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Minute
#35
Minute #80
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Brian
Therrien:
How are you today? For
everybody that doesn’t know, Barbara Mountain doesn’t live actually too
far from me. You’re down in New
Hampshire, right? Barbara Mountain:
I am. I’m in southern New
Hampshire. Brian Therrien: Southern New Hampshire. All we need is a little snow and life would be good for us all up here. Barb has had an extensive background and experience in dealing with Social Security, Social Security Disability, and it’s nice to have you come out and speak to our group today. But, so that everybody understands a little bit about your background, you spent 16+ years in this business, right? Barbara
Mountain:
I have. Brian
Therrien:
I was reading what you’ve done. You’ve
gone through everything from working with actual Social Security Disability
claims to customer satisfaction to service, quality control, training and
you’ve actually been -- you work for the Social Security Administration,
itself, correct? Barbara
Mountain:
Yes, I did. Yes, I did.
For seven years. Brian
Therrien:
Seven years and then came out of that and went into the private sector,
let’s call it, and worked on the, you know, what we call our member side or
direct-to-consumer, people trying to get their disability benefits and
actually established a program that had a 90 percent or 99 percent success
rate of getting people approved. That
is remarkable. Barbara
Mountain:
Right, yep, and the company that I work for now.
That’s what we do. We
focus on helping people get on Social Security Disability.
That’s the only type of people we work with. Brian
Therrien:
And now you work for IBI in Missouri? Barbara
Mountain:
That’s right. Brian
Therrien:
Integrated Benefits, Incorporated. Barbara
Mountain:
Integrated Benefits, Incorporated. Brian
Therrien:
Very nice. And so we’re
anxious to learn all about you folks and what you do and the great work that
you’ve done, but, you know, not to pick apart your -- what you’ve done in
the past but, just out of curiosity and for the audience as well as myself,
when you were working with the Social Security Administration as a Social
Insurance Specialist, what is that? Barbara
Mountain:
That is the person that you talk to when you go to Social Security and
you want to file for benefits, whether it be retired benefits, widow’s
benefits, or disability benefits. It’s
the person who’s going to take the application with you to make sure you
meet all factors of entitlement other than the medical condition.
So it’s who you talk to on the phone if you file by phone, it’s who
you sit and talk with when you file in person in the office.
And then they’re the people that, once the claim -- the medical
decision’s been made by DDS,
Disability Determination Services, it goes back
to the Social Security Field Office and it’s that Social Security employee
that then will process the claim into pay or process the claim to a denial. Brian
Therrien:
Okay. So you have a -- so
from this and, obviously, all the work that you’ve done in having a 99
percent success rate in the program, you’ve got a pretty good idea of what
is going to be a valid claim and not, right? Barbara
Mountain:
Yeah. Brian
Therrien:
I would expect. Barbara
Mountain:
Yep. Brian
Therrien:
Okay, good. So for those of you in the audience, regardless if you’re
approved for Social Security Disability or not or somewhere in between, this
really is a great opportunity, with Barb’s experience, to learn everything
you need to know to get through the process and I also have a big chunk of
questions for Barb today about those that are already approved and what the
future of the program is. So sit
back, relax, and let’s get into some stuff here.
Let’s start with the basics. What
is -- what is Social Security? Let’s
start -- let’s pull it all the way back to that and what are the advantages
of receiving a check or advantages of Social Security besides the monetary
check that a lot of people may not be aware of? Barbara
Mountain:
Well, Social Security is an insurance program.
A lot of people don’t think of it as insurance, but that’s what it
is. It’s insurance for workers.
So the only way you pay into Social Security is, basically, by working
and your premiums are your FICA taxes. So
you pay FICA on your wages or your debt from self-employment and that is how
you get the coverage -- you get this insurance coverage.
Now Social Security Disability is an income replacement program for
people who are unable to work. That’s
-- that’s what it was designed to do. The
definition of disability for Social Security is a disability that’s expected
to last for at least 12 months or result in death.
So you’re unable to work and you have a condition that’s going to
last for at least 12 months is what they’re looking for. Brian
Therrien:
Mm-hmm. Barbara
Mountain:
In terms of the advantages, you know, obviously the monetary check is
important. That’s the basic
foundation of the benefit you’re getting.
But there’s a whole lot more that a lot of people realize why it’s
important to file for disability benefits with Social Security benefits if
you’re out. You know, one,
you’re probably aware of Medicare. To
have that extra health insurance even if you already have current coverage,
you’re entitled to Medicare 24 months after your date of entitlement to
Social Security Disability. The
only exceptions to that are if you had end-stage renal disease or ALS.
In those cases you can get Medicare almost immediately, within three
months, but for everybody else you do have to wait two full years beyond when
you’re first entitled to disability to get that Medicare.
Another benefit, and this is probably -- Brian
Therrien:
Can I pause you there, Barb.
You just said something -- Barbara
Mountain:
Sure, go right ahead. Brian
Therrien:
You just said something that I was not aware of and I want to make sure
I get it. What are the two
conditions that would allow you to get Medicare right away? Barbara
Mountain:
End-stage renal disease. So
if you need a kidney transplant, if you’re on self-dialysis, that can get
you Medicare right away. Brian
Therrien:
Okay. Barbara
Mountain:
And ALS, Lou Gehrig’s disease. ALS
has been added to that list. That’s
relatively new in the past, I’d say, three or four years. Brian
Therrien:
Are both of these relatively new? Barbara
Mountain:
No. End-stage renal’s
been around a long, long time. Since
before I started, so over 16 years -- Brian
Therrien:
Okay. Barbara
Mountain:
-- since before I came into it. Brian
Therrien:
Okay. Well, didn’t know
that. That’s great.
Okay. Sorry to interrupt. Barbara
Mountain:
Nope, go right ahead. The
disability freeze provision. This
is probably one of the most important reasons to file for disability benefits
and most people do not -- do not know what this means or are even aware of
this. But when you’re out on
disability, typically you’re not working, but every year you’ve got
earnings going into your earnings record with Social Security.
So if you’re not working, you’ve got zero going into your earnings
record. Well, when you file for
Social Security benefits at any point, whether it be a disability benefit in
the future or it’s your retirement benefit, the way they calculate your
benefit is they take your lifetime’s worth of earnings, it’s not your top
three, it’s not your high five, it’s your lifetime, so when you file for
retirement benefits, they’re going to take your top 35 years.
What they do with that is they add up all your wages, they divide it by
420, which is the amount of months in 35 years, and they come up with your
average monthly wage over your lifetime. It’s
that figure that then goes into the formula that comes up with your benefit
amount. So the higher that average
monthly wage over your lifetime, the higher your Social Security benefit will
be. But if you’re not working -- Brian
Therrien:
Now, we’re talking Social Security retirement, now, right? Barbara
Mountain:
-- we’re talking retirement when we say 35 years, but it would work
the same -- Brian
Therrien:
Okay. Barbara
Mountain:
-- even if you were filing for disability. Brian
Therrien:
Okay. Barbara
Mountain:
It’s based on a lifetime’s worth of earnings and it’s coming up
with an average monthly wage. So
when you’re not working, you’re out of disability, you’ve got zeros
going into your earnings record. Well
down the road, that’s going to affect your Social Security benefit.
Your zeros for a whole year is certainly going to bring down your
average monthly wage. But if
you’re on Social Security disability, the years that you’re on Social
Security disability will be frozen out of any future computation.
So if you’re on disability for five years, those five years you were
not working will not be included when coming up with that average monthly
wage. So instead of taking the top
35 years, they’ll take the top 30 years you’re actually working to come up
with that average monthly wage. So
what you’re doing, in essence, is you’re protecting any future benefit
with Social Security from being eroded due to years when you were not working.
But the only way you have this happen is you have to be approved for
Social Security disability -- Brian
Therrien:
I gotcha. Barbara
Mountain:
-- and those years that you’re approved will not be included in that
future computation. Brian
Therrien:
So this would be applicable for somebody that’s got, you know, a
situation condition that would be four or five years let’s say.
For example, they know they’re going to be optimistically be able to
go back to work sometime -- Barbara
Mountain:
Mm-hmm. Brian
Therrien:
-- but they could either slug it out during their 401k or go this
route, which has advantages as you outlined, right? Barbara
Mountain:
Absolutely, yep. If they go
back to work, they’re protecting it and, of course, you know, the individual
that never filed Social Security disability, doesn’t get approved, you know,
they’re going to have a dramatic affect on reducing any future benefit
they’d be entitled to. Brian
Therrien:
Mm-hmm, mm-hmm. Barbara
Mountain:
You know, it’s particularly important for those people that have
recurrent conditions. They have a
condition, they can’t work, they go back to work, and it recurs.
Now, that second time they come on Social Security disability, it’s
going to be a dramatically higher benefit if they’re able to eliminate those
zero years. Brian
Therrien: Mm-hmm,
mm-hmm. Barbara
Mountain:
But the most successful disability [inaudible 08:48] and making sure
that you don’t have those zeros, because the less years of work you have to
work with the more zero is going bring down that future benefit. Brian
Therrien:
That’s a great strategy. Barbara
Mountain:
Yeah, yeah. It’s
important. Other benefits include
family benefits. The fact that if
you become disabled or you file for retirement benefits, there’s other
family members in your household that could be eligible for a benefit.
There’s your children. Children
under the age of 18. Spouse can be
eligible depending on the situation. There’s
aged spouse, if your spouse is 62 or older, or there’s a benefit to a spouse
if you have children under 16 in the household.
So it’s not just yourself that can be entitled to a check.
There’s other people in your household that can also be eligible.
And it’s Social Security’s job to look for those benefits for you. Brian
Therrien:
The key is you go to work. Barbara
Mountain:
Yes, yes. Also cost of
living increases. I mean I used to
be able to say every single year Social Security gives a cost of living
increase. Unfortunately, this
year’s the first year in over 30 years that you can’t say that.
There’s not going to be a cost of living increase this year but you
know, typically, there are and they range from -- I think the lowest I saw was
1.3 percent. In the 80s they were
up to about 13, 14, 15 percent. On
average they’re usually 3 to 4 percent per year that your benefit amount
will be increased. Brian
Therrien:
Yep. Recipients’
are going to have to be creative this year. Barbara
Mountain:
Right, yeah. Brian
Therrien:
So -- Barbara
Mountain:
The last thing I mentioned are work incentives.
I mean for those that that aren’t able to work but the goal is they
hope that, eventually, they will be able to, Social Security has some great
work incentives that people aren’t aware of that they encourage you to go
back to work and you don’t have to risk losing your benefits to try it out.
I’m a big proponent of that. I
think that, you know, a lot of people that are out on disability, if there’s
something they can do, they’d like to do it.
I mean, obviously, for the income alone, but Social Security really
does encourage that and they really do have a great program, so I can talk
more about that later if anyone had any questions, but if you are interested
in returning to work and you’re on or you’re thinking, you know, down the
road maybe if you got -- if things improved and you got to the point you could
return to work, it’s something to definitely talk to Social Security about
and inquire about. Brian
Therrien:
Sure. Let’s zero in on
that. I have a few questions set
aside that I’d like to learn more about from your perspective on that.
May I ask a few questions regarding the general, you know, the general
scheme of things for Social Security? Well,
actually, more specific questions. One
is one of the common things that we see is you have a stay-at-home mom, right?
Raised kids, did everything great, left the workplace. Barbara
Mountain:
Mm-hmm. Brian
Therrien:
Been out for, you know, eight, nine, ten years. Barbara
Mountain:
Mm-hmm. Brian
Therrien:
So, in that instance, the work history is not there. Barbara
Mountain:
Mm-hmm. Brian
Therrien:
And I know this is a problem in the system, but do you have -- I mean
is there any -- any insight that you have for those that fall into that sector
of the audience? Barbara
Mountain:
Yeah, what happens there is for Social Security disability different
from retirement benefits. Retirement
benefits, to be eligible, you have to have worked and earned 40 -- what’s
called 40 quarters over your lifetime. You
can earn a maximum of four quarters in a year, so it’s really just ten years
of work and it doesn’t matter when you earned it.
You may have worked from age 20 to 30 and you never worked again, but
at 62, you would be eligible for retirement benefits.
Disability is a little different in that not only do you have to be
what’s called fully insured, it means you’ve worked enough over your
lifetime based on your age, you have to be what’s called disability insured.
That means you have to have worked in the recent past from the point
you became disabled. What they
look at is they look at -- they go back ten years and you have to have worked
at least five of those ten years and you get technical.
What it means is they look back 40 quarters and you have to have worked
at least 20 quarters during the prior ten years. Brian
Therrien:
And paid your taxes. Barbara
Mountain:
Right, right, and the FICA taxes have been paid in. Brian
Therrien:
Yep. That is part of the
deal. Barbara
Mountain:
Yep. To get -- right
exactly, if you weren’t, you know, you weren’t paying -- you were working
but not paying those taxes; you’re not going to have the coverage.
It’s not going to show up. Brian
Therrien:
Yeah, yeah, okay. Barbara
Mountain:
For those people, there is SSI, which is Supplemental Security Income,
and that’s a disability program that is administered by Social Security.
It is not Social Security. It
is super confusing for people because you go to the Social Security office and
that’s where you file for it, but it’s not a Social Security program.
It is actually funded by general tax revenues and it’s based on
income. So when they start asking
you what do you have in resources, what do you have in the bank, how much
money do you make? They’re
asking, because they’re looking at the SSI program for you.
Social Security -- it doesn’t matter how much money you have in the
bank, it doesn’t matter if you won the lottery.
It’s an entitlement program that you paid for, but the SSI program is
based on need. So -- and for that
individual who has not paid into Social Security and is not eligible,
they’re going to want to look at that and look at your income and resources
and it’s a monthly benefit that you’re entitled to, but it is pretty
limited. It’s certainly not
enough that anyone can live on, but it is a disability benefit that’s out
there. Brian
Therrien:
Somebody could get both, correct? Barbara
Mountain:
Yeah, you can get both. SSI
is reduced. Based on any other
income you have, it will be reduced. So
the Social Security benefit you have is going to reduce the SSI benefit.
In order to get both, your Social Security benefit would actually have
to be less than the SSI benefit so you have that offset amount. Brian
Therrien:
Mm-hmm. Good to know.
On the other end of the work/aid spectrum, there’s a lot of question
and confusion around somebody that is approaching early retirement, age 62.
The questions are, and a lot of people I don’t think are aware, that
if you’re 62, 3, 4, all the way up to your 65th birthday, they
can apply for Social Security disability. Barbara
Mountain:
Mm-hmm. Brian
Therrien:
But could you outline, you know, some of the advantages of that and how
it relates to the check amount. Are
the check amounts the same? Are
they different? What happens when
you turn 65? Barbara Mountain: Okay, great. All right. Yeah, this is confusing and it’s something really important to know if you’re up towards the age 62 or beyond. What a lot of people don’t realize, is when you file for Social Security disability, the benefit amount you get is what you get if you were at your full retirement age. So if I filed to disability benefits today, my benefit amount would be what I get when I hit 67. That’s my full retirement age. So if I file for disability today and I continue to receive it and I continue to receive it the rest of my life, nothing’s going to change for me when I hit 67 or 65. It’s not going to change because I’m already getting my maximum amount. Now, when a person is approaching 62 or they’re already 62 or they’re 63 or they’re 64 and they go in to file for disability benefits, Social Security is going to advise them to do this. They’re going to say is what we should for you is we should start taking a retirement application for you today and let’s file for disability. The reason they’re going to take a retirement benefit for you is they can start paying you checks right away because you’re eligible based on your age. Now, when you take retirement early it is reduced. It’s reduced for every month you take it prior to your full retirement age. So it’s going to be a reduced amount. The reason you’re filing for disability at the same time is if you’re approved for disability benefits, the benefit amount is going to be up at the full amount. You’re not going to have that reduction that you take at retirement and you’ll get paid the difference. So if you get awarded the disability benefits and they’ve paid you $1,200 but you’re due $1,600 as a disabled individual, once you’re awarded, you’re going to get that $300 difference for those months. Brian
Therrien:
Okay, that’s great. So,
so from a monetary perspective, if somebody is clearly disabled, financially
it’s better for them to pursue disability? Barbara
Mountain:
Right, it is. File for
retirement if you need the income right now and then file for disability at
the same time and if you get the disability, it will wipe out any reduction
that you have as long as that date of disability is prior to when you started
receiving retirement. Brian
Therrien:
Okay. Now, Barbara, what
happens to the individual if, you know, we’ll use the -- their standard
retirement check was $1,200, their disability check is $1,600.
What happens when they turn 65? What’s
their check amount? Barbara
Mountain:
When they hit 65, it’s going to -- as long as they’ve been approved
for disability, they’re already at the higher amount, so they’ll already
be receiving the higher amount, which means nothing will change. Brian
Therrien:
So they’ll be at -- so they’ll -- okay, so they’ll be at -- Barbara
Mountain:
They’ll have already gone up. So
once they get awarded, they were getting the $1,200, as soon as they get
awarded disability, they’re gone up to the higher amount, the $1,600 and
it’s just going to stay at that rate. Brian
Therrien:
Okay. So if this -- see if
I get this. If this -- in this
example which is, I’m sure is a little vague, if this individual had waited
until they were 65 just to collect their regular disability, a regular
retirement check, would have check have been the same amount as their
disability check? $1,600? Barbara
Mountain:
Yeah, yeah. In most cases
it will be the same. Brian
Therrien:
Okay. Barbara
Mountain:
It could be slightly different. Something
called a benchmark year. That
could change based on retirement year versus the disability year but, yeah,
pretty much will be about the same. But
they’ll look at how much money they’ll have given out that they could have
gotten earlier by getting on disability and the Medicare. Brian
Therrien:
Sure. Barbara
Mountain:
You can get Medicare early. So
if you file at 62, you can get the Medicare, potentially, at 64 versus having
to wait until 65. Brian
Therrien:
Mm-hmm, mm-hmm. Barbara
Mountain:
The other thing to think about is most people, today, if their full
retirement age is not 65 anymore. You
know, it’s moved out based on your year of birth, so most people’s
retirement age now is around 66. Brian
Therrien:
Mm-hmm. Barbara
Mountain:
Sixty-five in ten months, even longer they have to wait to get that
full amount. In essence, there’s
no disadvantage to doing it unless you really wanted that full amount and you
file for retirement and disability and your disability claim was denied.
Then you’re stuck with that reduced retirement amount you took.
Once you take -- Brian
Therrien:
Oh right, okay. Barbara
Mountain:
-- the reduction ... Okay? Brian
Therrien:
Boy, I’ll tell you. You’ve
got to really think it through. Well,
thanks for sharing that with us. Barbara
Mountain:
Yeah. Brian
Therrien:
Is there any -- I’ve heard of some people said, listen, I took an
early retirement at 59½. Barbara
Mountain:
Mm-hmm. Brian
Therrien:
Is that -- is that a real deal? Barbara
Mountain:
They didn’t -- they didn’t take it from Social Security.
They’re probably talking about with their own employer. Brian
Therrien:
Oh. Barbara
Mountain:
You can’t get -- you cannot get retirement earlier than 62. Brian
Therrien:
Okay, all right. Barbara
Mountain:
They might be talking about -- well, no, they wouldn’t even be
getting widows -- widows or widowers benefits starts at the age of 60. Brian
Therrien:
Mm-hmm. Barbara
Mountain:
But disabled widow’s benefits or widower’s benefits you can get as
early as age 50. Brian
Therrien:
Mm-hmm. Barbara
Mountain:
But that means you’re filling for disability, but you’re actually
filing on your deceased spouse’s record and you still have to get a medical
decision, but you can actually get that as early as age 50. Brian
Therrien:
That’s interesting. How
do you get -- you have a deceased spouse -- Barbara
Mountain:
You have a deceased spouse. Brian
Therrien:
-- and you’re going to get a disability payment based on their
medical record. Barbara
Mountain:
Based on your medical record. You’re
disabled. Brian
Therrien:
Okay. On your -- okay.
I was going to say, how are you going to get a -- how are you going to
get a decision based on somebody -- Barbara
Mountain:
Yeah. Brian
Therrien:
-- okay. I gotcha.
I’m with ya. All right.
So I’m sure the folks in the audience out there that haven’t
applied or going through the process are like, you know, on the edge of their
seat saying, well, how long’s it going to take?
You know, what do you have to say to them?
That’s one of the common concerns oftentimes.
It prevents people from filing because they’re like just, oh my God,
you know, Johnny down the street tried to get it and it took him three years. Barbara
Mountain:
I mean there’s no doubt it’s frustrating.
I mean Social Security is not expedient, not timely.
They are making some changes, trying to improve some things.
But right now, the outlook isn’t that great.
Let me give you just some -- some Social Security statistics, okay?
This is Social Security’s national statistics on award rate.
At the initial level, only 36 percent of everyone who files is going to
be awarded and it’s going to take about 108 days to get awarded.
So, you know, we usually say three to six months for that initial claim
decision. The reconsideration
level, and that’s the first level of appeal, so everyone who’s denied the
initial level files the appeal for the reconsideration.
Only 14 percent of everyone who files for that reconsideration are
going to be awarded. So not many
are awarded at the recon level. And,
again, it’s about three to six months to get that decision.
It’s pretty similar to the timeframe for the initial level. Brian
Therrien:
Mm-hmm. Barbara
Mountain:
Denied at the reconsideration level, you’re going to go to a hearing
in front of an adjudicative law judge and the award rate is 63 percent and
that’s the best chance of being awarded.
So the best advice is just keep going.
Get to that hearing level, get to where you’re going before the judge
because that’s your best chance your best chance of being awarded.
However the rub here is by the time you get that hearing decision, that
hearing is going to take probably at least a year to get the hearing date.
Some cases you’re upwards to two years to get that hearing decision.
So it is, without a doubt, a lengthy process, you know, but some people
do get awarded and there’s things that you can do to improve your chances of
getting awarded. I mean it is a --
it is a factual statistic that having a representative can greatly increase
your chances of getting awarded at the initial level.
I recently saw a statistic from the National Organization of Social
Security Claims Reps and showed they can increase your award rate, at the
initial level, from 36 percent, which is the national average, to, I believe,
it was 62 percent. Brian
Therrien:
Depending it’s the right rep. Barbara
Mountain:
Right, it’s the right rep. You
know, I can tell you that our company, IBI, we have a 67 percent award rate at
the initial level. Brian
Therrien:
At the initial, that’s fantastic. Yeah.
The -- well, those statistics certainly are intimidating, but I would
-- I’m -- my sense is is that is the overall percentage, right? Barbara
Mountain:
Mm-hmm, yeah. Brian
Therrien:
And if you look at the overall -- the typical American has this, you
know, diner wisdom that they’re going to go apply on their own, one, because
that’s what everybody else they know has done; two, they don’t know the
other options unless they’ve, you know, either met you or come to the
Disability Digest. So they apply
on their own, they don’t do it right commonly, unfortunately, and they get
denied, so if you look at that then certainly that makes, you know, I can -- I
can see that and then when you get to the hearing, likely, they don’t go on
their own. So, all right -- Barbara
Mountain:
That’s exactly the situation. As
a matter of fact, if you go into a hearing unrepresented, they’ll actually
-- Social Security will try and stop it and say don’t you want to reschedule
and here’s a list of attorney’s that can work with you.
They don’t want people to come into -- Brian
Therrien:
Yeah. Barbara
Mountain:
-- a disability hearing without representation. Brain
Therrien:
Yeah. It’s not fair for
them, but they can do it. So well
that’s -- that’s good. So you
shared a little bit of, you know, the bad news, but there is -- there is some
good news for folks and for everybody listening to this.
You know, you’re in the right place to get the right resources to -- Barbara
Mountain:
Right. There is some good
news. They’re making some
changes. I mean they have what is
now quick disability determination process and something else called
compassionate allowances and they’re really -- Brian
Therrien:
Mm-hmm. Barbara
Mountain:
-- trying to beef those up and those are the claimant’s, you know,
sever disabilities and the idea is let’s get them awarded really quickly.
You know, we shouldn’t have to be spending a lot of time on these
claims. Let’s award them, get
them done, and move on to the claims that we need to do a little more
development on and they’re increasing those from last year, about 2.7
percent of all claims went through that and this year they expect to be over 4
percent of claims and that’s -- when you’re talking about three million
people filing for disability a year -- Brian
Therrien:
Sure. Barbara
Mountain:
-- that’s a pretty good percentage. Brian
Therrien:
Yeah, that -- Barbara
Mountain:
The goal there is they make those decisions within ten days. Brian
Therrien:
Certainly it’s a step in the right direction. Barbara
Mountain:
Mm-hmm. Brian
Therrien:
I want to go on to the next question and talk
about, you know, I don’t want you to give away all your trade secrets, Barb,
but I want to ask you a few things that your team at IBI does that allows and
helps with, you know, the member or claimants get through the 62 percent that
you’re mentioning, but before I do, I just want to outline to the audience
that IBI is what I view or call this, kind of coin this phrase, a full-service
disability representative and what most people do is file on their own from
the very beginning and there is
advantages to it and our position here at the Disability Digest is we don’t
advocate either way. We just -- we
advocate that you understand that that’s an option, explore it, and compare
that versus, you know, filing your own claim and then make up your own mind
based on an educated decision. With
that being said, the statistics that you’re sharing are really brilliant for
somebody getting through at the -- at the initial application and so to do
that am I correct in understanding that the work that you do is, you know,
somebody has to sign initial representation papers, they agree to work with
you as their representative, and you will work with them to groom and put
together their initial application. That
if they were to do it on their own and do the paper version, it would be 100+
forms, right? Barbara
Mountain:
Right. Basically what we do
is we fill out the forms with them on the phone so we work nationally.
We work with anyone. So
we’re --we’re are asking them all the questions and filling out those
applications for them, making sure that we’re answering everything
completely, we’re not missing out on any potential entitlements that they
might be eligible for, other people in their family for example, getting that
date of onset right, which is really important.
You know, date of onset sounds easy.
You know, what date were you disabled?
You know, when was the last date you worked?
But, you know, for a lot of people, that’s not a clear cut date.
They may have had a condition that they went out of work then they went
back to work and then they went back out of work again and Social Security has
some regulations that allow you to move that onset date back.
It’s called an unsuccessful work attempt.
But you need to know that and you also need to know that there’s
additional forms to be filled out to do that and so we’re going to do that
with them and make sure that we fill all that out correctly and one other
thing that makes this a little easy is that we hire at this -- we have three
teams and the team that does this, that takes these applications are all
former Social Security employees like myself.
But that’s what we were trained to do.
So we hire those employees. Who
better to, basically, complete the application for you than what Social
Security -- using Social Security’s knowledge to make sure you’re filling
it out correctly, in essence? Brian
Therrien:
Sure. Barbara
Mountain:
What we also do is -- then once we got the application, we’re then
going to gather the medical evidence and that’s the key to this.
You want to make sure you have your medical evidence and you want to
make sure you’re flagging the important pieces and you’re showing how you
meet the regulations. You’re
showing how you meet Social Security standard based on your age and your work
history that proves that you can’t work and earn what’s referred to as
substantial, gainful activity. For
Social Security, in the year 2009, that means you can’t work and earn more
than $980 a month. Brian
Therrien:
Mm-hmm. Barbara
Mountain:
And the team that we use to do this are all former DDS employees and
DDS is Disability Determination Services.
These are the folks that are making the medical decision for Social
Security. So we hire those
employees to come work for us because they know exactly what needs to be seen
and so when we put together the claim, we’re setting it up and we’re
positioning it exactly as they need to see it in order to get it awarded and
that’s what helps us get claims awarded and that’s what helps us get
claims awarded quickly which is -- you know half the battle with Social
Security is not just to get awarded, it’s how long it’s going to take you
to get awarded and our goal is, obviously, to get them awarded as soon as
possible at the appropriate time. Brian
Therrien:
Well, you know, I’m the guy standing here in the middle.
You know, I’ve got a group of members and then you folks out there
but I look at it and I think the effort to get these awarded quickly without
going to hearing is of everybody’s best interest.
I mean, first of all, you don’t have to spend a day of travel or go
somewhere or do all the preparation work and so you can do it and do it right
the first time and get it approved and that means that the member or the
claimant would get their money quicker and you might not make as much as if it
went to hearing, but you don’t have to go to the hearing. Barbara
Mountain:
Right. That’s exactly -- Brian
Therrien:
But not many people to get it, sorry to interrupt you, but small town,
you know -- I had somebody the other day, I’ll just share my -- this is my
vent for the day, okay, which totally drives me crazy -- this poor lady.
She’s clearly, in my opinion, should have been approved a long time
ago. But she had hired a local
disability attorney who had her sign the forms for representation and he told
her, he said go file the initial claim, you’re going to get denied.
Then when you get denied, you come back into the office and I’ll help
you fill out the next step. And
that happens. And for anybody out
there in the crowd, I would just call around to 10 or 12 different local folks
and you’ll find that that still goes on, which is a total disservice to
people, but they don’t get it. So
that’s my -- Barbara
Mountain:
See one of the things that that we try to do is actually trying to
prevent a person who’s filling out an application on their own from doing or
saying something that they don’t realize is detrimental to their claim.
I mean you might say something you don’t -- you just -- you don’t
recognize that that’s going to cause you another hurdle to overcome to get
awarded. You know, for example, I
used to take claims and I can remember a person coming in, I can remember it
happening several times, individual saying I’m filing for Social Security
disability. My insurance
company’s making me file. Brian
Therrien:
Oh, yeah. Barbara
Mountain:
And that is noted on the application because it
implies, oh the claimant doesn’t think they’re disabled when maybe
that’s not what the claimant meant at all.
They just meant, you know, yeah they have to file additional
requirement because of their long-term disability policy, but it -- it’s the
idea comes across that they don’t think they’re disabled and that is just
another hurdle they’re going to have to overcome to get awarded. Brian
Therrien:
Mm-hmm. Barbara
Mountain:
So, you know, having a person file on their own I -- and then just say
I’ll help you when it gets to hearing’s level, I think that they’re
missing the point of how much help they can actually provide early on, the
early stages. Brian
Therrien:
Yeah, yeah. Well, you know,
and a lot of people -- there are people that certainly have others that they
can -- that can help them and they can file and they can take the time and
study. We’ve got endless people
that have done it that way. But
there are those that are clearly sick and they just, you know, the value of
having somebody that’s there to help you is, you know, from the very
beginning is priceless. Barbara
Mountain:
Yeah, the idea should be that they’re taking the work out of process
for you. Brian
Therrien:
Yeah, right, right. Barbara
Mountain:
The other thing I’d recommend is negotiate.
Social Security -- one thing you need to know is that Social Security
must approve any fee that a representative is going to charge and there’s a
standard fee that is pretty much anytime you go anywhere they’re going to
tell you what the fee is. It’s
25 percent of past due benefits up to a cap of $6,000. Brian
Therrien:
Mm-hmm. Barbara
Mountain:
That’s what they’re going to say they’re going to charge you.
But there’s no reason why they can’t charge you less than that.
I’ll tell you, my company we don’t charge the full amount.
We actually do charge -- we go with less, so you don’t have to have
that cap of $6,000. They may
choose a different cap for you, so we’ll take 25 percent of past due
benefits up to a smaller cap. Brian
Therrien:
Mm-hmm. Barbara
Mountain:
So, you know, you’ve got some negotiating power there.
Just ask; ask the question. Brian
Therrien:
Mm-hmm. That’s a good
point. Yeah, and most people just
say well, you know, it’s in writing and it’s what it is and okay.
Well, that’s, that’s great. So
I guess one of the key things that I found from the very beginning at least to
interview a representative like somebody at the IBI team, is if they can spot
the onset date and move it back, you know, five or six months then they could
-- they can make a huge difference in the benefit check or that back benefit
check when awarded. Barbara
Mountain:
Right, yep, absolutely. Brian
Therrien:
Among others, so, okay. So
let’s talk about going into a hearing. So,
you know, goes through that. What
are some of the benefits of using a representative to go through at the
hearing process? Barbara
Mountain:
Well, a representative is going to help you prepare the claim.
I mean, they’re going to complete the forms with you, gather the
medical evidence, and prepare the case. One
of the big advantages and, you know, I hate saying this.
I’m a proponent of Social Security.
It’s a great program. It’s
incredibly necessary. I think they
do a lot right. Unfortunately they
also -- there’s a lot of areas they need to have some work.
One of the problems with Social Security, at the hearings level, is
you’ve got judges making decisions and the judges are all supposed to be
following the same laws. However,
it’s obvious, based on statistics that have come out, and basically what we
know, my company’s been around for 30 years, we’re national, we’ve seen
everybody, we know all the judges, some judges have a tendency to deny and
other judges have a tendency more to allow and I think that’s a big problem.
It should be consistent, but it’s not.
I just recently read an article in the, oh what was it?
The News Journal of Delaware, I believe, where they looked at three
judges and they were three judges from three different parts of the country
and they looked at their denial rates. One
just had a 56 percent denial rate, one judge had a less than 1 percent denial
rate, and one judge had a 93 percent denial rate.
And there’s just no way their dockets could differ that greatly.
So one of the things a representative is going to bring to you, one
that knows the judges in your area, is what is this judge that you are
assigned to -- what are his tendencies? And
it just better prepares you to go in and how you’re going to present that
case -- Brian
Therrien:
Sure. Barbara
Mountain:
-- to know that. Brian
Therrien:
Wow. Barbara
Mountain:
Yeah, it’s -- that’s a sad statement.
I hate to say it, but that is the reality. Brian
Therrien:
It is the game; you just have to play it, right? Barbara
Mountain:
It is and, you know, even if you look at the initial levels, look at
your state. There’s, you know,
you can go online and you can see what the awards and denial rates are for you
state. Brian
Therrien:
Mm-hmm. Barbara
Mountain:
You know if they’re following -- every state is following the same
guidelines, you know, there’s differences.
Brian
Therrien:
So if you -- if you’ve got a state, sorry to interrupt, but if
you’ve got a state that has a high denial rate at hearing level, you really
want to work your tail off to nail that at initial or recon? Barbara
Mountain:
Right or, you know, you look at judges.
The judges will all -- will vary differently.
That’s hard to get those statistics because -- but I’m saying even
at the initial and recon level, they have the statistics by state, because
those are state DDS -- Brian
Therrien:
Yeah. Barbara
Mountain:
-- DDSs that are making those decisions and, you know, some states it
is easier to get awarded at than other states. Brian
Therrien:
Okay. Barbara
Mountain:
You know, it isn’t a great commentary. Brian
Therrien:
Here’s a -- here’s a big issue.
Social Security regulations state that you can work and earn up to
$980.00 and still apply for Social Security, right? Barbara
Mountain:
Mm-hmm. Brian
Therrien:
You know this. I don’t
need to tell you that, but for the audience, clarification.
Those are the regulations and there’s kind of a mixed message out
there about working and applying. There’s
one side that says, you know, for -- certainly from the person, from the
claimant or a member, people have to survive, right?
The other side of it is, from Social Security, when they look at that,
there’s an argument that says well, you know, somebody can work 15 hours a
week and earn $900, maybe with some modifications to their job or a change in
treatment, they could work more and they’re not disabled.
So the big question here is, I mean, what is your take?
Is it a disadvantage to work when you’re applying?
Can you get these claims approved? Barbara
Mountain:
Well, you can get them approved and, you know, like you said you --
applicants should not be punished for working and earning under the limit.
However, when these claims get to the hearings level, this is where
judges will look at it differently. Some
judges will have no problem with it. Other
judges will look at it and look at it suspect because like you said, you know
what, maybe this person does have the capacity to work more than that.
The suggestion that I would make is if you are working and earning
under SGA, if you get a letter from your physician that’s very specific and
outlines why you can’t work more or why you have the modifications you have
to have, it’s very clear, that can help, that can go a long way.
Even doing that very early on at the initial level or the
reconsideration level, including that as a statement of, yes I’m working,
but this is why I can’t work and earn more.
I think that’s one of the best things you can do going forward. Brian
Therrien:
Great, great. Barbara
Mountain:
Also, there are times when it can actually help your case. Brian
Therrien:
Mm-hmm. Barbara
Mountain:
Would you try to go back to work and you haven’t been successful.
That can actually -- some judges look upon that very favorably because
it shows, you know, this person really tried to do it and they weren’t able
to for XYZ reasons. Brian
Therrien:
Yeah, you know, for the most part, people are just good, hardworking
Americans and they would rather work and it’s -- there’s a lot of
confusion about that, so that’s -- that’s very encouraging news and a
great tip for the letter. So
really, again, to recap this, if you’re at the initial phase and you’re
working, then the key is get a letter from your doctor stating that you
can’t work more, which you need the doctor’s support anyway, right? Barbara
Mountain:
Right. Brian
Therrien:
And include that in your application? Barbara
Mountain:
Right. Brian
Therrien:
Okay, okay. All right.
On the working topic, let’s bounce around a little bit here, once
somebody is approved, being the fact that you’ve outlined that you’re a
proponent of Social Security and there’s some work incentives, what are some
of the highlights? What are some
of the key things that you think are really keen in the program that would be
helpful for members to know more about? Barbara
Mountain:
Sure. The first one is
anybody who’s been approved for Social Security disability is entitled to
what’s called the trial work period and what that means is that you can go
back to work and no matter how much you earn, you still get your full Social
Security check and this trial work period is nine months.
So for nine months you can go back to work and, you know, you got a job
earning $10,000 a month, you get your full pay check and you also get your
full Social Security check and you’re at no risk of losing your benefits.
These nine months don’t have to be consecutive, so you may work for
two months and it doesn’t work out and a year later you try it again, you
work for three months. Well, now
you’ve used up five of your trial work months.
Social Security sees this as an opportunity for you to test it out, see
if you’re going to be successful without any fear of it affecting your check
or affecting your benefits. So -- Brian
Therrien:
So that’s not -- pardon me Barb, but it’s nine cumulative months? Barbara
Mountain:
Exactly, nine months. Brian
Therrien:
At any point in time? Okay. Barbara
Mountain:
Yep, yep. When that nine
months ends -- so you’ve used up your nine months, that next month you enter
a new period of time with Social Security that they refer to as your extended
period of eligibility, your EPE, Social Security loves acronyms.
So during your extended period of eligibility, which is three years in
length, so it starts when you finish that ninth month, for the next three
years any month you earn more than FGA, whatever FGA is that year and this
year it’s $980, they’re not going to pay you your check.
Any month you earn less than FGA, you are going to get your check, the
full check. Social Security with
disability doesn’t pay partial checks; it’s either all or none. Barbara
Mountain:
So you either are going to begin paying or you’re going to be in
what’s called work suspense. But
the key here is you’re not terminated, so you can come right back on at any
time. So it’s a three year
period of time where you may be in pay or not in pay, depending upon what’s
going on with your work situation. But
you’re not terminated. So Social
Security is saying, we know how long it took you to get on, we know you
probably don’t want to risk losing your benefits, but we’re going to give
you four years, when you look at the trial work period plus the extended
period of eligibility, to try it out and feel successful without risk of
losing your benefits. Brian
Therrien:
Mm-hmm. Barbara
Mountain:
A lot of people aren’t aware of that. Brian
Therrien:
Yeah, that’s -- that’s nice. Barbara
Mountain:
There’s also Medicare continuation.
A lot of people don’t realize how long Medicare can continue.
Medicare can continue for at least eight and-a-half years beyond when
you return to work. So even if you
come off Social Security disability, you can keep your Medicare for eight
and-a-half years, which is a great advantage.
That was linked into, let me think how long ago that was now, I think
that was the work opportunity back in 1999 that it got extended to how long
you can keep your Medicare. Brian
Therrien:
So if the trial work period, is that tied to ticket to work? Barbara
Mountain:
No. It’s actually --
it’s just this whole separate program that’s always been there.
Ticket to work is a physical ticket that you’re actually sent once
you’re awarded and with this ticket you can use it to take it to a whole
list of companies that will provide you with free vocational rehabilitation
services. These companies, if they
decide to work with you, if they’re successful in getting you back to work,
get paid by Social Security, but it doesn’t cost you anything. Brian
Therrien:
Mm-hmm, mm-hmm. Barbara
Mountain:
The whole point of the program was to give claimant’s choice in who
they go to to get voc rehab services and allow private industry to get
involved versus just using state voc rehab, which is what they had always done
in the past. Brian
Therrien:
Mm-hmm, yeah. You know, and
-- Barbara
Mountain:
And one -- oh, go right ahead. Brian
Therrien:
-- the concept, well, actually please finish and then I’ll go on
because my point is a little different than the topic we’re on. Barbara
Mountain:
I was just -- I was actually going to mention one other benefit is if
you are eventually terminated from Social Security because of work, if you
become disabled again any time within the next five years from termination,
when you go back to file for Social Security benefits, they will start paying
you immediately. They’ll pay you
while making the new decision. You
actually can get six months worth of checks while waiting for that new
decision to come in and if the claims comes back and you’re awarded, then
the checks will just continue, and if the claims come back denied, you
actually don’t have to pay that money back.
It’s kind of -- it’s something called their expedited or
reinstatement of benefits. Brian
Therrien:
Mm-hmm. The -- now, now for
the audience, you can earn up to $980 a month and that’s below SGA and that
would not apply to these programs, is my understanding, right? Barbara
Mountain:
Well, the trial -- right. Trial
work period, if you earn over $700 a month, you’ve used up one of your trial
work period months. Brian
Therrien:
Yeah. Barbara
Mountain:
So it’s actually a little bit less than the SGA figure, but when
you’re in the extended period of eligibility, if you’re earning less than
SGA, you’re entitled to your full check.
So as long as you’re earning under SGA, you’re going to continue to
receive checks. Brian
Therrien:
Okay, okay. What -- in your
opinion, why is it that -- why is it that the percentage of people that are
disabled that go back to work or do any work, even below the SGA, is so low? Barbara
Mountain:
You know, I think for a lot of people it’s fear of becoming overpaid
by Social Security. Not
understanding the rules and regulations. I
think people aren’t willing to take that risk.
Because it hooks -- for most people it was a struggle to get on Social
Security and without the fear of knowing if they’re going to be successful
coming out of it, they’re not willing to take that risk. Brian
Therrien:
Exactly. I concur. Barbara
Mountain:
I feel if Social Security does, and I felt this when I was in
administration, they’re not good at public relations, they are not good a
communicating and letting people be aware of how things work and people -- a
lot of people aren’t even aware of them.
A lot of people are not -- that are on Social Security disability
don’t even know that Social Security has these work incentives or understand
that. Brian
Therrien:
Mm-hmm, mm-hmm, yeah, yeah. Okay.
I said we’re going to bounce around, so let’s go back to the
getting approved side and oftentimes, as I’m sure you know, that especially
for people that are -- well, when they’re going through the application
process, a lot of people that are not employed or haven’t been employed by a
large company, haven’t had insurance. A
lot of people that have been independent contractors, owned their own
businesses. So the point is of my
question is they can’t afford treatment as their health continues to go down
and they’re not able to work and their insurance lapses.
How and can somebody -- can they get approved without having consistent
treatment? Barbara
Mountain:
Yes. I
mean, I think -- Brian
Therrien:
Is there a general -- Barbara
Mountain:
-- you know you can get awarded with limited medicals, however, it’s
harder. I mean, no doubt about it,
it’s more difficult because Social Security is looking for evidence.
I mean they’re looking for empirical evidence that more than just
your testimony that you don’t have the ability to work.
You know, a suggestion there would be try, you know, try and get
whatever you can. Look for free
clinics, negotiate with physicians. There’s
some doctors out there that will negotiate for lower rates to try and get
something to back up -- to back up or substantiate, you know, your testimony
and what you’re saying about your condition.
So you are going to have to have something.
Social Security will send you for a consultative exam, so they will pay
to have a doctor evaluate you. I
will tell you we hear a lot of claimants that aren’t pleased with these
consultative exams. They don’t
feel like the doctor fully evaluated them or really got to understand what
their issues were. Honestly,
sometimes we see consultative exams at the initial and reconsideration level
used more to deny a claim than help the claim.
But if that’s the only option to get somebody to look at you, then
that -- then at least you have that. I
guess I’d say that going forward. I
don’t think it’s the ideal case, but Social Security does need something
to base their decision on besides just verbal testimony. Brian
Therrien:
Mm-hmm. Good point and for
the members there’s a whole host of low-cost, no-cost treatment options that
are in the members area. If
you’re looking at the screen now, that’s the member’s areas, you can see
the address. Just go to our home
page and look at the top right-hand corner.
There’s also, regarding the medical exams as we’ve gotten some tips
from others about if you do go for an exam, there are some some strategies
that you can implement when you go to the exam like simply take notes and --
not you taking notes, but bring somebody that will take notes -- and ask the
doctor if you can record it and usually -- and follow the other steps that are
in our work, but what that does is it really -- it holds them accountable and
typically, when they are held accountable, they’ll -- they tend to do a
better job, so a few quick tips for the audience.
I don’t know if you have any more for anybody that’s got to go for
a medical exam, Barb? Barbara
Mountain:
I think -- I think what you’ve said is actually the best idea is to
have written down exactly what happens at that consultative exam so things
can’t be taken out of context. Brian
Therrien:
Mm-hmm, mm-hmm, yeah. And
don’t record it without knowing the regulation and the doctor, because there
are some -- there are some problems with that.
Problems with the law, yep. Okay.
So kind of wrap up this whole applying for disability, could you kind
of boil down maybe three or four tips for applicants that are, you know,
pursuing the application process now? Barbara
Mountain:
Sure. I think the first
thing I mentioned early is be prudent in what you say and how you answer
questions. Make sure you’re very
clear in what you can and what you can’t do.
Being vague, can often times, works against you and sometimes what you
meant is not how it came across and even one little statement can undo a
claim. So, you know, just be
careful and make sure that you, you know, you are clear.
I think being clear and concise and to -- so they understand exactly
what you mean is really important. I
say collect your own medical records. You
know, the agency is going to send away -- they have you sign medical release
forms and they tell you that they’re going to get your medical records from
your doctors and your hospital. However,
it can make a lot more sense if you get those medical records and submit them
for a couple of reasons. One is
because you know that your file’s complete.
You know they have everything they should look at.
The agency is not going to go out of their way to get information.
In addition, it’s going to cut down on time.
There’s a huge time delay when they are sending out for medical
records and having to wait for those medical records to come back.
So by you providing that, you might be able to shave a little bit of
time off of this potentially lengthy process.
In terms of gathering medical evidence, the onise is really on you
especially when you get to that hearing level.
And the last thing I’d say is learn the regulations or at least the
standards that apply to your age or work history.
The information is available on the internet for free, so, you know, do
your homework otherwise you’re going to be at a big disadvantage. Brian
Therrien:
Okay. Good tips.
As far as being prudent, see if I get this and maybe you can confirm or
expand upon it. What we find when
we talk to people that are applying for disability is we ask a question that
says, you know, explain to me in two sentences or less why you can’t do any
job in the United States, five days a week, 40 hours a week including, you
know, being a greeter at Wal*Mart or a ticket taker at a movie theatre?
So the common response that we get is, I have XYZ condition and I hurt
and I don’t sleep well and got lupus or fibromyalgia on the mind.
But when you say be prudent are you saying express how those conditions
limit your ability to work? Is
that the direction that you’re going? Barbara
Mountain:
Yes. I
say, yeah, don’t -- make there be a point to everything that you’re
saying. I almost say don’t
ramble. Just be clear going in at
the points you need to get across. What’s
important? Sometimes when you say
a whole lot, maybe the real important piece can get lost in that, and when
you’re even filling out the forms, you know, focus on -- what are they
looking at with Social Security? They’re
looking to see why you can’t work, so focus on how your condition is
preventing you from being able to work. What
makes sense in that area? How can
I show -- I, you know, my pain is affecting my ability to think clearly. Brian
Therrien:
Or, one, if not able to stand for more than 15 minutes and then
they’ve got to sit down and they only can sit for 10 minutes and then
they’ve got to reposition themselves and they can’t lift a gallon of milk
or climb 20 steps or all those things, right? Barbara
Mountain:
Exactly. Right, exactly.
Because when they’re looking at that at vocational, what needs to do
in the vocational world, that’s where that’s really important.
Because you’re showing them. You
know, you have so many modifications that would have to be made to make it a
viable situation. That’s
what’s going to help you get awarded. Brian
Therrien:
Yeah, great. Regarding the
medical records, another great point is when one goes to collect the medical
records, there -- what’s -- are there charges associated with that in some
or all cases or what do you find? Barbara
Mountain:
It depends. There can be
charges and they can charge and, I think, most of the time you do find
doctor’s offices will charge. Some
-- if some they get you to file and they let you do it yourself, you know,
they won’t. So it does vary, but
for the most part I’d say that you do see you have to pay for it in a lot of
situations. Brian
Therrien:
Yeah, yeah, okay. So real
quickly, before we take a few questions, and I’ll actually peruse questions
while I’m going through this, you know, there’s all this news out there,
Barb, about Social Security’s going to be bankrupt, it’s not going to be
around for me, etc., etc. Can you
-- what’s your take on that? What
can you -- any comforting thoughts that you can share with the audience? Barbara
Mountain:
Actually, I think I can. I
used to do -- I used to do public relations work for the administration.
I used to do solvency discussions.
Social Security is not going anywhere and the reason why I can say that
is it’s too important to this country. Last
year there were 51 million Americans receiving Social Security benefits.
That included nine million disable individuals.
It provides so much income into this country that the country could
really go bankrupt without the amount of money that gets pumped in on a
monthly basis based on Social Security. So
I can tell you it’s not going anywhere.
However, with that said, it can’t stay in its existing form.
There are changes that need to be made.
Social Security is a pay-as-you-go system, which means those that are
working today are paying for those that are receiving and what happening is
we’ve got more people that are receiving that are working now and that’s
what’s causing this problem. Currently,
in the year 2016, they will no longer be taking enough in to pay out the full
benefit, so they’re going to have to start dipping into their surplus and
they’ll start dipping into that surplus and that will continue it, right now
they’re saying until 2037, and in 2037, the surplus is gone.
So at that point, they’ll still be able to pay out benefits, but only
75 percent of the current benefit you’re entitled to.
That’s the estimates with today’s figures.
So that’s a problem, but it’s not the dire doomsday that I think
that the news might want you to hear. What
it does mean is that there needs to be some changes to the program.
But Social Security is a constantly evolving program.
It changes daily. There are
daily changes to this program. A
lot of people just don’t -- they’re so small they don’t -- it doesn’t
impact them that they don’t see that. Some
changes are larger than others. Back
in the 1980s there were some rather large changes.
Children used to be able to receive benefits through college.
Now kids can only receive benefits until the age of 18 or 19 if
they’re still in high school. That
was a relatively large change. I
see changes like that that are going to occur.
They’re going to have to change, you know, maybe who’s entitled to
a certain type of benefit or when benefits start may change or how they
calculate a certain benefit may change. Clearly
some things are going to change, but in terms of it going away, I just don’t
even think it’s feasible. I
don’t think it’s something that could even be considered. Brian
Therrien:
Yeah, I concur.
At least in -- well, at least in this administration. Barbara
Mountain:
Right. Brian
Therrien:
What’s -- what is your -- what’s your opinion on the 24-month wait
for Medicare? That’s a big
problem. I hear a lot of pain with
our members. You know, this is
when people really need to be treated. You
see any movement in that? Barbara
Mountain:
Well, I think that there was a pretty good push going on for awhile,
but the problem right now is Medicare is funding -- is even probably in a more
dire situation than the monetary benefit and I think that’s preventing there
from being any real progress. Brian
Therrien:
Mm-hmm. Barbara
Mountain:
I have seen more movement towards getting some other conditions
included in what can get awarded with -- before the 24 months, like the
end-stage renal and the Lou Gehrig’s disease.
I’m trying to think of what I -- what I recently I heard, what
condition was being thought of getting put in there.
A lot of that has to do with lobby groups, though.
How well you can lobby Congress. Brian
Therrien:
Doesn’t it though? Barbara
Mountain:
Yeah. You know there’s
been something put forward about eliminating the Medicare over a period of
time, reducing it. I just -- I
just don’t think they can even tackle that right now. Brian
Therrien:
Mm-hmm. Barbara
Mountain:
You know given the cost of healthcare. Brian
Therrien:
Yeah, yeah. Barbara Mountain: I think that they want to go that way, but I don’t think we’re going to see it for a long time.
Michelle
Toole:
Sure am. Brian
Therrien:
Nice to have you. Michelle
meet Barbara, Barbara Mountain. Michelle
Toole: Hi
Barbara. Barbara
Mountain:
Hi Michelle. Brian
Therrien:
Okay. I have a question
here from Charlene. I’ve been
waiting appeal for months. Was
told in September that my case is waiting to get on the judge’s calendar.
Can I do anything to speed it up? Thanks. Barbara
Mountain:
Not really. Unfortunately.
I mean, you can call the hearing office on a regular basis. Brian
Therrien:
Mm-hmm. Barbara
Mountain:
Sometimes the squeaky wheel gets the grease -- Brian
Therrien:
Yeah. Barbara
Mountain:
-- to see if there’s anything that they can do, but, if it was, I’m
going to say, just this past September, you know, on average, you’re
probably waiting at least a year before you’re going to get that hearing
date. One of the things, I don’t
know if you’re represented, but if you are, what they should be going for is
what’s called an on-the-record decision and that’s where they write up a
legal brief and they submit it and they try to get it awarded without the need
for a hearing and we do that on just about every single case we get and we
have great success in getting claimants awarded.
That’s another way we don’t have to go to a hearing, is we get them
to look at the facts and then they determine that can be awarded without
having everybody go before the judge. Brian
Therrien:
What about playing the on-the-record -- not on-the-record card, the
dire-need card? I mean, does that
have any -- is that working? Barbara
Mountain:
It can, but you have to provide a lot of, you know, a lot of proof.
You’ve got to prove that you -- that you aren’t going to have
housing or you’re going to, you know, you’re having trouble putting food
on the table. I mean you have to
supply a lot of paperwork and proof to show that you really do meet that
criteria. Brian
Therrien:
Mm-hmm. What about kids?
Does that play into it if there’s children involved? Barbara
Mountain:
Yeah, it can. It can.
But, again, you’ve got to show it.
You’ve got to be able to show that you are going to be without a home
or that you can’t put food on the table.
It’s your -- Brian
Therrien:
Mm-hmm. Barbara
Mountain:
-- basically those essential items for survival are at risk.
It can happen, it can. But,
again, a lot of it depends on where you are?
Who -- where are we talking about?
Some places treat things a little bit differently. Brian
Therrien:
Mm-hmm, mm-hmm, okay. Can
you read the questions that are in the -- Barbara
Mountain:
I can’t actually. I’m
not sure if there’s something I need to... Brian
Therrien:
Okay. I’ll read them for
you. I’m just going to find
another one. I have one here.
This might be hard for me to struggle through.
I have a son that is ADHD, but after all the meds he has tried; he says
pot is the only thing that gives him relief.
Twenty-one, been arrested many times, my other son is 29, refuses to
come out of the room. Trying to
get to the question here. Bear
with me a minute. I cannot afford
to support all three on an SSI check. Any
suggestions? Brian
Therrien:
I wonder if these children are on SSI. Barbara
Mountain:
Are the child -- the children on SSI? Brian
Therrien:
It doesn’t say. Barbara
Mountain:
Yeah, because it sounds like, at least the 21-year-old, if he has never
worked, then he only Social security isn’t really
going to be able to help. One
thought, I’m not sure how old you are, but when you are eligible for
retirement benefits or if you happen to be receiving Social Security
disability, your children can be eligible for a benefit based on your record.
What they’re called are adult-disabled children and as long as they
were disabled prior to the age of 21, it has to be proven that they were
disabled prior to the age of 21; they can receive benefits under your records
under Social Security, not SSI. With
Social Security it can be a little easier to deal with and it would be 50
percent of whatever you’re receiving. That’s
call the disabled adult child benefit. Brian
Therrien:
That’s a good tip. So for
local resources, I would go into our member’s area and go down to Section 8,
start with the Center for Independent Living and see what might be available
for local assistance especially if you’re living in a -- like here in
Vermont in a cold climate, you know, there’s fuel assistance and all kinds
of stuff that you can fine. Okay.
Sammy, I just -- you raised your hand and I gave you the power to
speak, so if you can hear us, try asking your question and then we have a
question here from Delores. Why
does a person receiving -- oh, okay. Why
does a person receive qualification letters from both SSDI and SSI? Barbara
Mountain:
Because -- it’s actually interesting.
Social Security, a lot of field offices, are required to take both
applications. Whether you are
potentially -- even if you went in and just filed for Social Security and no
interest in SSI, they’re going to take an SSI application, in a lot of
cases, just to rule it out and show that they checked and then you’re going
to get -- you’re going to get, you know, your denial letter if you’re not
eligible, but they should be always checking for both programs.
If it’s clear that your Social Security benefit would be so high that
you wouldn’t be eligible for anything on SSI, then they’re doing it, you
know, this is kind of an internal reason, because they get what’s called
work credit for it. The more
applications they take the more work credit that office gets and the more
credits they get it actually is tied to whether they can get more staffing.
So some offices have requirements saying, even if you know they’re
not eligible, just take a quick denial. So
that could be a reason why you’re getting it.
But they do need to check, they do need to make sure that they’re not
missing out on any potential benefits for you. Brian
Therrien:
Mm-hmm. Good tip.
Here’s a commonly asked question from Delores.
How long does it actually -- how long does it take to actually receive
your benefits once you’ve gotten the thumbs up, favorable decision from the
ALJ? Barbara
Mountain:
It’s usually 60 to 90 days and, unfortunately, it usually takes that
long from the time you know the judge is going to award it -- Brian
Therrien:
Mm-hmm. Barbara
Mountain:
-- because then he has to input his decision, the decision has to be
written up, then it has to go to payment center and they have to process the
pay and, unfortunately, it can take that.
I would say 60 days is probably most, on average, how long you’re
going to have to wait. Brian
Therrien:
Okay. Barbara
Mountain:
They’re hoping to -- one of the things they’re going to is
electronic signatures, allowing the judges to sign off on decisions
electronically and that is, hopefully, going to shave off some time. Brian
Therrien:
Here’s a general one. Good
question, but I’ll run it by you anyway.
I’m 45 years old, have a chronic illness that will not allow me to
work. My doctor made me quite work
due to my medical condition worsening. I
have a hearing date scheduled. What
are my chances of being awarded? What
was it, statistically, you said, Barb? Sixty-three
percent, yeah. Barbara
Mountain:
Statistically, Social Security statistics are 63 percent if you’re
represented. I would certainly
hope that it’s higher than that. We
have a 98 percent award rate. Brian
Therrien:
At hearing? Barbara
Mountain:
Yeah. Brian
Therrien:
Wow. Okay, so I guess a lot
of it has to do with -- well, what I also say to members sometimes is if you
are going into -- if you’re going into a hearing, I’m just going to
presume that this person is represented, is do your research and find out
who’s representing them and what they’re track record is and how many
cases they’ve had like yours and what their success rate is and if you
don’t get good results, then you might want to raise a flag. Barbara
Mountain:
Right. What do they know
about this judge? Are they
familiar with this judge and what do you know about him and what should I know
going in, because you should be prepared.
When you go in you want to make sure that somebody’s gone over what
questions you might be asked and how’s the best way to position the answers,
things like that. Brian
Therrien:
Yeah, yeah, okay.
I just want to wrap up the application process and then we want to --
we’ll get on here, but first before I do that I want to thank you.
This has been great information and going through -- I’ve learned a
ton doing this and so I trust everybody else has as well, Barb.
For the audience, if you’re applying or looking to advance your case,
the strategy that we have used is consistent with what Barb has communicated
and the folks at IBI do, is really just explore your options and what we mean
by that in our strategy and the whole long list of testimonials of people that
have used it and gotten approved quickly is understand what it’s like, by
using our mini course, to go through the system and prepare your case and get
your medical records and what you’re going to need, say, and do.
You need to do that anyway because even if you use a representative,
the more you know about the system the better it’s going to be to help you
work with your representative to get approved.
But one of the key strategies in helping you build or advance your case
is to interview a representative. Get
on the phone and talk to them and you can do this for free.
They’ll talk to you and they’ll go through your case and not
advocating that you need to use them. It’s
not my point here or what we do here at the Disability Digest.
We want you to make the decision and here’s really where I’m going
with this. If you interview a
representative and, you know, the few moments that we spent with Barb here,
she’s outlined a lot of reasons why you would want to do that.
First of all, if you’ve got a 62 percent success rate at initial
application, I would expect, Barb, that your team could talk to somebody and
say, well, you know what, I think we’ve got a pretty good crack at making
this work. We could accept your
case and if you do accept their case and their initial application, that tells
the member right away, well, I’ve got a 62 percent chance of getting this
through, right? Or, what was your
overall rate? Ninety-some odd? Barbara
Mountain:
Yeah, we get over, I mean, we look at everything.
We get about 99 percent of our claimants awarded. Brian
Therrien:
Ninety-nine percent. So if
you’re accepted by a representative and in this instance IBI, then you’ve
got a 99 percent chance of being approved.
So that’s the key thing. The
other thing is take a look at your onset date.
If you do it yourself and you kind of think you got it right or
you’re talking to somebody at Social Security, it doesn’t necessarily mean
that they’re going to come out and say well listen, we owe you five months
more benefits. I haven’t heard
that happen a whole lot, but you can get that uncovered with a representative
and formulate your case, right, and maybe discover that there’s other, you
know, diagnosed conditions that would be important in your application, but
there’s a whole host of things. So
that -- Barbara
Mountain:
One other thing I’d ask is I’d ask them how long -- what’s their
average time to get a claimant awarded? Because
you want to know that and you want to work with somebody who, you know, they
have a good success rate in getting claims awarded quickly, because you
don’t want to be sitting around and waiting forever.
So that’s just another important question when you’re interviewing
a representative. Brian
Therrien:
Yeah, great point. So on
this page that everybody’s looking at there is, if you scroll down, you’ll
see that there is a request form that you can complete and request an
interview with a representative and will review that information for you and
somebody will likely contact you and ask a few more questions to see if you
even qualify for an interview with a representative.
So just scroll down, have a look at that, and you can take advantage of
that and hopefully we can help you get through this process in a quick fashion
and like we tell everybody, once you get awarded and you’ve gone through and
do that, make sure you let us know so we can do our soon to be famous
Disability Victory Dance. Michelle
Toole:
Thank you. Brian
Therrien:
Great. Let’s
start with this. We are going to
go forward and announce the winners of the website start up kit contest that
we ran and for the audience that’s out there, maybe you were aware of this
and didn’t participate or maybe you were not.
I’ll just give you some background on how this all came about.
We have started a course for our members.
That’s a free course that you can take that will help you understand
if building a website is a vehicle for you to help you supplement your income.
And the course is available in the member’s area.
You can go into the member’s area and sign up for it, you go through
and Michelle Toole’s, with us here today, has put an immense amount of
effort into building this and Michelle has been successful at supplementing
her income through her disability and has done a great job at this as well as
giving time back. So what we did
is we took and developed a contest around the whole course that we watched and
one of the reasons is is that we understand that even with the free course, if
you’re going to start a business online, there are some start up costs and
you do need the right tools to make it work and to short cut it and streamline
the process and living on disability check oftentimes has limitations.
So we wanted to give a little bit back, run a contest, and, you know,
award some folks the ability to get started and pay for the whole shebang
right up front. So that’s what
we did. Did I miss anything
Michelle? Michelle
Toole:
The only thing you forgot to add is the 45 minutes coaching time they
get with me with the package. Brian
Therrien:
Perfect. That is priceless.
Okay. So the contest was
run and why don’t you tell -- give some background on the contest and what
we did and how we, you know, came about choosing the winners.
That’s up on the screen here Michelle. Michelle
Toole:
Well, you know, first of all it was a lot of fun.
I was glad to see people jump in and getting involved and take the bull
by the horn and start to formulate their ideas and to learn a little bit about
ecommerce, which was a big part of the goal is to get a better understanding,
like you said, if the internet is actually a vehicle for an individual to use.
They’re made for earning money on the internet or do they need to
find another viable resource for themselves?
So it was a lot of fun to see what effort people put into it, read a
little bit about their stories, and some of their needs and some of their
goals. What we did was we kind of
formulated an idea of how we would go about choosing the winners and there
were a couple sets of criteria that we used.
The first one is that someone would follow through and see the project
to fruition even with challenges. Somebody
that had that initiative, somebody that was tenacious enough to go ahead and
battle through some of the challenges it takes to learn a new language and a
new way of doing business, which varies from the offline world.
Also someone who’s willing to share their experience with others.
That’s something that’s really important to all of us in this
community is that we give and take and be able to build off of each other’s
successes and help each other out. Its
sometimes only a matter of five minutes sharing our ideas or some of the
knowledge that we’ve gained where it could be an immense help to others and
lifesaving to some. So that was a
criteria. And another one was that someone had showed us, in
their entry, that they had the basic set of skills necessary to create an
online business. Some basic
writing skills, nothing advanced, just your basic.
Can follow instructions. That
was a real important one. Basic
understanding of computers, basically enough just to get on the forum, get
signed on, and post a blog, and had a good grasp of either already had a good
understanding of ecommerce through some of the materials we suggested that you
read or showed a real eagerness or willingness to learn and that you were
resourceful. That if you needed
more information, you went ahead and sought it out or sought Brian or myself
to be able to find that information. And the last set of criteria, which was a real
important part of the decision making, which someone that really fully read
the instructions, took the time to listen to the contest question and answer
interviews and the SBI tour that Brian and I put together as well as took the
time to read over some of the materials that we suggested you read with SBI to
get a better understanding of what you can anticipate if you were to build a
business. So that’s kind of the
outline we used to make a decision. In
reading through all of the entries and it took a little bit of time.
Brian came up with a great kind of tool to help us decide and, like I
said, it was a lot of fun. I
don’t know -- I would be willing to do it again and again if we can get as
many people that are interested on board to have this experience.
I think that outlines everything Brian. Brian
Therrien:
That’s exactly it. So
that being said, shall we proceed? Michelle
Toole:
I think so. I’m excited. Brian
Therrien:
Okay. So we went through
and chose the winners and we’ve got them outlined here on the screen and so
before we start, my -- I’ve got some assistance from my kids today to
announce the winners. I have a
five-year-old son who likes drums so he let me borrow his drums so I could do
the drum roll before we announce the first place winner.
So we ready? Michelle
Toole:
Ready. Let’s
go. Drum roll Brian
Therrien:
First place winner is? Michelle
Toole:
Gracie G. Brian
Therrien:
All right. And I’m going
to show the profile on the -- and that is the -- Michelle
Toole:
Not everybody gave me their names. Brian
Therrien:
Okay. Michelle
Toole:
So I decided to just go by community names and they should know who
they are. Brian
Therrien:
Yeah. So if you’re in
attendance or listening to the replay, you have come in first place.
So that includes one full year of SBI and a coaching session with
Michelle. Congratulations. Michelle
Toole:
Yah. Brian
Therrien:
All right. Michelle
Toole:
This was really well done and anybody that wants to kind of get -- help
themselves get motivated with the process, take some time to read over
Grace’s entry. I think it was
great. Brian
Therrien:
Yeah, it was, it was. And
so second, third, and fourth place also receive the like prize.
So the second place winner. Michelle
Toole:
Faith Works. Brian
Therrien:
Faith Works and Faith was under the gun actually finishing this from,
if I remember correctly, she was finishing this from her hospital bed. Michelle
Toole:
That’s right. She said
she was doing everything she could to get this entry in.
With tech problems and all and having a hard time connecting to the
internet from the hospital. Brian
Therrien:
Yeah, yeah. Well, one of
the neat things is -- with these entries is really understanding the people
and a little bit about their background and what they went through and, you
know, it’s interesting. A lot of
people have tried for years to find a reliable way to supplement their income
and, unfortunately, haven’t been able to, so hopefully this will be the
answer. So for third place. Michelle
Toole:
Venom King 420. Brian
Therrien:
Venom King 420 had actually an entry -- I think we’ve got an awful
slow internet service. So 41, he
has children. This was a great
entry. Very entertaining.
Job well done. Congratulations. Michelle
Toole:
Yeah, he was actually the first entry in. Brian
Therrien:
Mm-hmm, yep. Okay.
And we’re on to fourth place. Michelle
Toole:
Fourth place, Crowetta. Brian
Therrien:
Crowetta, congratulations. So
we had a lot of entries to go through. This
was actually Curt Rowetta? Did I
pronounce that correctly? Fifty-one
years old in Marion, Ohio. Congratulations.
So those are your four winners. Now,
we have an honorable mention and for the honorable mention that we’re going
to load up on the screen here, that is -- how would you pronounce that
Michelle? Michelle
Toole:
RenoFXRS. Brian
Therrien:
Reno. Here’s what I would
say. It was a tough one as it
always is, but if you choose to go forward and use SBI, email your purchase
receipt to me, Brian at the Disability Digest, and I will pay for the first
two months. So usually if you use
SBI and follow it correctly, you can be profitable in what, four or five
months? Michelle
Toole:
Yeah, yeah, and SBI just started a new monthly payment system that
they’re testing out. Brian
Therrien:
Yeah. Michelle
Toole:
So you can purchase the whole thing or try it out for a couple of
months. Brian
Therrien:
Yeah, so for the honorable mention, job well done, send me your
receipt. I’ll be glad to do that
for you. So, at any rate, that was
fun. It was exciting.
Again for those of you who are in the audience that are listening that
didn’t partake, would like to partake or learn if building a business online
is for you, just go into our member’s area and you can scroll down into the
jobs and income section and you’ll see that you can register for the course
and get started and there’s tons of free information and audios and videos
and I don’t know how many hours we have in there Michelle, but a lot.
So that’s great. Michelle,
thanks for all that you do in putting this together.
That was -- that was great. Michelle
Toole:
Well, it was a pleasure. Just
make sure -- I’m going to be sending a note to the winner. Brian
Therrien:
Yep, yep, and for the winners, this is a --
this is a 12-month membership and it was purchased for you on Monday.
So timing is of the essence, so when Michelle contacts you, you know,
get the information back so you can take full advantage of this.
So great. Let’s just do a
quick recap. Barb, thanks, once
again, for coming out and spending your time and sharing all this valuable
information with us today. Certainly
appreciate that. And for those of
you who are in the application process and looking to advance your case, just
you can look at the page on your screen and the address or scroll down, if
you’re listening to the replay, and you can request an interview with a
representative and we’ll certainly review that and help you do the very best
that we can from our position to help you move your case forward.
So, and Michelle, again, thank you.
We’ll have to do this again. That
was fun. Michelle
Toole:
That was fun. Thanks for
everybody. Brian
Therrien:
Yep, thanks. So if you’re
listening, there will be a replay of this circulated in about a week, so if
you missed something, you can listen to the replay and if you’re listening
to the replay, thanks for listening to the replay.
We’ll be back. We do
these webinars usually the first Wednesday of every month, so we look forward
to having you back next month. Thanks
everybody. Have a great day. {end of
the interview}
|
This letter written by Brian
Therrien on behalf
of Disability Solution House, Inc.
Copyright 2009, Disability
Solution House, Inc.
All Rights Reserved