Understanding the DDS Appeal Process: What Happens, Who's Involved, and How to Make It Easier

Written By Rick Gach If you're applying for Social Security disability benefits, a recent rule change by the Social Security Administration (SSA) could have a significant impact on your claim. Effective June 8, 2024, the SSA will be making changes to how they evaluate your past work when determining your eligibility for disability benefits. Under the new rule, the SSA will only consider jobs you've held within the past 5 years as relevant to your disability claim. This is a significant reduction from the previous 15-year period. Additionally, any past work that lasted fewer than 30 calendar days will no longer be considered as part of your work history. What does this mean for you? In short, these changes should make the disability application process less burdensome and more focused on your recent work experience. You'll no longer need to struggle to remember details of jobs you held more than 5 years ago, which can often be difficult and lead to errors in your application. By focusing on your more recent work history, the SSA aims to improve the accuracy of the information you provide and potentially speed up the decision-making process. Another positive aspect of this rule change is that the SSA is updating its work history report forms and instructions. The new forms will align with the 5-year relevant work period and exclude jobs lasting under 30 days. This should make completing the paperwork easier and less time-consuming for you. It's important to note that the SSA expects this rule change to result in an increase in disability benefit approvals. While this may lead to higher program costs, the SSA believes that the benefits to claimants like you justify the expense. During the rulemaking process, most commenters supported the proposed changes, recognizing the positive impact they could have on the lives of disability applicants. As you prepare to file your disability claim or if you're in the midst of the application process, be sure to keep this new rule in mind. If you have any questions about how the changes might affect your specific case, don't hesitate to reach out to the SSA or your disability attorney for guidance. Remember, the SSA's goal with this rule change is to make the disability application process more manageable and efficient for you. By reducing the burden of providing extensive work history details and focusing on your more recent and relevant experiences, the SSA hopes to provide better service and support as you navigate your disability claim. If you have any questions about how the new Social Security rule might impact your disability claim or if you need assistance navigating the application process, the experienced attorneys at Hogan Smith SSD are here to help. With a deep understanding of the ever-changing disability claim landscape, we can provide you with the guidance and support you need to maximize your chances of success. Don't let the complexities of the disability claim process overwhelm you. Call Hogan Smith SSD today at 407-377-0700 or visit our website at www.hogansmithssd.com to schedule a consultation with one of our knowledgeable attorneys. Let us put our expertise to work for you and help you secure the disability benefits you deserve. Source: https://www.federalregister.gov/documents/2024/04/18/2024-08150/intermediate-improvement-to-the-disability-adjudication-process-including-how-we-consider-past-work#print

Written by Rick Gach If you or a loved one receives Supplemental Security Income (SSI), a recent policy change from the Social Security Administration (SSA) could significantly impact your monthly benefits. As of September 30, 2024, rental subsidies will no longer count as income when calculating SSI eligibility and payment amounts. This is a substantial shift that could provide a much-needed financial boost for SSI recipients nationwide. What does this mean for SSI beneficiaries? Let's break it down: Currently, if an SSI recipient receives free or reduced rent, such as living with a family member rent-free, the SSA considers this "in-kind support and maintenance" (ISM). The value of this ISM is counted as income, which reduces the individual's SSI payment. For example, if an SSI recipient receives $300 worth of ISM in the form of free rent, their monthly SSI payment would be reduced by $300. Under the new rule, effective September 30, 2024, rental subsidies will no longer be counted as ISM. This means that SSI recipients who receive free or reduced rent will be able to keep their full SSI payment without any reduction. In the example above, the individual would receive their full SSI payment (e.g., $914 in 2023), even while benefiting from the $300 rental subsidy. This policy change is a significant win for SSI beneficiaries. It allows individuals to maintain stable housing situations with support from family or other sources without jeopardizing their SSI benefits. The extra money in their monthly SSI checks can make a real difference in covering essential expenses like food, healthcare, and utilities. Moreover, this change may allow more individuals to qualify for SSI in the first place. By excluding rental subsidies from income calculations, some people who were previously over the income limit may now be eligible for SSI benefits. If you or someone you know receives SSI and benefits from a rental subsidy, it's important to understand how this policy change may impact your situation. As always, our team at Hogan Smith is here to help navigate the complexities of SSI and ensure you receive the maximum benefits you deserve. Contact us today to discuss your case and learn more about how this new rule may apply to you.

Written By Rick Gach The Social Security Administration (SSA) provides financial assistance to millions of Americans through various programs, such as retirement, disability, and supplemental security income (SSI). In some cases, the SSA may require a representative payee to manage the benefits on behalf of the recipient. This blog post will explore the reasons behind this requirement and the rights of beneficiaries in choosing their representative payee. Why Does the SSA Require a Representative Payee? The SSA may determine that a beneficiary needs a representative payee if they believe the individual cannot manage their finances independently. This decision is made to ensure that the benefits are used for the recipient's basic needs and well-being. Some reasons why the SSA might require a representative payee include: Mental or physical impairments that hinder the ability to manage finances History of substance abuse or mismanagement of funds Being a minor child receiving benefits The representative payee is responsible for using the benefits to pay for the beneficiary's living expenses, such as food, housing, medical care, and personal needs. They must also keep accurate records of how the funds are spent and report to the SSA when required. Your Rights in Choosing a Representative Payee As a beneficiary, you have the right to participate in selecting your representative payee. The SSA will consider your preferences when appointing a payee, but they must also ensure that the chosen individual is suitable for the role. Here are some key points to keep in mind: You can suggest a preferred representative payee to the SSA, such as a family member, friend, or organization you trust. If you disagree with the SSA's choice of representative payee, you have the right to appeal the decision and present evidence supporting your preferred choice. You can request a change in representative payee if you believe the current payee is not acting in your best interests or mismanaging your benefits. If no suitable family member or friend is available, the SSA may appoint an organizational payee, such as a social service agency or non-profit organization. It is essential to choose a representative payee whom you trust and who will prioritize your well-being. Open communication with your payee is crucial to ensure that your needs are met and that your benefits are being managed appropriately. Conclusion The representative payee system is designed to protect the interests of Social Security beneficiaries who may have difficulty managing their finances. While the SSA makes the final decision on appointing a payee, beneficiaries have the right to participate in the selection process and voice their preferences. By understanding the role of a representative payee and your rights as a beneficiary, you can work towards ensuring that your benefits are managed effectively and in your best interests. SSI - Representative Payee

In a significant move to improve access to critical benefits, the Social Security Administration (SSA) has published a final rule titled "Omitting Food from In-Kind Support and Maintenance (ISM) Calculations." This rule, set to take effect on September 30, 2024, is the first of several updates to the agency's Supplemental Security Income (SSI) regulations aimed at helping people receiving and applying for SSI. The SSI program provides monthly payments to adults and children with disabilities or blindness, as well as adults aged 65 and older, who have limited income and resources. These benefits help cover basic needs such as rent, food, clothing, and medicine. To be eligible for SSI, applicants must meet specific requirements, including income and resource limits. Under the previous rules, ISM included food, shelter, or both that a person receives, and the agency counted ISM as unearned income, potentially affecting a person's eligibility or reducing their payment amount. The new rule removes food from ISM calculations, eliminating a significant barrier for SSI eligibility due to an applicant's or recipient's receipt of informal food assistance from friends, family, and community support networks. This change brings several important benefits: 1. The new policy is easier to understand and use by applicants, recipients, and agency employees. 2. Applicants and recipients will have less information to report about food assistance received from family and friends, reducing a significant source of burden. 3. Reducing month-to-month variability in payment amounts will improve payment accuracy. 4. The agency will see administrative savings because less time will be spent administering food ISM.  As a representative for claimants in their disability claims with the SSA, I welcome this change. The removal of food from ISM calculations will help more individuals access the critical benefits they need to support themselves and their families. By simplifying the application process and reducing the burden on applicants, the SSA is taking a significant step towards promoting equity and removing barriers to accessing payments. The SSA has stated that it will continue to examine programmatic policy and make regulatory and sub-regulatory changes as appropriate. In the coming weeks, we can expect more announcements related to the SSI program, further demonstrating the agency's commitment to improving access to benefits for those who need them most. If you or someone you know is interested in applying for SSI, visit the Social Security Administration's website for more information on eligibility and how to apply. As always, if you need assistance with your disability claim, do not hesitate to reach out to a qualified representative who can guide you through the process and help ensure you receive the benefits you deserve.

If you're in the process of applying for Social Security Disability benefits, you may be asked to have a friend, family member, or caregiver complete a Third Party Function Report. This form, also known as the SSA-3380-BK, is designed to provide the Social Security Administration (SSA) with valuable insights into your daily activities, limitations, and overall functioning. In this blog post, we'll walk you through the key steps and tips for completing this important form. 1. Choose the right person: Select someone who knows you well and has regular interaction with you, such as a close family member, friend, or caregiver. This person should be able to provide accurate and detailed information about your daily activities and limitations. 2. Provide specific examples: When describing your limitations, it's essential to be as specific as possible. Instead of simply stating that you have difficulty walking, provide concrete examples, such as "I can only walk for 10 minutes before needing to rest due to severe back pain." The more detailed the examples, the better the SSA can understand your situation. 3. Be honest and comprehensive: It's crucial to provide an honest and complete picture of your daily challenges. Don't downplay or exaggerate your limitations. Be sure to include information about any assistance you require or adaptive devices you use to complete daily tasks. 4. Discuss the impact on daily activities: Focus on how your impairments affect your ability to perform everyday tasks, such as personal care, household chores, and social interactions. Provide examples of activities you struggle with or can no longer do because of your condition. 5. Address good days and bad days: Many people with disabilities experience fluctuations in their symptoms. It's important to discuss how your condition varies on good days versus bad days, and how often you experience each type of day. 6. Collaborate with the person completing the form: Work closely with the person filling out the Third Party Function Report on your behalf. Schedule a meeting or phone call to discuss your daily experiences, challenges, and limitations in detail. This collaboration will help ensure that the information provided is accurate and comprehensive. 7. Review the completed form: Before the Third Party Function Report is submitted, take the time to review the form for any errors, inconsistencies, or omissions. If necessary, provide additional information or clarification to ensure that the SSA has a clear understanding of your situation. Remember, the Third Party Function Report is an opportunity for the SSA to gain a better understanding of how your impairments affect your daily life. By following these tips and providing detailed, accurate information, you can increase your chances of a successful disability claim. If you have any questions or concerns about the Third Party Function Report, don't hesitate to reach out to your disability attorney or advocate for guidance.

Medicare is a health insurance plan for people who are age 65 or older. People who are disabled or have permanent kidney failure or amyotrophic lateral sclerosis (Lou Gehrig’s disease) can get Medicare at any age. Medicare has four parts: Hospital insurance (Part A) helps pay for inpatient hospital care and certain follow-up services. Medical insurance (Part B) helps pay for doctors’ services, outpatient hospital care and other medical services. Medicare Advantage plans (Part C) are available in many areas. People with Medicare Parts A and B can choose to receive all of their health care services through a provider organization under Part C. Prescription drug coverage (Part D) helps pay for medications doctors prescribe for medical treatment. Who is eligible for hospital insurance (Part A)? Most people get hospital insurance when they turn 65. You qualify for it automatically if you are eligible for Social Security or Railroad Retirement benefits. Or you may qualify based on a spouse’s (including divorced spouse’s) work. Others qualify because they are government employees not covered by Social Security who paid the Medicare tax. If you get Social Security disability benefits for 24 months, you will qualify for hospital insurance. If you get disability benefits because you have amyotrophic lateral sclerosis (Lou Gehrig’s disease), you do not have to wait 24 months to qualify. Also, people who have permanent kidney failure that requires maintenance dialysis or a kidney replacement qualify for hospital insurance if they have worked long enough or if they are the spouse or child of a person who has worked long enough. Who can get medical insurance (Part B)? Almost anyone who is eligible for hospital insurance can sign up for medical insurance. Part B is an optional program. It is not free. In 2008, the standard monthly premium is $96.40. Some people with higher incomes will pay higher premiums. Who can get Medicare Advantage plans (Part C)? Anyone who has Medicare hospital insurance (Part A) and medical insurance (Part B) can join a Medicare Advantage plan. Medicare Advantage plans include: Medicare managed care plans; Medicare preferred provider organization (PPO) plans; Medicare private fee-for-service plans; and Medicare specialty plans. You might have to pay a monthly premium because of the extra benefits the Medicare Advantage plan offers. Who can get Medicare prescription drug coverage (Part D)? Anyone who has Medicare hospital insurance (Part A) or medical insurance (Part B) or a Medicare Advantage plan (Part C) is eligible for prescription drug coverage (Part D). Prescription insurance is optional, and you pay an additional monthly premium for the coverage. For more information, contact SSA and ask for Medicare (Publication No. 05-10043). Help with Medicare expenses for people with low income. If you have a low income and few resources, your state may pay your Medicare premiums and, in some cases, other “out-of-pocket” medical expenses, such as deductibles and coinsurance. Only your state can decide whether you qualify for help under this program. If you think you qualify, contact your state or local medical assistance (Medicaid) agency, social services or welfare office. You can get more information about this program from the publication, If you need help paying Medicare costs, there are programs that can help you save money (Publication CMS-10126). To get a copy, call the Medicare toll-free number, 1-800-MEDICARE (1-800-633-4227). If you are deaf or hard of hearing, you may call TTY 1-877-486-2048. “Extra help” with Medicare prescription costs : If you have limited income and resources, you may qualify for extra help to pay for your prescription drugs under Medicare Part D. Social Security’s role is to help you understand how you may qualify and to process your application for extra help. To see if you qualify or to apply, call Social Security’s toll-free number or visit our website.

During a trial work period, a beneficiary receiving Social Security disability benefits may test his or her ability to work and still be considered disabled. We do not consider services performed during the trial work period as showing that the disability has ended until services have been performed in at least 9 months (not necessarily consecutive) in a rolling 60-month period. In 2007, any month in which earnings exceed $640 is considered a month of services for an individual's trial work period. In 2008, this monthly amount increases to $670. Monthly earnings that trigger a trial work period Year Monthly earnings: 1978 & prior $50 1979-1989 75 1990-2000 200 2001 530 2002 560 2003 570 2004 580 2005 590 2006 620 2007 640 2008 670

THE SAVAGE TRUTH | Enrollment time is here again -- follow these steps to choose what works best November 17, 2008 TERRY SAVAGE savage@suntimes.com Here we go again. Starting today, seniors have six weeks to sign up for another year of Medicare Part D -- the prescription drug benefit -- that goes along with Medicare Part A (hospitalization), Part B (outpatient and doctor costs) and Medigap (the supplement that covers other costs including co-payments and deductibles). It's a must-do project, even if you're among the few seniors who don't currently take prescription drugs. If you don't sign up when you first become eligible, there will be big penalties to pay once you do need some prescriptions -- and for sure you will need them at some point. The Medicare.gov Web site sorts through all of the alternative plans to find you the best coverage at the least cost in a plan that is available at a pharmacy near you. The only exceptions are those seniors who are covered by a comparable company or retiree prescription plan, or those who have signed up for an all-in-one Medicare Advantage plan. Some seniors have prescription drug access through the Veterans Administration, though they may want to choose an inexpensive Part D plan for drugs the VA does not cover. For those who recently turned 65 and now qualify for Medicare, this will be the first time going through the process of choosing the least-expensive plan. But every senior, even those currently enrolled and happy with their drug plan, should go through the process of reviewing the alternatives for 2009. That's because each year, the plans change the prices of the drugs they cover and may not even include the same medicines in the year ahead. So here's my annual, step-by-step guide through the Medicare.gov Web site, the only place that can sort through all of the alternative plans to find you the best coverage at the least cost in a plan that is available at a pharmacy near you! Finding your plan at Medicare.gov Step 1. Get a complete list of all of the medicines and dosages you are now taking. The easiest way is to ask your pharmacist for this list, or simply line up all of your prescription bottles. Step 2. Go to www.Medicare.gov. (If you don't have a computer, you can call 800-MEDICARE, and they will help you through this process over the telephone.) Step 3. Click on the line near the top of the first page screen that says: "Medicare Prescription Drug Plans -- 2009 Plan Data." Step 4. On the next page, click on the box that says "Find and Compare Plans." Step 5. On the next page, you have a choice of either a "personalized" search or a "generalized" search. If you already have your red, white, and blue Medicare card, you can use the personalized search, in which you input your Medicare number and other information from your card. (You can use the generalized search to find and compare plans in your ZIP code.) Step 6. On the next page, you can enter the drugs you are currently taking, and the dosages. Even if you do not take prescription drugs now, you must fill out this page, stating that fact. This list can be saved securely for your future visits to Medicare.gov. You can either type in the names of your drugs, or search for them alphabetically. The most common dosage will automatically pop up, but you should be sure that is the dosage you are taking. The program will also let you know if there is a less-expensive generic available. When you've finished listing your prescriptions, click "continue" to move on to the next page where you can recheck the list of names and dosages. Then click "continue" again. Step 7. You'll be asked if you have a specific pharmacy that you'd like to work with -- one that's within walking distance of your home, for example. Then click again. Step 8. You've finally arrived at the most important page -- the one that lists all of the plans, ranked with the lowest total cost at the top of the list. You can select up to three plans to compare. You can click to see how you might lower your cost, perhaps by switching to a generic. Or the program might suggest an alternative but less-expensive drug in the same category. That's something you'd have to discuss with your physician. This year, there are also "star" ratings, up to five stars, based on a survey done for Medicare about the quality and performance of those plans over the last year. Step 9. After comparing the plans by cost, click on the name of each plan provider to find full details, including a helpful graph of the average monthly cost, as well as information about participating pharmacies and mail order availability. You can print out the pages for each plan, and keep them handy. Step 10. Before signing up, call the plan's toll-free number and reconfirm their prices and coverages for the drugs you take, as well as all co-payments. Then you're ready to ask them to send you the application so you can sign up! A plea for help: Government should be required to make these decisions easier for seniors. But since it hasn't, I'm asking the more computer-literate among you to clip this column, find a senior, and offer to help. It's easy once you've done it. And that's The Savage Truth. Terry Savage is a registered investment adviser. Distributed by Creators Syndicate. Copyright Terry Savage Productions Ltd. Visit www.terrysavage.com and suntimes.com.

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