So, you’ve filed your application for disability benefits.  Now, you’re freaking out.   Why?  You’re asking yourself all kinds of questions:
How am I going to get treatment?
How can I pay for treatment?
How can I afford the medication?
How can I pay for the medical records?

Your mind is running a mile a minute.  You don’t know what to do.  You’ve never gone through this before.   You are still trying to figure out how you’re going to survive while you wait through this process.    Food, clothing and shelter are more of a priority than treatment, medication, and medical records.

Unfortunately, treatment, medication and medical records are what you need to prove your disability case.  But, how do you do that with no insurance?  You can’t afford the co-pay.  Out of pocket is almost impossible.  What can you do?

Before you start freaking out, take a breath first and step back.  For most people, the journey into the uninsured population is a new one but it can be navigated.  More importantly, if you are trying to prove you’re disabled while uninsured, you have a few cost effective options:

1. While your case is at the Local Office level, make sure you let SSA know the names of all of your doctors.

SSA typically gets all of your records when the case is pending at the local office level.  Let them know so they can get the records for you-for free.

2. SSA will only pay for a certain dollar amount so if they don’t have everything, be prepared to get it yourself.

When someone contacts a medical facility for records, the facility usually will charge for copying the records.  SSA normally puts a cap on the amount of money they spend for records.  Make sure you find out what SSA was able to get so you can get whatever they don’t have, instead of also paying for documents they already have.

3. The moment your case is turned over to the hearing office, review the file to find out what they have and don’t have.

A lot of time people have no clue what SSA has or has not been able to retrieve from their providers.  Make sure you look at the file as soon as the file is at the hearing level.

4. Start looking for a free clinic or low cost clinics.

The moment you no longer have insurance, you need to start looking for free clinics or low cost clinics in your county.  If you have them, use them.

5. After you’ve seen your doctor, immediately ask for a copy of your records.

In most situations, the clinic you attend will provide you a copy of your records if you ask. Whenever you have a visit, ask if you can get a copy of the records

6. Contact your county health department for treatment programs and services.

Most people don’t know where to begin to find resources to help them.  The health department is the best place to start.

7. Don’t be afraid to ask for free samples of medications.

Sometimes, doctors have the ability to provide free samples to you.  Don’t be afraid to ask.

8. Pace yourself and your money.

Remember, the process can take a while so try to do the best you can to make your money stretch over the entire process.   Make sure you stress to your doctors your financial situation.

9. Doing something looks better than doing nothing.

Most people don’t realize that, at some point, you will have to go before a judge.   If you don’t have treatment, the judge is going to ask why.  It’s better to tell the judge what you have done to try and get treatment as opposed to saying you haven’t done anything.

Remember, the process can take up to a year or longer.  Focus on your health and well being and use the resources available to the best of your ability

Don’t misunderstand the title of this post. I’m not saying you need to go back to work in order to get Social Security Disability.  After all, the main reason you are applying for Social Security is because you can’t work.

Still, it’s important that you understand the reality of the current climate:

“The prolonged economic slump has fueled a surge in applications for Social Security disability benefits, with many desperate Americans seeking refuge in the program as a last resort after their unemployment insurance and savings run out. “Damian Peletta and Dionne Searcy, Jobless Tap Disability Fund, Wall Street Journal, December 26, 2011.

“Republicans in Congress continue to press to destroy the American social safety net. They insist Social Security, Medicare and Medicaid, as well as other social programs, remain ‘on the table’ for major cuts and restructuring — which could end them as we know them.” Donald E. Maypole, Republicans are out to destroy our safety net, Duluth News Tribune, January 8, 2012

“The Social Security Administration has commissioned an independent review of the federal disability system amid concerns it awards benefits to those who don’t deserve them and denies benefits to those who do.”  Damian Paletta, Disability Systems Faces Review, Wall Street Journal, December 14, 2011.

“The takeaway is that you can’t rely on anyone, least of all a government program that’s outlived its usefulness, to keep you fat and happy in your dotage”. Greg MacFarlane, Will Social Security Live to See 80?, Financial Edge, December 19, 2011.
Face it, folks. We have what a perfect storm: On the one hand, more and more Americans are turning to Social Security as a potential revenue stream yet, on the other hand, a good number of our elected officials are at least considering cutting back on the program, viewing it as a strain on the national economy.

So what does that mean to you?  It means that the Social Security Administration is probably going to be more critical when evaluating disability cases, so you need to make sureyou have everything you need in order to prove that you are disabled:

1) You must prove you are disabled.

I have said this a million times so we will make this a million and one:  you must prove that you are disabled.  You have to go to the doctors.  You have to get the medical records.  You have to follow the treatment.  You and only you have to prove you are disabled.  Stop whining about how you are entitled to receive something.  The only entitlement you have is to apply, not receive.

2) You’d better try to find any medical treatment you can.

I have three words for you: know your area.  In other words, you need to investigate every resource that is available to you in your area.  Contact the Health Department.  Contact Social Services.  Find out if there are any free clinics in the area.  See if your county or city offers any free health insurance.  Make sure you apply.  Make sure you keep a copy of all of your attempts.

3) Most sick people try to find something.

You have to think about this logically.  Most people want to feel better.  So, if someone feels bad, they try to improve their situation.  If you hear voices telling you to hurt yourself, most hospitals have the ability to admit you so you don’t hurt yourself.  Most people who are in pain will go to the drug store and get something.  You won’t get much sympathy if you do absolutely nothing.

4) Do exactly what the doctor tells you.

The true measure of your disability is based on how you are doing after you receive medical treatment.  Unless you went to medical school, your best bet is to do what your doctor tells you to do.  Don’t make excuses.  Do what they say and be smart.  If you can’t find money to buy fruits or vegetables but you can find money to buy cigarettes or alcohol, you are not going to get much sympathy.

5) Do what your representative tells you.

If you have hired a representative, they are your best resource for information on how to fix problems with your case.  If they tell you to do something, they are doing this for your benefit.  They are not guessing or making stuff up.  They see a problem.  Help them fix it.

It’s tough out there.  We all know it.  It’s even tougher when you can’t support yourself due to your disability.  However, don’t waste your time thinking that you are entitled to receive something.  You gotta fight for what you want because it will not be given to you without more.

When evidence is needed to prove your eligibility or your right to continue to receive benefit payments, you will be responsible for obtaining and giving the evidence to us.  20 CFR 404.704

This is one very simple statement of the law.    In a nutshell, you are responsible for providing evidence to prove you are disabled.   I can’t tell you the number of times people believe that it is the other way around.   Social Security Administration can get the information for your case but you bear the burden of providing that information.

However, it’s important for you to realize that you can’t pick and choose what evidence you provide.  You can’t get the one page from your doctor’s notes to provide to SSA just because it’s the only one that says you’re disabled.  SSA is going to want all of your records from that doctor.  You can’t leave out the fact that you went to a doctor who said you were not disabled.   SSA is going to want to see those records.

I know it gets frustrating because you want to get your benefits but here are a few things you need to know:

1) SSA needs to make an informed decision

SSA needs to review your case in its entirety in order to make an informed decision.   They will look at your entire file when they are making their decision.

2) If you leave something out (and SSA finds out), it will hurt your credibility

You will be surprised by the number of people who get burned because they leave out information.    Remember, SSA speaks to your friends and family.  Also, you don’t know what the doctors put in their notes.   All it takes is one mention or one note and if it looks like you are hiding something, you may not be looked upon favorably.

3) Just because it’s bad, it doesn’t mean it will kill your case

So many times, people instinctively think that a negative piece of information will devastate their case.   Depending on the evidence, the information may have little to no impact.

4) If you don’t give it to SSA, they may deny you based on insufficient evidence

If the evidence is something SSA needs and you fail to give it to them, SSA may deny you.  Remember, SSA needs to make an informed decision.

5) If you don’t give it to SSA, they may send you for a CE which may or may not be helpful

If SSA is missing something they need, they may send you to a consultative evaluation.  So if you have a bad back but you fail to tell SSA that you went to a rheumatologist, SSA may send you to an evaluation.  Unfortunately, this evaluation may help or hurt your case.

The SSA process is a long and difficult process.  You can make it more difficult to prevail on your case.  Don’t do anything that will hurt your case.

“Mark Williams went without sleep for his teeth. What was remarkable about that was he was joined by about 2,000 other people Thursday night doing the same thing in the dark outside a church in Woodstock.”  By Jeffry Scott, The Atlanta Journal-Constitution.

“It was an outpouring, and pulling out, of bad teeth. And maybe even a new economic indicator in a nation where millions are out of work and the insurance that goes with it, especially dental insurance, which many consider a luxury and the first place they cut when trimming budgets to survival mode.” By Jeffry Scott, The Atlanta Journal-Constitution.

“More than 1.5 million people in Illinois are uninsured, and many others have just bare bones coverage.” Reported on August 19, 2011 by Nesita Kwan, NBC Chicago.

“That’s why more than 600 medical professionals from 24 states came to Malcolm X college Friday for a three-day clinic in which dentists, doctors, opthalmologists, and many others are working for free: offering health care to people who couldn’t otherwise afford it — or have never even had it.  For the hundreds of people who lined up starting at 3 a.m. Friday, this may be the only way to get a medical evaluation, or maybe the first time they’ve had one in years.” Reported on August 19, 2011 by Nesita Kwan, NBC Chicago.

Thousands of people lining up for Free Dental Care.  Hundreds of people lining up for Free Health Care.   How many of these people would use  universal health care if it was available?

A few years ago, when President Obama took office, his push for universal health care was (and still is) a hot political topic.  Pundits yelled, screamed, debated and demonized this so-called Socialist attempt to take away our society’s free market ability to get health care on our dime and on our own time.  “Obamacare” was seen as just one more example of an over-reaching, overly expensive government effort to bankrupt the country, remove our freedom of choice, and add one more layer of government intrusiveness.

I found it interesting as the media covered the thousands of community activists and political experts, I didn’t see one interview of a person this program was intended to cover:  The uninsured.   I am curious.  Are any of those persons who were screaming against universal health care now in the position of needing universal health care?

Sometimes it’s easy to disassociate yourself from someone you believe is not like you.   It’s easy to paint a picture of the uninsured as deadbeats, homeless or dredges of society.  When you have that picture in your mind, you can find a lot of reasons to discount this segment of society.  In your mind, they aren’t contributing to the greater good.  They aren’t contributing to the financial well-being of the country.

However, when you take the time to really speak to the uninsured, you will find a very large population of those individuals who have college degrees.  They are management personnel.  They are people who have worked for 10, 20 or even 30 years for the same employer.   They are educated, sophisticated, and dedicated.  And, equally as important, they vote.

Unfortunately, due to the state of the economy, these people are no longer working.  They can’t afford the co-pays for their insurance.  They can’t afford to pay for COBRA coverage.  They can’t afford to pay out-of-pocket for their medical expenses.

As a business owner who pays for health insurance out of his own pocket, I understand what it is to have and NOT have health insurance.   I, also, have represented hundreds of clients who have found themselves in the powerful position of trying to obtain disability benefits with no health insurance benefits to pay for their doctors.  These clients used to work actively and had the benefit of employer sponsored health insurance.  They now have to figure out how they are going to pay for their doctors’ visits since they no longer have insurance.

And now, we are in situation where a growing number of people are forced to look for health treatment with no insurance.    People who would normally have insurance through their employers are now finding themselves in the powerful position of understanding what it is like when you no longer have your benefits.  I’m curious to know how many of them were against universal healthcare.  I bet they have a different position now.

I hope this video helps answers your questions.

1) Workers Compensation. How can a Utica Mohawk Clause help me with keeping more of my disability? I was disable under Longshoreman and Harbor workers act.
a. The Utica-Mohawk clause of a contract is generally used to explain how a settlement is paid out to a person. Usually, rather than just awarding a person one lump sum payment the payment is broken down into so much money paid periodically, such as weekly or monthly.
b. http://youtu.be/9ETjILrly5E (March 31, 2011) – Special Show — Workers Compensation and Offset

2) Does social security have to take into consideration that my current and new treating doctor is supporting me as being disabled? Will this weigh heavy on their final decision do u think?
a. Treating Doctor’s rule
b. Weight of the medical evidence

3) My examiner will be forwarding all med records to the dr review with social security this week… any ideas on what u think my chances are for approval??
a. Medical determination

4) I was told that If the DDS determines that you are disabled they will not establish your onset date earlier than the date of the ALJ denial. When I got my ALJ denial, I submitted a new application within the first week of the denial. Can DDS really go back to the first claim then without stepping on the ALJ toes sorta speaking?
a. Res Judicata

5) Understanding the new rule, Social Security Ruling 11-1p, New SSR Changes Subsequent Application Policy (effective July 28, 2011)