Cancer and Social Security Disability benefits: Not as easy as you think
Today, I was going through my normal surfing like most people do and realized that Bo Griffin, former TV Host of HGTV’s “The Big Reveal” passed away due to Cancer. She was experiencing pain in her back and was unaware that she had cancer. Unfortunately, her bought with cancer was fairly short as she died with a few weeks of its discovery. She was diagnosed with intestinal cancer. The news of her death spread fairly quickly (thanks to the advent of social media, twitter, and you tube).
However, upon hearing of her death, I instantly thought about Roger Ebert, noted movie critic, and his widely publicized bought with Thyroid Cancer. He was successful in his fight but it left him with the inability to speak.
The thing that really resonated to me was the distinctive difference between the two types of cancer. In Ms. Griffin’s case, she had no knowledge of the cancer and it overwhelmed her quickly. In Mr. Ebert’s case, a radical procedure saved his life yet the possibility of it returning still remains.
I’ve represented a number of people who have had different types of cancers over the years and I have found that each one presents a unique set of circumstances as they relate to Social Security Disability benefits:
1) Suspected Cancer versus Cancer
The word “Cancer” is a terrifying word. Like HIV and AIDS, there is no known cure for cancer. As such, you can use chemo, surgery and radiation but you may not totally keep it from reoccurring. For purposes of Social Security, it’s important to know the difference between being diagnosed with Cancer and being ’suspected’ of having cancer. Usually ’suspected’ comes into play when the doctor has a reason to believe that some type of nodule or growth or something that has alerted them to the possibility of cancer. However, for Social Security purposes, this doesn’t not guarantee the receipt of disability benefits.
2) No two cancers are the same
Under the Social Security regulations, individuals may be found disabled if they meet the criteria for certain medical impairments that are listed in the regulations (The listings). Most people don’t realize that Social Security maintains several listings of different types of cancers. As such, just merely being diagnosed with cancer by itself doesn’t guarantee an immediate favorable result.
3) Remission sometimes means Recovered
Cancer is a devastating condition. The treatment that people have to go through in order to combat cancer can be painful and traumatic. However, most people don’t realize that it is not uncommon for people who have gone through the treatment to go back to their normal lives. As such, Social Security can be tough on some cases where the person has completed the treatment and their doctor has given them a clean bill of health.
4) Remission and BEYOND: How are you doing now?
Most people have to follow an aggressive follow up routine to make sure that the cancer doesn’t come back. Some people come out of the treatment with no problems or any residual problems. The key is ‘how are you doing now’? Most people don’t understand that Social Security wants to know if you are still having problems and MORE IMPORTANTLY, does your doctor know that you are still having problems?
5) Cancer and the TERI case
TERI stands for Terminally Ill. These cases are usually expedited because the person has a high likelihood of dying in a short period of time. I had the opportunity to represent my client’s mother when her cancer returned. Due to the aggressive nature of the cancer, she received disability benefits in less than a month. Unfortunately (god rest her soul), she passed a few months later.
I’ve had a few cases where I’ve literally watched someone deteriorate before my very eyes and so I take Cancer very seriously when clients complain that they believe they are disabled due to cancer. The word, by itself, doesn’t guarantee a result. Keep in mind that even though cancer is devastating, you must realize that you may need to provide SSA more in order to demonstrate that cancer is disabling to you.
The REAL World frustations for you and the Social Security Administration
I’ve represented clients before the Social Security Administration for over 8 years. During that time, I’ve had a chance to worked with, talked to, or interacted with some great people who are truly trying to do the right thing. What is the right thing? Processing a person’s claim when they apply for Social Security Disability benefits. I’m a firm believer that you “Catch more flies with honey than with vinegar”. For those of you who don’t know what that phrase means, I am a firm believer that you can get more useful information from SSA by just asking questions and (more importantly) listening when the people who do this EVERY DAY have some thing to say.
I am not going to sit here and say I speak for the Social Security Administration (because I don’t) nor am I going to defend them or slam them. However, after spending so many years talking to some great people in the agency, here’s a few things I’ve found to be relatively consistent:
1) They are trying to move your case as fast as they can
I know you don’t want to hear this but do you REALIZE how many cases come through SSA every day?? Imagine if 100 people file a new claim every day in one office. That’s about 500 people a week FOR ONE OFFICE. So what makes you think your case is special?? I hate to be nasty but you have to keep in mind that when you apply, your case is one of ALOT of cases that are coming through the pipeline so you have to keep that in mind. Another thing you need to realize is that SSA has the burden of processing your case as fast as possible. It serves no purpose for them to sit on your case. They want to get you in and out.
2) If you don’t give them everything they need, they can’t help you
SSA relies on information that you give them. Listen to me when I say this. They rely on information that YOU give them. So if you decide to NOT tell them about a doctor because YOU decided that it wasn’t important and they discover that you went to that doctor, NOW, you have to wait while they get those records. Remember, don’t pick and choose what you THINK is important. Provide them with everything they need so they can make an informed decision.
3) Cussing them out, Calling them out, Telling them off, or Blowing up their phones DOES NOT HELP!
I”ve said this a million times. How would YOU respond if someone called you “cussing you out” or “telling you off” or “calling every 5 to 10 minutes”? Come on now. Think about all of those telemarketers or bill collectors. You will unplug your phone or put the phone on silent. If you answer the phone, the first nasty word you hear, you hang up the phone. Now, SSA doesn’t unplug their phones or put their phones on silent. However, what makes you think they are going to be responsive to you ‘going off on them on the phone’? I know you’re frustrated but you have to keep things in their proper perspective. These people are PEOPLE, too.
4) Contrary to popular belief, ALOT of people are in the same position as you.
Here’s where it really gets tough. When most people apply for Disability, they aren’t able to work. When you’re not able to work, the wheels fall off the car. What I mean is that you aren’t able to pay your bills, buy your food, or pay for your medicines. You aren’t able to sustain yourself. Unfortunately, a lot of people are in the exact same situation. I represented a guy who applied while he lived under the Interstate overpass. I’m not saying that your situation isn’t important. I’m just saying that, unfortunately, a lot of people are in the same position as you.
5) If you don’t tell them something has changed, how will they know
Remember, remember, remember, you must inform SSA of your changes in circumstances. If you have a new doctor, you gotta tell them. If you move, you gotta tell them. If you go back to work, you gotta tell them. You can’t trust that SSA will figure it out on their own. If they do, they have to investigate. Remember, that takes time to investigate which adds time to your case.
6) If you are a TERI case, they will move your case but it still takes time.
For those of you who don’t know, TERI stands for Terminally Ill. These cases are tricky because when SSA gets these cases, they move on them fast. However, they still need a little time to get the necessary paperwork to process the case. SSA takes these cases very seriously but they still take a little time to process.
7) It is a PROCESS and there is no going around it
I’ve said this a million times but it still is tough to appreciate sometimes. Remember, when you are applying for Social Security Disability, you must go through the Social Security Disability PROCESS. You can’t skip any steps. You must go through the process in order to ensure that you meet the requirements. There are no short cuts.
If you make it up, bring it up, add something new, or make them look for it, it adds time to the process
The SSA has a duty to investigate anything that is relevant to your case. So its important that you keep them informed early and often about anything that is relevant to your case. Sometimes, when you are listening to others who have had success getting disability benefits, you may add a few things that you think will help you. Remember, SSA has to look at everything that may impact your case so be upfront and honest.
9) There is no single one piece of MAGICAL evidence. They have to look at it all.
SSA has a responsibility to look at the weight of the evidence. In other words, SSA has a burden to look at all of the evidence to determine if leans in your favor or against you. The reason this is important is because sometimes people think that one letter from their doctor will guarantee a favorable outcome. Remember, SSA has to review everything before they can make a decision. The letter from your doctor may help but it’s not a slam dunk.
10) If you keep starting over, so will SSA
I’ve had a few people mention to me that they wanted to know if it was ok to reapply after an initial denial. Remember, every time you start your case over again, they start your case from scratch. Now, they will usually re-open your prior application (depending on how long you waited to file again) but they are going to start from scratch with your new application. More importantly, your case won’t move faster just because you are starting over again.
11) If they ask for it, give them what they need
When you file for disability, get ready. They are going to send you a BOAT load of paperwork. This paperwork is designed to assist them with processing your case. The longer you wait to give it to them, the slower your case will be processed.
12) Sometimes, it’s JUST NOT THEIR FAULT!
Recognize this, if they are waiting for something and it hasn’t come their to them, what do you expect them to do? If you tell them that your doctor says you’re disabled but your doctor won’t release your medical records, what do you expect them to do? If you tell them that your friend can answer questions about you but your friend won’t call them back, what do you expect them to do? If they schedule you for an appointment but you keep missing the appointment, what do you expect them to do? If they contact your child’s school and the school refuses to cooperate, what do you expect them to do? Most people don’t realize that the SSA process is a two way street. If they aren’t getting what they need because of someone else, you can’t get mad or frustrated because they aren’t making a decision fast enough.
Contrary to popular belief, SSA is frustrated as well. They have to handle a large case load and they have to make sure the cases are handled as fast as possible. Your case is important to them but they can only work with what they have.
Can somebody explain how I get paid after I get a favorable decision?
So you got approved for Disability benefits. YAAAAAAY!! Congratulations. After stressing, waiting, and going through this lengthy process, you are finally going to get your disability benefits. Even better, you are so happy with your representative who was successful in helping you get your benefits.
However, now comes the confusing part. What happens next? When are you getting paid? Who pays your attorney? When should you expect the money? Now, it seems that you have more questions than you do answers.
Well, here’s a few things to help you out:
1) About 60 to 90 days before you get paid.
There is no hard rule on how fast it takes you to get paid. IN most instances, it takes about 60 to 90 days to process your pay.
2) Why does it take so long?
Even though it may not seem like it, it takes longer to calculate your disability benefits than it it is to get disability. Think I’m joking? Here’s how it works. First, they have to figure out which programs you qualify. Second, they have to determine if there are any programs that offset the benefits. Third, they have to determine if there is any retroactive benefits. Fourth, they have to determine if there is any benefits going forward. Fifth, they have to calculate any representative fees and ensure they get paid. Sixth, they have to determine if there is a need for a representative payee. Finally, they have to deal with any other issues that pop up. Interestingly enough, this process may take place at two different Social Security offices that must talk to each other. See how this may take a while.
3) How does my representative get paid and WHEN does my representative get paid?
This question is one that I get alot. In terms of “HOW”, Social Security is responsible for calculating the back pay. From that back pay, Social Security will withhold 25% towards attorney fees. For example, lets say that your back pay is $10,000. 25% of $10,000 is $2500 which means your attorney will receive $2500 and you will receive the remaining $7500. Now, the WHEN part is trickier. The reason it’s trickier is because Social Security will sometimes release the check to the attorney first (Usually because this part is the easiest to calculate) and then send the rest to the claimant.
4) Why am I getting all of this Paper from Social Security?
Over the next few months, you will received “Important Notices” and “Award Notices”. These papers are crucial because they explain IN DETAIL everything you’re entitled to receive as well as a discussion of how your representative gets paid, any offsets, and future benefits.
5) Why did I get a Medicare card in the mail? Do I have to keep Medicare?
If you qualify for Disability Insurance Benefits (this is different from SSI), then after receiving 24 months of benefits, you are entitled to Medicare. So if your back pay takes you back to October 2007, you will receive a benefits starting October 2009. Now, here’s the tricky part. You have to pay for Medicare and they take it DIRECTLY out of your monthly Disability Insurance Benefits check. If you DON’T want it, just remember that there is a penalty if you decide to come back later (Contact Medicare, they can help you on this one).
6) Should I call Social Security’s 1-800 number or the local office if my money is late?
I always tell people that they can call who they want to but recognize this point. The Toll free number for Social Security is NOT designed to answer all of your questions once you’re paid. Once you get paid, a different office takes over (so the 1-800 will probably not be helpful). The local office can help if you are entitled to receive SSI but your DIB check may be processed in Alabama, Maryland, or New York.
7) I’m fighting foreclosure and an eviction. Will that help?
If you have documentation that you are about to be evicted or foreclosed or your health has turned terminal (i.e. you may be dying), give evidence of this information to Social Security as soon as possible. This information may assist them in speeding up your case.
Congratulations on your case. I know it’s a long time coming but you deserved it. So just be patient a little while longer and it should all work out for you.
Tough love and tough facts about applying for Social Security Disability benefits
Let me be the first to tell you that representing Social Security Disability clients can be tough. My heart goes out to all people who are in the position of having to apply for Social Security disability benefits. Unfortunately, some times I have to be in the unenviable position of having to give some ‘tough love’ or ‘tough facts’ about the Social Security disability process:
1) Just because you got it quick BEFORE doesn’t mean you’ll get it quick again!
Remember this phrase “CASE BY CASE basis”. I can’t tell you the number of times people who have received disability benefits before who keep relying on their previous experiences when they are reapplying for disability benefits. Just because you got it QUICK the last time, that’s no guarantee that it will happen quickly again.
2) Just because you GOT it BEFORE doesn’t mean you’ll get it again!
The regulations do NOT provide an automatic favorable outcome to you merely because you had received disability benefits in the past. That MEANS NOTHING! Especially if you worked after the period of time that you were receiving disability benefits.
3) Just because your FRIEND gets it, doesn’t mean YOU will!
I know you don’t want to hear this but the simple fact is that YOU haven’t seen every MRI your friend has, every doctors’ notes your friend has, every medical appointment your friend has, or every medication your friend has had to take. With that being said, you have absolutely NO WAY of knowing if your friend’s situation is EXACTLY the same as yours. So stop racking your brain trying to understand why THEY got it and you are still waiting.
4) YOU are NOT the doctor!
I can’t tell you how many times I’ve had people who have DECIDED what they feel is best for them DESPITE what their doctors tell them. I’ve seen people who have refused to go to a doctor their primary has referred them. I’ve seen people refuse to take medication. I’ve seen people refuse to come back to their doctors for follow ups. What these people realize is that every one of these scenarios HURTS your case! Remember, you have to prove that you are medically disabled. Unfortunately, refusing to do what the doctor tells you DOESN’T help!
5) You can’t have it BOTH WAYS!!
Let me break it down as simply as I can. You can’t complain about breathing problems yet still be smoking a pack of cigarettes a day. You can’t complain about your diabetes but you don’t take your insulin pills or shots. You can’t complain about being depressed but you still use illegal drugs and drink alcohol. These types of things DON’T go together in proving you’re disabled.
6) If you don’t go to the doctor, then there is nothing a representative can do
Here is the BOTTOM LINE SIMPLE FACT: YOU bare the burden of proving you are disabled. It’s not your Representative’s responsibility. It’s not Social Security’s Responsibility. It’s YOURS! I understand if you are in an area that doesn’t have medical treatment available. However, if you can go to a free clinic or get county health insurance BUT you DON’T AND you don’t go to the doctor, there’s not much else anyone can do.
7) In some parts of the Social Security Disability process, you HAVE to wait!
This part is the most painful part of the process with my clients. Unfortunately, when you are going through the initial development and/or the reconsideration development, you HAVE to wait for Social Security to get all of the information they need to determine your status. If you get to the hearing level, you HAVE to wait until it’s your turn for a hearing date. So many times, people don’t realize that there is really nothing that can be done except WAIT!
Everybody is in a critical situation!
Let’s face it. A lot of people are in eviction proceedings or foreclosure proceedings or bankruptcy proceedings. A lot of people can’t pay their bills. Alot of people are broke. Unfortunately, a great DEAL of these people are applying for Social Security disability. Social Security is in a tough spot because if you got 1000 people applying and 900 of them are screaming that they want their case expedited and each of them are in foreclosure or evictions or bankruptcy, WHO moves to the front of the line??? See the dilemma.
9) TERI cases are the rare cases that move to the front!
TERI stands for Terminally Ill. If you are terminally ill, your case is going to be processed QUICKLY. So I hate to tell you, if it’s a choice between working your case (and you just have a bad back) and a cancer case, your case will be moved back.
10) Blowing up Social Security’s phones does NOT help!
Let me tell you that you get NO WHERE when you call Social Security 100 times a day! For every time you call them about your case, this STOPS them from working on your case. Just let them work.
11) No representative or Social Security wants you to wait.
The simple fact is that anyone involved in this process WANTS you to get your determination quickly. No one wants you to have to wait a 2 months, 6 months or a year for a determination.
12) If you go to the doctor, do what the doctor says, do what Social Security says, stay clean, & wait, the process runs a smoother!
‘Nuff said!
As always, I am super sympathetic to the struggles of people who are trying to get disability benefits. However, you must realize that some things CAN be helped and some things CAN’T!
-
Brought to you by:
