How does one get Medicare

March 15, 2009 at 3:10 am

I have a 1 page form (front & back) that doctors can fill out to describe your limitations to Social Security in detail so that SSA doesn’t have to try to infer your limitations from the hundreds if not thousands of medical documents they receive. Sometimes it seems to be helpful. If you want it, send me a message with your e-mail address & I will get it to you.

How does one get Medicare

March 1, 2009 at 10:45 am

Hi Cheryl, I worked 13 years as a state employee and medically retired under the public employees retirement system at the age of 39. I started receiving my disability pension from the State of Oregon nearly right away. Even though I was getting my pension, I was able to get Social Security (SSDI). I started receiving cash benefits (SSDI) from Social Security approxmately 1 year after my original filing date and I got medicare 2 years after my original filing date. Today I receive both my disability pension from the state & my SSDI from Social Security. I have medicare through SSA & a medicare supplement through the public employees retirement system.

When I medically retired from the state, I took out a loan to cover the cost of COBRA until I got on medicare. I paid the loan payments with my state pension.

As far as Social Security is concerned, it is a nightmare system. Many people get denied 2 or 3 times and end up going to the administrative law judge level. Often this is because the paperwork isn’t written in a way to solicit true information about a persons medical condition & resulting limitations. Often both the applicant & his/her doctors fill out the paperwork incorrectly. For example, Social Security will ask you if you cook & and they will give you a yes or no box to check. Most people will check the yes box if they can make themself a sandwich. When they say yes, then SSA thinks why couldn’t that person work as a cook or at a sandwich shop? In reality, people who are truly disabled often take much longer to prepare a meal and/or skip meals altogether, therefore the answer should be no with a written explanation that the task of cooking cannot be performed either in a timely manner and/or on a regular basis. The same thing goes for laundry. Most people will check yes even if it takes them hours/days to do the laundry because they are to ill to get it done in a timely fashion like an able bodied person would. That makes SSA question why the person couldn’t work at a laundry mat. What most people don’t seem to understand is that SSA doesn’t care if you can’t perform your job. They are checking to see if you can perform any job in the economy, even if the job doesn’t exist in your home town & you have to travel 2000 miles away to find a job like that. So how people fill out forms is a big barrier to getting approved. When you answer the questions, you always have to remember to ask yourself, when I am having my worst day, can I do these things like the average person. When your doctor fills out the paperwork, it is always good to have a frank discussion about your ability to perform tasks in comparison to an average able bodied individual. I find it helpful to make a photocopy of the blank medical form, fill it out myself & then take it with me to talk about it with the doctor as he/she is filling out their copy of the form.

Another problem with getting approved for benefits from SSA is that applicants aren’t efficient with their paperwork. They don’t send their paperwork registered mail, they don’t keep copies, they don’t write down who & when they talked to SSA. I have a friend who works at SSA & her caseload is 7,000 cases. With that kind of caseload, paperwork is bound to get lost on occasion. Therefore, it is really important to keep copies of all your paperwork & keep a notebook that chronicles any interaction you have with SSA.

When I filed my paperwork, SSA initially didn’t want to take an application, but I called my Congressman & SSA reversed that decision within a couple of days. You are definately on the right track by getting your elected officials involved if SSA lost your app and you have copies of your application and/or you have records of when you filed.

With regard to attorney’s, there is a lot of controversy around whether to hire them or not. They usually work on contingency & take a big chunk if you happen to be lucky enough to get awarded benefits. Some attorneys know/understand how SSA works & some attorneys don’t, but most people think any attorney can represent them. It may be true that an attorney can represent an applicant, but just because their an attorney doesn’t guarantee they will do a good job. It just depends on the attorneys level of experience and understanding of SSA’s rules & regulations.

Hmmm…I could go on & on about this stuff because part of my job as a state worker was to help people obtain their SSA benefits. However, this post is getting pretty long, so I’m going to end it here. I hope this information may be of some use to you.