Colorado Social Security Law

I was surprised to read in Popular Science that Dean Kamen’s iBot (an electric, motorized wheelchair which goes from four wheels to two wheels lifting the writer in the process, and can climb stairs,) has been discontinued due to costs. Neither insurance companies, nor Medicaid, wanted to foot the bill for this expensive, although amazing, power chair.

If you are lucky enough to have an iBot, HiZook notes that service will continue on the iBot until 2013.

Here is a commercial for the now departed iBot:

HiZook also  has a review of the Segway RMP 50 robotic platform,  an omnidirectional powered platform that reminds me of something I read in comic books as a kid. Can you imagine using something like this as a base for a powered wheelchair?

Segway RMP Omni 50 from Cressel Anderson on Vimeo.

I previously wrote about how Social Security stops benefits for fleeing felons. However, there has been considerable litigation across the country regarding what constitutes a “fleeing felon.”

Social Security changed its definition of “fleeing” due to a settlement in the nationwide class-action lawsuit.

The April 2009 issue of capital NOSSCR Social Security Forum has a lengthy discussion of this: Continue reading →

To qualify for Social Security disability benefits you have to show that your disabilities prevent you from being able to work. In general, you have to show that you are unable to perform a substantial gainful activity (SGA).

However, there are exceptions to this general rule, including Subsidized Wages or Sheltered Work environments.

Social Security can only consider the money you earn in deciding if your work is a substantial gainful activity. Anything over the “reasonable value” of your work, may be a subsidy. Social Security cannot consider a subsidy, basically a “gift,” as earnings in determining if the work is a substantial gainful activity.

A subsidy is any compensation over the fair value of your work.  This often happens if you work for a family member or if you work through an agency like Goodwill.

If you are paid for a 40 hour week but you only work 25 hours, you have a 15 hour subsidy.  Another possibility is if the value of your work is $8.00 an hour, but you are paid $10.00 an hour (a $2.00 an hour subsidy).

If you subtract the subsidy, and your gross income is below the SGA amount, you might still be able to keep your Social Security benefits. Continue reading →

Even if you know the definition of a substantial gainful activity (SGA), could you apply it? Can you be sure that the last job you tried before you applied for Social Security disability benefits was SGA?

Charles Hall proposes that substantial gainful activity (SGA) has become just too complicated.

If one is engaging in SGA, one cannot be considered disabled, but SGA is a term of art. Work may not be SGA if low earnings, unsuccessful work attempts, made work, subsidized employment, impairment related work expenses, trial work periods, etc. are taken into consideration. 

…The biggest problem now is that SGA is just too complicated. Claimants have no idea how it works. Even many Social Security employees who should understand how SGA works, don’t.

Read Charles Hall’s original article is by Charles Hall on his Social Security News blog.

I have to give credit to Gordon Gates for bringing Charles Hall’s article to my attention in the first place. Gordon responds:

I also agree with the assessment that SGA is too complicated. There are some very important exceptions and adjustments to the $980 per month SGA amount, including the unsuccessful work attempt. A thorough knowledge of these complicated SGA rules is critical because SGA exceptions can make the difference between winning and losing a claim (the cliff).

Here is one of the exceptions taken from the introductory section of the Substantial Gainful Activity regulations (20 CFR 404.1571):

Even if the work you have done was not substantial gainful activity, it may show that you are able to do more work than you actually did.

Basically, this says that even if you earn less than SGA, you still might have a problem with a disability claim.

To some extent, this makes sense. Let’s say you are able to do construction work, but your disabilities limit you to only part-time work, and you earn less than the SGA amount ($980 per month for 2009).

Non-SGA heavy work may suggest the ability to do SGA work at a lighter level. 

Being able to do part-time construction work might mean you could do full time lighter work, such as a cashier where your earnings would be more than the SGA amount (and potentially make you ineligible for Social Security disability benefits).  

What it all comes down to is that the SGA is complicated. And this is only one issue. See all the articles dealing with substantial gainful activity.

If you hire a lawyer on a Social Security case after today, you may be surprised to learn that the maximum fees are $6,000.

I thought the most a lawyer can charge in a Social Security case was $5,300?  That’s what the attorney who helped my cousin said.

Don’t worry, no one is trying to pull a fast one. Social Security has just increased the fee cap (for the first time since 2002).

I have to pay $6,000 to hire an attorney?!?

No, the $6,000 amount is the cap on attorney fees. In most fee agreements:

1. You only pay fees if you win (contingency fee agreement).
2. If you win, you pay 25% of the back benefits owed to your or your family; or
3. the maximum amount, $6,000 as of June 22, 2009.

So, you only pay if you win and then only 25% or $6,000, whichever is less.

If you are wondering whether you will get Medicare or Medicaid with Social Security, it all depends on the type of Social Security you receive.

• Social Security disability insurance (SSDI) comes with Medicare.
• Social Security Supplemental Security Income (SSI) comes with Medicaid.

What’s the difference between Medicare and Medicaid?

The Colorado Bar Association has a great page discussing the differences. Here is a quick summary:

Medicare provides only partial coverage, and requires beneficiaries to pay premiums, deductibles, and co-payments.

Medicaid provides more complete coverage, without significant payments from the beneficiaries.

Click to read more about the differences.

I have written a bit lately about service animals (such as seeing eye dogs, as well as dogs for disabled individuals with seizure disorders and children with autism).

I recently came upon an article asking the question why doesn’t the Department of Veterans Affairs provide money for service dogs?  There is no question about the benefits provided to disabled individuals by service animals.

… while the VA talks about “providing” dogs, the only thing they’ve really been trying to decide is whether to pay the same monthly stipend to disabled veterans with a service dog that they’ve been paying to those with guide dogs for many years.  That’s it – there’s been no intent (and that I’m aware of there still isn’t) to “pay for service dogs” the way some describe it, i.e., fund organizations who train assistance dogs.

There was a January 2008 memo signed by the former Secretary which summarized their position. …  I’ve read the memo, but I’ve got something even better for you – the man behind the memo describing the VA thinking about service dogs in his own words a few months later.

Fred Downs, the VA’s Chief Consultant, Prosthetics and Sensory Aids did an hour-long interview with Brian Lamb for C-SPAN on June 5th, 2008, during which he discussed many things, including his handling of the service dog issue.  You can watch the video below – skip to the 51:20 mark which is where the pertinent section starts.

Click the link: Al Brittain to read the entire article and watch the linked video.

If you win your claim for Social Security disability insurance (SSDI), you are also eligible to receive Medicare benefits. But, you don’t get Medicaid right away, with some exceptions, you have to be “in pay status” for 24 months before you become eligible for Medicaid.

That means you have to be receiving 24 months of Social Security disability insurance to get Medicare.

Another two years? I just waited two years to get my case approved.

Fortunately, Social Security considers your back benefits when they count the 24 months. So, if Social Security 24 months of back Social Security disability insurance, you are already “in pay status” for 24 months, and you can get Medicare now.

Aren’t there any exceptions to the 24 month Medicare waiting period?

Only two. If you have one of the following conditions, the waiting period does not apply and you can get Medicare immediately:

1. End stage renal disease.
2. Amyotrophic lateral sclerosis (ALS, or Lour Gehrig’s disease).

Check out this demo for a Xbox Project Natal game called “Milo & Kate.”

Can you imagine the therapeutic value of this? From phobia therapies like the one below, to helping people with social phobias, to even more complex therapies such as helping individuals with Asperger’s syndrome pick up on social cues, vocal inflections and body language. The possibilities are amazing!

It also opens the possibility of long distance and even multiple provider therapies: the patient interacts with a single avatar which may be “driven” by different therapists at different times (allowing 24 hour care and a consistent “face”), or even running on auto-pilot as in the “Milo & Kate” demo above.  I did not realize we were so close the the ‘ractors in Neal Stephenson’s Diamond Age.

Virtual Phobia Therapy:

Virtual therapies could be amazing, or they could be awful! What’s your opinion?

We have written about service dogs for children with autism and mentioned two groups which provide training: 4PawsforAbility and Guiding Eyes.  The response has been amazing! A lot of people want to learn more about these programs.

Many people have asked who is eligible for a service dog? Continue reading →

I previously wrote about the various exceptions which may allow you to keep your Social Security disability benefits even if you return to work. The most common of these is an Unsuccessful Work Attempt (UWA). 

If you work for 6 months or less at a substantial gainful activity (SGA) level, your work may qualify as an Unsuccessful Work Attempt and not affect your application for benefits (or your current Social Security disability benefits if you have already won your case).

Another benefit of the Unsuccessful Work Attempt exception is that it applies for both Social Security Disability Insurance (20 CFE 404.1574) and Supplemental Security Income (SSI) (20 CFR 416.974) cases. This is a major difference between Unsuccessful Work Attempts and Trial Work Periods. Continue reading →

Alright! Dean Kamen’s prosthetic “Luke” arm is one step closer to helping amputess, especially injured veterans:

Last week, VA announced the start of a three-year clinical trial that represents the first large-scale testing of the arm, a critical step before it can be made widely available. The first patient was fitted with an arm in April.

The device was developed by Deka Research and Development, the New Hampshire company whose founder, Dean Kamen, invented the Segway and various medical devices. 

The robotic arm, nicknamed the “Luke arm” after the artificial arm worn by Luke Skywalker in the “Star Wars” films, allows those who have lost a limb up to their shoulder joint to perform movements while reaching over their head, a previously impossible maneuver for people with a prosthetic arm.

via VA Tests New Arm That Could Benefit Amputees – washingtonpost.com.  

Check out the video demonstrating the arm in my earlier post.