Ckhs community advocacy final

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  • Welcome slide for Dan & Joanne to give introduction and discuss purpose of today’s training.
  • Brief introduction of HELP: MLP by Dan.
  • Healthcare in the United States
  • The ACA sets out to accomplish three goals: 1. Better health of individuals 2. Better health care system 3. Lowered costs.
  • ACA huge law- recent poll showed 42% of respondents were unsure of whether the ACA was still law.
  • Philadelphia Department of Behavioral Health & Intellectual disAbility Services Recovery│Resilience│Self-Determination
  • http://coveroregon.com/ https://www.mahealthconnector.org/portal/site/connector
  • Households with incomes of $75,000 will receive a subsidy to buy health insurance, but households with incomes of $23,000 would not.
  • Photo- once folks lose their cash benefits they often are dis-enrolled from medical, as well.
  • Standard 10 year repayment plan Lowest interest charge Graduated 10 year plan; payments grow over time Extended Fixed or graduated payments up to 25 years Income-Based Pay As You Earn
  • 3 Step Analysis: No Substantial Gainful Activity (SGA) Severe Impairment Meet, equal, or functionally equal a listing
  • 1. Acquiring and Using Information 2. Attending to and completing Tasks 3. Interacting and relating with Others 4. Moving about and manipulating objects 5. Caring for oneself. 6. Health and Physical Well-being
  • Disability Determination Reconsideration Administrative Law Judge Appeals Council Federal Court
  • Ckhs community advocacy final

    1. 1. Presented by:•Crozer-Keystone Healthy Start’s Public EducationCampaign Committee &•HELP: MLP a Medical-Legal Partnership betweenCrozer-Keystone Healthy Start &Widener UniversitySchool of LawTuesday, May 21, 2013Legal Rights for People who are Pooror have Disabilities
    2. 2. AgendaIntroduction Joanne Craig, Project Director of Crozer-Keystone Healthy Start Daniel Atkins, Co-Director of HELP: MLPThe Affordable Care Act: What it means for clients Shannon Mace Heller, JD, MPHPennsylvania Welfare Sanction Policy Laura Handel Schwartz, EsquireConsumer Law Basics: From mortgage foreclosures tostudent loans Jordan Mickman, EsquireSSI and SSDI: The basics of Social Security Disability Daniel Atkins, Esquire
    3. 3. WELCOMEJoanne CraigDaniel Atkins
    4. 4. HELP: MLPHealth, Education& Legal assistanceProject: A Medical-Legal Partnership(HELP: MLP) is acollaborationbetween Crozer-Keystone HealthyStart, Crozer-Keystone NurseFamily Partnershipand WidenerUniversity Schoolof Law.
    5. 5. SHANNON MACE, JD, MPHHELP: MLPPUBLIC HEALTH LAW SPECIALISTThe Affordable Care Act: Whatit means for clients
    6. 6. The Affordable Care Act: AgendaBackground of the Affordable Care Act (ACA)Major Provisions Coverage Reform Quality/Payment Reform Individual Mandate Eligibility & Enrollment Health Insurance MarketplaceState ImplementationMedicaid ExpansionTakeaways
    7. 7. Healthcare in the United StatesFragmented Complex PoliticalExpensive Unequal Reactive
    8. 8. The Promise of the ACA: The Triple Aim
    9. 9. Goals of the ACAIncreasing access to care for ALL individuals regardless ofrace, ethnicity, gender/sexual identity, income or disabilitystatusUsing data to identify areas of need and drive improvementwithin the healthcare systemProviding comprehensive, holistic care to individuals thataddress unmet needs including those beyond the traditionaltreatment settingImproving health information technology to reduceduplication of services, improve exchange of information,reduce errors and improve individuals’ access to informationStrengthening the healthcare workforce including, increasingdiversity and capacity in underserved areasIncreasing access to prevention and health promotion services
    10. 10. ACA Timeline
    11. 11. The Affordable Care ActFive majorcomponents:Coverage ReformQuality ReformPayment ReformInsurance ReformHealthInformationTechnologyReform
    12. 12. Coverage ReformMany provisions are already in effect:Pre-existing condition coverage to age 19Family coverage to age 26No annual or lifetime limitsClosing the Medicare Donut HoleNo co-pays/deductibles for prevention/promotion interventionsMedical loss ratio now at 85 and 80 %
    13. 13. Quality & Payment Reform:A Move to Integrated CarePatient Centered MedicalHomes (PCMH) andHealth HomesAccountable CareOrganizationsEstablishment of NationalQuality MeasuresEstablished the PatientCentered OutcomesResearch Institute(PCORI)Innovation grant funding
    14. 14. Individual MandateMost controversialprovision of the ACARequires individuals toobtain health insurance orpay a penaltyPenalties increase eachyear Exemptions include: Religious Incarceration Undocumented statusYear Amount Owed2014 $95 per adult; $47 per child( up to $285 per family or 1.0%of family income)2015 $325 per adult; $162. 50 perchild (up to $975 or 2.0%family income)2016 $695 per adult; $347.50 perchild (up to $2085 per familyor 2.5% of family income)
    15. 15. Eligibility & EnrollmentMajor changes toeligibility &enrollment October 1, 2013 is openenrollment for Marketplace Elimination of incomeverification Screened for multipleoptions through oneapplication Income calculation now“modified adjusted grossincome” or MAGI
    16. 16. Enrollment Timeline
    17. 17. Health Insurance MarketplaceStates must establish by January 2014 or default tothe Federal governmentSeveral requirements: User Friendly Phone, In-person, and online services Language accessibility Must screen and enroll public & private coverage Must establish “navigators” Transparency Self-financing by 2015
    18. 18. State Implementation The Affordable Care Act and the subsequent U.S. Supreme CourtDecision provides states considerable discretion in how it isimplemented at the state level. State decisions include: Whether to expand Medicaid eligibility to 138% of the federalpoverty level Whether to establish a state-based health insurance marketplace*, astate-federal partnership marketplace or defer to the federallyfacilitated marketplace Choosing the benchmark plan for the Essential Health Benefitspackage & the benchmark plan for the Medicaid alternative plan fornewly eligible Medicaid enrollees Participation in Health Home State Plan for individuals withchronic illnesses Other funding opportunities (Bridge to Reform, Public Health &Prevention Fund grants, Centers for Medicare & MedicaidInnovation grants, etc.)*Previously known as “health insurance exchange.”
    19. 19. Pennsylvania:Federally Facilitated Marketplace
    20. 20. Federally Facilitated Marketplace:Implementation Issues in PAInfrastructure Pennsylvania returned Health Insurance Exchange Establishmentfunding to the Federal governmentEducation and Outreach 896,000 eligible for tax subsidies through Marketplace in PAChanges to eligibility calculation Movement to Modified Adjusted Gross Income (MAGI) $13 million in PA’s Dept. of Public Welfare (DPW) BudgetQualified Health Plan (QHP) selection (HHS to decide) Supplementation of default benchmark planMedicaid determination State has the option of accepting federal determination as binding ornot
    21. 21. For Expansion Against ExpansionIncreased access tocoverage & careSignificant fundingsource 100% FMAP 2014, 2015,2016 90% 2020 and beyondJob creator“The right thing to do”Too much reliance onpublic systemIncreased costs due toadministration &“woodwork effect”Job killerPolitical ideologyMedicaid Expansion in PA: The Debate
    22. 22. PA Medicaid Expansion:Recent ActivityGovernor Corbett metwith Sec. Sebelius April 2ndConsidering alternativeoptions like the ArkansasPlanWill not move forwarduntil “more informationfrom HHS”Legislation introduced inPA Senate
    23. 23. Issues withoutExpansionOpportunities withExpansionIncrease in individualsseeking services due toElimination ofDisproportionateShare Hospital (DSH)payments could resultin a loss of $8.1 billionover next 10 yearsCoverage gap forindividualsOpportunity to expandinsurance coverage toappx. 650,000 PAresidentsEnsuring access to highquality health servicesMaintaining efficiencyMedicaid Expansion
    24. 24. PA Coverage GapSource: PA Health Law Project, Medicaid Expansion in Pennsylvania IsGood For Families (2013).
    25. 25. TakeawaysThe implementation of the ACA will take place overmany years; however, major provisions take effect in2014Many individuals will need assistance navigating thenew Health Insurance MarketplaceIndividuals currently receiving Medical Assistanceshould not lose coverageMany advocacy opportunities exist with regard to theimplementation of the ACA
    26. 26. The promiseof the ACA:The AffordableCare Act hasgreat potential toincrease healthequity withinPennsylvaniaHowever, inorder to fulfillthat potential thestate mustimplement fullyin a meaningfulway.
    27. 27. ACA ResourcesPhiladelphia Department of Behavioral Health &Intellectual disABILITY Services, Health Reform & HealthEquity Unit: http://dbhids.org/health-reform-health-equity-unitwww.Healthcare.govKaiser Health Reform Source: http://kff.org/health-reform/Health Reform GPS: www.healthreformgps.orgCMS, Streamlined Application:http://go.cms.gov/11SGmKFPA Health Law Project: http://www.phlp.org/home-page/reformPA Health Access Network: http://pahealthaccess.org/
    28. 28. Thankyou!Questions?Contactinformation:Shannon MaceHeller, JD, MPHPhone: 215-685-5411Email:sm.helpmlp@gmail.com
    29. 29. Laura Handel Schwartz, EsquireHELP: MLPStaff AttorneyPennsylvania Welfare Sanction Policy
    30. 30. Welfare Sanction Policy: AgendaWhat are sanctions?Reasons sanctions are issuedSanction issuesKey conceptsHow does the sanction process work?How will a recipient know she’s being sanctioned?Importance of fighting sanctionsNew penaltiesHow to fight sanction threatsHow to prevent sanction threatsCounty Assistance Office information
    31. 31. What are sanctions?• Sanctions can affect recipients of cash assistance benefitsadministered by the Department of Public Welfare (DPW)– i.e., recipients of Temporary Assistance for NeedyFamilies (TANF).• Sanctions are the denial of welfare benefits for which aperson or family are eligible based on allegednoncompliance with welfare program rules• Sanctions can be for employment-, child support-, personalresponsibility- or fraud-related reasons.• This training will focus on employment-related andsupport-related sanctions.
    32. 32. What are welfare “sanctions”?If Temporary Assistance for Needy Family (TANF)recipients do not follow certain Department of PublicWelfare (DPW) rules and do not have “good cause” or anexemption, they will be “sanctioned.”The welfare office will “sanction” a noncompliant benefitrecipient by reducing her monthly cash grant. Can reduce just her share or her whole family’s share. Reductions can be temporary or permanent. Repeated violations can lead to terminations of benefits that arepermanent for either just the noncompliant head of household or herchildren as well.
    33. 33. Why is this subject important now?Sanctions are used as astrategy to reducewelfare benefit caseload– related to DPWphilosophy and budgetNew sanctions up 130%from January 2011 tocurrent dateSanctions that were ineffect already now up72%Image from www.philly.com.
    34. 34. Another view: Growth in New Sanctions New Sanctions Statewide Sanctions in effect Statewide
    35. 35. Reasons DPW issues sanctionsTANF recipients can be sanctioned for: Failing to cooperate with child support enforcement Failing to sign an Agreement of Mutual Responsibility(AMR) Failing to cooperate with work or a “work-relatedactivity” requirement on an AMR Voluntarily quitting a job Voluntarily reducing earnings Failing to apply for work Failing to accept a bona fide offer for a job that therecipient could do
    36. 36. Sanction Issues IMPORTANT ISSUES TO BE AWARE OF:1. Sometimes a recipient does not even realize that shehas been, or is being, sanctioned.(a) The biggest clue that a recipient has been sanctioned is if herwelfare grant suddenly decreases, or is less than the maximumfor her family size (unless she has earnings or other incomethat would explain why the grant is reduced)1. Sometimes benefit recipients do realize that they arebeing sanctioned, but choose to accept the penaltywithout an appeal.(a) This is harmful. If you spot or hear about such a situation,advise the recipient to appeal immediately.
    37. 37. Why do some recipients acceptsanctions without appeal? Confusion Difference between termination and sanction Resignation “what can I do? I can’t win.” Guilt “I did it so I should take my punishment.” Belief (justified or not) that no attorneys oradvocates available to help “Legal Services probably won’t handle it.” “It’s only 30 days.”
    38. 38. Key concepts: Willful NoncomplianceWillful Noncompliance DPW may only sanction a recipient for violatingrules if “the noncompliance was willful andwithout good cause.” (CAH §135.712) Corollary: recipient cannot be sanctioned if she had agood cause reason for why she did not follow a rule.
    39. 39. Key Concepts: Good CauseAsking to be excused from TANF program requirements forreasons beyond the recipient’s control or because therequirements would endanger her or unfairly penalize herfor hardship circumstances is called “requesting a waiver”or “claiming good cause.”If good cause is established, no sanction should beimposed, and existing or past sanctions related to that goodcause should be lifted or rescinded. An “exemption” or “good cause” can be establishedAFTER a sanction is threatened or imposed, as well asbefore.
    40. 40. Key Concepts:Reasonable AccommodationThe welfare office is required to make a good faith effortto assist the client in overcoming whatever problems shehad complying with work requirements (CAH §135.5) orfor accommodating other hardship circumstances thatmay arise as a result of:disabilitydomestic violence, orsubstance abuse
    41. 41. How does the sanction process work?Agreement of Mutual Responsibility (AMR)Alleged violationAdvanced notice (sanction threat)Compliance review Determining good cause Opportunity for advocacy!Fresh start vs. sanctionEnding the sanction or sending notice of sanction
    42. 42. How will a recipient know if she’s beingsanctioned?For either a childsupport or a work-related sanction, DPW isrequired to send advancenotice to the recipient,telling her she’s about tobe sanctioned. Recipient should APPEALTHIS NOTICEIMMEDIATELY, and askfor “aid paid pending.”
    43. 43. How will a recipient know if she’s beingsanctioned?For a work-related sanction, DPW must offer toconduct a “compliance review” before actuallyimposing the sanction. If DPW imposes a sanction without first offering a compliancereview, the sanction is illegal – appeal IMMEDIATELY! If no notice of sanction is received, sanction has probably beenimposed if the Cash Assistance grant is less than it should befor the family size/income level.At the compliance review, the recipient can explainwhy she did or did not do something required of her.
    44. 44. How will a recipient know if she’s beingsanctioned?The CAO is required to make a good faitheffort to assist the client in overcomingwhatever problems she had complying withwork requirements (CAH §135.5). Asexamples, DPW should: Reschedule appointments to better fit recipient’sschedule Provide help with transportation Provide help with childcare Explore revising her AMR
    45. 45. The importance of fighting sanctionsIndividuals and families are often sanctionedincorrectly, as a result of miscommunication,mental illness, domestic violence, disability, orother justifiable barriers to compliance.Sanctions have harsh impacts in both the shortand the long term. Child Support-related sanctions Work-related sanctions
    46. 46. The importance of fighting sanctionsChild Support-related sanctions: A TANF applicant/recipient is required to seek childsupport and establish paternity unless she has good causefor not doing so. If she does not cooperate with either requirement, thefamily’s grant will be reduced by at least 25%. This benefit reduction will continue indefinitely, until theparent cooperates or establishes “good cause.” The noncompliant parent stays on the TANF grant (eventhough her share of the cash is what’s technically beingtaken away), remains subject to the work requirements,and the benefits still count toward the five year timelimit.
    47. 47. The importance of fighting sanctionsWork-related sanctions IMPORTANT: with work-related sanctions, it’s a“three strikes and you’re out”-sanction scheme. Note: these sanctions will affect Cash Assistancebenefits, specifically; they should not affect SNAPor Medical Assistance benefits.
    48. 48. New penalties for First SanctionFirst Sanction: individual cut off from cashbenefits for 30 days Sanction continues until individual demonstratescompliance for at least one week After 90 days, if compliance not demonstrated,entire family ineligible until compliancedemonstrated for at least one week
    49. 49. New penalties for Second SanctionSecond Sanction: individual cut off fromcash benefits for 60 days Sanction continues until in compliance for atleast one week After 60 days, if compliance not demonstrated,entire family ineligible until compliancedemonstrated for at least one week
    50. 50. New penalties for Third SanctionThird sanction now makes entire familypermanently ineligibleBe sure to appeal any sanction notice!Remember “good cause” -- including domesticviolence
    51. 51. How to fight sanction threatsAppeal immediately, request “aid paid pending”outcome of appealExplore why non-compliant event occurred Common reasons: transportation issues, no childcare, domestic violence, illness, misunderstandingExplore possibility of “good cause” waiver Special note: ANY circumstances beyond recipient’scontrol can probably qualify as good cause; usecommon sense! If the reason was good and recipientis acting in good faith, there’s room to advocatesuccessfully.
    52. 52. How to fight sanction threatsExamples of circumstances that qualify for “good cause”waiver of work requirements (55 PA Code § 165.51): Recipient tried to get care for a child or adult with disabilities, butcould not. Domestic violence. Homelessness. Transportation problems. Recipient or family member was ill. Job or job training was beyond recipient’s ability, and she is willingto look for another job or do other training. Working conditions were substandard or unsafe, or wages paid werebelow minimum wage or below the prevailing wage normally paid forthat job. Participation in drug or alcohol treatment can be “good cause” if thetreatment program prevents recipient from working at the sametime. Other personal emergency.
    53. 53. How to fight sanction threatsA recipient with limited English proficiency cannotbe sanctioned for failing to attend an activity or ameeting if she was given notice of it in a languageshe does not understand (Title VI of the CivilRights Act of 1964)DPW cannot sanction recipient for not doingsomething she only volunteered to do; may onlysanction for failing to do something she wasrequired to do (CAH § 135.261) Some items in the AMR are mandatory, some are not;recipient (or her advocate) should always check to seewhat the AMR actually says!
    54. 54. How to fight sanction threats“Benefit of the doubt”policy: DPW issupposed to giverecipient the benefit ofthe doubt whendeciding to approve ordeny someone awaiver. DPW must consider allfacts and circumstancesof the alleged violation,“especially if thetransgression isrelatively minor… orisolated in nature” (55PA Code § 165.52(b))
    55. 55. How to fight current or past sanctionsFor sanctions that have already been imposed: It is sometimes possible to get a sanction lifted whileit is in effect, or even retroactively, if the facts showthat the recipient had good cause at the time of theviolation. This is important for two reasons: To get back the benefits that the recipient missed To get the “strike” removed from her record, if thesanction was work-related, since these are subject tothe “three strike” system that will result in permanentpenalties.
    56. 56. How to prevent sanctions or sanction threatsRecipient should: Communicate any problems or potential problems tocaseworker in writing. Verify information and get copies of all documents,especially her AMR! When possible, try to get written documentation ofproblems that interfere with ability to comply with workrequirements (i.e., illness of self or dependent child). Talk to a supervisor if caseworker is unresponsive. Notify both CAO and welfare work program contractor ifan appointment must be missed for good cause reasons. Notify both CAO and welfare work program contractor ifshe gets or loses a job.
    57. 57. DPW – local County Assistance Offices:Delaware CountyCrosby District (alsoDelaware CountyAssistance OfficeHeadquarters)701 Crosby Street Suite A,Chester, PA 19013-6099Phone: 610-447-5300FAX: 610-447-5399Darby District845 Main Street, Darby, PA19023Phone: 610-461-3800FAX: 610-461-3900Delaware CAO Headquarters
    58. 58. DPW – local County Assistance Offices:Chester & Philadelphia CountiesChester County AssistanceOffice100 James Buchanan Drive,Thorndale, PA 19372-1132Toll Free: 1-888-814-4698Phone: 610-466-1000FAX: 610-466-1130Philadelphia County AssistanceOffice Headquarters801 Market Street,Philadelphia, PA 19107Phone: 215-560-7226FAX: 215-560-3214Philadelphia CAO Headquarters
    59. 59. Pennsylvania Welfare Sanction PolicyDisclaimer: the information in this presentationis general legal information and is not intendedas legal advice to be applied to any particularcase.
    60. 60. ResourcesDPW Cash Assistance Handbook:http://services.dpw.state.pa.us/oimpolicymanuals/manuals/bop/ca/Legal Aid of SE PA = http://www.lasp.org/or toll-free 1-877-429-5994
    61. 61. ThankYou!For more generalinformation about thistopic:Laura Handel Schwartz,Esq.E-mail:LH.helpmlp@gmail.comFor legal assistance or tomake a referral, pleasecontact Legal Aid ofSoutheastern Pennsylvania(LASP) toll-free at:1-877-429-5994Questions?Referrals?
    62. 62. JORDAN MICKMAN, ESQUIREHELP: MLPCONSUMER LAW FELLOWConsumer Law Basics:From mortgage foreclosures tostudent loans
    63. 63. Consumer Law Basics: AgendaPrioritizing debtGarnishmentDebt collection harassmentBankruptcyCredit reportsFederal student loansMortgage foreclosure
    64. 64. Prioritizing DebtSecured vs. Unsecured DebtAlways pay secured debt firstExamples: Secured: Mortgages and Car loans Unsecured: Credit cards, legal and medical bills, loansfrom friendsException: Utility service (failure to pay cannot result in seizure ofassets to satisfy arrears, but can result in adverseaction)
    65. 65. Prioritizing Debt
    66. 66. Prioritizing DebtDebt should not move up in priority basedon creditor’s threats to sueDo not pay when legal defenses availableDo not pay lower priority debts based onsettlement offer if income is too limited topay more important expenses
    67. 67. Garnishment in PAWages Very limitedcircumstances Child/spousal support Federal student loans Unpaid rent Criminal restitution Some taxesBank account Once judgmentobtained, bankaccounts are fair game(with some exceptions) Wages deposited intobank account are NOTprotected Exception: Social Securitypayments depositedinto bank accountcannot be garnished
    68. 68. Debt Collection HarassmentI’ve stopped paying, but now they won’tleave me alone. Now what?What debt collectors CAN do: Stop doing business with the consumer Report default to credit bureau Sue in court Just because they can, doesn’t mean they will Suing and winning a judgment are not the same if theconsumer shows up to defend
    69. 69. Debt Collection HarassmentWhat debt collectors CANNOT do: Abusive, deceptive, and harassing tactics Continue contacting consumer after: Written request to cease & desist contacting consumer Consumer disputes debt in writing Communicate with 3rdparties about a debt w/o theconsumer’s permission Exception: can request location info from 3rdparties Call at known inconvenient times or places Generally before 8:00 a.m. or after 9:00 p.m. Threaten arrest or wage garnishment
    70. 70. Avoiding Collection HarassmentCall the creditor first! Possibly arrange deferment or repayment agreementbefore turned over to collectionWrite a letter requesting the collector to stopcollection efforts Explain why unable to pay now Explain expectations for repayment in the future Send by certified mail if possibleDispute debt within 30 days of first writtencollection attemptFile complaint with Govt. agency (FTC, CFPB,AG) and send the complaint to the collectorBankruptcy
    71. 71. Bankruptcy BasicsWhat bankruptcyCAN do: Discharge most debts Stop foreclosure andprovide chance tocatch up on missedmortgage payments Prevent repossessionof car or otherproperty Stop collectionharassment Restore or preventshut-off of utility
    72. 72. Bankruptcy BasicsWhat bankruptcy CANNOT do: Eliminate security interest of creditors Discharge: child support, alimony, most studentloans, criminal fines, certain taxes Protect co-signers (if only one co-signer files, theother is left solely responsible) Discharge debts that arise after filing Prevent eviction after landlord has judgment forpossession
    73. 73. Bankruptcy BasicsChapter 7 (straight bankruptcy) Discharge debts in exchange for giving up non-exemptproperty.Chapter 11 (corporate reorganization)Chapter 12 (family famers)Chapter 13 (reorganization) File a plan showing how the consumer will repay debts overa period of 3 to 5 years. Can keep valuable property if consumer makes paymentsaccording to the plan Must prove to court that consumer has regular income Payments usually go UP in chapter 13 plans
    74. 74. Credit ReportsType of info on thereport: Name, DOB, SSN, currentand former addresses Employment info Payment history on creditaccounts List of creditors whorequested a copy of thereport Public records(bankruptcy, foreclosure,judgment)Who can see it? Creditors Potential employers Insurers Govt. agencies tryingto collect childsupport Landlords
    75. 75. One Free Report Each Year(Experian, Equifax, & Transunion)Getting a copy: Online at:www.annualcreditreport.com By phone: 877-322-8228 By mail: Annual CreditReport Request Service,P.O. Box 105281,Atlanta, GA, 30348-5281Credit Reports
    76. 76. Federal Student LoansTypes of Federal Loans Subsidized No interest while in school, grace period, or deferment Unsubsidized Not based on financial need; interest charged at all times Plus Pay for expenses up to the cost of attendance, minusother financial aid Parent Plus (parent co-signs for dependant children) Graduate Plus (no co-signer needed for graduateschool) Consolidation Combine the above into a single loan
    77. 77. Federal Student LoansGrace Periods: Subsidized &Unsubsidized 6 month graceperiod Direct Plus No “grace” period But:6 monthautomatic“deferment” forGraduate Plus andParent Plus
    78. 78. Repaying Student LoansAuto Payment = 0.25% reduction in interestrateDelinquent vs. Default Delinquent: Payment not received by due date Default: Payments not made for 9 monthsConsequences of Default: Acceleration of loan debt Tax lien, garnishment, denial of professionallicense, ineligible for new student loans
    79. 79. Repaying Student LoansSolutions for Default Loan Rehabilitation Borrower and Servicer agree on reasonable andaffordable repayment plan Make voluntary payments on the agreed-uponrepayment plan (6-9 months usually) Loan Consolidation First make several voluntary payments Then, consolidate defaulted loan Loan Consolidation = Paying off old loan, andissuing new loan
    80. 80. Student Loan Repayment Plans
    81. 81. Student Loan Repayment PlansStandard 10 year repayment plan Lowest interest chargeGraduated 10 year plan; payments grow over timeExtended Fixed or graduated payments up to 25 yearsIncome-BasedPay As You Earn
    82. 82. Income Based Repayment PlanMaximum monthly payment is 15% ofdiscretionary income Discretionary Income = AGI – 150% of povertyguideline Up to 25 years repayment Any balance after 25 years is forgiven Must have a partial financial hardship Examples: Family Size of 1 with AGI of $45,000 has repayment of$353 per month Family Size of 4 with AGI of $45,000 has repayment of$130 per month
    83. 83. Public Service Loan ForgivenessCriteria: Make 120 on-time, full,scheduled, monthlypayments Work full-time atqualifying public serviceorg. Payments made inqualifying repayment plan IBR or ICR Standard technically,but after 10 years, nobalance to be forgiven!
    84. 84. Forgiven, Cancelled, or DischargedTotal and Permanent Disability Discharge Unable to engage in substantial gainful activityby reason of medically determinable physical ormental impairment that: Expected to result in death Has lasted, for continuous period of no less than 60months Can be expected to last for 60 months, or Unemployable due to service-connected disability (asdetermined by VA)
    85. 85. Forgiven, Cancelled, or DischargedDeath Discharge If the borrower dies, the loan will be discharged Parent Plus: If the Parent or the Student dies,the loan will be dischargedClosed School Discharge School closes while you’re enrolled and unableto complete program School closes within 90 days after you withdrawTeacher Loan ForgivenessPublic Service Loan Forgiveness
    86. 86. Mortgage ForeclosureHousing Counselors! Loan Modification / HEMAPAct 6 (Right to Cure) Before filing in court, lender must give at least 30days notice of intention to foreclose Act 6 notice must tell homeowner the amountneeded to repay in order to prevent court filingAct 91 (HEMAP) Emergency mortgage assistance program to non-FHA borrowers who fall behind through no fault oftheir own (unemployment, divorce, medical)
    87. 87. ResourcesConsumer Complaints CFPB:http://www.consumerfinance.gov/complaint/ FTC: https://www.ftccomplaintassistant.gov/ PA Attorney General:http://www.attorneygeneral.gov/complaints.aspx?id=451 Delaware County:http://www.co.delaware.pa.us/consumeraffairs/consumer.html
    88. 88. Thankyou!Contactinformation:Jordan Mickman,Esq.Phone: 610-497-7395Email:jm.helpmlp@gmail.comQuestions?
    89. 89. DANIEL ATKINS, ESQUIREHELP: MLPCO-DIRECTORSSI and SSDI: The basics of SocialSecurity Disability
    90. 90. Basics of Social Security Disability: AgendaDifferences between SSI and SSDIncome eligibilityBenefit amountsEligibility criteria & determination Non-Citizens Children AdultsAppeals processSpecial circumstancesWhat to look forOverpaymentsRepresentative Payee
    91. 91. SupplementalSecurity IncomeSocial SecurityDisability A means-testedpublic benefit forpeople who are poorand disabled Health Insurance:MedicaidInsurance for people whohave worked or children ofdisabled/deceased workers.Health Insurance:Medicare after two yearwaiting period. Waiting period starts withmonth of entitlement (5months after the onset date).Basics of SSI/SSD
    92. 92. Income eligibilityTo qualify for SSI you must have little or no income and fewresources. This means that the value of the things you own mustbe less than $2,000 if you are single or less than $3,000 if youare married. Child support counts. The value of your home doesnot count. Usually, the value of your car does not count up to$4,500. And the value of certain other resources, such as a burialplot, may not count either.In-kind income and support counts so if family memberproviding or paying for food or shelter, that amount will besubtracted from monthly SSI amount. Pay for cell phone or cabledirectly to vendor. Money to recipient is considered income.
    93. 93. Benefit AmountsSSI $710 federal benefit amount. No earlier than applicationdate.SSD Amount of cash benefit varies. Can go back to onset date but can’t be paid more than oneyear prior to the application date. Five month waiting period from onset to date ofentitlement.
    94. 94. Eligibility for Non-CitizensIf you are not a U.S. citizen, but you are a resident,you still may be able to get SSI.A non-citizen qualifies if he or she is lawfullyadmitted for permanent residence in the U.S. and: is a refugee or asylee in his/her first 5 years of U.S.residency; or is an active duty member of, or an honorably dischargedveteran of, the U.S. Armed Forces, or is the spouse orunmarried dependent minor child of such a person; or has worked and earned 40 quarters of credit (10 years)under Social Security;
    95. 95. Disability EligibilityEvaluation the same for adult SSI and SSD Onset differences: SSI can be no earlier thanapplication date. SSD can go back to onset date,but no pay more than one year prior to applicationdate.5 month waiting period for SSDIf dual application, can get SSI and Medicaidduring waiting periodDifferent for adults and children
    96. 96. Child Disability Standard: 3 Step Analysis
    97. 97. Functional Equivalence “Marked” in twodomains offunctioning. “Marked” meansinterferes seriouslywith child’s abilityto independentlyinitiate, sustain orcomplete activities. Extreme in onedomain . “Extreme” =seriouslyinterfere . . .
    98. 98. 6 Domains of Functioning
    99. 99. Adult Disability Standard:5 Step Analysis1. SGA- Substantial GainfulActivity in 2013 > 1040 If No, proceed. If Yes, lose.1. Severe MedicallyDeterminableImpairment? Severe if significantly limitsability to do basic work Not severe if slightabnormality with no morethan minimal effect onability to do basic work. If Yes, proceed to step 3.If No, lose.3. Meet or equal a listing?And expected to last 12months. If Yes, win. If No, proceedto 4.4. If don’t meet a listing–can do past work? If Yes, lose. If No, proceed to5.5. Can you do any otherwork? If Yes, lose. If No, win.
    100. 100. SSA Appeals Process
    101. 101. Ineligibility While IncarceratedSSD and SSI not payable for monthsconfined to a jail or prison or another publicinstitution.No benefits for any month in which youviolate a condition of probation or parole.Children receiving benefits on your accountcan receive benefits when you are in prison.Upon release, request benefits to re-start byproviding SSA with copy of releasedocuments.
    102. 102. Protecting SSI Eligibility if WindfallIf client going tocome into money–perhaps a settlementfrom a lawsuit, forinstance– refer to alawyer for advice onhow to set up a trustto protect eligibilityfor Medicaid/SSI.Windfalls don’timpact SSD.
    103. 103. What to Look ForAnyone in special educationChild failing in schoolChild struggling socially or at homeAny child or adult who has been in-patient formental health problems.Any adult with a serious impairment who has beenout of work for a long time.Any child with a serious impairment who hasmissed school.Chronic homelessness.
    104. 104. Questions to AskHow is your child doing in school?How is your child doing socially? At home?Were you in special education? How fardid you go in school? Where did you go toschool?How long have you been out of work?Are you receiving treatment for your mentalhealth condition?Have you ever applied for SSI/SSD before?
    105. 105. OverpaymentsWork or other income not reportedproperly.No longer disabled or eligible.SSA recovers by withholding of benefits.Request Waiver if without fault ofbeneficiary and hardship to repay. For SSIrecipients, hardship automatic.Request Reconsideration if overpayment.
    106. 106. Representative PayeesIf beneficiary cannot manage own money.SSA must approve.To change to own payee, doctor mustsubmit letter supporting ability to managemoney.Mental illness does not necessarily meanrecipient needs a payee.
    107. 107. SummarySSI SSDMedical Insurance MedicaidMedicare two yearsafter five months afteronsetFinancial CriteriaYes – must meetincome/resource testsNo, but work historyrequiredDisability Criteria Sequential Evaluation Sequential EvaluationBenefit Amount$710 retroactive to dateof applicationDepends on how muchclaimant paid in andstarts five months afteronset
    108. 108. ObservationsDon’t SaveDon’t work toomuchDon’t expect muchDon’t expect theprocess to be quickand painless.
    109. 109. ResourcesSocial Security Administration Bluebook (disabilitylistings):http://www.ssa.gov/disability/professionals/bluebook/Social Security Administration Forms page:http://www.ssa.gov/online/forms.htmlSocial Security Administration POMS (subregulatory materials):http://policy.ssa.gov/poms.nsf/aboutpomsNational Association of Social Security ClaimantsRepresentatives (NOSSCR): http://www.nosscr.org/
    110. 110. Thankyou!Contactinformation:Daniel Atkins,Esq.Phone: 484-557-0171Email:da.helpmlp@gmail.comQuestions?
    111. 111. VISIT US ON THE WEB:WWW.HELPMLP.ORGThank you!http://on.fb.me/10OTObX@HELPmlp

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