of as absolute totals. If we were to compare absolute numbers, the number of claimants would always be increasing, if the number of workers increased. More workers, more injuries, more disability.

This last point is also very notable in this discussion. Workers: Injuries: Disability: SSDI. SSDI is a benefit for workers; it is an insurance program they (workers) have paid into through their payroll, and is not “welfare,” in the pejorative sense.

In fact, looking at the data, even in recent years – while the rate of those claiming disability has gone up, the rate of the award has remained at the 0.5% we just discussed. By this measure, Social Security has been more restrictive than expected in awarding claimants’ disability benefits.

Taking all this into account, it is tough to see how the “fastest growing program” is the program that has become more restrictive to applicants over the last couple of years. Of course, this is because SSDI is in fact, NOT the fastest growing program administered by the Social Security Administration.

 

It’s Not Just Our Take on This…

The LA Times dug into this issue – comparing in precise numbers the rise in awards for SSDI (in absolute terms) vs. the increase in awards for SSI. While SSI enrollment has grown by 10 million in the last eight years, SSDI enrollment has increased by only 1.2 million in the same amount of time, and in fact, decreasing since 2014.

 

Social Security Disability is a “Very Wasteful Program?”

Sadly, the President’s budget director only let out this tiny soundbite. However, when you are already telling a fib, why not tell another. Again, we covered this in our series on Social Security Myths. In particular, Myth #2: People Are Denied Benefits Because of Fraud in Social Security Claims.

To concede a point, we will call something a waste whether the intent to receive improper benefits was purposeful or merely a happy accident.  We will be very loose in our definition to give the absolute best interpretation of the Budget guru’s words.  So how do they bear out?

Between 2005-2014, Social Security found that 0.7% of those receiving benefits knowingly or unknowingly received some level of benefits they should not have.  That’s $11 Billion over 10 years.  A pretty big number!  So, how does this rate of fraud, waste, and abuse compare to other government programs? Or even, the private sector?

In 2011, it was estimated that ~7% (10x SSDI by %) of Medicare spending was lost to fraud and abuse. In real terms that is $11billion lost in 10 years for Social Security disability and $177billion lost in 1 year for Medicare. That is not a typo – it’s the Economist.

Private Sector: In 2014, a study by the National Retail Foundation and the University of Florida found that shrink (lost product to theft) averaged, 1.38% (2x SSDI by %). In total numbers, that is $44 billion lost in 1 year to private sector retail theft, vs. $11 billion over ten years for SSDI.

 

Consequences and Why We Should Care

It is honestly a head scratcher how Social Security Disability is the “most wasteful program.” For that matter, how it is the “fastest growing program.” By all analytical accounts, it is neither. However, it is the easiest program to bash, and that has genuine consequences.

When truly legitimate applicants seek disability benefits, they already face an uphill battle. Social Security is already more likely than not to deny a claim on the first go-round. This barrier is on top of the terrible realization that their injuries are in-fact obstacles to employment. Shaming remarks towards the benefit itself or those who need it very likely will make people avoid pursuing it or avoid letting their support network know they are seeking it.

If you are reading this, and think you might need Social Security Disability benefits, please reach out to Lilac City Law. We will help you figure this out, without spin.

 

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The Real Cost of Hiring A Social Security Disability Lawyer

The Real Cost of Hiring A Social Security Disability Lawyer

 

Sometimes the idea of hiring a lawyer creates a barrier to action. We all know that when the stuff gets sideways, turning to a lawyer to fix it can be the best bet.

However, we also know that lawyers cost money. There’s no pretense that their services are free.

What most do not realize, though, is that the cost of hiring a Social Security Disability lawyer is defined very precisely by federal law, and it is this way to enable you to be able to afford it.

 

The Cost of Hiring a Social Security Disability Lawyer

Here’s the breakdown. The Federal government has limited the fee a Social Security disability lawyer can collect to 25% of past-due awards, with a maximum of $6,000. This fee breakdown means that all reputable Social Security disability lawyers work on contingency. If they do not help you win your appeal, they will not get paid.

In that sense the upfront cost is nothing. There’s no reason for you to delay communicating with one just to get a second look at your claim, and advice on your denial, if you have been denied.  That much, at the very least, is free.

Some Social Security disability attorneys may ask for an upfront fee, usually <$200 to pay for medical records and other costs associated with gathering evidence on your behalf. This fee arrangement is among other reasons, why it is both wise and prudent to consider with whom you want to work. Not every disability lawyer is necessarily of equal quality, accessibility, or cost.

As you consider the next couple of examples, you may want to brush up on the process of a disability claim appeal.

 

 

Cost Example #1: SSDI Appeal @ 30 months

Joan Smith has a Social Security Disability Claim (SSDI). Her claim was initially filed 30 months ago. It has been in an appeal for the last 24 months. After her ALJ hearing her claim was awarded because she hired a firm like Lilac City Law. 🙂 It was determined that her monthly compensation should have been $1000 per month for the last 24 months.

Total Award: $30,000 (30 months x $1000)
25% of $30,000 = $7,500

Since Social Security Lawyers may only collect a maximum of $6000 on the award, the amount directed to the law firm would be $6,000. Moreover, the fee would be paid directly from Social Security. So, Joan would not have to write a check to the firm. She would instead receive a check for $24k in back pay ($30k award minus attorneys fees).

 

Cost Example #2: SSI Appeal @ 18 months

Marvin Jackson has a Supplemental Security Income (SSI) Claim. His claim was initially filed 18 months ago. It has been in an appeal for the last 24 months. After his ALJ hearing, the claim was awarded. It was determined that his monthly compensation should have been ~$735 per month for the last 18 months.

(The actual monthly rate would be variable per respective year and match the standards described here. In 2016, Marvin’s monthly rate would have been less than in 2017. However, for the sake of simplicity, we are assuming all months at one rate)

Total Award: $13,320 (18 months x $735)
25% of $13,320 = $3330

Since Social Security Lawyers may only collect a maximum of 25% up to $6000 on the award, the amount directed to the law firm would be $3,330.

The fee would be paid directly from Social Security. So, Marvin would not have to write a check to the firm. He would instead receive a check for $9,990 in back pay ($13,320 award minus attorneys fees).

 

The Cost of NOT Hiring a Social Security Disability Lawyer

Sometimes claimants pursue an appeal on their own. Also, sometimes they are successful. However, that is the exception, not the norm. Though, going-it-alone is something we firmly advise against. You can look at the dozens of articles we have written on the various quirks of Social Security claims to get an idea of how easily things can get goofy.

However, a fantastic article that gives a high-level perspective on the claims and appeals process in their totality is this one laying out how you can win an SSI or SSDI claim step-by-step.

 

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