PLEASE HELP continuation of benefits approved, not getting them

[kalamm06]

What is the name of your state (only U.S. law)?

 

[justalayman]

Either edit that post or simply click on "reply to thread" and make another post


Preview doesn't work like it should but edits the post to remove everything

 

[kalamm06]

My first post was...lost. this one is unedited because I'm exhausted. There are a lot of further details I can provide.

Hi, this seems like a place I can get a good opinion from! I am helping my mother with her ssdi redetermination (prior she had been found offically disabled for 33 years for anxiety, depression, and fused/herniated discs).
She went for the review and the results said that she had depression and anxiety issues. Physically she cannot crouch, bend over, or climb things. They reported deteriation of the spine (causing her to lose an inch in height). These conclusions were made during this recent evaluation.

They determined her to have improved health, and she was denied. The letter actually suggested that she could get a job involving crouching and climbing scaffolding even though two sentences before that she was found unable to physically crouch or climb. They reported detereration of the spine, which by definition means it has gotten worse. I am baffled.

She appealed within the 10 day timeframe to continue her benefits, both money and Medicare. Obviously, she requested an appeal on the decision within 10 days, far before the 60 day limit. No decision has been made yet. She received 3 checks for three months, but her Medicare was terminated after 1 month. Now they are not sending her checks all the sudden. It has been verified that the case is in appeal.

We have been communicating with the local office by phone and person 3 times a week. Still no medicare. We were in person when the continuation was approved and sent to the main "server/office" in Baltimore but they won't activate it...it's just lost.

About 3 wweeks ago we were told, despite the verified fact that no decision had been made, that her checks were not showing that they would continue coming. Most recently we got a call from the local office saying they are pushing the emergency payment through, even though the checks and Medicare shouldn't have stopped yet. The emergency money not available or pending. She said quote, "it should be available as we speak." It is not. The local office was closed so we called the 1 800 number. This person said he saw no money released, and in addition no information about her continuing or discontinuing payments/eligibility. This was strange he said. This information is usually avalible; he can do nothing.

We are going to the office asap, but I have little hope. We are strained to the max. The reason for posting (sorry for the length) is that I want to have some objective opinions. This all seems really fishy to me. We know to just keep in contact with them, but there seems to be nothing we can do about it. We don't have money for a private attourney. Are we justified in feeling ill-treated? Does this all sound fishy to you? They just keep brushing us off.

We have called legal aid...but they are pretty sure they can not help us, and haven't called back. The stress this is causing my mentally disabled mother is making me worry for her personal safety, especially when I read about the lawsuit in Kentucky for suspension of benefits leading to 3 suicides. I keep her in eyeshot at all times and sleep in the same room. She has no insurance to get a second opinion...or to hospitialize her god forbid.

Am I jaded because this is my family? Is this normal? Any suggestions, thoughts, or opinions would help here. Also if I am justified, I want people to know what the system is capable of...the system is not working right...the implications. It can shake your faith a little lol. There's a ton more about this...every detail is all messed up. Thanks for reading. Kala

P.s. continuation of benefits during appeal is seperate to the actual appeal of decision.

Is it a law that they continue her benefits if she requests on time? Even if it isn't people need to be aware that they may request continuation and on a whim of a person or lost paperwork their official request may result in diddly. Why does the option exist then...for face value comfort? What do they use a lottery to decide who they keep their word for? dk what is messing my original post up.

My state is ohio...

 

[kalamm06]

Thanks I was really confused.

 

[justalayman]

This is not my forte so bear with me.

From what I see you must apply for continuation of benefits within 10 days of the notice of discontinuation of benefits.
It was stated that while the requirement is 10 days, how it is calculated is 15 days from the date on the DQ notice. Any idea if that time limit was met?

Then just to be certain; you have recieved no denial of the request for continuation of benefits since your original request For continuation of benefits, correct?

If the answers are yes and then no, it sounds like you are simply caught up in the bureaucracy of the system.

Deterioration of the spine does not mean it has gotten worse since the last evaluation. It means there is deterioration as compared to a healthy spine. The level of deterioration would be required to determine if it had worsened or improved. I myself deal with deterioration of my spine but the level or amount of deterioration has held steady for several years yet it is diagnosed as deterioration of the spine.

 

[kalamm06]

Yes we actually have the paper that says the continuance was on time and accepted. We also have recieved no denial of continuation. In fact everyone we speak to doesn't understand what's going on.

The deterioration was an all together new diagnosis. She had no deterioration during her previous approval and reviews. It's something in addition to the original diagnosis.

It's weird because this doctor found issues previously unknown, while not denying the original issues. Even if I am still somehow mistaken, which is possible, I still don't understand why bureaucracy is either aloud to break the law or make itself redundant.
(I explained the deterioration bit a little better in the edit, but it was lost.)

I feel like this might scare some people. They could end up homeless because of some paperwork error...I just don't know.

 

[justalayman]

I'll have to hunt it up but the deterioration being a new issue is answered in how the review process works. I don't remember it that well at the moment but it was basically not a comparison but a new determination based on the new medical reports.

Yes, it can be frightening but is surely a daunting task even for those not intimidated by the bureaucracy.

 

[OHRoadwarrior]

My understanding is that SS is tightening approvals on SSI and SSDI as many people have back problems, anxiety and depression. They manage to function in the job market fine. Those were the 3 specific areas they were tightening the criteria on. If she does not have a regular history of medical treatment and medication to manage them, it is very likely she will be found able to work.