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What You Need to Know About Medicare and SSDI Benefits

What You Need to Know About Medicare and SSDI Benefits

SSDI and Medicare

Medicare Open Enrollment is October 15 – December 7, 2020. If you are applying for Social Security Disability Insurance (SSDI) benefits and are wondering when your new health insurance will kick in, now is the best time to learn how Medicare works, who it benefits, and how Medicare and SSDI benefits can work together. Social Security Disability Advocates USA explains what beneficiaries need to know about getting the most out of their disability benefits and healthcare coverage.

What Is Medicare? Who Qualifies For It?

Before we delve into the intricacies of SSDI and Medicare, let’s take a moment to go over what Medicare is and who benefits from it. Medicare is a federal insurance program established in 1965 that is designed to provide health coverage for the following individuals:

  • People who are 65 years old or older
  • Persons with qualifying disabilities who are under the age of 65
  • People diagnosed with end-stage renal disease

Medicare is split into four parts: 

  • Medicare Part A is hospital insurance that covers any inpatient hospital stays, skilled nursing facility stays, and some types of home healthcare.
  • Medicare Part B is medical insurance that covers preventative care, routine doctors’ visits, outpatient appointments, and medical supplies.
  • Medicare Part D is prescription drug coverage that helps beneficiaries pay for the cost of their prescribed medications, shots, and vaccines.
  • Medicare Part C is private health insurance (also called a Medicare Advantage Plan) that has been approved and partially paid for by Medicare. This includes HMOs and PPOs. Medicare Part C often combines Medicare Parts A, B, and D, plus extra coverage options like dental, vision, and hearing.

Is Medicare Free If You Are Disabled?

The cost of Medicare depends on several factors and varies from Part A, B, C, and D. In most cases, as long as you or a spouse has paid sufficient Medicare taxes and amassed enough work credits*, Medicare Part A will be free of cost to you, if you are under the age of 65 and have a disability. This is often referred to as “premium-free” Part A. 

*If you do not have enough work credits to qualify for SSDI benefits and are under age 65, you may still qualify for Supplemental Security Income (SSI) and Medicaid.

While Part A Is Usually Free, Part B Requires a Monthly Premium

For Medicare Part B, you’ll likely pay a monthly premium. If you receive Social Security benefits of any kind, your Medicare Part B premium will be automatically deducted from your monthly benefit amount. 

Just how much will your monthly premium be? The standard monthly cost of Medicare Part B in 2020 is $144.60. In 2021, that cost will rise slightly to $148.50 per month. If, however, you earned more than $87,000 two years prior to enrolling ($174,000 for tax returns filed jointly), you will pay an additional fee for Part B called Income Related Monthly Adjustment Amount (IRMAA). In addition to monthly premiums, you’ll also be subject to variable deductible and coinsurance costs.

Part D Premiums Are Determined by Private Health Insurance

Similar to Medicare Part C, Medicare Part D is administered by private health insurance companies that are approved and partially funded by Medicare. As a result, how much you’ll pay for your premium, deductible, and other costs will vary depending on the Medicare drug plan you select. 

That being said, the Centers for Medicaid and Medicare Services (CMS) announced that the  national average monthly cost for 2021 will be $43.07. This is in addition to your deductible costs and any coinsurance included in your plan.

How Long Do I Have To Be On SSDI Before I Get Medicare?

SSDI and Medicare often go hand in hand, but unfortunately there is a waiting period before you can start receiving both Medicare and SSDI benefits. Once you begin receiving monthly SSDI benefits, you must wait 24 months before qualifying for Medicare. Considering how long it often takes just to qualify for and begin receiving disability benefits, this can leave some disabled workers with no healthcare and little to no income.

Although the Social Security Administration does not automatically offer any interim financial aid while waiting for disability, other resources may be available to help you stay afloat until your SSDI and Medicare benefits go into effect. 

Contact your local Department of Social Services or Department of Health and Social Services to find out what kind of interim assistance may be available to you, including programs like Medicaid, Temporary Assistance for Needy Families (TANF), and the Supplemental Nutrition Assistance Program (SNAP).

In some cases during your Medicare waiting period, you may be eligible for healthcare coverage through a former employer. If you are able to work in some capacity, you can also qualify for a trial work period which won’t affect your benefits as long as you earn less than what is considered Substantial Gainful Activity (SGA).

Where Can I Get Help Applying for SSDI Benefits and Medicare?

Filing for disability benefits can be a frustrating, drawn-out process—but it doesn’t have to be. With proficient legal counsel at your side, you can ensure that you get the maximum disability benefits amount and minimize the amount of time spent waiting for Medicare eligibility. Whether you’re considering applying or dealing with the frustration of a denied claim, a Social Security disability attorney can help.

At Social Security Disability Advocates USA, we offer free consultations to all disability claimants. We believe that everyone should be aware of all their legal options before hiring a lawyer. To get in touch with our team and claim your complimentary no obligation review, call us at 602-952-3200. We also have LiveChat agents standing by to answer your questions, or you can go ahead and request your free case review using this form.

This is attorney advertising. SSDA, LLC is a group of attorneys that pursues claims for Social Security Disability benefits on behalf of its clients against the Social Security Administration. SSDA, LLC is in no way a part of the Social Security Administration. Further, the information on this blog is for general information purposes only. Nothing herein should be taken as legal advice. This information is not intended to create, and receipt or viewing does not constitute, a representative-client relationship.
Will Social Security Disability Increase in 2021?

Will Social Security Disability Increase in 2021?

2021 SSDI COLA increase

The Social Security Administration recently announced a 1.3% benefit increase for Social Security and Supplemental Security Income (SSI) recipients beginning in January 2021. The annual cost-of-living adjustment (COLA) reflects an overall increase in the Consumer Price Index, which is calculated yearly by the Department of Labor’s Bureau of Labor Statistics.

Find out everything you need to know about the 2021 SSDI COLA increase and how it may affect your finances next year with this rundown from Social Security DIsability Advocates USA.

Who Is Eligible for the 2021 COLA Benefits Increase?

Cost-of-living adjustment benefit increases will be made available to the following beneficiaries beginning in January 2021:

This includes all retired workers, widows and widowers, and disabled workers, plus their spouse and children.

How Much of An Increase Is 1.3%, Anyway?

Compared to the past two years, the 2021 SSDI COLA increase is on the low end, but it still beats out other years in which many people faced economic hardship, such as 2010, 2011, and 2016, when there was no COLA increase at all.

From month to month, you may not notice a huge jump in your disability benefits amount. For example, the average disabled worker received a monthly payment of $1,261 in 2020. In January 2021, the same worker can expect their monthly benefits to increase to $1,277. This provides the average disabled beneficiary with an additional $192 per year.

On the other hand, the maximum monthly benefit for disabled workers in 2020 is $3,011. These beneficiaries will receive a slightly more substantial addition of $469 per year, or an extra $39 per month, with a total of around $3,480 in annual benefits in 2021.

What Other Changes Are Coming to the SSA in 2021?

The 2021 SSDI COLA increase isn’t the only thing changing in the Social Security Administration in 2021.

Maximum Earnings Subject to Social Security Tax

Beginning in January 2021, the maximum amount of annual earnings subject to Social Security taxation will increase from $137,700 to $142,800. This is based on an overall increase in average wages. If you are still working and earned more than the maximum in any year, the SSA will only take into consideration the maximum taxable earnings figure to determine your benefits. 

Trial Work Periods

In 2020, disabled individuals were allowed to earn up to $910 a month during a trial work period. In 2021, this amount will increase to $940 a month. Earnings of more than $940 a month may be considered substantial gainful activity (SGA), so those who are working part-time on disability should be aware of this change.

How Can I Maximize My Monthly SSDI Benefits?

If you’re thinking about applying for disability benefits or need information about the SSDI appeal process during the coronavirus pandemic, legal help is available to assist you in getting the maximum possible monthly benefit for you and your family.

Contact our Social Security disability lawyers by calling 602-952-3200. We’ll schedule a free consultation to help you navigate the process of filing for disability and what to do if your claim is denied. Have questions? Representatives are standing by via LiveChat to answer them. You can also request your free case review by filling out this simple form.

This is attorney advertising. SSDA, LLC is a group of attorneys that pursues claims for Social Security Disability benefits on behalf of its clients against the Social Security Administration. SSDA, LLC is in no way a part of the Social Security Administration. Further, the information on this blog is for general information purposes only. Nothing herein should be taken as legal advice. This information is not intended to create, and receipt or viewing does not constitute, a representative-client relationship.
Does Traumatic Brain Injury Qualify for Disability?

Does Traumatic Brain Injury Qualify for Disability?

TBI disability benefits

Across the United States, more than 13.5 million people live with a disability caused by a traumatic brain injury (TBI). That number continues to grow by as many as 90,000 people per year, according to the American Association of Neurological Surgeons (AANS).

After any kind of serious injury that results in long-term cognitive or physical deficits, many victims and their families may wonder how they will continue to support their families financially. 

If you are unable to return to work because of the effects of a TBI, it’s important to know what resources are available to you, such as Social Security Disability Insurance (SSDI). Find out everything you need to know about TBI disability benefits from Social Security Disability Advocates USA.

Are TBIs Considered a Disability?

A traumatic brain injury alone is not considered a disability in its own right. Although TBIs can be very serious injuries with devastating effects, not everyone who sustains head trauma will become disabled. Others may temporarily suffer ill effects but eventually make a full recovery from their injuries. 

For this reason, having a history of a traumatic brain injury is not enough to automatically qualify someone for TBI disability benefits. Your condition must also meet other strict criteria described in the Social Security Administration (SSA) blue book, a list of impairments that meet the administration’s disability eligibility requirements.

What Is the Blue Book Definition of a Traumatic Brain Injury?

According to Section 11.18 of  the SSA listing of neurological impairments and evidentiary requirements, a TBI is defined as a fractured skull, closed head injury, or penetration of brain tissue by an object. An individual who has suffered a TBI and also medically documents the following signs and symptoms meets SSA blue book requirements:

(A) Disorganization of motor function in two extremities (arms, legs, or a combination of both) resulting in an extreme limitation in the following tasks for more than three months after the injury:

  • Standing up from a seated position
  • Balancing while standing or walking, 
  • Using the upper extremities

OR

(B) Marked limitation in physical functioning, and limited mental functioning in at least one of the following areas for more than three months after the injury:

  • Understanding, remembering, or applying information
  • Interacting with others
  • Concentrating, persisting, or maintaining pace
  • Adapting or managing oneself

What If My Disability Is Mental, But Not Physical?

The TBI section of the blue book addresses mental or cognitive disabilities resulting from brain injuries, but also has a physical limitation component. However, this doesn’t necessarily mean that you cannot qualify for TBI disability benefits. 

If you or a loved one has sustained persistent mental problems after a TBI but do not suffer from marked or consistent physical impairments, you’ll want to consult Section 12.02 of the blue book, which covers neurocognitive disorders including those caused by traumatic brain injuries.

Blue Book Definition of Neurocognitive Disorders

Neurocognitive disorders are characterized by a clinically significant decline in cognitive functioning. This umbrella term includes not only cognitive decline due to TBIs, but also dementia, progressive brain tumors, and other neurological diseases. To qualify for disability benefits based on a neurocognitive disorder, your medical documentation must support the following requirements:

(A) Medical documentation of a significant cognitive decline from a prior level of functioning in one or more of these cognitive areas:

  • Complex attention
  • Executive function
  • Learning and memory
  • Language
  • Perceptual-motor
  • Social cognition

AND

(B) Extreme limitation of at least one or marked limitation of at least two of the following areas of mental functioning:

  • Understanding, remembering, or applying information
  • Interacting with others
  • Concentrating, persisting, or maintaining pace
  • Adapting or managing oneself

OR

(C) Your mental disorder in this listing category is serious and persistent—that is, you have a medically documented history of the existence of the disorder over a period of at least two years, and there is supporting evidence of the following:

  • Medical treatment, mental health therapy, psychosocial support(s), or a highly structured setting(s) that is ongoing and that diminishes the symptoms and signs of your mental disorder, AND
  • There has been only marginal adjustment—that is, you have minimal capacity to adapt to changes in your environment or to demands that are not already part of your daily life

What If My TBI Disability Doesn’t Meet Blue Book Eligibility Requirements?

The SSA blue book is a useful tool in determining whether or not you may be eligible for disability benefits, but it isn’t all or nothing. Disability claims are reviewed on a case by case basis. If the exact details of your condition are not listed in the blue book, but you suffer from a combination of partial listings, you may very well still qualify for SSDI benefits.

In addition, you may still be eligible for benefits if the SSA determines that your physical or mental limitations keep you from working any job. The only way to find out for sure whether or not you may be entitled to TBI disability benefits is to begin the Social Security disability application process.

How Do I Get Help Applying for TBI Disability Benefits?

Determining eligibility is a long, often drawn-out process. Many first-time applicants are denied and must file an appeal for reconsideration. You or your lawyer will need to provide sufficient medical documentation of your condition (i.e., diagnosis, treatments, medications, etc.) in order for your disability to be validated by the Social Security Administration. 

Those with severe TBI-related disabilities may qualify for benefits after as little as three months, but for many with more moderate injuries, the wait can stretch as long as one year just to be able to file your first application. This is not to mention the application and appeals process, which can go on for months or even years.

When your family’s financial wellbeing is on the line, getting help with TBI disability benefits is essential. To expedite the process of qualifying for the highest possible benefits amount, it is advisable to contact a Social Security disability lawyer who knows the ins and outs of meeting stringent SSA eligibility standards.

Contact Social Security Disability Advocates USA

Need help with the application or appeals process? Wondering if you have a disability case? Contact Social Security Disability Advocates USA today for a free no obligation review of your case. An experienced attorney who specializes in SSDI cases will go over all the details of your injuries, limitations, and get you the maximum benefit amount for you and your family.

Call us today at 602-952-3200 to schedule your free consultation. Alternatively, send us a message with your case details and a representative will contact you directly. You can also find out more by connecting with a representative on LiveChat  , or by reading about the seven ultimate disability secrets the SSA doesn’t want you to know about.

This is attorney advertising. SSDA, LLC is a group of attorneys that pursues claims for Social Security Disability benefits on behalf of its clients against the Social Security Administration. SSDA, LLC is in no way a part of the Social Security Administration. Further, the information on this blog is for general information purposes only. Nothing herein should be taken as legal advice. This information is not intended to create, and receipt or viewing does not constitute, a representative-client relationship.
How To Win a Social Security Disability Hearing

How To Win a Social Security Disability Hearing

Social Security Disability Hearing

According to the most recent data from the Social Security Administration (SSA), just under 36% of first-time Social Security Disability Insurance (SSDI) applications were approved in 2019. The remaining 64% of applications were denied, leaving hundreds of thousands of potentially disabled Americans with no access to benefits.

Fortunately, you can appeal an SSA decision. However, this process can take up a significant amount of time and resources. Your first step after a denial is to ask for a reconsideration, in which your claim is reviewed by someone not involved in the original denial. If your claim is still not approved, you may move onto the second step of appeals: a hearing by an administrative law judge (ALJ).

A Social Security disability hearing is a key component of the appeal process, but it can also be the most stressful since it requires you to appear in court. To ensure that you obtain the SSDI benefits you deserve, everything needs to go smoothly from start to finish. For this reason, Social Security Disability Advocates USA has compiled the following guide to winning your disability hearing. 

Submit Up-to-Date Medical Information

The time between the initial SSDI application process and your disability hearing may be considerable, so it’s important to submit up-to-date medical records. You should receive a notice by mail 20 to 30 days before your hearing date is to take place. 

Once you receive this notice, be sure to collect any new evidence (such as medical reports or exams) and send them directly to the Office of Hearings Operations (OHO), which administers disability hearings. Any new information you submit should be no more than two to three months old.

Write a Compelling Brief about Your Case

Before your Social Security disability hearing, you will need to submit a legal brief explaining why the ALJ should approve your claim. This brief should be compelling, succinct, and professional. 

In it, you should outline the most recent medical data supporting your disability claim and explain how your condition meets the criteria for disability benefits. This brief must be submitted no less than ten days before your scheduled hearing. A social security disability lawyer can assist you in crafting a case-winning brief.

Dress up, Show up, Speak up

In the past, almost all disability hearings were held in hearing offices. However, due to SSA office closures, most disability hearings are currently conducted by telephone. Virtual video hearings are expected to debut in fall of 2020. 

A Social Security disability hearing is your chance to make a good impression on the administrative law judge. This may sound simple, but it’s all too easy to get flustered under these stressful circumstances. Regardless of whether your hearing occurs in person, over the phone, or via webcam, remember these golden rules to strengthen your case.

  • Be punctual. Do whatever you can to make sure you are present during your hearing. While your hearing may be postponed under certain extenuating circumstances, you need to make every effort to show up on time.
  • Dress appropriately. While wearing your finest suit isn’t necessary, you should be well-groomed and dress nicely. Avoid wearing clothing that is ripped, stained, or which contains references to questionable content. That being said, make sure you are comfortable enough to sit through your hearing, which could last upwards of forty minutes.
  • Be polite and receptive. Treat the ALJ and any other SSA representatives with respect. Answer questions as promptly and thoroughly as you can.

Be Prepared to Answer Questions

The ALJ will most likely ask you questions pertaining to your disability claim and supporting medical documents. You should be familiar with every aspect of your claim in order to adequately answer their questions. 

Knowing what to expect at a disability hearing can make all the difference. A social security disability attorney can help you prepare for these kinds of questions, coach you on what to say, and provide useful moral support during your Social Security disability hearing.

You should also expect to hear from a vocational expert during the hearing. Their job is to explain the type of work you should be able to do with your current medical conditions. You will need to pay close attention to what the vocational expert says in order to counter any statements they make that don’t apply to you or your particular disability.

Moreover, be honest when talking about how you are affected by your disability. Don’t exaggerate your symptoms, but don’t downplay them, either. You above anyone else knows how your disability affects you, so be straightforward at your hearing for the best possible outcome.

Consult an Experienced Social Security Disability Lawyer

If you want to win your Social Security disability hearing, one of the best courses of action is to work with a qualified attorney who specializes in disability cases. Between strict deadlines for filing paperwork and anticipating the difficult questions that may be asked during the hearing, a Social Security disability lawyer can guide you through every step of the appeals process with efficiency and compassion.

At Social Security Disability Advocates USA, we offer free consultations and application denial reviews to all disability claimants. We believe that everyone should be aware of all their legal options before hiring a lawyer. To get in touch with our team and claim your complimentary no obligation review, call us at 602-952-3200. We also have LiveChat agents standing by to answer your questions, or you can go ahead and request your free case review using this form.

Filing for disability benefits can be a frustrating, drawn-out process—but it doesn’t have to be. With proficient legal counsel at your side, you can ensure that you get the maximum disability benefits amount in the shortest amount of time. Contact us today to learn more.

Have more questions about Social Security disability benefits? Check out our guide to the ultimate disability secrets the SSA doesn’t want you to know, and be sure to follow us on Facebook.

This is attorney advertising. SSDA, LLC is a group of attorneys that pursues claims for Social Security Disability benefits on behalf of its clients against the Social Security Administration. SSDA, LLC is in no way a part of the Social Security Administration. Further, the information on this blog is for general information purposes only. Nothing herein should be taken as legal advice. This information is not intended to create, and receipt or viewing does not constitute, a representative-client relationship.
Can I Get Financial Aid While Waiting For Social Security Disability?

Can I Get Financial Aid While Waiting For Social Security Disability?

financial aid while waiting for disability

A recent study by the U.S. Government Accountability Office (GAO) is shedding new light on a widespread epidemic of financial insecurity affecting those who apply for Social Security disability benefits. 

The report, released last month, revealed that between 2014 and 2019, around 48,000 people filed for bankruptcy while awaiting a decision on their disability appeals. An additional 109,725 people died between 2008 and 2019 while waiting for their appeal.

This kind of delay is unacceptable, and low-income disabled Americans are particularly at risk during the economic downturn of the coronavirus pandemic. If you’re thinking about applying for disability benefits and are wondering if you can get financial aid while waiting for disability, this guide is for you. Find out more from the social security disability lawyers at Social Security Disability Advocates USA.

Does the Social Security Administration Provide Financial Aid While You Wait?

The Social Security disability application process can take a long time in and of itself. On top of this, first-time applicants are frequently denied. This means you can be waiting months or even years to get the disability benefits you need (unless your disability is severe enough to qualify you for compassionate allowance, in which case you may be automatically approved).

While a social security disability lawyer can help you streamline the process of getting approved for benefits, how you’ll generate income while waiting for disability is an important consideration. The Social Security Administration (SSA) does not automatically provide any intermediary assistance to those waiting for disability decisions. 

The only exception to this rule is if you qualify for expedited reinstatement—that is, you qualified for disability benefits in the past and lost your benefits due to earning too much money, but have been prevented from working again due to the same disability. In this case, the SSA will issue disability benefits in the interim while your case is reviewed.

If you are able to do so, you do have the option to work while you wait for your claim or appeal to be processed. However, you must not earn a monthly income of more than $1,260, which the SSA considers to be Substantial Gainful Activity (SGA) and which may disqualify you from receiving Supplemental Security Income and affect your disability eligibility as well.

Where to Get Financial Aid While Waiting For Disability?

Although the SSA doesn’t offer any interim financial assistance for disability applicants, there are many state and local resources that may be able to help you stay afloat until your disability benefits are approved. Check out the following list of resources to help get you started.

Temporary Assistance for Needy Families (TANF) 

TANF is a short-term state-administered program designed to assist those who are pregnant or responsible for a child under the age of 19 who are also low-income, unemployed, or otherwise unable to work. TANF provides cash benefits to help you pay for food, shelter, utilities, and other living expenses. 

Each U.S. state has its own TANF program, so you will need to apply directly through your state of residence. See the Office of Family Assistance website for help applying.

Supplemental Nutritional Assistance Program (SNAP)

Also commonly known as food stamps, SNAP is another federally-funded, state-administered program that can provide financial assistance while waiting for disability in the form of a monthly stipend you can use at most grocery stores. See the U.S. Department of Agriculture website for information on eligibility and how to apply.

Other Department of Social Services Programs

For additional assistance, contact your local Department of Social Services, where you can find more information on child care, energy assistance, medical programs, and other forms of aid that may be available to you. If you have applied for SSI, many states also offer Interim Public Assistance loans to be repaid once you begin receiving benefits.

Department of Vocational Rehabilitation

Your state’s Department of Vocational Rehabilitation (VR) may also be able to help you by providing an assessment by a physician of your current abilities and connecting you with available services. This assessment will not only help VR connect you with resources, but can also help document your disability and improve your chances of being approved for disability benefits.

Have More Questions About Disability Benefits?

To get help with applying for Social Security Disability programs, appealing a decision, or just to talk about all your SSDI legal options, contact Social Security Disability Advocates USA. 

We’ll schedule a free consultation to review your case and help you navigate locating financial aid while waiting for disability. Call us today at 602-952-3200, chat with us via LiveChat, or send us a message using our secure contact form

For more information about disability benefits, check out the ultimate disability secrets the SSA doesn’t want you to know and be sure to follow us on Facebook.