Medicare, Medicaid, and Disability

When you apply for Social Security Disability Insurance or Supplemental Security Income, it is due to having some form of medical condition that impairs your ability to work. Oftentimes, these conditions require ongoing medical care so that the patient can experience as high of a quality of life as possible. Of course, those who are on either Social Security Disability Insurance or Supplemental Security Income tend not to have a lot of expendable cash on hand to help pay for medical treatment. This is where another facet of disability comes into play – that of Medicare and Medicaid. One or both of these programs may become available to you once you get approved for disability treatments.

What’s The Difference?

Medicaid is a poverty program that is run differently in every state, whereas Medicare is the national insurance program. The premium for Medicaid for both of these programs is deducted from your disability check, but the medical attention that you are entitled to is well worth the cut from the check. There are four different parts of Medicare, which are called A through D. If you would like to learn more about Medicare or learn how to enroll for these benefits, you can visit the website.

Medicaid is a little more complicated because it is run by the states and thus there are different rules, requirements, and provisions that it offers depending on where you live. There are no premiums deducted from your disability payments when you are part of Medicaid, but you may have to furnish money for a co-pay depending on your state. Not all doctors will accept Medicaid, but Medicaid tends to be better for covering prescription drugs as compared to Medicare.

If you are approved for either Social Security Disability Insurance or Supplemental Security Income, you will be eligible for Medicare through the federal government two years after you are accepted to the program. If you are awarded Supplemental Security Income, you will be entitled to Medicaid as soon as you are accepted to the program. Those who only have Social Security Disability Insurance are generally not considered eligible for Medicaid, due to the fact that Supplemental Security Income is considered a form of welfare whereas Social Security Disability Insurance is reliant on the work the claimant did prior to sustaining the disability in question.

No matter which program you apply for, there are medical benefits that can come alongside the monetary ones. Remember to stay healthy and keep going to the doctor!

What Every Social Security Disability Attorney Wants You to Know

The unfortunate reality about disability insurance is that many claimants who file for Social Security are denied, particularly during their appeal for benefits. Legal representation, such as a Social Security disability attorney, can increase your chances of approval during your initial claim, or if need be, during your appeal process.

Who Should File for Social Security Disability?

Social Security is a type of disability insurance that pays benefits to recipients and certain members of their family who meet specific criteria. The recipient must have worked for a long enough period in order to be eligible. In addition, they must have a medical condition currently preventing them from working, one that is expected to prevent them from working for a minimum duration of 12 months, or one that is expected to end in death. Although the Social Security Administration (SSA) does not mandate it, individuals who are looking to submit claims for this benefit can utilize legal representation for the process.

Obtain Representation as Soon as Possible

One of the biggest mistakes that potential claimants make in the filing process is that they don’t seek out a Social Security disability attorney as early as possible. The truth of the matter is that securing legal representation early in the process can potentially lead to a desirable outcome. How? A lawyer who is knowledgeable about this particular claim process can give you the benefit of their experience, and most importantly, they can present your case in the most legally favorable light.

According to the SSA, many applicants only seek out a disability attorney after their initial claim has been denied. Certainly, lawyers versed in these types of disability claims are more than willing to assist a claimant with what is called the reconsideration appeal process; however, there is usually very little that they can do once a claimant has been denied. In fact, the SSA reports that the reconsideration appeal rate is between 85 and 87 percent, which only serves to emphasize the grave importance of obtaining counsel before beginning the filing process. The majority of the cases won during the appeal process are the result of the legal representation’s labor.

Other Information to Consider

A disability attorney is entitled to receive 25 percent of the claimant’s back payment in the event of a win in court. This is standard operating procedure, and the fees should alarm no potential claimant looking for legal representation. However, be advised that the fee is typically deducted from whatever back pay is owed to the claimant first before the claimant receives their benefit.

Expertise in this particular type of disability takes focus. As a result, a Social Security disability attorney that only deals with this type of law is likely your best bet should you have a choice between a lawyer whose time is divided between other areas of the law and one who solely devotes their time to these types of cases.

How to Keep From Treating People With Disabilities Differently

Workshop Goals

To understand the history of American attitudes and legislation regarding people with disabilities;

To learn how to properly assist individuals with disabilities in a courteous and respectful manner;

To practice providing assistance to people with disabilities, both fellow employees and museum guests.

In order to gain the most out of the presentation, please:

  • Listen with an open mind;
  • Be respectful of each other;
  • Challenge your thinking;
  • Be willing to learn something new that you can use on the job!

Challenge Activity

Bean Bags

  • Place a bean bag on your head
  • Move to the music!
  • If your bean bag falls off your head, freeze until another player, without losing his/her beanbag, retrieves the fallen one and replaces it on the frozen person’s head.
  • If the rescuer loses his/her beanbag, then he/she is also frozen until another person appears to rescue them both.

What is the object of the game?

How do you “win”?

What is the advantage of picking up a classmate’s beanbag?

What is the Definition of a Disability?

The Americans with Disabilities Act (ADA), as amended by the ADA Amendments Act of 2008 (ADAAA), prohibits discrimination on the basis of disability in several key areas including: state and local government services, places of public accommodation, employment, telecommunications and transportation.

The individual with a disability is a person who (3 part definition):

  • Has a physical or mental impairment that substantially limits one or more major life activities;
  • Has a record of such an impairment, even if they do not currently have the impairment; or
  • Being regarded as having such an impairment.

What is considered a disability?

The ADA does not list conditions that are considered disabilities; however it does list those which are not included.

Not covered by the ADA are homosexuality, bisexuality, transvestism, transsexualism, compulsive gambling, kleptomania, pyromania, pedophilia, exhibitionism, voyeurism, gender identity disorders not resulting from physical impairments, other sexual behavior disorders.

The ADA does not cover individuals who are currently engaging in illegal drug use.

A short-term condition is generally is not a disability. The test is whether the impairment markedly limits major life activities when assessing the duration, scope, and impact of the impairment.

Small Group Activity

Divide into small to discuss your experiences and examples of instances you have assisted co-workers or museum guests with the following disabilities:

  • Physical
  • Sensory
  • Intellectual or Developmental
  • Emotional
  • Invisible

Remember that each person’s situation is unique!

Physical disabilities: a limitation on a person’s physical functioning, mobility, dexterity or stamina; a short list of examples:

  • Spinal cord injury
  • Amputation
  • Cerebral palsy
  • Multiple sclerosis
  • Spina bifida
  • Musculoskeletal injuries (eg back injury)
  • Arthritis
  • Muscular dystrophy

Sensory impairment: a limitation of one or more of a person’s senses; including:

  • Hearing Loss
  • Tinnitus
  • Limited vision/Blindness
  • Loss of Smell
  • Spatial awareness

A person could be born with the impairment or could it could develop throughout the lifetime.

Intellectual disabilities – significant limitations in both intellectual functioning and in adaptive behavior, which covers social and practical skills. Originates before age 18 years. Affects approximately 3% of the population.

  • Autism Spectrum Disorders
  • Down’s Syndrome
  • Fragile X Syndrome
  • Fetal Alcohol Spectrum Disorder (FASD)

Emotional

  • Mental illness has nothing to do with intelligence.
  • Mental illness is a condition that disrupts a person’s thinking, feeling, mood, and ability to relate to others.
  • Results in a diminished capacity for dealing with everyday life
  • Can include major depression, schizophrenia, bipolar disorder, obsessive compulsive disorder (OCD), panic disorder, and personality disorder.

The Invisibility of Disabilities

Be sensitive that disabilities come in a variety of types, and each person is an individual

The impact of a person’s disability may not be easily seen.

Person may be perceived as lazy, when in fact, the disability impacts his/her ability to learn, work, and function.

Teachers and peers may see only behavior problems or uncooperative behaviors, rather than accommodating the disability.

A Brief History of Legislation

1964 – Title 7 of the Civil Rights Act

1973 – Rehabilitation Act, Section 504

1990 – Americans with Disabilities Act – First comprehensive civil rights law for people with disabilities.

History, continued

2008 – ADA Amendments Act

Expanded definition of the term disability to include individuals with amputations, intellectual disabilities, Epilepsy, Multiple Sclerosis, HIV/AIDS, Diabetes, Muscular Dystrophy, and cancer;

Strikes a balance between employee and employer interests;

Overturned two key Supreme Court decisions (Sutton vs. United Airlines, Inc. and Toyota Motor Manufacturing, Kentucky, Inc. vs. Williams), where lower courts had found individual’s situation did not constitute a disability, therefore the question of discrimination had never been addressed.

American Attitudes – FDR

Franklin Delano Roosevelt

32nd President of the United States from 1933 to 1945.

Had suffered paralysis as a result of Polio.

Although the his use of a wheelchair was common knowledge, the wheelchair was not shown by the media.

Gather Your Thoughts

How do you feel about the cloaked FDR statue?

What do you think is more important: to respect President Roosevelt’s wishes OR to reflect modern views of people with disabilities?

How could this spectrum of opinion be reflected in the workplace?

As a manager, how do you work to bring understanding and acceptance among your staff, while following current ADAAA guidelines?

Let’s examine recent examples of people with disabilities who have achieved celebrity status!

Stevie Wonder

Born prematurely in 1950 in Michigan. Suffered retinopathy of prematurity (ROP), due to too much oxygen in the hospital’s incubator.

Began playing instruments at an early age and signed with Motown Records at age 11. Has had an amazing writing and recording career.

Celebrity spotlights can aid in bringing important issues into the spotlight.

Jim Abbott

Born in 1967, in Flint, Michigan, without a right hand

Baseball star for University of Michigan

Played in the 1988 Summer Olympics

Played Major League Baseball, and pitched a no-hitter in 1993 as a NY Yankee.

Amy Purdee

Born in 1979 in Las Vegas, Nevada

Contracted meningitis at age 19, resulting in double amputation below the knees and kidney transplant

Paralympic Athlete in Snowboarding – Bronze Medalist

Terminology Over Time

Crippled – an invalid and derogatory term that is no longer acceptable to describe people with disabilities;

Retarded – a medical term that can be used as a slur; no longer acceptable in everyday language:

Handicapped – something that hampers or hinders, such as in a race; no longer used in referring to people;

Normal people – avoid using this term when making a comparison, as this implies a person with a disability is not normal. Everyone is unique and has their own identity and abilities;

Person with a Disability – “people-first” language that focuses on the individual, not their condition.

Using People-First Language

American Psychological Association Style guide

  • Person’s name or pronoun first
  • Description of impairment or disability second
  • Descriptors should not modify or limit the person

Examples:

  • A boy with Down’s Syndrome, not “the Down’s Syndrome boy”;
  • Sydney has a hearing impairment, not “the deaf girl.”

Discussion: What Do You Do?

On the Job Situations You May Encounter

A guest arrives at an event with a cat in a stroller. She claims the cat is a service animal. Do you allow her entrance?

A group of 60 children is moving from the 1st floor exhibit to the 2nd floor through the only staircase in the wing. One child is on crutches. As the group’s tour guide, how do you handle the transition between floors?

What Do You Do?

Guidelines to Follow

  • If the guest claims the cat is with her as a service animal, the cat can be permitted to accompany her into the event. She does not need to produce any paperwork to justify the service animal.
  • Review the options with the student’s teacher/chaperone. If the child wishes to take the elevator, suggest a small group of students and an adult accompany her, so she does not feel alone or singled out.
  • Ask the guest if he would like to sit or hold onto in a chair inside the ride.

Employees with Disabilities: What is Reasonable Accommodation?

A reasonable accommodation is assistance or changes to a position or workplace that will enable an employee to do his or her job despite having a disability.

Under the Americans with Disabilities Act, employers are required to provide reasonable accommodations to qualified employees with disabilities, unless doing so would pose an undue hardship

Examples of Reasonable Accommodations

  1. Providing a chair for a cashier who uses crutches so he or she can sit when not assisting customers.
  2. Reserving a parking space close to the entrance for an employee who has difficulty walking because of loss of a limb.
  3. Providing instructions and information in writing for an employee with hearing loss.
  4. Permitting a staff member to bring a service animal to work.
  5. Allowing an employee with tinnitus to play background music to help block out the ringing in his ears.
  6. Allowing more frequent work breaks or providing back-up coverage when an employee with a disability needs to take a break.
  1. Providing specialized equipment for an employee who has lost a hand or finger, such as a large-key keyboard, a one-handed keyboard, a trackball, a touchpad, or speech recognition software.

  2. Flexibility in scheduling to allow an employee with Post Traumatic Stress Disorder to attend counseling sessions or offering a later start time to a staff member with a spinal cord injury who has a lengthy personal care routine.
  3. Decreasing distractions, providing information in writing, breaking down complex assignments into small steps for a person with a traumatic brain injury.
  4. Making sure equipment is within reach for an employee who uses a wheelchair.
  5. Adjusting the height of an office desk for a staff member who uses a wheelchair, and ensuring the space is not obstructed by wastebaskets or other items.

Unacceptable Practices

Examples of A Record or History of Disability

Examples:

  • An employer refuses to hire a qualified candidate due to a history of mental illness, even though the person has recovered sufficiently to perform all essential functions of the job.
  • A dentist refuses to treat a patient because he was diagnosed as having HIV, even though the diagnosis was proven to be incorrect.
  • A retail outlet fires a woman who is pregnant, because they assume she will not be able to work during the busy holiday season.

Unacceptable Practices

Regarded as Having an Impairment

Examples:

  • An employee has controlled high blood pressure, which is not substantially limiting. However, his employer fears that the employee will suffer a heart attack and reassigns the employee to a less strenuous job.
  • A person with a severe burn or scar does not actually have a disability. He may be regarded as having a disability when he faces discrimination based on people’s attitudes toward him.
  • An overweight candidate for a bus driver position is not hired because the employer assumes (without conducting tests) that she will not be able to move fast enough in case of an emergency.

Courtesy

Gum chewing – Do not chew gum when speaking to people with hearing loss. It makes you more difficult to understand

Stand in front – When speaking to people with hearing loss, stand directly in front, so they can see your lips

Paper and pencil – Have a paper and pencil ready, in case communicating through written word may be more effective than spoken word

Sit down – when speaking to a person in a wheelchair, take a seat! Looking upward may hurt their neck, and it is common courtesy to be at eye level.

Ask if the person wants help before acting – Do not assume that someone needs help. Have the respect and courtesy to ask how you may help, and then follow directions

Be patient – Do not roll your eyes, cross your arms, or rush a person who needs extra time.

Use people-first language – always refer to the person first and do not use their situation as a descriptor.

End of Session Quiz

You are at the Information Desk and a guest in a wheelchair has a question. What is the most courteous way to approach the interaction?

An employee you are managing has been diagnosed with multiple sclerosis. She begins to walk with a cane, and is able to perform her job functions as school group facilitator in the laboratory. Discuss what types of accommodations can be made for her.

A child who uses crutches wants to watch the Dive Show at the Kelp Tank. All the seats are filled and many patrons have filled the open viewing area. How do you accommodate the child, so he can see the show?

List 3 new pieces of information that you learned, which you can use on the job.

1- Information Desk

Invite the guest to the side of the counter that is wheelchair accessible.

Sit at the chair, so you are eye-level.

Answer his questions respectfully.

Ask if the guest needs any assistance.

Ask if he is familiar with the location of the elevator.

2- Employee Accommodations

Review the employee’s job duties and discuss if any accommodations need to be made at this time, such as reassignment, additional time for tasks, use of a chair while working.

Make a plan to review her situation as needed, to see if any accommodations or a reassignment needs to be made.

For example, an employee who lead the student experiments in the laboratory could be reassigned to the Information Desk to answer the telephone with a headset.

3- Viewing the Show

  • Given that the situation involves a child, consult with the student’s parents or chaperone.
  • Ask if the child would like to sit by the tank or in the bleachers.
  • Show the family where the seating area for people with disabilities is located.
  • If someone is sitting in that area, respectfully work with the guest to find a spot for the child. Posted signs indicate that the are is reserved for people with special needs.
  • If there is no wiggle room, ask if the child would like a chair to sit, or ask a guest if they would mind moving over to accommodate the child.
  • Remember that you are responsible for the guests during the dive show. Feel empowered to make the situation pleasant for the guests, in a courteous manner. Call your supervisor if you need additional assistance.

The Insurance Science of Disability

If you are young and healthy, you probably have given little thought to the notion of disability insurance. Most employees in this age-range may even scoff it off as negligible in view of their youth.

“Disability insurance? “Compensation if I become unable to work?” they may exclaim. “Why, this is coverage that I do not really need.”

If you would speak to the professionals – those in the trenches when it comes to related liability and insurance claims, you would hear a very different story. In fact, the discussion would lead you to be ever so grateful that you are covered!

Deep down, every person understands that any blessing we have in life should never be taken for granted. Car accidents, business mishaps, home devastation – all these things happen. Likewise no one can guarantee that sickness or illness will not disrupt a life once devoid of it – regardless of the current station one finds oneself in.

Need more on the matter? Here are the sobering facts:

• 1 in 4 young people in the age bracket of twenty years suffer from a long-term illness or injury.

• Each year, there are over 700,000 paid workers and employees that are awarded social security disability insurance benefits.

• In general, 1 in every 15 employees files a short-term disability claim per year.

• Almost fifty percent of all Americans do not have the money to fund a four hundred dollar medical emergency.

• Breaking or fracturing a leg may cause a three month or longer employment disruption.

• On the average, a long term disability insurance claim lasts longer than two years and six months.

• A work related physical disability can be the result of varying factors, including chronic headaches, ongoing backaches, cancer related treatments, treatment, the birth of a new baby, loss of eyesight, heart disease, mental and emotional illness and stokes as well as other maladies and situations.

• The average income of newly graduating higher education students is approximately $1,101. Weigh that with the average long-term disability maximum claim of $125,450 of loss of income.

With the current available data about young working people, a disability that renders someone incapable of working would have devastating effects without the proper insurance coverage.

Did you know?

• Thirty five percent of young employees experience difficulties in meeting everyday monthly costs.

• Close to 70 percent of all US citizens do not have even a thousand dollars in savings.

• To make matters worse, thirty-one percent of those in the age bracket of eighteen years to thirty years have no savings at all.

Life has its monetary responsibilities. These may include rent, mortgage, student loans, auto payments and more. Shield your earnings and the ability to make ends meet by making sure you have protective indemnity of disability insurance.