H and I are hanging out in his hospital room with a movie on, just having some quiet time. While he seems to be drifting in and out of sleep, I am continuing work on the online application for the SSI Disability benefits he is going to need. Apparently, qualifying for disability is the first step to getting him into “the system” that may provide some ongoing care and rehabilitation for him once the private insurance runs out. Everyone tells me that the SSI Disability application process is a nightmare, and that I should expect him to be turned down the first time. This seems hard to believe, given the severity of H’s physical and cognitive challenges, but I’ll trust those who have been through this that it’s going to be a long, drawn out process. But we’re jumping in. Oh joy.
(As an aside, I gotta tell you that this is not an online activity I ever thought I’d have to undertake.)
14 Responses to “SSI Disability – jumping into the morass”
Sorry, the comment form is closed at this time.
Having had to navigate this for an extended family member, I would strongly advocate for consulting an attorney before submitting the application. It is often true that your first applications will be denied, which is all the more reason to consult with an attorney. They will know the terms, how to place the narrative, and most importantly, how to forecast for future services and monies.
It’s good you are not waiting, and are doing this now. Good luck….
We had to do this for my mother in law and I have to agree that an attorney is the way to go.
Putting on my rehabilitation counselor hat here – as many as 70% of applicants get turned down the first time. If you can get an attorney who is experienced in applying for SSI/SSD, you’ll have a better chance the first time around. Its also worth checking with your local department of social services – they sometimes have people on staff who are there to assist with the application, keep tabs on its status and then go through the appeals process (the idea being that it gets people off of local aide programs and into federal programs more quickly). Your local chapter of the Brain Injury Association might also have some resources for help with entitlements. Having someone who is experienced with the process and the documentation requirements will help in terms of ensuring that you have not only a complete application, but a solid case that H qualifies.
Good luck — fingers crossed, he’ll be one of those people who gets approved quickly.
Hi. First let me say that I have read your blog for several years but don’t typically comment. I have been thinking about you and your family and your son regularly since I read about his injuries. It’s so terrible what’s happened to your son. I don’t quite know how to put it into words, but your story means a lot to me. I have two young sons and feel pretty much like “there but for the grace of god (may) go I” and anyone else. I admire you for putting your story out there to try to help others.
That said, I have been an SSA disability adjudicator in Pennsylvania for 8 years. We’re the people who decide who gets approved and who doesn’t. I know the program inside out and backwards and would be happy to help you if you have any questions. Although the “culture” of adjudicating varies from state to state, it’s supposed to be uniform throughout the country.
After reading the preceding comments, I can’t help but to add my two cents here. I would argue against getting an attorney at this point. The only help would be to offer you peace of mind at this point. That can certainly be worth a lot, but they don’t actually help much with getting approved at the initial stage. If your son is approved, they would basically just get a chuck of money for not doing very much. If you have to appeal, that’s the time to get an attorney. Also, I can give you a heads up that with brain injuries, cases are supposed to be deferred for a period of 3 to 6 months from the time of the injury to see how he recovers, so you may have a long wait ahead of you because of the nature of his injuries.
You shouldn’t feel like it’s a nightmare or that he’ll necessarily be turned down “the first time.” We hear that kind of blanket statement all the time and it’s not true. If you understand the process it won’t seem so overwhelming. Like so many others have done for you, my impulse is to try and help so that’s why I’m writing. You may not be interested, but if you do have any questions, you can email me. Hopefully you can get my email from this post since the site requests it.
Good luck to you and your whole family.
SSI Disability is a rough and ridiculous system. My husband has Progressive MS and we have been in the SSI fight for almost 2 years now. We were told at tje beginning that you will get denied on the first application. He was. We then hired an attorney to handle the case on the advice of a friend who had been through the process with his terminal parent. After doing an enormous amount of research I found that the state of TN has the highest denial rate on 1st application and 1st appeals. Only 4% of 2nd time applicants are approved. And they make it more and more difficult.
I work 2 jobs 7 days a week just to support out family of 4 and have a husband who sometimes can’t make it to the restroom without help.
I’m sorry if I sound like a Debbie Downer but I am not living anything close to what you are going through and I get so very angry at “the system”
I will pray and pray that you do not have a long battle with SSI.
Continuing to send love and healng to you, H, and your family.
Hi Katie, I’m friends with Betsy and have been actively keeping up with Henry’s progress. My prayers for you…..
Just wanted to mention that you might actually check WITH the hospital to see if they have a person who’s job is to help you fill out all of the necessary paperwork completely. My sister just went through cancer treatment in Chattanooga – she’s 50 years old and my parents have repeatedly been denied in the past but she was just approved with the help of this gentleman who knew every in and out and “i” to be dotted and “t” to be crossed.
I hinted at this before in reagrds to your insurance issues, but it is time to be explicit.
You and H need a lawyer. Now! WIth all due respect to the SSI adjudicator, immediately is not too soon to get a lawyer to help with an SSI disability case. The claim will probably be denied and you will probably need to appeal. What you say and do now may impact the success of your appeal.
An attorney can also help with your private insurance. A letter from you is one thing, a letter from a lawyer is something else. When an insurance company gets a letter from a lawyer they immediately think “lawsuit.” Lawsuit means “we may lose a lot of money if we are not careful.” That is what I meant when I said that you need to find a way to convince your private insurance company that it is cheaper to provide the care than it is to deny it.
H needs a lawyer, katie, and so do you. Start asking and calling around for referals. When you get two or three referals to the same guy or gal, give ‘em a call. Odds are you are going to have to do this eventually anyway, so why not do it now?
Hi Katie,
Amid this, the work of signing your son up for SSI, I offer a great essay by a writer you may know–Sweet/Salty. She sums up the randomness of it all. None of this is your fault.
http://www.sweetsalty.com/sweetsalty/2010/5/17/suggestions-for-the-no-speak-list.html
Maybe Allison the SSI adjudicator can help you make sure you fill out the forms properly and write the correct “words” that SSI wants on the application so it gets approved easily.
I have to agree Krisha here. I would not recommend using an attorney as long as you are able to wade through forms and follow instructions carefully. Although I am an attorney, I was not a lawyer who had any experience with disability before I applied for disability benefits at age 35 for bipolar disorder. I was approved on the first round. This is very very rare for someone my age, and especially for mental illnesses. You just need to have lots of medical documentation and to leave no stone unturned. Do not assume that they will understand how sick your son is or that is condition is obviously disabling. Nothing will be obvious to them. You need medical doctor after medical doctor who will demonstrate the long-term severity of his condition and why he will not be employable in any way, doing any work. An attorney is only going to take the money that is rightfully his, and these attorneys have hundreds of clients. You will not get the personal attention that you deserve. You are an intelligent woman. Follow the instructions and deadlines and handle yourself. Just stay on top of them and understand that the process is slow. Best of luck to you.
As a psychiatrist who has written disability applications for several of my patients, with a pretty good track record of approval, I can say that the key is good medical documentation. The doctors should say straight out in a very detailed way how disabled H currently is, and exactly what kind of injury, and may even have to submit current research or standard of practice to document what the likelihood of improvement is for his particular type of injury. On the first round my understanding is that the person should not reasonably be expected to be able to work within the next year, and once the year is up it gets renewed more permanently if necessary. The patients who I have had who got turned down had a cursory, poorly written evaluation after a one-time appt with a psychiatrist. The appeals that I wrote for them were more detailed, showed that I had seen them over time, documented every detail of why they could not work. You are smart, obviously verbally talented, and can be an advocate for your son. I can’t offer an opinion as to whether a lawyer is helpful on the first round because most of my patients are indigent and did not have access to a lawyer until they were denied, so I honestly don’t know if it helps or not. Best of luck, I agree this is the best option for your family. Private insurance just doesn’t cover this kind of long-term care, unfortunately.
There’s an attorney in Knoxville that handles Social Security claims. His name is Ken Miller. Give him a call.
Just wanted to offer our experience as a bit of encouragement. My husband was approved for disability without any problem. We didn’t have a lawyer and for us the process was almost simple. I think the key was the amount and quality of the medical documentation. We found the people we worked with at SS very helpful as was the hospital staff. Good luck!
I used Binder and Binder as my attorney when I was denied my disability. They only get paid if you get approved. You don’t know me but I had to put that out there.