This is topic DON'T give up on SSDI.......good news in forum Medical Questions at LymeNet Flash.


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Posted by TicksinNC (Member # 1510) on :
 
For those of you fighting to get SSDI (disability) I wanted to let everyone know that after two denials, getting an attorney and having a hearing...

I received my FULLY FAVORABLE letter today after filing in 12/2003. The other good news is that I am only 35 which makes it harder for approval due to my age and guess what else...

The favorable decision was based on the symptoms of Lyme for the most part, then Narcolepsy and Fibromyalgia. It seems from what I understood, the letter from my LLMD letter explaining how it has affected me had a lot of weight.

Apparently, the first quack they sent me to stated I could work, that I had a steady gait, can bend my knees etc etc, but the physicologist stated a big fat "No" that I had a comprehension problem, depression etc.

More to this, due to my son, Jonathon, whom was born 12/04 being very ill since birth and has a tracheostomy and gtube for feeding, my insurance (under COBRA) ended in April of 2005.

I have not seen a doctor since his birth due to finances and/or no insurance and being "caught up" in just being there for Jonathon (he has ben hospitalized over a dozen times since birth not counting his first 3 mths of life in ICU), he still approved it.

Now that I am approved I can finally use the funds I get to pay for private insurance and get back to the tx for Lyme and it's symptoms.

I just wanted to share my story of triump and how relieved I am about it being, for the most part, behind me so I can now move on.
 
Posted by AZURE WISH (Member # 804) on :
 
Just so you know eventually you will qualify for medicare... I think it is about 3 years from your date of disability.

I am glad you won your case.

Best wishes [Smile]
 
Posted by TicksinNC (Member # 1510) on :
 
Thanks for the well wishes. My understanding is it is 2yrs here before getting Medicare and from what I understand, it isn't all that great, but better than nothing I suppose. I think I may actually qualify for SSI due to income with 5 in the family and only one income. So if that's the case, I will automatically get Medicaid which would be great considering my LLMD does take it. [Smile]
 
Posted by bettyg (Member # 6147) on :
 
Angela, WHOOPIE for you/family! You had a SHORT fight with them.

Yes, waiting period for medicare is 2 yrs. So what did your letter show was the effective date?

You showed filed 12-03, but what was your DATE OF ONSET OF DISABILITY?

They will send you detailed letter with more info.

Mine went back 3 yrs. to when I started 2nd ssdi app. 2 yrs. ended 12-04 for HOSPITAL medical and they determined 6-05 for out-patient.

Could you get on your former employer's DIABILITY/RETIREE health insurance program?

Read Minoucat's disability/finance info on TREEPATROL'S NEWBIE LINKS, 1st screen of medical.

Print it off, check off after you read things as it will take many months to read all & tree constantly updates.

I hope you will get your son checked for lyme disease from the womb to the baby transfer.

Please have shorter paragraphs and double space please. Your 2nd post could be edited to break it up for us neuro lymies who can't read continuous long paragraphs.

Happy for you especially with your young age. [Wink]
 
Posted by burnbitter (Member # 7088) on :
 
quote:
Originally posted by AZURE WISH:
Just so you know eventually you will qualify for medicare... I think it is about 3 years from your date of disability.

I am glad you won your case.

Best wishes [Smile]

medicare should start as soon as you qualify. It takes a little time to get it set up. If you have a secondary private insurance you will want to make sure that they don't end up being secondary insurance with medicare as the primary. Also I was not able to find private insurance that would take me because of my disease.
Good news is that you can get some of the medicare prescrition plans to cover drugs like IM bicillin. And the SS people are actually really nice once you get approved. Call them if you need help finding resources now availible to you.

congrats.
 
Posted by EtherealGirl (Member # 4780) on :
 
Congratulations Angela. That's fantastic news!

I'm on my first appeal right now, having originally filed in July of 05. I hope mine doesn't take years like most everyone else's does.
 
Posted by bettyg (Member # 6147) on :
 
quote:
Originally posted by burnbitter:

medicare should start as soon as you qualify. It takes a little time to get it set up.

If you have a secondary private insurance you will want to make sure that they don't end up being secondary insurance with medicare as the primary. Also I was not able to find private insurance that would take me because of my disease.

Good news is that you can get some of the medicare prescrition plans to cover drugs like IM bicillin.

And the SS people are actually really nice once you get approved. Call them if you need help finding resources now availible to you.
congrats.

Burnbitter, mine is set up where medicare is 1st payer, and our wellmark, bc/bs is 2nd payer. We've had NO problems with that. Why are you stating to do it just the opposite?

Burnbitter, also, please hit enter to break up your long text into paragraphs and double space for us neuro lymies who can't read/comprehend as is in 1 long paragraph. Thanks so much BB.

Also, BB and anyone who uses the " " which BOLDS THE ENTIRE POST,

I have a big favor to ask of you. On the above post, you " " quoted whoever, and then it was BOLDED for 3-4 paragraphs.

For people like me with such severe neuro lyme, the pain the BOLD causes me is unbelievable.

For me, it's like looking directly at the sun.
----------------------------------------------

Could you EDIT/PENCIL icon your post and do 1 of 2 things:

1. DELETE the [/QB] at the beginning of the quote right after the quote in brackets and also at the END of the quote...delete the bracker q/b there too; 2 places to delete.

Then it's normal print and doesn't hurt our eyes.

2. Just use the POST REPLY at the top/bottom of screen to show your rely comments. When I started on here, I just couldn't see the black & white post reply, so I too used the " " area. That's how I learned for myself to delete the BOLD codes myself to ease my pain.

FYI, you don't need to quote them, just use the SEND REPLY box..ok UNLESS you want to quote part of what they said, then use the other option DELETING THE BOLD LIKE I'VE SHOWED. THANK YOU!

Thanks for helping me & others. We value reading all the experience and suggestons from all on this board.

Thanks for sharing yours as well. Peace.
[Cool] Bettyg
 
Posted by bettyg (Member # 6147) on :
 
duplicate

[ 27. February 2006, 02:36 AM: Message edited by: bettyg ]
 
Posted by tickedntx (Member # 5660) on :
 
You become eligible for Medicare in the 25th month of disability. This includes any time going back to your effective date.

My understanding is that Medicare is always the first payor.

Medicare Advantage Plans can be a great way to limit out-of-pocket medical expenses. Advantage Plans deliver Medicare through a private company. You get all the benefits of Medicare Part B (and Part D in some plans), plus more.

Available plans vary by location, but I have just enrolled in the SecureHorizons Direct Plan 5. For me, the primary benefit is that my annual out-of-pocket benefits are limited to $3,000 of covered services at a cost of only $45/month. For $95/month, I could limit my out-of-pocket expenses to $1,000/year.

You can research plans at medicare.gov. I would also recommend finding an insurance agent in your area who works with these plans.

The benefit of a Medicare Advantage Plan that does not include prescription coverage is that you can select the best Advantage Plan for you as well as the best Prescription Drug Plan (PDP) for you, and, if things change, you can change one without having to change the other.

Suzanne

[ 26. February 2006, 04:00 PM: Message edited by: tickedntx ]
 


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