Disability Benefits For Children With HLHS

I’ve addressed children’s disability benefits in previous posts, but would like address a specific disability, hypoplastic left heart syndrome, in this post.  Hypoplastic Left Heart Syndrome (HLHS) is a congenital heart defect where most of the structures on the left side of the heart are too small and underdeveloped (hypoplastic) to provide enough red blood flow for the body’s needs.  The Social Security Administration has listed HLHS on their list of compassionate allowances. Compassionate allowances are medical conditions so serious that their conditions obviously meet disability standards.  Compassionate Allowances are a way of quickly identifying diseases and other medical conditions that will ultimately qualify for benefits.

To recap, children’s disability benefits will be awarded to those children with:

  1. physical or mental condition(s) , or combination of conditions, that results in marked and severe functional limitations;
  2. The condition(s) must have been disabling, or expected to be disabling, for at least 12 continuous months; and
  3. The child must not be working and earning more than $1,010 per month.

HLHS is a rare congenital congenital heart defect (CHD) that may be diagnosed at birth or on a prenatal ultrasound.  HLHS consists of under-development of the left side of the heart.  Usually, the entire left side of the heart is affected, and can include the left ventricle, mitral valve, the aortic valve and the aorta.  Because of the under-development of the left side of the heart, the right side of the heart must work harder to maintain circulation to sustain both lungs and the rest of the body.  This, in turn, may cause heart failure.

A social security disability claim can take up to 2 years to process before being awarded benefits or ultimately denied, depending on many factors.  Because HLHS is listed on SSA’s list of compassionate allowances, the process may be expedited, and families may receive benefits in a matter of weeks versus a matter of months or possibly years.

Am I Eligible For Social Security Disability – Part 4

In part 4 of our 5 part series, we are discussing the process you must go through to be approved for social security disability benefits.  We’ve already discussed the first three steps, which address working, the severity of your impairment, and if your medical condition meets or equals a listed impairment by the Social Security Administration.  In this series, we will discuss step 4 of the sequential evaluation process which addresses if you can perform your past work.  The 5 step sequential evaluation process is noted below for reference:

  1. Are you currently working?  Does your impairment prevent you from performing substantial gainful activity?
  2. Is your condition severe?
  3. Does your medical condition meet or equal a listed impairment?
  4. Can you perform your past work?
  5. Can you do any other type of work?

Step 4

Step 4 of the sequential evaluation process evaluates your past relevant work.  Generally speaking, past relevant is described as work you performed in the last 15 years.  Only work that was performed at the SGA (substantial gainful activity) should be factored into your past relevant work.  In order to figure out whether you can perform past relevant work, the SSA will examine the physical and mental requirements of your former job in conjunction with your current residual functional capacity. If you are able to perform past relevant work, you will not be considered disabled for purposed of social security disability benefits.  If SSA decides that you can no longer perform your past job, your case will be evaluated at step 5 to determine if you can do any other type of work.  To simplify the analysis, take the least-taxing job you performed in the previous 15 years and argue as to why you can no longer do that job.

In the next series, we will discuss step 5, “Can you do any other type of work?”

Children’s Disability Benefits

Can my child qualify for disability benefits? This is an often asked question and the answer is yes.  Disabled children are entitled to disability benefits under the Supplemental Security Income (SSI) program.

Similar to adults applying for disability, your child’s case will be examined by the State agency that is assigned to evaluate the case and make a decision on disability.  The process and standard for being examined, however, are a bit different for children.  The process to determine disability for adults focuses on the severity of the claimant’s impairment and how the impairment affects the claimant’s ability to work.  As the majority of those applying for children’s benefits do not work, the process must address separate factors.  Children will be found disabled if two elements are satisfied:

  1. The child’s physical or mental condition or a combination of conditions results in marked and severe functional limitations.  The condition(s) must severely limit your child’s activities, and;
  2. The condition(s) must have been disabling, or be expected to be disabling, for at least 12 continuous months.

Some of the areas examined to determine if there are marked and severe functional limitations are:

  • Acquiring and using information
  • Attending and completing tasks
  • Interacting and relating with others
  • Moving about and manipulating objects
  • Caring for yourself
  • Health and physical well-being

If the child’s condition(s) results in marked and severe functional limitations for at least 12 continuous months, Social Security will find the child disabled and award SSI benefits.  In most States, children receiving SSI benefits will qualify for Medicaid coverage.

For a No Cost case evaluation, or if you have any questions regarding your child’s eligibility for disability benefits, feel free to contact our office at (508) 421-4610.

Am I Eligible For Social Security Disability – Part 3

In part 3 of our 5 part series, we are discussing the process you must go through to be approved for social security disability benefits.  We’ve already discussed the first two steps, which address working and the severity of your impairment.  In this series, we will discuss step 3 of the sequential evaluation process which addresses whether your medical condition meets or equals a listed impairment by the Social Security Administration.  The 5 step sequential evaluation process is noted below for reference:

  1. Are you currently working?  Does your impairment prevent you from performing substantial gainful activity?
  2. Is your condition severe?
  3. Does your medical condition meet or equal a listed impairment?
  4. Can you perform your past work?
  5. Can you do any other type of work?

Step 3

Quite simply, if your condition meets or equals a listed impairment, you will be awarded benefits.  So if your condition is not on the list, does that mean you will be denied?  Not necessarily.  If  your medical condition does not meet or equal one of the listed impairments, it means you must be evaluated under steps 4 and 5 to be awarded benefits.  Steps 4 and 5 address your prior work history and whether you could potentially transition to other types of work if applicable.

In the next series, we will discuss step 4, “Can you perform past work?”

Am I Eligible For Social Security Disability?

As a disability attorney, I hear this question all the time.  Unfortunately, there is no easy answer.  All disability cases must be reviewed by the Social Security Administration using the five-step sequential evaluation process to determine if a person is disabled.  Only after a thorough assessment will a claimant be awarded disability benefits.  The five steps are:

  1. Are you currently working?  Does your impairment prevent you from performing substantial gainful activity?
  2. Is your condition severe?
  3. Does your medical condition meet or equal a listed impairment?
  4. Can you perform your past work?
  5. Can you do any other type of work?

[Read more…]

Massachusetts AED Legislation

I read an interesting post today from the American Heart Association – Massachusetts chapter regarding legislation in Massachusetts that would require automated external defibrillators (AED) in schools.  Automated external defibrillators, or AEDs, are a medical product that can be used during sudden cardiac arrest. Sudden cardiac arrest generally occurs when a person’s heart stops beating. Without intervention, a person’s chances of survival can drop 7 to 10 percent for every minute during the time their heart is not beating normally. If the patient is not treated within minutes, the patient can die. Having an AED close at hand can make it possible for anyone trained in their use, including non-medical personnel, to treat a heart attack victim and increase their chances of survival.

Current Massachusetts law passed in 2006 requires AED’s in health clubs.  It only makes sense that this requirement extend to all schools and sporting events.  I urge everyone, especially those with school aged children, athletes and children with cardiac issues to contact their elected officials to ask for help in passing this important legislation.  I’ve included a link to use in contacting your representatives.   http://www.yourethecure.org/composeletters_open.aspx?AlertID=23647

 

 

 

 

 

 

 

How Do I Qualify For Social Security Disability?

Am I Disabled?  That is the first question that must be addressed. To receive benefits under the Social Security Disability (SSDI) and Supplemental Security Insurance (SSI) programs, you must have physical or mental health problems (or a combination of both) severe enough to keep you from working for at least one year.  The inability to get work, or go back to your old job, may not be enough to qualify under the Social Security definition of disability.  The test is whether you are capable of doing  jobs that exist in the economy in significant numbers.

Using a complex set of rules and regulations, the Social Security Administration will take into account a number of factors before deciding your case and awarding benefits for disability. Some factors include your age, work experience, training you’ve received, remaining ability to work and medical condition to name a few.  As you get older, Social Security’s regulations make it easier to be found disabled and possibly be approved for benefits.

Social Security Disability Benefits

Social Security Disability and Supplemental Security Income are federal programs that provide assistance to people with disabilities.  Both SSDI and SSI are administered by the Social Security Administration and are only available to individuals who have a disability and meet medical criteria.

  • SSDI – SSDI pays benefits if you worked long enough and paid social security taxes
  • SSI – SSI pays benefits based on financial need

What is the definition that Social Security uses to determine if an individual is disabled?

         Under the Social Security Act, “disability” means “inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or has lasted or can be expected to last for a continuous period of not less than 12 months.”  Unfortunately, there is no set list of disease, injury or disability that Social Security uses to determine eligibility for benefits.  Social Security will make a decision based on the severity of the disability and how it affects the specific claimant.

Please call our office for questions regarding your claim or application or to schedule an initial consultation.

Financial Planning For Families With Special Needs

ESSENTIAL STEPS TO ACCOMPLISH YOUR GOAL

  • Start Early and Get Help –  Lack of planning may have disastrous consequences.  Planning for special needs families often involves several  financial, legal and benefits-related strategies.  Assembling a team of qualified professionals to advise you will take time.  A financial advisor, estate planning attorney, benefits coordinator, trustee/trust company, family physician/registered nurse, and of course family members may all need to be involved in the ultimate plan.
  • Establish a Special Needs Trust – If you’re receiving government sponsored benefits, a gift or inheritance may cause a disqualification of those benefits.  A frequently asked question  is how to provide for a family member with special needs without jeopardizing those government benefits.  Parents may purchase life insurance to be paid out to a special needs trust.  They may also designate the special needs trust as a beneficiary in a will, trust or retirement account.  The funds designated to the special needs trust at death may be used to supplement the special needs family member without jeopardizing their benefits.
  • Draft a Letter of Intent – How can you be assured that proper care will be given to your child? You’ve established a special needs trust  to provide financial assistance when you’re gone, but have you named  a person that will assume the role of guardian or caregiver?  Do they know the name and address of your child’s physician?  Do they know their therapies, procedure and medication schedule?  Do they know their faith and where they attend religious services?  Answers to these and many other questions should be discussed and memorialized to ensure the best possible care for your child.
  • Consider Life Insurance – Someone, most likely a family member, will have to step in to act as a guardian and raise your child.  In all likelihood, that family member will have to pay for some of the services the parents had provided when able.  If the estate was not large enough, life insurance can provide the needed funds to help defray the cost of care.
  • Review Often – Many changes will occur during the course of your life.  Reviewing your plan annually will ensure everything is up to date to give you the peace of mind your family is taken care of.

Caregiver Contracts On The Rise

A recent study by the AARP found that nearly a quarter of the adult population are providing voluntary care for family members and friends.  As the population ages and people live longer, this number is sure to rise.  To reward these caregivers, parents often would leave an unequal inheritance to the caregiver child.  Often these unequal inheritances would lead to family feuds.

One alternative to an unequal distribution to a caregiver is to hire the caregiver and pay them for their services.  This is accomplished by drafting a “caregiver contract”.  This option allows the elder to acknowledge the time, effort, and services provided, and possibly eliminate the feud inherent in unequal distributions at death.

Caregiver contracts, by listing what duties or services the caregiver will provide, will often open the lines of communication and encourage families to discuss the arrangements to care for the elder.  If there is family communication, most times additional family members will assist the caregiver in providing certain services.  This often times will minimize family disagreements pre- and post death. 

Be sure to discuss your personal situation with a qualified elder law attorney as there may be tax consequences  or if your goal is to qualify for medicaid benefits.