On SSDI 14 years..."in jeopardy"!

[JCatGuy1]

What is the name of your state? New York (nyc)

Hi,
I've been quite ill for a rather long time with a terminal illness that has me on full Disability (SSD) and also receive Social Security Supplemental insurance (SSI), which thus entitles me for me for Medicaid. I've been ill for about 20 years, but have been on Disability for about 14 years. Life is getting harder by the year...then again...most didn't think I'd have made it this long.

I'm writing in because over the 14 years I've been collecting I have had minor problems, and a few re-assessements, but they all went okay, however, I'm quite tense about this...and tension works against my illness, so I'm trying to rectify this matter...here's the situation:

As you know, SSI and Medicaid are both "Means Based"...in NYC, you are not allowed to have over $2000. I've always paid my bills on time...over the years my account has never gone above that amount (years ago, it was even a lower limit). However, being recently diagnosed with yet another extremely disabling illness, although not "life threatening"...over the past 6 months my mind "just hasn't been on top of things". Upcoming...a double hip replacement, knee replacement and right shoulder...although my ID MD doesn't isn't even sure I can make it through such surgeries due to my main condition.

Having others help me out with many things, I started getting sloppy...paying my bills with money orders...cash...and rarely spending a dime beyond essentials because basically "I'm in bed". Unfortunately, I wasn't paying attention to anything but "physical pain"...and my bank account has gone over the $2000 statement. And just as I noticed this...sure enough, I get a recontinuation assessment, asking for bank statements going back 2 1/2 years. To my shock...I noticed that of the 28 statements (I'm missing 2)...I went over the limit 4 times, all within the past 6 months. All 4 times it was as little as $93 to as high as $400.

I'm terribly frightened because they gave me 14 days to get them the information requested and when I called and asked to speak to the woman who is evaluating my case...she did speak to me, but was very matter of fact, "Do you have over $2000?". I tried to explain...it all came out wrong.
My biggest fear is that I'll lose my SSI and then (and it states it on the form) Medicaid is in jeopardy. I have over 15 prescriptions that I get and need per month. In addition, without the SSI...within a couple of months, I face the streets. The last thing is...I barely have enough strength to make it through "one day", now I have to face this, and I cannot afford a lawyer...90% I'm homebound/bedbound. I sure created a problem for myself.

If anybody knows this situation, whether or not I will lose all of my benefits, get fined...a way to work things out? Any help or thoughts will be most appreciated, for I have nobody to else to ask.
Thank you so much, JR

 

[ladyc4]

I don't have answers but I do suggest that you start checking with your state's Bar to see if you can be assisted by Legal Aid,a law clinic or an attorney who would take your case "pro bono"(free) or for an affordable payment arrangement. Also you may find that there are advocacy groups for people with your medical issue(s) and that might be of help.

Off-hand that really doesn't sound like that big an overage, but as a general rule people on SSD/SSI, unless they have some other income-private disability insurance,other pensions-are expected to be "in the hole" at the end of each month- not having money ahead OK that might be a bit of an exagerration,but that might be what they are hoping to ferret out-that you've got some other source of income that they don't know about. Now I'm NOT saying that claiming whatever benefits you are entitled to is WRONG-Heavens no! But SS administration wants to know about it.

Once you get this resolved, considering everything else you are having to deal with,it might be smart to hook up with someone you trust to watch over your general financial situation so this doesn't happen again-by all means get the arrangement in writing,don't just hand somebody your checkbook But also if you may be undergoing surgery, if your condition is worsening, you really need to have someone else authorized to act in your behalf financially.While you are talking to whomever you find to provide you with legal assistance,it might be a good idea to get something set up now.

 

[JCatGuy1]

Thank you for your reply.

I must tell you though...I have absolutely "no" other income whatsoever. The accumulation of my money when it went over the $2000 mark, during the past 4 out of 6 months (by $93 to $400) was due to me, not doing as I always did, which was two things. Paid my bills, which I did. Have someone I trust, go to an ATM and take out money for the month (grocery deliveries, laundry, etc.), which was usually about $300 per month. Because it's been like "crisis" mode, physically speaking...all my thoughts/energies have been on "making it through each day". And thus...I just "without". Lost my appetite...basically let things go...things that "used to also cost money and come out of the $300. But now it's all too late.

I appreciate your help and will follow the it for the future, for sure, although I can't think of a person I can trust with finances completely. As far as "legal aid", is it the suggestion that before I send them my paperwork, I ask for more time and then have a lawyer go through it...or wait for their final result and then follow up?
But for now...I'm quite concerned, and I have nobody to help financially. Here's my last question:

Does this mean I'm going to lose my Medicaid and SSI? And no matter what happens, I'm going to tell it exactly the way it is...because, that is exactly the way it is. So, I will tell them and give them the documentation requested. I just hope they'll work with me, such as recoup for those months I went over...anything but to cut me off entirely. To lose my Medications, is basically "it" for me. And I will take every dime to pay for them...but, that won't last...those 15 RX's monthly (one of them is $600 per month). I don't know what to do. Thanks for your concern.
Thanks, JR

 

[hmmbrdzz]

Hi JR: LadyC4 has given you some good advice. Does your ID doc know what's going on with your benefits? Are they (SS) making you go to a physician of their own for an assessment, or are they just on your case because you went over $2000.00 assets? Do not delay in getting them that information. IF you can't get it there in 14 days, you contact that representative and request an extension. You can get those missing statements from the bank, I think.

$93.00 to 400.00 over isn't all that bad, but it could (COULD) affect your benefits. (it wasn't like you were working and not reporting income!) If you have a debilitating illness and have not been able to manage your affairs, it might be wise of you to advise your doctor of your inability in this regard and to also speak to him about recommending to SS that you have recently been unable to handle your financial affairs. This might require a temporary appointment of someone to handle your disability funds, but they will be required to handle them in YOUR interest, and they will be closely monitored by SSD. When things get better for you and you want to manage your own funds again, that can be recommended through your doc and approved by SSD / SSI.

If they (SSD / SSI) make a decision to deny your SSI (and thus you lose your medication benefits), that would not be good, and you would need to follow their appeals process and appeal their decision. Get your doc behind you . Get all the help you can from SS, too, during this process since you might feel overwhelmed. Hopefully they (SSD) will consider every reason you had for going over 2000.00 and will not penalize you for this.

Good luck. Now take a deep breath, and don't get too stressed.


hmmbrdzz

 

[ladyc4]

http://www.ssa.gov/pubs/11011.html

This is a lot of generic information about SSI.

I realize that you don't have other income, but SS administration wonders why there were some months that you had extra money in your bank account-(I have to admit I don't know as much about SSI as I do SSD)and they want to know why. They want to make sure that they aren't overpaying you.

From what I can determine with a quick read, probably the worst they would do is REDUCE you monthly benefit,and possibly want repayment if they find they've been overpaying you. I'm not a lawyer, and as I said before I don't know a whole lot about SSI,but my take here as a reasonable(wo)man is that they probably are NOT going to dump you off the SSI/Medicaid rolls.

And you have appeal rights if they do.

To put this is a more specific frame of reference, the SSI bean counters want to find out if there were or are changes to your situation that saved you money,like having someone come and live with you and contribute to your expenses, or you sold something, or worked, even if you were paid with a weeks groceries rather than cash. I don't think that they will hold it against you if you just didn't eat as much,or you slept a lot so that you weren't running lights appliances,electronics(or showering) which resulted in lower utility bills.
It comes down to what I said before,they want to know why there were some months you didn't use up all the money they gave you. If you had months where there was more than $2000 in your bank account,they want to know why! Whether they could come in and question you if the reverse occurred, I'm not sure, but I think if I were you,I'd cover my *ss if I withdrew much of the $2000.I'm sure there are justifiable reasons-home repairs,car repairs,car replacement,or if you chose to convert part of that $2000 into another "asset"-provided you stayed within the 2K limit.

I still think it would not hurt to seek some guidance from an attorney or if there are any "advocacy" organizations in your area,and do it before you go talk to them so you can avoid more "explanations" that "come out wrong". (I'm not being a smart-aleck here, I know EXACTLY what you mean,the IRS is good at that too

This is a shot in the dark, but if there is a United Way chapter in your area,many of them have a "211" or "First Call For Help" telephone#,and they may be able to steer you in the right direction

Now calm down!

 

[JCatGuy1]

To LadyC4 and hmmbrdzz,
I want to thank you both very much for the time, information and recommendation to "calm down" (I easily stress, it seems the more sick/in pain I get, the more I worry...perhaps because I feel such a loss of control). But you both gave me a sense that "there's a chance" it won't be catastrophe...maybe not a big chance, but or something in the middle.
Today, a friend who helps me out very much (no family in NY), well, she brought in the all the bank information that they requested, less a couple of months here and there...I couldn't locate. They did receive months I went "over" the limit...I believe it was 4, worse yet...it just so happened to be most recent.
When my friend handed the re-assessment form and the statements they asked for in, she gave them to a woman who brought them to the office...she was gone about 5 minutes and came back to make copies of originals, when my friend got them back she asked woman, "If he needed to come down in person or call someone to follow up on the case". She basically said, that she spoke to the person in charge of my case and that she'd reviewed them, and that to tell him "he will be getting his checks".
My friend left there feeling good and called to tell me what went on and it seem okay. The worrier I am...until I get something in the mail, or something, I don't know. But, she also asked the lady, "will he receive anything in mail or get call"...and the woman replied something like, "No...he's going to get his checks".
By the way, my friend is the opposite of me, she's very optimistic.
But, I've done all I could do for now.
If they cut my medicaid and benefits, I will seek out some free legal advice as you both suggested...for an appeal. I will also speak with my "long-term" physician and see if he can help as advised. Can't imagine where'd I'd get the strength from to do a whole court matter, so hoping for the best.
Gotta lay down...will try to "put it out of my mind" and rest now, but, I just wanted to thank you both very much once again.
I would put that in "bold", but the site doesn't want bold, but the feeling is............Thanks again, JR

 

[hmmbrdzz]

Hi JCatGuy1. That sounds like very good news, and I know you're relieved and feeling better about things now. I'm glad you had someone to assist you (good friends are like gold). You hang in there, and keep us updated. We'll no doubt be hanging around here! I had a friend tell me once (when I was super stressed out over something one time).... he laughed and said "well -- look at it this way: What is the worse they can do to you? Eat you?". I always remember that "funny" when I get stressed, and honestly -- it seems to help.

Good Luck


hmmbrdzz