Articles from prior issues of The Advocate

March/April 2001

President's Message

ANYONE WHO HAS BEEN INVOLVED in Social Security disability learns rather quickly that the Title II (DIB) allowances and the Title XVI (SSI) allowances are entitled differently for both cash benefit payments and medical coverage. The Title II recipient has a five month waiting period from his established onset before being eligible for his first check. He also has to wait two more years in order to qualify for medical coverage under Medicare. On the other hand, an SSI recipient is eligible for a check the month after filing and for Medicaid in the month of filing. One cannot help but question the unfairness of this, and NADE has broached this subject many times in the 20 years I have been a member. I know that eliminating the waiting period for benefits and/or medical insurance would be a costly endeavor but it is the right thing to do. Two years ago I asked that the issue of the five month waiting period be put on the Mid-year Board agenda because, as a supervisor, I had seen so many tragic cases where this waiting period meant little or no assistance because the claimants died before that period was up or shortly thereafter. Even when death is not eminent, the waiting period often imposes severe economic hardship on claimants who do not have private disability policies. The Board all agreed that we would prepare a Position Paper urging repeal of the Title II waiting period. We have Jeff Price to thank for researching and then penning the paper which is reprinted in this issue.

To further illustrate, let me tell you about a couple of memorable cases adjudicated in my unit. Melissa had a case of a claimant who had cancer of an unknown origin. Medical records showed significant metastatic disease but the claimant enjoyed his work and really did not want to accept the severity of his condition. He continued to work for months until he fell down on the job one day in severe pain and had to be transported to the hospital. The examiner contacted his employer hoping that she could document subsidy or an unsuccessful work attempt and thus establish an earlier onset, but his supervisor was not only unaware of the claimant’s condition, he noted that the claimant only missed a few days of work and his job performance, amazingly, was not diminished. This was a younger claimant who told the examiner that he kept working because he had a wife and children and he did not want to let them down and have his children do without because he could not provide for them. Of course this was a DIB only case so benefits were delayed by the five month waiting period.

In another interesting case, a 49 year old claimant had been having passing out spells for over a year but had just started to see a doctor. There was no real diagnosis when the case was adjudicated and the claimant was denied. Later, the examiner received medical information which provided a definitive diagnosis of multiple sclerosis so she recalled the case and was able to allow but had to establish an adverse onset. The claimant had been fired from his job and his wife was working two jobs but her income wasn’t sufficient for them to pay their mortgage. They lost their home and had to move in with a relative. Shortly after the case was allowed, the claimant’s wife called and explained that her husband had recently died in his sleep from complications. In this case, he died in the five month waiting period and was therefore not eligible for benefits.

In the last few weeks I have probably seen almost a dozen TERI cases. The examiners work very hard to expedite those claims, but one commented to me just today that it really didn’t matter because all of hers had worked up to the last month or so and would still have to wait for a check even though they received a speedy decision. That is truly sad but true all too often. Recently we were delighted to learn that legislation had been introduced that would not only eliminate the five month waiting period but would also waive the 24 month wait for Medicare. We need to do all we can to support this bill. We need everyone to be involved in promoting our position on eliminating the waiting period so please contact your legislators today. As always, I appreciate your commitment to our organization. Thank you.