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New to this....need answers please

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Old 10-14-2008, 10:19 PM   #1
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New to this....need answers please

After being diagnosed with stage 4 breast cancer on 8-3-08 and began treatment, my doctor said she would support my decision to apply for SSDI in case I couldn't return to work in February. Of course I'm hoping for the best but trying to plan since I'm alone and have only my income to rely on. So I started the process online then spoke to a SS rep who took the rest of my application, I mailed them the paperwork they needed and now the wait starts. He did say something about "expediting" the application.
Question: I understand the trial work period but do I have to wait until approval and benefits started?

Question: Is there anyone who has purchased their own medical insurance even with the disability they have and what's your experience with it?

Thank you

Last edited by Mod08; 10-15-2008 at 04:13 PM.

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Old 10-15-2008, 09:22 AM   #2
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Re: New to this....need answers please

I'm not sure I understand this question; "I understand the trial work period but do I have to wait until approval and benefits started?"

As for medical insurance, it is my understanding that you can't get Medicare benefits until you've been approved for and receive SSDI benefits for 24 months. I'm in the appeals process right now after being denied SSDI and rely soley on my husband's health insurance from his work.

I hope they indeed expedite the process for you!

Old 10-15-2008, 09:46 PM   #3
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Re: New to this....need answers please

Originally Posted by wayover20 View Post
Question: I understand the trial work period but do I have to wait until approval and benefits started?
I will try to help you the best I can...It can be confusing, so hang in there with me and ask all the questions you want. If anyone catches a mistake I make, by all means, please correct me.

Your application date may or may not be your qualification date. On your application, you have to list when you became disabled. This is called your "onset date" and is what SS goes by. If you are approved at some point (could be a short time period, or a long one), SS backdates you back to this date.

Once you qualify for SS benefits, you can receive Medicare 24 months later. However, there is a 5 month waiting period before you are eligible for SS benefits, so it's really 29 months (from your onset date).

So, lets do a quick example......Say you apply today, but your disability date is 8-3-08. There is a 5 month waiting period, thus, you will become eligible to start receiving SS disability on Jan 3 2009. Twenty four months later, or Jan 3 2011, you will be eligible for Medicare.

Let's say for the sake of argument, SS doesn't approve you for disability until sometime next Spring or Summer. It doesn't matter how long it takes, they will still back date you to your onset date, or 8-3-08. Some are approved right away, while others must wait a very long time. There seems to be little rhyme or reason as to why. A search of these boards will yield all sorts of stories on the subject.

Now, the "trial work period" is where it gets confusing. The trial work period allows a person to test their ability to work. During your trial work period, you will receive your full disability benefit regardless of how much you earn as long as your work activity has been reported and you continue to have a disabling impairment. Your trial work period will last until you accumulate 9 months within a rolling 60-month period (5 years). The 9 months do not have to be consecutive.

The amount goes up each year, but in 2008, any amount earned over $670 is considered a "trial work period." If you make less than $670, then it's not considered a trial work period.

If you complete a trial work period (9 total months), you have 36 months during which you can work and still receive benefits for any month your earnings are not “substantial.” In 2008, earnings of $940 or more are considered substantial. No new application or disability decision is needed for you to receive a Social Security disability benefit during this period. If you make over $940 on any given month, then your benefits stop.

If your benefits stop because your earnings are substantial, you have five years during which you may ask SS to start your benefits immediately if you find yourself unable to continue working because of your condition. You will not have to file a new disability application and you will not have to wait for your benefits to start while your medical condition is being reviewed to make sure you are still disabled.

If your Social Security disability benefits stop because of your earnings, but you are still disabled, your free Medicare Part A coverage will continue for at least 93 months after the nine-month trial work period.

If you lose your job during a trial work period, your benefits are not affected. If you lose your job during the 36-month extended period of eligibility, your benefits will be reinstated as long as you are still disabled.

This is the very important part......Where people tend to get in a bind (me included) is that they apply for SS disability, but they continue to work or work part time as a means to pay the bills. Not only will SS look at this when they review your application, but once your award is backdated, those months you work are counted towards your trial work period (if over the max amount listed).

I know what you're thinking....It's crazy! But, that's SS. It doesn't seem fair....A person applies for SS disability, but because they are waiting on a decision, they must work to pay some basic bills. Very few have enough savings built up to support themselves without jepordizing their benefits.

If you have to work, the key is I think, to either stay below the $670, or if you have to make more, don't go over 9 months. Of course, you have to also remember that until you are officially awarded benefits, they will be looking at any type of income. It's a real catch 22! I've read stories here where some have literally crawled into work in order to earn some money as the only means to support themselves because they are waiting patiently for SS to make a decision.

I highly recommend that you become aware of all the details. I would go to SS and get a brochure on the topic, or make an appointment with someone at SS and get your questions answered. What you don't want to do is miss out on some much needed benefits due to a technicality, or just miss the cut off amounts because you weren't aware of how much one can make & etc.

Originally Posted by wayover20 View Post
Question: Is there anyone who has purchased their own medical insurance even with the disability they have and what's your experience with it?
You will need some type of insurance until Medicare kicks in....Whether it be your prior employers, Cobra, or whatever. You can also purchase your own independent policy if needed. You would just need to search around and pick one that best fits your needs and has a good balance between cost and benefits provided.

Lastly, you can have insurance in addition to Medicare (say a spouse or independent policy). You just have to specify which is the "primary" and which is the secondary. The Medicare rules permit this.

Take care, and let me know if I can help further.



Last edited by Executor; 10-15-2008 at 10:12 PM.

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