JustCare

Tag: Disability

  • People with disabilities face undue delays getting Social Security benefits

    People with disabilities face undue delays getting Social Security benefits

    Lisa Rein reports for the Washington Post on the inability of Social Security offices to meet the needs of people who are applying for disability benefits. In some states, the backlog is staggering, preventing people from getting benefits to which they are entitled for a year or longer. Congress must step in and appropriate the funds needed to adequately staff Social Security offices.

    Today, more than a million Americans wait to learn whether they are eligible for disability benefits. People typically wait 214 days–more than seven months–for a determination of disability, up from 79 days three years ago. The delays mean vulnerable Americans are not receiving critical income, forcing them to forgo basic necessities.

    Social Security outsources many claims for disability benefits. State employees do the work, even though the benefits are federal. Pay is low and offices are seriously short-staffed.

    Decades ago, Congress gave states the authority to do the hiring of Social Security workers and make decisions about their terms of employment, including their pay. Pay varies wildly. And, many claims examiners lack needed training.

    Pay is more than twice as high in Washington DC than in Florida, $75,506 and $32,655 respectively. Puerto Rico staff are paid half as much as Florida staff, $16,128. And, states can implement hiring freezes!!!!

    When it comes to delays, some states are worse than others. In one Texas office, 130,000 disability benefit claims still need to be reviewed, and it is taking 214 days on average to review each one. Florida, Wisconsin, Georgia and Delaware have longer delays, 225, 227, 246 and 261 days respectively.

    Many people whose claims are reviewed are inappropriately denied benefits and must appeal those denials. The appeal process can take another year.

    What’s worse is that people under 65 are only eligible for Medicare if they qualify for Social Security Disability Benefits. So delays keep them from getting good health care coverage.

    Social Security is trying to fix the problem. But, Congress has too often not appropriated the money Social Security needs to operate effectively, even though these administrative funds, like Social Security benefits, all come from the Social Security Trust Fund. Social Security needs the money to hire more people, conduct appropriate staff training, upgrade its technology and better coordinate with the states. The Social Security acting commissioner explains that there is also a shortage of physicians available to make medical determinations and review cases.

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  • How prior authorization requirements in Medicare Advantage could threaten your health

    How prior authorization requirements in Medicare Advantage could threaten your health

    If you’re in a Medicare Advantage plan and have needed any costly care, you likely know about prior authorization requirements that save corporate health insurers money but can threaten people’s health and well-being. Doctors say that many of these requirements are not evidence-based but, somehow, they are allowed. In an opinion piece for the AMA News, Gerald Harmon, MD, President of the AMA, describes how prior authorization “administrative hassles” could threaten your health.

    People in traditional Medicare do not have to deal with prior authorization requirements in order to get the care they need. If their doctor recommends a test or a specialty service, Medicare pays. In stark contrast, Medicare Advantage plans impose prior authorization requirements in a variety of situations, often harming patient health. AMA doctors surveyed reported incidents of preventable “hospitalization, disability and permanent bodily damage, or death” for patients they care for as a result of prior authorization requirements.

    Dr. Harmon writes about his attempt to get prior authorization for his 92-year old mother, which kept her from getting important drugs for an unknown period of time. He spent an hour trying to expedite approval of his mom’s prescriptions with no success. After trying to get help from a variety of folks, he turned to his mom’s doctor who took over the effort to get his mom the drugs she needed.

    Even with help from his mom’s doctor, there was no guarantee his mom’s insurer would authorize her drugs for several days. In turn, Dr. Harmon was deeply concerned about the deleterious effects on his mom’s health of not having needed medications. Note: Dr. Harmon was not concerned about drug copays–another enormous barrier to care–that leads to thousands of unnecessary deaths of people with Medicare each year.

    The AMA has an initiative to “fix” prior authorization requirements. For sure, prior authorization should either be eliminated or restricted to specific evidence-based situations when certain treatments might not be warranted. They should never prevent patients from getting timely access to needed care.

    The AMA supports bi-partisan legislation in Congress that would help people in Medicare Advantage plans, the Improving Seniors’ Timely Access to Care Act of 2021 (H.R. 3173/S.3018). It wouldn’t eliminate prior authorization, but it would simplify and standardize it.

    If you have stories about how prior authorization in Medicare Advantage kept you or someone you love from getting needed care, please send them to [email protected].

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  • People with long Covid struggle to get disability benefits

    People with long Covid struggle to get disability benefits

    Amanda Morris writes for the New York Times on the difficulty people with long-term side effects of Covid are facing getting disability benefits. People with “long Covid” can have serious health issues and might not be able to work. They need disability benefits, including health care and housing.

    The issue is that the Social Security Administration wants proof of long-term disability in order to award benefits. But, the side effects of long Covid are not easy to prove. Often lab tests show that things look normal. People do not have specific medical evidence to support their claims for disability benefits.

    President Biden, for his part, has promised “to make sure Americans with long Covid who have a disability have access to the rights and resources that are due under the disability law.” But, how is long Covid diagnosed without medical evidence? Moreover, to qualify for Social Security disability benefits you need to be able to show that you cannot work for at least a year.

    An estimated three to ten million Americans could have long Covid, according to the American Academy of Physical Medicine and Rehabilitation. These people are still getting care for several different medical conditions long after they were diagnosed with Covid-19.

    To date, about 16,000 Americans have been able to prove that they have long Covid to the Social Security Administration. It’s early days, since it takes about five months for Social Security to make a disability determination. To make matters worse, the Trump Administration underfunded the Social Security Administration. President Biden has proposed that Congress allocate $1.3 billion additional dollars to it.

    Today, about 9.5 million workers and their families receive Social Security disability benefits. Benefits tend to average $1,280 a month. People receiving Social Security disability benefits also qualify for Medicare.

    Of course, if everyone in the US had Medicare, it would be a huge help to people with long Covid. These days, Medicare for all seems more like a dream. Instead, millions of Americans are living a nightmare.

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  • Social Security benefits need to increase

    Social Security benefits need to increase

    Michael Sainato reports for The Guardian on Social Security’s failure to provide many retired Americans a livable income. Consequently, millions of people in their 70’s are still working in order to cover the cost of basic necessities, if they can find a job. At the same time, people with long-term disabilities are struggling to get Social Security benefits, reports Nancy Altman in The Hill.

    Millions of Americans receive Social Security benefits of less than $10,000 a year. The average benefit is little more than $18,000 a year. These benefits represent all or most of people’s annual income; it is too often not enough to survive.

    What’s equally troubling is that many older adults between the ages of 50 and 64 lost their jobs during the pandemic. Most of them relied on those jobs for their health insurance. And, many of them have not been able to find new jobs, likely in part because their health insurance costs are so high.

    It’s time for Congress to increase Social Security benefits, which have not kept up with inflation over the years. If you consider Social Security benefits as a portion of people’s earnings before retirement, benefits in the US are not as high as they are in other wealthy nations. Moreover, in the US, these benefits can be taxed and they generally go towards the cost of people’s Medicare Part B premiums.

    It’s also time for Congress to ensure that the Social Security Administration is granting disability benefits to the people who qualify for them in a timely fashion. President Biden has not ousted Trump’s SSA appointee, Commissioner Andrew Saul. Saul has made a point of denying people Social Security benefits to people who are entitled to them in the name of “program integrity.” Rather than ensuring that people who have earned their Social Security benefits receive them, SSA is making people with serious disabilities prove repeatedly that they cannot work.

    Because Social Security benefits are often not meeting people’s needs, some Americans are moving to Mexico in retirement; it costs much less to live there.

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  • Will Biden quickly replace Social Security leadership?

    Will Biden quickly replace Social Security leadership?

    Union heads are leading the fight to install new leadership at the Social Security administration. They want Commissioner Andrew Saul and Deputy Commissioner David Black out on day one. How quickly will President Biden replace them?

    The American Federation of Government Employees (AFGE) speaks for Social Security field office workers. The Association of Administrative Law Judges represents judges employed to make Social Security disability determinations. They say that neither the SSA Commissioner nor the Deputy Commissioner have any intention of either strengthening Social Security or supporting the reopening of its field offices post-pandemic.

    Under the Trump administration, Social Security has granted disability benefits to one hundred thousand fewer people in the period between July and November 2020 than it did in that same period in 2019.  It is estimated that, as a result, 230,000 individuals do not have access to SSI benefits, an average of $560 a month, or Medicaid.

    The Social Security Administration has also put into effect a group of policies that undermine Social Security. It has weakened the power of union workers. It closed its 1,200 field offices during the pandemic but did not let most employees work from home. And, the unions allege it is violating labor laws.

    McIntosh, president of the Association of Administrative Law Judges, said agency leadership has repeatedly violated federal labor laws in dealings with her union.

    Leadership has directed salaried staff beholden to them, and not independent judges, to make disability determinations. There is no apparent Covid-19 plan in place and no plan in place for reopening the Social Security Field Offices and making them safe for workers and visitors.

    Even though Saul and Black are political appointees, their term is not scheduled to end until 2025. That said, President Biden has the power to fire them for cause.

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  • Federal anti-poverty programs work!

    Federal anti-poverty programs work!

    Alexia Campbell reports for Vox on new 2017 poverty and income data from the Census Bureau. The data show that federal anti-poverty programs work. But, President Trump and the GOP are looking to slash their budgets and make it harder to qualify for them.

    The good news from the Census Bureau is that 2.4 million more Americans had full time jobs in 2017.  In addition, household income was up a bit, and the official poverty rate dropped from 12.7 to 12.3 percent.

    The bad news is that women are still earning 80 percent of what men earn. As bad, millions of people with full time jobs qualify for welfare because they are paid poverty-level wages; and income was up principally for the wealthiest Americans.

    Incomes dropped for the poorest Americans, people with incomes averaging just over $14,000 a year. In 2017, the federal poverty level was $12,060.

    The data also show the valuable benefits of Social Security and safety net programs such as food stamps, disability insurance, refundable tax credits and help with housing costs. These programs help tens of millions of minimum and low-wage workers. Nearly 45 million workers avoided poverty with the help of these programs.

    Social Security alone kept 27 million people from falling into poverty.

    But, health care costs undermined the economic security of almost 11 million people, pushing them into poverty. Health care costs are a growing driver of impoverishment in the U.S. In 2016, health care costs drove 10.5 million people into poverty. One year later, health care costs drove 10.9 million people into poverty, 400,000 more people.

    President Trump and the GOP’s 2019 budget slashes funding for these social safety net programs, including a 7.1 percent cut to Medicare. Trump and the GOP also want to add work requirements, which will disqualify many people from these programs without improving their lives. The data show that work requirements don’t bring people out of poverty because people’s wages generally are very low.

    And, many programs already have work requirements, including food stamps. Unless you are disabled or have children, you must work 80 hours a month.

    Medicaid does not have work requirements under federal law, but two-thirds of people with Medicaid work. And a large portion of those who do not work have serious disabilities and other conditions that leave them unable to work.

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  • More than 1 million await Social Security disability decision

    More than 1 million await Social Security disability decision

    More than 1 million people await a Social Security disability decision, according to an ABC news report. People typically wait nearly two years for a determination. And, some die while waiting.

    Most people who apply to Social Security for disability benefits generally are rejected the first go round. Only about one in three applications are approved. But, the majority of people who appeal their decisions to an administrative law judge end up being awarded disability benefits.

    Congress has cut money from Social Security’s administrative budget in recent years, even though these administrative costs come directly out of the Social Security Trust Fund. Moreover, Social Security’s administrative costs are a tiny fraction–less than one percent–of its budget.

    Today, about 10 million people receive Social Security benefits based on their or their spouses’ work contributions into Social Security. Another 8.5 million people who have not contributed enough to be eligible for Social Security benefits receive Supplemental Security Income because of a disability. The average monthly Social Security disability benefit is $1,037.

    Only people whose disability prevents them from working qualify for Social Security disability benefits. And, they must have had a disability for at least one year or a life-threatening disability.

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  • 91-year old gymnast competes in Berlin

    91-year old gymnast competes in Berlin

    Some people are never too old to do handstands on the parallel bars and other knock-your-socks off gymnastics feats. Watch Johanna Quaas, a 91-year old gymnast, perform at a competition in Berlin. And, even if you are not feeling up to competing–how many of us ever do–try to find a way to exercise.

    Take a bike ride, a trip up and down stairs, or a long walk. Exercise is good for your heart and your health! One study found that exercise is good for memory and attention, another that it reduces the likelihood of disability in older adults, another that it  helps people with Alzheimer’s, and yet another that exercise reduces the likelihood of stroke. 

    If possible, find a health care buddy to exercise with you. Believe it or not, a buddy brings additional health benefits.

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  • Programs for vulnerable Americans on chopping block

    Programs for vulnerable Americans on chopping block

    President Trump has released his budget, and it puts programs for vulnerable Americans on the chopping block. Along with food stamps, Medicaid, Supplemental Security Income (SSI) and CHIP (the Children’s Health Insurance Plan), Trump proposes to slash Social Security, expressly violating his campaign pledge not to touch Social Security. All told, Trump’s budget slashes $1.7 trillion from these programs over 10 years.

    Trumps plan would cut as much as $62 billion from Social Security Disability Insurance and $9 billion from SSI. It also ends the Community Services Block Grant, which supports the Meals on Wheels programs that provide hot meals to older adults in their homes; it cuts $193 billion in food stamps. And, it ends the low-income Home Energy Assistance Program (HEAP), which helps older adults pay for the cost of their heat. Under the plan, Medicaid cuts would total $610 billion, putting at risk long-term care for vulnerable older adults.

    Trump’s budget plan is in line with those of the Republican-controlled House, which is also looking to pay for massive tax cuts by stripping funding from programs for vulnerable Americans, according to Politico. People in need of help paying for food, housing, education assistance are all at risk. Republicans are even considering cuts to veterans’ benefits. The American Health Care Act (AHCA), if passed, would cut $880 billion from Medicaid.

    Bottom line, to balance the budget in ten years, President Trump and Republican leaders are willing to slash hundreds of millions of dollars currently supporting programs that protect low-income and working families. At the same time, their goal is to come up with the money needed to enhance funding for the military and cut corporate taxes. Balancing the budget will require about $8 trillion.

    Which specific programs serving vulnerable Americans get cut likely won’t be determined until the fall.

    Politico further reports that the Republicans in charge of the 2018 fiscal budget are likely also to propose privatizing Medicare, essentially adopting Speaker Ryan’s plan, though that would be symbolic this year.

    Republicans hope to get their plan through Congress without a filibuster, using the budget reconciliation process, which only requires a majority vote to pass. But, it’s not clear whether they will be able to get support for slashing low-income programs from moderate Republicans.

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  • Exercise may help memory and attention

    Exercise may help memory and attention

    There has been considerable research to show that exercise can reduce the likelihood of disability in older adults, lower your risk of stroke and improve bone health. It’s good for your heart, your lungs and your muscles. Now, according to Stat News, research reveals that exercise may help memory and attention.

    Exercise causes your muscles to release molecules that enter your brain. These molecules can possibly stimulate the brain to grow new neurons. And, some are suggesting that this could make you smarter.

    We don’t begin to fully understand the effects of exercise on the brain. But, the data is showing that people with early dementia, for example, fare better through exercise. And, exercise offers clear benefits to memory for healthy people.

    Wendy Suzuki, a New York University psychologist is looking at how running on a treadmill affects people’s consumption of oxygen. She has found benefits to their memory and attention. She has also run tests that reveal mood improvements from exercise for people with brain injuries.

    Suzuki cautions that to improve brain function your exercise must be more strenuous than walking. But, you don’t have to run a marathon either. Suzuki suggests that moderate exercise a few times a week might just do the trick.

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