From the Philadelphia Inquirer:
The pair are homeless. Currently, she sleeps in a bed at Chester County Hospital, while Don sleeps in the chair next to her. Medicaid covers hospital costs. They survive on $350 a month in food stamps, and whatever cash and gas money for Don’s father’s old car, a 2005 Nissan Altima, that friends, Chester County churches, and charitable strangers can give. ...
While Maureen has suffered through three years of chemotherapy, radiation, and other treatments, Don — who once earned $53,000 a year selling parts for BMWs — has been laid off twice, and now devotes his time to caring for his wife and looking for a part-time job.
The couple have applied for Supplemental Security Income (SSI) for Maureen, but have been denied by the federal government three times. SSI, which amounts to about $770 a month, is given to disabled and destitute people who can’t work. Despite a mythology that has grown around the program — that payments are easily obtained by cheating the system — approximately two-thirds of applicants are turned down, federal figures show. ...
Doctors have said Maureen might live a year or less, as cancer has ravaged one breast and lodged in the other. The disease has further metastasized to her lungs and her liver.
“This is a sad case, a sad case,” said Jan Leaf, executive director of the Lord’s Pantry of Downingtown food bank, which offers the Walls food, and has bought them a hot plate so Maureen can eat vegetables. "To see people who worked all their lives, just to end up in this situation ... .
listing met; needs rep and aaod
ReplyDeleteI suppose it's particularly egregious when it is a long-term worker being victimized, but we really need to move away from the framing of "no one who works full time should experience _____" and to the proper "no one should experience_____," which doesn't leave disabled folks and others who simply can't be (that) economically productive out of the mix.
ReplyDelete11:06 are you proposing we need a national guaranteed income?
ReplyDeleteJust want to know who is going to pay for it?
What is the incentive for anyone to work then?
@11:42
ReplyDeleteNot 11:06, but there is a massive distinction between providing benefits which would allow someone to merely subsist, and an amount of money which could even in theory remove the incentive to work.
Also, can you explain why you assume income discourages work? Plenty of people make decent money, but still choose to work. Why are you assuming the average American won't choose to work, even if their basic, immediate, needs are satisfied?
As to paying for some sort of "national guaranteed income," I imagine such a system would be paid through general tax revenue, assuming such a system is truly "national."
Something isn't right with this picture. I know it seems like they are financially destitute but this smells like a technical denial to me. I would get political muscle involved to get to the bottom of it.
ReplyDelete1142 you are either a very pitiful person or a troll who lives in their mom's basement or the equivalent there of
6:10 a.m.--I beg to differ. Of course, the Listing criteria are met; but amending the AOD is not necessarily warranted. Many times during two decades as an ALJ and almost as long as a staff attorney before that I came across attorneys in cases like this who wanted to prove the slam-dunk facts and were willing to sell the rest of their clients' rights for their own convenience. More than once I had to say something like, "Despite your amendment of the alleged onset date to the date the Listing criteria are clearly met, Counsel, we will develop the earlier evidence to protect your client's rights." Often it turned out that the Listing was met earlier than alleged, and/or the effect of all the impairments and of the side-effects of their treatment resulted in an earlier onset.
ReplyDelete@2:10 if 11:42 is living in the basement, you are willing to pay them to be there with a living wage. That makes sense.
ReplyDeleteAnon 11:42 "What is the incentive for anyone to work then?"
ReplyDeleteWhy should there be an incentive to work? This poor woman probably meets some kind of cancer listing at the very least. Let her have some dough before she leaves this Earth.
Agreed w/ Anon 1:38 "As to paying for some sort of "national guaranteed income," I imagine such a system would be paid through general tax revenue, assuming such a system is truly "national."
Politicians like Bernie have floated this idea. Now, I am independent. But Obamacare was the idea of a base-line national health coverage. It needs fixing.
I have lived in Spain, studied law of many European countries, and visited places like Italy and Greece. Now, they tax a lot. But they don't live to work. They work to live. It's a necessity. But they want to enjoy life.
But why can't we come up with some base-line income?
I wonder if the husband's income plus the ISM from their son is too high for her to get SSI and she's no longer insured for SSDI.
ReplyDeleteI "love" how "abled-bodied" and some with "disabilities" that they are able to overcome talk about incentive to work or will power... As if will alone is the difference between "disabled" and "not disabled." They appear to not understand, or have the will to understand, that some of us have been overcoming our disabilities for decades... I am sure you all have heard the expressions "the straw that broke the camel's back" and "death by a thousand paper cuts." Just because you were able to overcome yesterday, it doesn't mean you will be able to tomorrow as additional issues get in your way. If will alone could make you overcome, would Peyton Manning still be playing quarterback in the NFL? Would Michael Jordan still be playing in the NBA? Will can only take you as far as the body allows.
ReplyDeleteAssuming the facts are as stated, a big assumption I know, it is possible that the case is pending at a hearing office and waiting for a hearing. In those cases, particularly if unrepresented, no one will be looking at the case until it is ready to be scheduled, if it is looked at even then on a substantive basis.
ReplyDeleteYes, an OTR could be requested, but no claimant knows to do that on their own.
Could an amended onset be appropriate? Sure, but what date should that be? The suggestion from the former ALj above to the effect that the day it met the Listings, i.e. the day the cancer was found to have metasticised, may or may not make sense. Was she well the day before?
Facts matter, and it is not at all clear what the facts are in this case.
I don't understand why someone "who worked their whole life" is hanging their hat on SSI instead of social security disability.
ReplyDeleteOur cultural forebears from Europe did create generous social safety net programs that include medical care but they also tend to have stronger pushes into work than our programs and they also tend to devote time and money to skills development for those capable of work.
US has taken the stance of give people a roughly subsistence income and they will go to work to avoid starvation even if they don't have any unemployable skills they will magically go to work.
This sounds like a technical denial of SSI based on financial eligibility, rather than a medical denial. But the article is annoyingly vague on details.
ReplyDeleteSomething is missing from this story. Terminal (TERI) cases are given very high processing priority. Either it is a tech denial or not a TERI case, or both.
ReplyDeleteANONYMOUS AT 6:42AM HIT IT ON THE HEAD. THE STORY IS VAGUE, AND SINCE SHE IS IN A HOSPITAL COVERED BY MEDICAID ALMOST ANY OTHER INCOME WOULD MAKE HER INELIGIBLE-NOT A MEDICAL DENIAL BUT A TECHNICAL DENIAL
ReplyDeleteShe is lucky she has Medicaid because in some states you do not qualify for Medicaid without qualifying for disability. And in some getting DIB benefits kicks you off from getting Medicaid because of income even though you still do not qualify for Medicare because you have not been disabled for two,years yet. Someone who has breast or colon cancer may be denied initially because the cancer has not yet metastasized or encoached far enough. Once it does metastasize if they re- apply the DDS can reopen the prior determination without the need to go,to the ALJ. As others have said there is not enough info in this story to know what the situation is in this case.. I have seen technical denials agent some kind hearted soul started a go fund me for the person. I have also seen cases where person had insurance but were denied coverage because the insurance company erroneously stated it was a pre-existing condition.
ReplyDelete