Monday, December 31, 2012

Self-Employment and Social Security Disability Benefits

Recently, I was asked the same question by two potential Social Security Disability Claimants: one is a small business owner who suffers from Lyme's disease and the other one, is a self-employed electrician who suffers from rheumatoid arthritis.  They both wanted to know whether they could continue to work on a part-time basis and be eligible for Social Security Disability Benefits.
The answer to their question is fairly complicated due to the fact that both of them are self-employed.  If they had been salaried employees, the answer to their question would have been relatively straight forward.  Under Social Security Disability rules a person cannot be eligible if he or she is engaging in a Substantial Gainful Activity (SGA).  For salaried employees, SGA is generally work that brings in over a certain dollar amount per month. In 2012, that amount is $1,010 for non-blind disabled applicants, and $1,690 for blind applicants. If a salaried employee makes more than that amount per month, the Social Security Administration figures that the applicant must not be disabled.  If a person makes more than the amount determined to be the SGA level, that person cannot be eligible for Social Security Disability regardless of how sick he or she may be.
However, in the case of persons who are self-employed, SGA is not determined solely on monthly income.  A small business owner might work 40 to 50 hours a week and make very little or no profit.  In order to deal with this particular issue, the Social Security Administration has an evaluation criteria which consists of three tests.
The Social Security Field Offices will consider all three tests before it can be established that the individual's work activity is not SGA. The following are just brief descriptions of each of the three tests:
1. Test One: Significant Services and Substantial Income
The individual's work activity is SGA if he or she renders services that are significant to the operation of the business, and if he or she receives from it a substantial income; or
2. Test Two: Comparability of Work Activity
The individual's work activity is SGA if, in terms of all relevant factors such as hours, skills, energy output, efficiency, duties, and responsibilities, it is comparable to that of unimpaired individuals in the same community engaged in the same or similar businesses as their means of livelihood; or
3. Test Three: Worth of Work Activity
The individual's work activity is SGA if, although not comparable to that of unimpaired individuals, it is, nevertheless, clearly worth more than the amount shown in the SGA Earnings Guidelines when considered in terms of its effect on the business, or when compared to the salary an owner would pay to an employee for such duties in that business setting.
As one can see from these requirements, those who are self-employed while applying for Social Security Disability Benefits will undergo a high level of scrutiny by the Social Security Administration.  The Field Offices will make a determination on a case by case basis depending on the level of involvement and the value of the work that the applicant performs for his or her particular business enterprise.
Given these complicated circumstances, it is advised that self-employed applicants  who wish to continue working while applying for Social Security Benefits should seek the assistance of a skilled Social Security Disability Lawyer.

Monday, December 24, 2012

Holiday Greetings!

The Holiday season is a perfect time to reflect on the the things that we have accomplished during the year and to take a moment to thank those who were there for us when we needed a helping hand.
Obtaining Social Security disability benefits for those who suffer from chronic conditions or physical ailments is not an easy task.  Fortunately, I am very proud to say that during 2012 I was able to count on  an outstanding network of medical and social service providers who were always there for my clients.  I would like to mention just a few of them in this post.  In the next few days, I will attempt to look back at my office records in order to find those that I have missed.  Hopefully, I will have sometime to call these great friends or to send them a note expressing my gratitude. 
Since the list of people that I have to thank is very long, I most instances, I am just mentioning the particular organization or group that they belong to.
  • Community Health Services (CHS)- with special thanks to Soraya Maldonado
  • Latino Community Services
  • Institute for the Hispanic Family
  • Catholic Charities
  • Charter Oak Clinic
  • The Village for Families and Children
  • Hartford Behavioral Health
  • The Malta House
  • The Institute of Living
  • The Lupus Foundation of America, Connecticut Chapter
  • Magda Quinones from St. Francis Hospital
  • Dr. Miguel Colan
  • Dr. Keshav Rao
  • Dr. Gary Belt
Finally, I would like to add that words cannot describe the emotions felt by my clients when they are able to get Social Security Disability Benefits after a prolonged struggle.  Most of them wait well over a year and endure enormous hardships before they are able to receive benefits.  As their lawyer, I know very well that each and everyone of my clients are also very grateful for the assistance provided by their medical and social service providers in the process of obtaining social security disability benefits. 

Monday, December 17, 2012

35 More Compasionate Allowances Added by the Social Security Adminstration

Social Security has an obligation to provide benefits quickly to applicants whose medical conditions are so serious that their conditions obviously meet disability standards.

Compassionate Allowances (CAL) are a way of quickly identifying diseases and other medical conditions that invariably qualify under the Listing of Impairments based on minimal objective medical information. Compassionate Allowances allow Social Security to target the most obviously disabled individuals for allowances based on objective medical information that we can obtain quickly.

This month, the Social Security Adminstration added 35 more compassionate allowances, bringing the total number of such conditions in the expedited disability process to 200.  The new conditions include: rare diseases, cancers, traumatic brain injury (TBI) and stroke, early-onset Alzheimer's disease and related dementias, schizophrenia, cardiovascular disease and multiple organ transplants and autoimmune diseases.
Note: Conditions highlighted in Red are effective December 1, 2012.
Acute Leukemia
Adrenal Cancer - with distant metastases or inoperable, unresectable or recurrent
Adult Non-Hodgkin Lymphoma
Adult Onset Huntington Disease
Aicardi-Goutieres Syndrome
Alexander Disease (ALX) - Neonatal and Infantile
Allan-Herndon-Dudley Syndrome
Alobar Holoprosencephaly
Alpers Disease
Alpha Mannosidosis - Type II and III
Alstrom Syndrome
Alveolar Soft Part Sarcoma
Amegakaryocytic Thrombocytopenia
Amyotrophic Lateral Sclerosis (ALS)
Anaplastic Adrenal Cancer - with distant metastases or inoperable, unresectable or recurrent
Angelman Syndrome
Aortic Atresia
Aplastic Anemia
Astrocytoma - Grade III and IV
Ataxia Telangiectasia
Batten Disease
Beta Thalassemia Major
Bilateral Optic Atrophy- Infantile
Bilateral Retinoblastoma
Bladder Cancer - with distant metastases or inoperable or unresectable
Breast Cancer - with distant metastases or inoperable or unresectable
Canavan Disease (CD)
Carcinoma of Unknown Primary Site
Caudal Regression Syndrome - Types III and IV
Cerebro Oculo Facio Skeletal (COFS) Syndrome
Cerebrotendinous Xanthomatosis
Child Neuroblastoma - with distant metastases or recurrent
Child Non-Hodgkin Lymphoma - recurrent
Child T-Cell Lymphoblastic Lymphoma
Chondrosarcoma - with multimodal therapy
Chronic Myelogenous Leukemia (CML) - Blast Phase
Congenital Lymphedema
Cornelia de Lange Syndrome
Corticobasal Degeneration
Creutzfeldt-Jakob Disease (CJD) – Adult
Cri du Chat Syndrome
Degos Disease - Systemic
DeSanctis Cacchione Syndrome
Dravet Syndrome
Early-Onset Alzheimer’s Disease
Edwards Syndrome (Trisomy 18)
Eisenmenger Syndrome
Endometrial Stromal Sarcoma
Endomyocardial Fibrosis
Ependymoblastoma (Child Brain Tumor)
Erdheim Chester Disease
Esophageal Cancer
Ewing Sarcoma
Farber's Disease (FD) – Infantile
Fatal Familial Insomnia
Fibrodysplasia Ossificans Progressiva
Follicular Dendritic Cell Sarcoma - metastatic or recurrent
Friedreichs Ataxia (FRDA)
Frontotemporal Dementia (FTD), Picks Disease -Type A – Adult
Fryns Syndrome
Fucosidosis - Type 1
Fukuyama Congenital Muscular Dystrophy
Fulminant Giant Cell Myocarditis
Galactosialidosis - Early and Late Infantile Types
Gallbladder Cancer
Gaucher Disease (GD) - Type 2
Glioblastoma Multiforme (Adult Brain Tumor)
Glioma Grade III and IV
Glutaric Acidemia - Type II
Head and Neck Cancers - with distant metastasis or inoperable or unresectable
Heart Transplant Graft Failure
Heart Transplant Wait List - 1A/1B
Hemophagocytic Lymphohistiocytosis (HLH) - Familial Type
Hepatopulmonary Syndrome
Hepatorenal Syndrome
Histiocytosis Syndromes
Hutchinson-Gilford Progeria Syndrome
Hypocomplementemic Urticarial Vasculitis Syndrome
Hypophosphatasia Perinatal (Lethal) and Infantile Onset Types
Hypoplastic Left Heart Syndrome
I Cell Disease
Idiopathic Pulmonary Fibrosis
Infantile Free Sialic Acid Storage Disease
Infantile Neuroaxonal Dystrophy (INAD)
Infantile Neuronal Ceroid Lipofuscinoses
Inflammatory Breast Cancer (IBC)
Jervell and Lange-Nielsen Syndrome
Junctional Epidermolysis Bullosa - Lethal Type
Juvenile Onset Huntington Disease
Kidney Cancer - inoperable or unresectable
Krabbe Disease (KD) – Infantile
Kufs Disease - Type A and B
Large Intestine Cancer - with distant metastasis or inoperable, unresectable or recurrent
Late Infantile Neuronal Ceroid Lipofuscinoses
Left Ventricular Assist Device (LVAD) Recipient
Leigh’s Disease
Lesch-Nyhan Syndrome (LNS)
Lewy Body Dementia
Liver Cancer
Lowe Syndrome
Lymphomatoid Granulomatosis - Grade III
Malignant Brain Stem Gliomas – Childhood
Malignant Gastrointestinal Stromal Tumor
Malignant Germ Cell Tumor
Malignant Melanoma - with metastases
Malignant Multiple Sclerosis
Mantle Cell Lymphoma (MCL)
Maple Syrup Urine Disease
Mastocytosis - Type IV
MECP2 Duplication Syndrome
Medulloblastoma - with metastases
Menkes Disease - Classic or Infantile Onset Form
Merkel Cell Carcinoma - with metastases
Merosin Deficient Congenital Muscular Dystrophy
Metachromatic Leukodystrophy (MLD) - Late Infantile
Mitral Valve Atresia
Mixed Dementias
MPS I, formerly known as Hurler Syndrome
MPS II, formerly known as Hunter Syndrome
MPS III, formerly known as Sanfilippo Syndrome
Mucosal Malignant Melanoma
Multicentric Castleman Disease
Multiple System Atrophy
Myoclonic Epilepsy with Ragged Red Fibers Syndrome
Neonatal Adrenoleukodystrophy
Nephrogenic Systemic Fibrosis
Neurodegeneration with Brain Iron Accumulation - Types 1 and 2
NFU-1 Mitochondrial Disease
Niemann-Pick Disease (NPD) - Type A
Niemann-Pick Disease-Type C
Nonketotic Hyperglycinemia
Non-Small Cell Lung Cancer - with metastases to or beyond the hilar nodes or inoperable, unresectable or recurrent
Obliterative Bronchiolitis
Ohtahara Syndrome
Ornithine Transcarbamylase (OTC) Deficiency
Orthochromatic Leukodystrophy with Pigmented Glia
Osteogenesis Imperfecta (OI) - Type II
Osteosarcoma, formerly known as Bone Cancer - with distant metastases or inoperable or unresectable
Ovarian Cancer – with distant metastases or inoperable or unresectable
Pancreatic Cancer
Paraneoplastic Pemphigus
Patau Syndrome (Trisomy 13)
Pearson Syndrome
Pelizaeus-Merzbacher Disease-Classic Form
Pelizaeus-Merzbacher Disease-Connatal Form
Peripheral Nerve Cancer - metastatic or recurrent
Peritoneal Mesothelioma
Peritoneal Mucinous Carcinomatosis
Perry Syndrome
Phelan-McDermid Syndrome
Pleural Mesothelioma
Pompe Disease – Infantile
Primary Cardiac Amyloidosis
Primary Central Nervous System Lymphoma
Primary Effusion Lymphoma
Primary Progressive Aphasia
Progressive Multifocal Leukoencephalopathy
Progressive Supranuclear Palsy
Pulmonary Atresia
Pulmonary Kaposi Sarcoma
Retinopathy of Prematurity - Stage V
Rett (RTT) Syndrome
Rhizomelic Chondrodysplasia Punctata
Roberts Syndrome
Salivary Tumors
Sandhoff Disease
Schindler Disease - Type 1
Severe Combined Immunodeficiency - Childhood
Single Ventricle
Sinonasal Cancer
Small Cell Cancer (of the Large Intestine, Ovary, Prostate, or Uterus)
Small Cell Lung Cancer
Small Intestine Cancer - with distant metastases or inoperable, unresectable or recurrent
Smith Lemli Opitz Syndrome
Spinal Muscular Atrophy (SMA) - Types 0 and 1
Spinal Nerve Root Cancer-metastatic or recurrent
Spinocerebellar Ataxia
Stiff Person Syndrome
Stomach Cancer - with distant metastases or inoperable, unresectable or recurrent
Subacute Sclerosing Panencephalitis
Tabes Dorsalis
Tay Sachs Disease - Infantile Type
Thanatophoric Dysplasia - Type 1
The ALS/Parkinsonism Dementia Complex
Thyroid Cancer
Transplant Coronary Artery Vasculopathy
Tricuspid Atresia
Ullrich Congenital Muscular Dystrophy
Ureter Cancer - with distant metastases or inoperable, unresectable or recurrent
Usher Syndrome - Type I
Walker Warburg Syndrome
Wolf-Hirschhorn Syndrome
Wolman Disease
Xeroderma Pigmentosum
Zellweger Syndrome

Monday, December 10, 2012

Religious Leaders go to Washington to Defend SSDI

Last week, Former Connecticut Governor John Rowland used a section of his daily radio talk show on WTIC News 1080 to criticize the Social Security Disability Program.  I didn't have a chance to listen to the show but I was told that he blasted SSDI and criticized it for allegedly being plagued with  widespread misuse of public funds.  Readers of this blog who don't reside in Connecticut might not be aware that John Rowland was a Republican Governor who, in 2004, resigned from office during a corruption investigation.  He later plead guilty in federal court and served ten months in prison, followed by four months of house arrest.  
While John Rowland was using disability claimants as scapegoats for the financial havoc that corrupt politicians like him have caused, a group of well respected religious leaders were in Washington defending SSDI.  On December 4th, The Jewish Council for Public Affairs and the Interfaith Disability Advocacy Coalition gathered on Capitol Hill to speak out in support of the Social Security Disability Insurance (SSDI) benefits program.  SSDI is an important lifeline for Americans unable to work due to illness or injury.  The two groups provided compelling testimony dispelling the myths about the program being widely abused and wasteful.  Their visit to Congress was a persuasive push to ensure that SSDI is not a victim of fiscal cliff negotiations.

The briefing featured presentations from two former SSDI recipients who were able to return to full-time employment after suffering tragic accidents that rendered them unable to work. The first, Donna Eshghi, a full-time nurse from Wichita, KS, contracted Hepatitis C after an unexpected needle-prick at work. A single mother, she was able to use SSDI benefits to support her family until she was able to return to work. And Deborah Krotenberg, an attorney from Atlanta, used SSDI benefits to keep herself afloat until she was able to return to work full-time after she was paralyzed in a serious car accident.

Kathy Ruffing, a Senior Fellow, Center on Budget and Policy Priorities,discussed her recent report: Social Security Disability Insurance is Vital to Workers With Severe Impairments. Additionally, Curtis Ramsey-Lucas, of the American Baptist Home Mission Societies, closed the event with an interfaith prayer.

"As a nation, we need to be committed to ensuring that when Americans become unable to work due to illness or accident, there is a safety net," said Rabbi Steve Gutow, President and CEO of JCPA. "SSDI is literally a lifeline for millions of Americans. People who collect disability insurance have paid into the system and therefore it is critical that the benefits they have earned are available in their time of need. Recent political attacks on SSDI are misguided at best. And now, as Congress and the President find ways to negotiate away from the fiscal cliff, we hope they will remember that SSDI is a critical program that must be protected."

Some key facts about SSDI:
  • According to the most recent government statistics, in October of 2012, there were 8.8 million Americans collecting SSDI.
  • There are record numbers of SSDI recipients now not because the government has made it easier to collect disability benefits, but rather because Baby Boomers are getting older and more prone to illness or injury, as well as a record number of women in the workplace. In fact, Steve Goss, the Chief Actuary of the Social Security Administration recently testified about these trends before the United States Congress.
  • By cutting funding to the Social Security Disability Insurance program, states and local communities will feel the brunt of the burden.
  • Denying or delaying benefits to disabled Americans leads to additional human suffering. They might have to file for bankruptcy or apply for welfare; some may end up in home foreclosure or be unable to get medical treatment without their SSDI benefits.
  • It’s not easy to qualify for SSDI benefits. The qualifying standards have been raised and there are many diseases which no longer solely qualify claimants for benefits, like alcoholism, diabetes, drug abuse and obesity.

Monday, December 3, 2012

Do I Automatically Get Medicare with SSDI?

...this is definitely one of the questions most often asked by my clients...  Clients also ask me a lot about whether they will get Medicaid.  I will address these questions separately below:


You will receive Medicare after you receive Social Security Disability Benefits for 24 months. When you become eligible for disability benefits, the Social Security Administration will automatically enroll you in Medicare. 

It is important to note that Social Security starts counting the 24 months from the month you were entitled to receive disability, not the month when you received your first check.  This two year period starts five months after your disability began.  (This is due to the fact that there is a five month waiting period to receive SSDI.)

However, special rules apply to:

End-stage renal disease (permanent kidney failure). People with permanent kidney failure get Medicare beginning:
  • The third month after the month a regular course of renal dialysis begins; or
  • The month of kidney transplantation.
Lou Gehrig's Disease (amyotrophic lateral sclerosis). People with amyotrophic lateral sclerosis get Medicare beginning with the month they become entitled to disability benefits.
Medicare has four parts:
  • Hospital insurance (Part A) helps pay hospital bills and some follow-up care. The taxes you paid while you were working financed this coverage, so it's premium free.
  • Medical insurance (Part B) helps pay doctors' bills and other services. There is a monthly premium you must pay for Medicare Part B and you have the option to refuse this coverage.
  • Medicare Advantage (Part C) plans generally cover many of the same benefits a Medigap policy would cover, such as extra days in the hospital after you have used the number of days Medicare covers. People with Medicare Parts A and B can choose to receive all of their health care services through one of these provider organization under Part C. There might be additional premiums required for some plans; and
  • Prescription drug coverage (Part D) helps pay for medications doctors prescribe for treatment. Anyone who has Medicare hospital insurance (Part A), medical insurance (Part B) or a Medicare Advantage plan (Part C) is eligible for prescription drug coverage (Part D). Joining a Medicare prescription drug plan is voluntary and you pay an additional monthly premium for the coverage.

In Connecticut and Massachusetts, if you are an SSI beneficiary, you may be automatically eligible for Medicaid; an SSI application is also an application for Medicaid.  Typically, SSDI recipients get Medicare and SSI recipients get Medicaid.  SSI recepients do not have to wait a 24 month period to receive Medicaid benefits.