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 Social Security Disability & Medicare

Social Security Disability & Medicare coverage is a government program that determines if you are disabled, through documentation from your physican, Rehab personnel and even your prosthetist.

If you are planning to return to work, this program can still be utilized. You can apply for Social Security Disability on a short term basis, and when you return to work, end your coverage. You can also find, that once you return to work, the situation may be more difficult than you thought. You can always re-apply for permanent Disability.

My experience with filing for Disability was a good one. The only down side to applying is the waiting! And you can wait for up to 120 days.

You can apply for SSDI benefits in-person at any SSA office, or by telephone and mail. Going in-person for your disability interview will get you free advice from the claims representative, an examination of your papers for errors and oversights. This is especially important! I've had LadyAmp's tell me they had to return 3 times because of mistakes in their reporting of information. The mistakes they made were minor, but the Representative wouldn't take the forms unless everything was correct!

When you call your SSDI office, you may be asked to do a 'phone intervew', instead of going to their office. This is alright, but I would suggest asking for an 'office interview' instead. My opinion is, they see who you are, and your disability. They may try and make a 'phone interview' more attractive, but you have the right to request an 'office interview'.

The important thing is to have everything they require when you meet with them. They will set up an appointment for you to come into their office. Make sure you have everything they require!

You'll need:
  • At least one Doctors Report which will establish your diagnosis and impairment (amputation). (Your doctor will be sent a form to complete. You won't be required to have this report in hand at the time of your interview). Your doctor can also 1. establish your inability to work because of your amputation, ie: restrictions on walking long or short distances, lifting, etc. due to your amputation. 2 He will be required to give SSDI real-life examples of what you can and cannot do. (It might be a good idea to let your doctor know you are filing for SSDI. I told my doctor and he asked me what I could and couldn't do in regards to my ADL's (Activities of Daily Living). He will also evaluate your long term (permanent) disability. In other words, will you be disabled from now on. I would suggest listing ALL the doctors who were involved in your care.
  • Certified (Registered) copy of your Birth Certificate. (with the embossed seal)
  • Photo Identification (Driver's License) which shows your proof of age.
  • Names, Addresses, Phone Numbers of physicians, clinics, Rehabilitation Facilities, therapists, surgeons, etc. involved in your pre-amputation and post amputation care. You will be required to complete a form for these individuals or hospitals, giving your consent for them to release your medical records.
  • You will need to have the dates of treatment as well. ie: Anytown Hospital, Admission date: 12/1/99 Discharge Date: 12/22/99.
  • Social Security Card - You need to know, they will not accept a Social Security card that isn't issued in the name you are currently using. If you still have your SS card in your maiden name and are married, you need to send away for a new card immediately! You can't apply for your SSDI without it! (You may have to verify your married name by sending the Social Security Administration a copy of your marriage license. So if you don't have a copy of your marriage license, you'll need to send away for it prior to applying for your new Social Security card).
  • You will need to list ALL of your current medications as well as the dosage of each.
  • You'll be required to list a summary of where you have worked in the past 15 years and the kind of work you did. They will require company names, addresses and phone numbers and dates of employment.
  • You'll need a W-2 Form (Wage and Tax Statement) for the last year you worked. If you're self employed, your federal tax return for the past year.
What does the SSA/SSDI mean by the term 'disabled'?

I wasn't sure what SSDI deemed 'disabled' so I went to their website and searched it out. Here is their explanation of 'disabled':

SSA considers a person "disabled" if he or she: (1) lacks the ability to engage in any substantial gainful activity; (2) the incapacity is due to one or more medically determinable physical or mental impairments; and (3) the incapacity has lasted or can be expected to last for a continuous period of at least 12 months or to result in death. (Other guidelines govern blindness and claims of disabled children.) This definition is found in Section 223(d)(1)(A) of the Social Security Act, and applicants must supply SSA the evidence that proves their condition meets these criteria. "Substantial gainful activity" is defined as working on a regular and continuing basis and earning at least $500 a month. If you are working and earning $500 a month or more, SSA will be reluctant to accept your claim because they see you doing substantial gainful activity. This should not be a problem if you are on sick leave or leave of absence, because then you are not actively working.

Something to know, if your spouse is working it will not affect your SSDI benefits. SSA considers your work capacity -- not the income or resources of your spouse. Your savings and investments also will not disqualify you. There are some incidents where some income from state agencies (Welfare) may decrease your monetary benefit. Talk to your representative about this!

Important to know: Every LadyAmp I've talked to has said the same thing. Their claim for disablity was denied the first time!! BUT, even if you were denied, immediately re-apply! They give you 60 days after you receive their Notice of Decision. I found out that the agency reconsiders your claim the second (or third) time, but assigns a different decision-maker than the one who decided the claim initially.

Let's say you were denied the second time. You have the right to request a hearing before an administrave law judge within 60 days. This will be a hearing much like a court hearing, but from what I hear, less formal. You'll be required to testify under oath and submit additional evidence.

What if your claim is denied again? If the judge denies your appeal, you can request review by the Appeals Council within 60 days. The Appeals Council also may review a judges decision on its own initiative within 60 days after the date of the your last decision.

The Appeals Council may affirm, modify or reverse the decision of the judge, or may send the case back to the judge for further action. The SSA notifies you in writing of the final action of the Appeals Council, and of the right to obtain further review by filing suit within 60 days in a United States District Court.

I hope this information has helped you in knowing in advance to what SSDI/SSA will require of you should you file a Disability Claim. If you have any questions, please feel free to E-mail me.