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
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
AgendaIntroduction Joanne Craig, Project Director of Crozer-Keystone Healthy Start Daniel Atkins, Co-Director of HELP: MLPThe Affordable Care Act: What it means for clients Shannon Mace Heller, JD, MPHPennsylvania Welfare Sanction Policy Laura Handel Schwartz, EsquireConsumer Law Basics: From mortgage foreclosures tostudent loans Jordan Mickman, EsquireSSI and SSDI: The basics of Social Security Disability Daniel Atkins, Esquire
HELP: MLPHealth, Education& Legal assistanceProject: A Medical-Legal Partnership(HELP: MLP) is acollaborationbetween Crozer-Keystone HealthyStart, Crozer-Keystone NurseFamily Partnershipand WidenerUniversity Schoolof Law.
SHANNON MACE, JD, MPHHELP: MLPPUBLIC HEALTH LAW SPECIALISTThe Affordable Care Act: Whatit means for clients
The Affordable Care Act: AgendaBackground of the Affordable Care Act (ACA)Major Provisions Coverage Reform Quality/Payment Reform Individual Mandate Eligibility & Enrollment Health Insurance MarketplaceState ImplementationMedicaid ExpansionTakeaways
Healthcare in the United StatesFragmented Complex PoliticalExpensive Unequal Reactive
Goals of the ACAIncreasing access to care for ALL individuals regardless ofrace, ethnicity, gender/sexual identity, income or disabilitystatusUsing data to identify areas of need and drive improvementwithin the healthcare systemProviding comprehensive, holistic care to individuals thataddress unmet needs including those beyond the traditionaltreatment settingImproving health information technology to reduceduplication of services, improve exchange of information,reduce errors and improve individuals’ access to informationStrengthening the healthcare workforce including, increasingdiversity and capacity in underserved areasIncreasing access to prevention and health promotion services
The Affordable Care ActFive majorcomponents:Coverage ReformQuality ReformPayment ReformInsurance ReformHealthInformationTechnologyReform
Coverage ReformMany provisions are already in effect:Pre-existing condition coverage to age 19Family coverage to age 26No annual or lifetime limitsClosing the Medicare Donut HoleNo co-pays/deductibles for prevention/promotion interventionsMedical loss ratio now at 85 and 80 %
Quality & Payment Reform:A Move to Integrated CarePatient Centered MedicalHomes (PCMH) andHealth HomesAccountable CareOrganizationsEstablishment of NationalQuality MeasuresEstablished the PatientCentered OutcomesResearch Institute(PCORI)Innovation grant funding
Individual MandateMost controversialprovision of the ACARequires individuals toobtain health insurance orpay a penaltyPenalties 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)
Eligibility & EnrollmentMajor 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
Health Insurance MarketplaceStates must establish by January 2014 or default tothe Federal governmentSeveral 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
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.”
Federally Facilitated Marketplace:Implementation Issues in PAInfrastructure Pennsylvania returned Health Insurance Exchange Establishmentfunding to the Federal governmentEducation and Outreach 896,000 eligible for tax subsidies through Marketplace in PAChanges to eligibility calculation Movement to Modified Adjusted Gross Income (MAGI) $13 million in PA’s Dept. of Public Welfare (DPW) BudgetQualified Health Plan (QHP) selection (HHS to decide) Supplementation of default benchmark planMedicaid determination State has the option of accepting federal determination as binding ornot
For Expansion Against ExpansionIncreased access tocoverage & careSignificant fundingsource 100% FMAP 2014, 2015,2016 90% 2020 and beyondJob creator“The right thing to do”Too much reliance onpublic systemIncreased costs due toadministration &“woodwork effect”Job killerPolitical ideologyMedicaid Expansion in PA: The Debate
PA Medicaid Expansion:Recent ActivityGovernor Corbett metwith Sec. Sebelius April 2ndConsidering alternativeoptions like the ArkansasPlanWill not move forwarduntil “more informationfrom HHS”Legislation introduced inPA Senate
Issues withoutExpansionOpportunities withExpansionIncrease in individualsseeking services due toElimination ofDisproportionateShare Hospital (DSH)payments could resultin a loss of $8.1 billionover next 10 yearsCoverage gap forindividualsOpportunity to expandinsurance coverage toappx. 650,000 PAresidentsEnsuring access to highquality health servicesMaintaining efficiencyMedicaid Expansion
PA Coverage GapSource: PA Health Law Project, Medicaid Expansion in Pennsylvania IsGood For Families (2013).
TakeawaysThe implementation of the ACA will take place overmany years; however, major provisions take effect in2014Many individuals will need assistance navigating thenew Health Insurance MarketplaceIndividuals currently receiving Medical Assistanceshould not lose coverageMany advocacy opportunities exist with regard to theimplementation of the ACA
The promiseof the ACA:The AffordableCare Act hasgreat potential toincrease healthequity withinPennsylvaniaHowever, inorder to fulfillthat potential thestate mustimplement fullyin a meaningfulway.
ACA ResourcesPhiladelphia Department of Behavioral Health &Intellectual disABILITY Services, Health Reform & HealthEquity Unit: http://dbhids.org/health-reform-health-equity-unitwww.Healthcare.govKaiser Health Reform Source: http://kff.org/health-reform/Health Reform GPS: www.healthreformgps.orgCMS, Streamlined Application:http://go.cms.gov/11SGmKFPA Health Law Project: http://www.phlp.org/home-page/reformPA Health Access Network: http://pahealthaccess.org/
Laura Handel Schwartz, EsquireHELP: MLPStaff AttorneyPennsylvania Welfare Sanction Policy
Welfare Sanction Policy: AgendaWhat are sanctions?Reasons sanctions are issuedSanction issuesKey conceptsHow does the sanction process work?How will a recipient know she’s being sanctioned?Importance of fighting sanctionsNew penaltiesHow to fight sanction threatsHow to prevent sanction threatsCounty Assistance Office information
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.
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.
Why is this subject important now?Sanctions are used as astrategy to reducewelfare benefit caseload– related to DPWphilosophy and budgetNew sanctions up 130%from January 2011 tocurrent dateSanctions that were ineffect already now up72%Image from www.philly.com.
Another view: Growth in New Sanctions New Sanctions Statewide Sanctions in effect Statewide
Reasons DPW issues sanctionsTANF 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
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.
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.”
Key concepts: Willful NoncomplianceWillful 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.
Key Concepts: Good CauseAsking 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.
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:disabilitydomestic violence, orsubstance abuse
How does the sanction process work?Agreement of Mutual Responsibility (AMR)Alleged violationAdvanced notice (sanction threat)Compliance review Determining good cause Opportunity for advocacy!Fresh start vs. sanctionEnding the sanction or sending notice of sanction
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.”
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.
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
The importance of fighting sanctionsIndividuals 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
The importance of fighting sanctionsChild 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.
The importance of fighting sanctionsWork-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.
New penalties for First SanctionFirst 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
New penalties for Second SanctionSecond 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
New penalties for Third SanctionThird sanction now makes entire familypermanently ineligibleBe sure to appeal any sanction notice!Remember “good cause” -- including domesticviolence
How to fight sanction threatsAppeal immediately, request “aid paid pending”outcome of appealExplore why non-compliant event occurred Common reasons: transportation issues, no childcare, domestic violence, illness, misunderstandingExplore 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.
How to fight sanction threatsExamples 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.
How to fight sanction threatsA 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!
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))
How to fight current or past sanctionsFor 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.
How to prevent sanctions or sanction threatsRecipient 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.
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
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
Pennsylvania Welfare Sanction PolicyDisclaimer: the information in this presentationis general legal information and is not intendedas legal advice to be applied to any particularcase.
ResourcesDPW 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
ThankYou!For more generalinformation about thistopic:Laura Handel Schwartz,Esq.E-mail:LH.firstname.lastname@example.orgFor legal assistance or tomake a referral, pleasecontact Legal Aid ofSoutheastern Pennsylvania(LASP) toll-free at:1-877-429-5994Questions?Referrals?
JORDAN MICKMAN, ESQUIREHELP: MLPCONSUMER LAW FELLOWConsumer Law Basics:From mortgage foreclosures tostudent loans
Prioritizing DebtSecured vs. Unsecured DebtAlways pay secured debt firstExamples: Secured: Mortgages and Car loans Unsecured: Credit cards, legal and medical bills, loansfrom friendsException: Utility service (failure to pay cannot result in seizure ofassets to satisfy arrears, but can result in adverseaction)
Prioritizing DebtDebt should not move up in priority basedon creditor’s threats to sueDo not pay when legal defenses availableDo not pay lower priority debts based onsettlement offer if income is too limited topay more important expenses
Garnishment in PAWages Very limitedcircumstances Child/spousal support Federal student loans Unpaid rent Criminal restitution Some taxesBank account Once judgmentobtained, bankaccounts are fair game(with some exceptions) Wages deposited intobank account are NOTprotected Exception: Social Securitypayments depositedinto bank accountcannot be garnished
Debt Collection HarassmentI’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
Debt Collection HarassmentWhat 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
Avoiding Collection HarassmentCall the creditor first! Possibly arrange deferment or repayment agreementbefore turned over to collectionWrite 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 possibleDispute debt within 30 days of first writtencollection attemptFile complaint with Govt. agency (FTC, CFPB,AG) and send the complaint to the collectorBankruptcy
Bankruptcy BasicsWhat 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
Bankruptcy BasicsWhat 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
Bankruptcy BasicsChapter 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
Credit ReportsType 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
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
Federal Student LoansTypes 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
Federal Student LoansGrace Periods: Subsidized &Unsubsidized 6 month graceperiod Direct Plus No “grace” period But:6 monthautomatic“deferment” forGraduate Plus andParent Plus
Repaying Student LoansAuto Payment = 0.25% reduction in interestrateDelinquent vs. Default Delinquent: Payment not received by due date Default: Payments not made for 9 monthsConsequences of Default: Acceleration of loan debt Tax lien, garnishment, denial of professionallicense, ineligible for new student loans
Repaying Student LoansSolutions 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
Student Loan Repayment PlansStandard 10 year repayment plan Lowest interest chargeGraduated 10 year plan; payments grow over timeExtended Fixed or graduated payments up to 25 yearsIncome-BasedPay As You Earn
Income Based Repayment PlanMaximum 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
Public Service Loan ForgivenessCriteria: 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!
Forgiven, Cancelled, or DischargedTotal 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)
Forgiven, Cancelled, or DischargedDeath Discharge If the borrower dies, the loan will be discharged Parent Plus: If the Parent or the Student dies,the loan will be dischargedClosed School Discharge School closes while you’re enrolled and unableto complete program School closes within 90 days after you withdrawTeacher Loan ForgivenessPublic Service Loan Forgiveness
Mortgage ForeclosureHousing Counselors! Loan Modification / HEMAPAct 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 filingAct 91 (HEMAP) Emergency mortgage assistance program to non-FHA borrowers who fall behind through no fault oftheir own (unemployment, divorce, medical)
DANIEL ATKINS, ESQUIREHELP: MLPCO-DIRECTORSSI and SSDI: The basics of SocialSecurity Disability
Basics of Social Security Disability: AgendaDifferences between SSI and SSDIncome eligibilityBenefit amountsEligibility criteria & determination Non-Citizens Children AdultsAppeals processSpecial circumstancesWhat to look forOverpaymentsRepresentative Payee
SupplementalSecurity IncomeSocial SecurityDisability A means-testedpublic benefit forpeople who are poorand disabled Health Insurance:MedicaidInsurance 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
Income eligibilityTo 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.
Benefit AmountsSSI $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.
Eligibility for Non-CitizensIf 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;
Disability EligibilityEvaluation 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 SSDIf dual application, can get SSI and Medicaidduring waiting periodDifferent for adults and children
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.
Ineligibility While IncarceratedSSD 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.
Protecting SSI Eligibility if WindfallIf 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.
What to Look ForAnyone in special educationChild failing in schoolChild struggling socially or at homeAny 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.
Questions to AskHow 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?
OverpaymentsWork 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.
Representative PayeesIf 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.
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
ObservationsDon’t SaveDon’t work toomuchDon’t expect muchDon’t expect theprocess to be quickand painless.
ResourcesSocial Security Administration Bluebook (disabilitylistings):http://www.ssa.gov/disability/professionals/bluebook/Social Security Administration Forms page:http://www.ssa.gov/online/forms.htmlSocial Security Administration POMS (subregulatory materials):http://policy.ssa.gov/poms.nsf/aboutpomsNational Association of Social Security ClaimantsRepresentatives (NOSSCR): http://www.nosscr.org/