Florida Special Needs Law Blog : Florida Special Needs Lawyer & Attorney : David J. Lillesand : Lillesand & Wolasky Law Firm : Disability, Medicaid, Special Needs Trusts : Miami, Gainesville, Florida

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The Supreme Court decision on the Affordable Care Act (ObamaCare) has tremendous implications for our practice, primarily negative, but is a huge boon to planning for persons with disabilities who have been shut out of the private insurance market in the past.  Our law firm's loss is our clients' gains, and we couldn't be happier about it.

Depending on the November election, if Obama is re-elected, our clients with Special Needs Trusts will have the option to get off of public health programs, like Medicaid, and begin to pay for private health insurance from private health companies.  For the reasons mentioned in the attached "Commentary", we believe there are substantial resons why this will be appealing to many.  Whether, how and when to do it, however, will require a careful analysis of individual client's needs.  Click the link below:

www.floridaspecialneedslaw.com/uploads/file/Lillesand - Commentary on the Impact of Affordable Care Act.pdf

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We're working on an appeal of another attorney's client's case that was lost at a Social Security Adminsitration Administrative Law Judge hearing.  In reviewing the twelve page decision, we find the judge wrote the following (the typos are ALL his):

"Rather, when examined by Dr. Miguel xxxx, a psychiatrist at the request of the office of Dislikable Dtermiatnos, the claim was fully oriented and his speech was coherent and relevant.  While he seemed anxious, he was attentive and denied any suicidal intention so r ideas.  He also denied any homicidal ideas.  There w err no signs of hallcuiotnsm delusions, bizarre behavior and his cognitive function was age aprpruioatpe. HTer ewe rno signs of hyperactive or attendtion difficulties.  he knew the date, his socials ruvity number and his abstract thinking was intact. (Exhibit 9)."

Where to start.  The Office of Disability Determinations, labeled not-so-inaccurately as the "office of Dislikable Dtermaitnos" is not even called that any more.  And on, and on.  It will make funny reading for the Appeals Council at least while we win this man's case.

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It would be difficult to underestimate the positive impact of ObamaCare - the Affordable Care Act - on persons with disabilities.  In the last two weeks, I have had three clients who were seeking a finding of "disabled" by the Social Security Administration because being found eligible for a monthly disability check would qualify them to receive health care.  None of them are now that they can purchase health insurance.

The private profit-making health insurance industry will not take individuals with pre-existing health conditions.  One client, a published author, had lost her health insurance when she developed Crohn's Disease.  Although it was initially somewhat managed, painfully, by medications, she now needs to have many feet of necrotic intestinal tissue removed surgically from her stomach.  Even though she has money, no insurance company would sell her health insurance.  She has too much money for Medicaid eligibility.  She will die without surgery.

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Each year the Social Security Administration announces in October if there will be any changes in the amount of payments of SSI and SSDI due to Cost of Living Adjustments.  The new payments for SSI for 2012 are $698 to and individual, and $1048 to a married couple who are both on SSI.  SSI is the welfare disability program for persons who were disabled since birth or who haven't paid sufficient minimum taxes to qualify.

SSA administers another program for persons with disabilities who did pay taxes.  The payments for persons on Social Security Disability Insurance (SSDI) benefits are based on the amount of Social Security taxes paid during their working years. 

The average benefit paid to a disabled worker, his spouse and one or more children in $1,892 per month.

See the full description of benefits see www.floridaspecialneedslaw.com/uploads/file/2012 Social Security NUMBERS.pdfre.

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Congratulations and a  big thank you to our Florida Congressmen, Ander Crenshaw and Kendrick Meek, who have introduced legislation to allow families to plan for their loved ones with some significant tax saings.   Information on the bill follows.  To see the bill in its entirety, click on H.R. 1205.

Disability Savings Accounts

The bipartisan Achieving a Better Life Experience Act of 2009 (ABLE Act), H.R.1205/S. 493, was introduced in both the House and Senate on February 26.  The bills would allow individuals and families to establish special accounts for meeting the future needs of children and adults with disabilities.  Funds in the accounts and expenditures which meet the requirements of the bills would not affect the individuals' eligibility for federal benefits.  Using these accounts, parents would be able to save funds for a child's future in a manner similar to the special "529 accounts" currently used to save for a child's future educational expenses.  The House bill was introduced by Rep. Ander Crenshaw (R-FL) along with Representatives Patrick Kennedy (D-RI), Cathy McMorris Rodgers (R-WA), and Kendrick Meek (D-FL).  The Senate bill was introduced by Senator Robert Casey, Jr. (D-PA) along with Senators Sam Brownback (R-KS), Richard Burr (R-NC), Christopher Dodd (D-CT), Orrin Hatch (R-UT), and Edward Kennedy (D-MA).  The bills were referred to the House Ways and Means and the Energy and Commerce Committees and to the Senate Finance Committee.  The Arc and UCP worked with the sponsors and with other supporting organizations on development of the bills.

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If you've ever wondered how the Social Security Administration decides whether a person is disabled, look here.

If you've wondered what are the steps to get disability, look here, and note the length of time between each step.

If you're absolutely bewildered by the length of time it takes to get a hearing before a federal Administrative Law Judge, read some of the entries on NOSSCR's collection of news and editorials on the scandal (scroll down on the web-page to see the articles).  Last year, SSA judges heard 550,000 cases.  Unfortunately, the backlog grew to 750,000 severely disabled people waiting to get a hearing.

In the 1990's we had a system in place that moved the cases much more quickly.  But that was before all the tax cuts and then the staff cuts - eliminating or not replacing judges, secretaries, and other staff.  We are now operating with a Social Security staff workforce that is the same size as when John Kennedy was president, and the population was 179 million, not the 304 million we have now.

You can't have a hearing without a judge.  And a judge can only hear 15-20 cases per week.  Less judges means long, long delays waiting for a judge to be assigned and your hearing to be scheduled by SSA.

More funding, more judges, more judges, less delay in getting a hearing.  Write your congressman!

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On July 19, 2008, we will all have access to a new Internet tool courtesy of the Social Security Administration.  It is called the benefit estimator, and will allow each of us to secure a reasonably accurate estimate, online, of our Social Security retirement or disability benefit monthly check amount. 

The benefit estimator will use live SSA records to make the calculations.  We will have to enter some identifying information on the SSA website for authentication purposes.  We will then be able to check out different scenarios and see how our benefits would be impacted, such as taking early retirement at age 62, or waiting to full retirement age, such as age 66 or 67.

Check SSA's main web-pageafter July 19th for instructions.

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Until recently, if you wanted to see what SSA was up to in terms of proposing new regulations, you would go to policy information page on the Social Security Administration's main website.

Under a new policy, all federal agencies' proposed regulations, and other announcements, will appear on a new website called Regulations.gov.  One of the neat things about the website, is that we can sign up for notification of any new proposed regulations by whatever agency we're interested in.  We will be sent an email.

This is an important development because it makes it easier to alert the public so that timely comments can be made to proposed regulations before they are adopted.  These NPRM items, "Notice of Proposed Rule Making" are published in the Federal Register pursuant to the Administrative Procedures Act.  But wading through the Federal Register every day or each week is tedious.  Now the Internet will do it for us!