posted
copying this over to here; minou, can you show the update of 6-2-09 and new amount of $6,000 in the upper parts of your info? thanks!! betty
ConnieMc Frequent Contributor (1K+ posts) Member # 191 posted 03-05-2009 11:29 AM
FYI
At this point, the max fee for representatives is $5300. Effective June 2, 2009, it will go up to $6000. *****************************************************
If a representative, attorney or non-attorney, wants to go for a higher fee, for example, for a case that requires much more work than typically required, a representative can file a fee petition with detailed records of all work done on a claim.
The ALJ or an office in MD handles these requests. I have never done it, or requested a higher fee than allowed - which is 25% of past due benefits or $5300 maximum.
These limits are for good reason. I had one claim which took years to get to hearing and by the time the claimant won, she was entitled to about $130,000 in back pay for herself and her dependents. Yes, I would love to have 25% of that, but wouldn't be fair at all. My fee was $5300.
Posts: 2116 | From NC | Registered: Oct 2000
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bettyg
Unregistered
posted
copying this here .... from connie mc !!
ConnieMc, Member # 191, posted 07-05-2009 09:10 AM ________________________________________
DDS is not allowed to tell a claimant or representative a decision on a claim.
Once a decision is made at the initial or reconsideration level, it is sent back to a processing center at SSA and they send out a letter.
If it is an allowance, the local SSA office processes the case. If Supplemental Security Income (SSI) is involved, the SSA office generally contacts the claimant and asks them to come into the office so thay can confirm that the financial situation is the same as it was when the initial application was filed.
If it is Social Security Disability Insurance (SSDI), a letter is issued to notify the claimant of the allowance, then the claim is actually processed at one of the payment centers.
It is true that in a SSDI only claim, the claimant sometimes finds their back pay in their account before they even receive their letter notifying them of their allowance.
MADDOG, since you worked for years and paid into the system, your claim is likely an SSDI only claim, so you could find money in your account before you are notified of the claim decision.
When a decision is made at DDS, the decision is issued.
A claim would not be "closed", but would either be sent for processing (payment) or remain in limbo for 60 days waiting for the claimant to appeal.
Don't get discouraged if you receive a denial. Keep your claim active by appealing immediately, and by all means do not wait and risk letting the claim lapse.
Follow the instructions on the letter exactly and leave a paper trail. Make sure you have proof you filed the appeal and file it away in a safe place. And good luck!!
Posts: 2117 | From NC | Registered: Oct 2000
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Keebler
Honored Contributor (25K+ posts)
Member # 12673
Tips for getting insurance when you have a pre-existing condition
Excerpts:
1. Become a group of one.
In about a dozen states, you can be a group all by yourself for insurance purposes. What this means is that you become, in effect, just like any other company, and insurers can't deny you insurance or charge you higher premiums because of your pre-existing condition, according to Lembo. "You'd be surprised at the number of folks who open their own landscaping business" to get the group of one, he says. . . .
2. If you've been laid off, get COBRA. . . .
3. When you lose your employer-related insurance, apply for new insurance within 63 days. . . .
4. Find out whether your state has a high-risk pool. . . .
5. See whether your professional organization offers group insurance.
Some professional groups, such as those representing real estate agents and freelance writers, offer health insurance. Check and see whether your profession does the same. Here's another piece of advice, offered somewhat tongue in cheek: Move to Maryland, Massachusetts, New Jersey, New York or Vermont.
"In those states, everyone has to sell to you," said Cheryl Fish-Parcham, deputy director of health policy at Families USA. Not only do insurance companies have to sell you a policy in those states, there are limits on how much they can charge you, she says.
For more help in finding insurance when you have a pre-existing condition, you can contact the Cover Me Foundation at 877-678-7631 or Coverage For All at 800-234-1317. . . .
. . . . -
[ 04-14-2010, 12:26 PM: Message edited by: Keebler ]
Posts: 48021 | From Tree House | Registered: Jul 2007
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bettyg
Unregistered
posted
minou, without going thru all of this, do you have advise on DIVORCE LAWS; steps to take, etc.
deafromlyme needs help; thought of your links here as well. big thanks! if you do; comment on her NEED MASS. ATTORNEY FOR DIVORCE post xoxox
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minoucat
Frequent Contributor (1K+ posts)
Member # 5175
posted
Betty -- PM'd you, need more info on what's wanted.
-------------------- ********************* RECIDITE, PLEBES! Gero rem imperialem! (Stand aside plebians! I am on imperial business.)
Hi gang, I FINALLY found my old password so I could sign in and say "Hi!" I had messages in there from 2006 that people wrote me that I never knew were there. Oops! [Smile]
I hope you all are doing well. Lymetoo...over 40,000 posts??? Wow, lady, have you been busy or what? [Wink] However, you are badly needed to give advice and keep everyone's spirits up so keep it up!
Bettyg, thanks for the message. Like I said, I got it but I couldn't find my password and didn't have time to look until now. Looks like you've also been busy...over 25,000 posts! You and Lymetoo are dedicated! [Smile]
OptiMisTick, hello old pal, how are you doing? [Smile] I'm doing a little better and have just returned to school.
It's been so long since I've worked that I am auditing some prior classes for a review. Hopefully, I can do that for a while and then, if I am fortunate and can pass the GMAT, I hope to be on to grad school for my MBA or MACC.
If anyone is interested, I'm going through Vocational Rehabilitation so if anyone out there is receiving SSDI and feels like attempting a return to work but would like a review or more training, call them up, they LOVE it when we are willing to head back to work and are very helpful in providing accomodations (like special desks or chairs), computers, software, paying for classes and books.
It's pretty cool and, in the long run, it is much cheaper for the government to get us back on our feet and back to work than to keep paying benefits.
If I can, I'd much rather work - as would you all, I know. It has taken me 8 years to get to this point. What the heck, may as well give it a try. [Smile]
-------------------- I surf to serve! Posts: 1987 | From Charlotte, NC, US | Registered: Sep 2001
********************************* great story, wasn't it? betty
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i posted in my good lawyers' list i started and brought it back up to top; will post it also in MINOUCAT'S DISABILITY link in support .... great info!!
our member trishee was sent this information below and also his letter stated this,
Betty,
"My letter does include helping me or "any Lyme disease awareness or advocacy organization" help in submitting disability claims. *************************************
He mentions 15 years experience before starting his own practice a year ago."
Offers his help with lyme disease claims. ************************************************
Lyme Attorney is George Thompson
Sager & Schaffer LLP
182 Turnpike Rd.,Suite 250
Westborough, MA 01581
508-898-9900
Fax:508-898-9889 *********************
i also showed this in my good lawyer's list i started 2-3 yrs. ago
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seekhelp
Frequent Contributor (5K+ posts)
Member # 15067
posted
Wow, there is a LOT of info here. Pretty smart Lymies. Posts: 7545 | From The 5th Dimension - The Twilight Zone | Registered: Mar 2008
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bettyg
Unregistered
posted
seek, we just need people to LEAVE MEDICAL and look around at the other forums...SUPPORT has outstanding info at top, and this is the BEST THERE IS !! $$$$
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bettyg
Unregistered
posted
dream22 posted this for a newbie today, and i didn't want to see these good links go to waste, but be shared with others needing it.
Here's one on the need for clinical judgment in the diagnosis and treatment of lyme disease. Good synopsis: FALL 2009
There are 2 standards of care re: lyme disease. The most important part being that treatment is based on informed choice of the patient. Ultimately, your treatment is up to you:
ConnieMc
Frequent Contributor (1K+ posts)
Member # 191
posted
Look up stats for your ALJ - the following link will take you to a SSA website which lists every Administrative Law Judge in the country and provides stats for each ALJ. I use this site every time I have an ALJ I do not know assigned to one of my claims.
As you can see, there is wide variation in stats from one ALJ to another. Some ALJs are quite liberal with their allowances and others allow below 50 of their claims. You can arrange the data in each column by clicking on the column headings.
Interesting stuff.
Connie Accredited Disability Rep Lyme patient
Posts: 2276 | From NC | Registered: Oct 2000
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METALLlC BLUE
Frequent Contributor (1K+ posts)
Member # 6628
posted
Minoucat or anyone else who has supplied abundant information about insurance company information, would you be willing to review the rewritten Lyme Disease Guide that I have? The guide was originally the one Betty had put together -- though it now is significantly transformed.
Any help would really be great.
-------------------- I am not a physician, so do your own research to confirm any ideas given and then speak with a health care provider you trust.
Tips applying for SSD - disability benefits you paid into through your participation in payroll deduction with each paycheck under the Social Security Administration . . . -
[ 07-06-2016, 05:49 PM: Message edited by: Keebler ]
Posts: 48021 | From Tree House | Registered: Jul 2007
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Keebler
Honored Contributor (25K+ posts)
Member # 12673
posted
- * VESTIBULAR ? If you have ANY inner ear disorder (balance, tinnitus, hyperacusis) that may be considered as a separate condition. Depending upon the degree, vestibular disorders - alone - can be the basis for some help from SSD.
Your LLMD may know of a LL neurotologist or other vestibular specialist for you to consult - if you have any symptoms that seem to either be caused by or include this system. There are very specific tests for the various vestibular disorders.
* MCS ? Multiple Chemical Sensitivities can also be considered separately, depending upon the severity.
=============
All about EARS: ------------------
For those who are sensitive or pained by even normal or soft sounds (sounds not even at noise level):
Click here (at the link) for the Selected Bibliography of Research Articles. - six pages of studies and articles on chemical sensitivity published in peer-reviewed journals.
Click here (at the link) for a copy of the QEESI questionnaire, which is useful for evaluating a person's level of chemical sensitivity or intolerance.
Topic: Social security disability and lyme disease - good info -
Posts: 48021 | From Tree House | Registered: Jul 2007
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Keebler
Honored Contributor (25K+ posts)
Member # 12673
posted
- About whether "chronic lyme" even exits - and the "need" for on-going treatment.
Not discussing all that but - we need to know how doctors think and what the professional medical organizations' official stance is on this diagnosis.
I just stumbled upon this "blog of concern" (how else can I describe this?). This doctor is so against the idea of lyme but today, from a medical journal this summer - we do need to be aware of this:
. . . Some persons have advocated use of the term chronic Lyme disease (Table 5) to describe the persistence of nonspecific signs and symptoms in patients with or without clinical or laboratory evidence of Lyme disease.
These advocates suggest that patients with the so-called post-Lyme disease syndrome (category 4) or antibiotic-refractory arthritis have a latent intracellular infection that may require months to years of antibiotic therapy for eradication. . . .
. . . Although controversy exists regarding post-Lyme disease syndrome and chronic Lyme disease treatment, four randomized clinical trials found no evidence that prolonged antibiotic therapy is of benefit.
Therefore, the
1) American Academy of Pediatrics,
2) American Academy of Neurology,
3) American College of Rheumatology, and
4) IDSA
do not recommend prolonged antibiotic therapy.
A recent survey concluded that 97 percent of primary care physicians in Lyme disease-endemic areas did not diagnose or treat patients for chronic Lyme disease.
You can search site with title for the article abstract but full article access restricted to members only. -
Posts: 48021 | From Tree House | Registered: Jul 2007
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Keebler
Honored Contributor (25K+ posts)
Member # 12673
posted
- ILADS Annual Conference, November 2012, Boston, MA
Disability Claims and Lyme Disease, Part III: Overcoming the Hurdles:
How to defend against the various justifications for denying coverage, including the mental illness defense and the claim that chronic Lyme does not exist or is not objectively verifiable.
Scott Riemer, Esq - DVD is $15. You can see a four minute video preview at the link above.
Working Together: How providers and lawyers can collaborate to effectively represent their disabled patients
Glenn Kantor, Esq, Mala M. Rafik, Esq, and Scott Riemer, Esq - DVD is $15. You can see a four minute video clip at link above. -
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The
Lyme Disease Network of New Jersey 907 Pebble Creek Court,
Pennington,
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