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SS Disabilty \ Medical Insurance


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#1 CraigR

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Posted 26 February 2011 - 08:07 AM

I've been in the process of filing for SS disability for 18 months. My initial application as well as the appeal were denied without any medical consultation.

My problems mainly focus on CREST scleroderma and Sjogren's syndrome, made much more serious by a bout with lymphoma 8 years ago (treatment, including an autologous stem cell transplant). Greatest difficulties are with pulmonary hypertension, extreme fatigue and myositis.

I'm lucky to have private long-term disability, and the insurer had no difficulty finding me disabled and has been making payments.

My problem is mainly concerning medical insurance. Currently I have COBRA, which ends in November. With SS disability I would be eligible for Medicare. I could get a private medical policy, but it obviously wouldn't cover pre-existing conditions and would likely be very expensive.

My disability attorney came highly recommended, but, due to illness, had to transfer the case to a different attorney last Summer. This attorney was his previous partner.

Since this time I haven't been able to contact the new attorney, nor has he made any attempt to contact me. When I tried to call him, I got a receptionist that put me through to voice mail - which turned out to be "full". I called back to mention this to the receptionist who told me that I would just have to try calling again when the voice mail wasn't full (incredible...).

I'm wondering if I should try to get a new attorney or keep the one I have. A new attorney would likely restart the hearing process, extending the process.

I even also sent a letter to my congressman with the request for explanation why the government can ignore statute law concerning scleroderma and Sjogren's, and quoted the law.

Any suggestions on how I might find out if the attorney is getting anything done?

Thanks,

Craig

#2 annkd

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Posted 26 February 2011 - 09:39 AM

Hi Craig. How about sending a certified return receipt letter asking the attorney where your case stands and that he be in contact with you as it has not been possible to leave messages? How frustrating this must be. I had a wonderful attorney that always responded promptly. This process is stressful enough without adding this to the mix. I know others are going to have some good suggestions. Please keep us posted. - Ann

#3 barefut

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Posted 26 February 2011 - 10:18 AM

Hi Craig,

What a nightmare. I think I would get another attorney. It wouldn't necessarily mean starting over with the appeal process. You might at least contact another attorney who gives free consultations and get some of your questions answered regarding what would happen if you did switch attorneys.

Also, how is your attorney getting paid? Mine gets paid 25% of any back pay I would receive from the time I filed for Supplemental Security Income until it is received. So, as you see it is not in their best interests to keep the ball rolling.

I had to show my attorney where it states on the government website that scleroderma is listed as a compassionate allowance. They do hide it well.

Good for you for writing your congressman! I am interested to hear the reply.

Also, I may be wrong but I thought part of President Obama's healthcare reform included a ban on insurance companies denying anyone based on a preexisting condition. (Not that, that would help much anyway when premiums would cost you 10K/mo!)

You know, it sounds like you may actually have a lawsuit against your attorney on it's way - ha. (yeah, not funny) Keep detailed documentation of your attempts to communicate with him anyway.

Keep hanging in there and good luck to you! And keep us posted!

#4 Jeannie McClelland

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Posted 26 February 2011 - 10:55 AM

Hi Craig,

How about contacting your state's Bar Association (responsible for licensing lawyers to practice and overseeing their conduct) and seeing if they can help you out. They might be able to jar this man into responding or at least tell you what your best course of action would be.

This must be incredibly stressful for you. Hang in there and we'll all be thinking of you.
Jeannie McClelland
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#5 Sweet

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Posted 26 February 2011 - 01:38 PM

Incredible! Nothing like incompetence. I like Ann's suggestion. Although if it were me, since I have zero tolerance for inefficiency, I would get a new attorney. You could ask this wonderful receptionist for copies of everything that has been done thus far, so the new attorney can get up to speed. Then again, she may give you the run around still, so better yet, hire a new attorney, sign a release of information, and have new said attorney demand all paperwork. Stuff like this irritates me to no end. Sorry Craig. :emoticons-i-care:
Warm and gentle hugs,

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#6 enjoytheride

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Posted 26 February 2011 - 02:51 PM

Sounds like you are caught in the "waiting forever for a hearing" mess. And with attornies who are not interested in you until the money can be made.

If I were in your place, I think I would call a Social Security office, ask for a supervisor in the Title II section and ask for any advice they can give. I would look to call to one of the smaller offices servicing one of the richer areas as they will hopefully be less overwhelmed with people calling. You may not get any help but you could luck into a person who wants to help you.
At least they may be able to tell you what happens if you change attornies (mostly a money issue.)
You can also call the Hearings office and ask for the same help. I would do both as what you need is information and the more the better to make a decision.

I don't think that any new attorney can "restart" the hearings process- he might recall the file to review it. You should ask the hearings office if this will interfere with the timeframe. If your case is just in a holding bin waiting to be scheduled, this might cause a delay if the hearing office just refiles it at the end of the line. If you have a copy of your file, that would be good enough for any new attorney you might have.

You might try sending a letter to the current (new?) attorney asking your questions. That might get you somewhere.
It's been a few years since I worked for Social Security but I have heard that the delays have become very long indeed.

I also remember something about COBRA and disability extensions- that is fairly vague with me now but I remember something about getting COBRA extended to 36 months. Maybe that might be something to ask too.
Hope you hear soon.

#7 CraigR

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Posted 27 February 2011 - 02:08 AM

Thanks for the advice. Plenty of calls to make and letters to write come Monday.

And there isn't any reason for the lawyer to drag it out, as the lawyer gets 25% capped at $6,000.

I've found it sort of strange that the commercial insurer immediately granted the disability. They are usually tougher to deal with than the government when it comes to money.

Thanks again,

Craig

#8 CraigR

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Posted 14 March 2011 - 11:16 PM

Well, I contacted another lawyer about the case. Very friendly fellow. I told him about my situation with the other attorney and he was astonished - said that attorney was the top man in town for the issue and he would try to contact him.

Ten minutes later the original attorney (that I couldn't seem to contact) called me to make an appointment for day after tomorrow.

Lesson learned: take action to stir up the situation and get some action.

Craig

#9 Sweet

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Posted 15 March 2011 - 12:18 PM

Isn't that amazing. I'd still fire him. :)
Warm and gentle hugs,

Pamela
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#10 Jeannie McClelland

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Posted 15 March 2011 - 12:29 PM

EEEEEeeeeehhhh! (I don't know how to spell that squeal of astonishment.) Good thing he's good, because he's so bad! Here's hoping things now move quickly in a positive direction. I don't see how anyone could possibly have a better case than you.
Jeannie McClelland
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#11 miocean

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Posted 15 March 2011 - 05:45 PM

I have a friend who has been turned down many times for SS Disability (not scleroderma) by the same judge. Her attorney has finally requested a different judge. She is currently in the hospital, almost died. That's pretty disabled.

Again, I received disability for renal failure not specifically scleroderma. I just received a copy of my award statement, which I requested because I couldn't find it. No one at SS could give me an answer as to how long benefits continued after transplant although the social worker told me 3 years. My report reads:

BENEFITS SHALL CONTINUE AS LONG AS BENEFICIARY MEETS ELIGIBILITY REQUIREMENTS

whatever that means. By the way, keep your awards statement if you have one. Sometimes you need it.

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#12 enjoytheride

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Posted 17 March 2011 - 01:21 AM

Miocean- there is usually a review after a certain amount of time has gone on unless you are low priority review. Once every year on conditions expected to get better- every 3-5 years otherwise unless those timeframes have changed in the last few years. There is a renal medicare review after a transplant at some point but I don't know how that works. Anyway, you should be able to find out the scheduled medical review date from SSA. And it does mean what it says- disability benefits last as long as you're disabled. But they are periodically reviewed. Unless you are old enough for it to no longer matter............... But I know you're not that old. :)

#13 miocean

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Posted 17 March 2011 - 07:22 AM

Enjoythe ride,
When I called the national SS number they told me they did not know and I would have to call my local office. When I called there I was told I have disability "until my file comes up for review." When I asked when that would be I was put on hold and after a few minutes received the answer "not for a couple of years." They couldn't give me anything more definate than that so I am just going by the 3 year information and will see what happens then. It is so reassuring to know that so many of our futures are in such good hands. :blink:

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