Faster Claims for Disability Benefits
The Social Security Administration (SSA) is keen on making the Quick Disability Determination (QDD) and Social Security Disability Insurance (SSDI) claiming processes faster by adding to the list of conditions under the Compassionate Allowances (CAL) program.
The CAL program was designed to quickly identify diseases and other medical conditions that need to be treated right away to lessen the waiting time for a patient to claim his/her benefits.
Compassionate Allowance – Complete List:
- Acute Leukemia
- Adrenal Cancer – with distant metastases or inoperable, unresectable or recurrent
- Alexander Disease (ALX) – neonatal and infantile
- Alstrom Syndrome
- Amegakaryocytic Thrombocytopenia
- Amyotrophic Lateral Sclerosis (ALS)
- Anaplastic Adrenal Cancer – with distant metastases or inoperable, unresectable or recurrent
- Aortic Atresia
- Astrocytoma – grade III and IV
10. Ataxia Spinocerebellar
11. Ataxia Telangiectasia
12. Batten Disease
13. Bilateral Retinoblastoma
14. Bladder Cancer – with distant metastases or inoperable or unresectable
15. Bone Cancer – with distant metastases or inoperable or unresectable
16. Breast Cancer – with distant metastases or inoperable or unresectable
17. Canavan Disease (CD)
18. Cerebro Oculo Facio Skeletal (COFS) Syndrome
19. Chronic Myelogenous Leukemia (CML) – blast phase
20. Creutzfeldt-Jakob Disease (CJD) – adult
21. Cri du Chat Syndrome
22. Degos Disease
23. Early-Onset Alzheimer’s Disease
24. Edwards Syndrome
25. Eisenmenger Syndrome
26. Endomyocardial Fibrosis
27. Ependymoblastoma (child brain tumor)
28. Esophageal Cancer
29. Farber’s Disease (FD) – infantile
30. Fibrodysplasia Ossificans Progressiva
31. Friedreichs Ataxia (FRDA)
32. Frontotemporal Dementia (FTD), Picks Disease -Type A – adult
33. Fukuyama Congenital Muscular Dystrophy
34. Gallbladder Cancer
35. Gaucher Disease (GD) – Type 2
36. Glioblastoma Multiforme (brain tumor)
37. Glutaric Acidemia Type II
38. Head and Neck Cancers – with distant metastasis or inoperable or uresectable
39. Heart Transplant Graph Failure
40. Heart Transplant Wait List 1A/1B
41. Hemophagocytic Lymphohistiocytosis (HLH), familial type
42. Hurler Syndrome, Type IH
43. Hunter Syndrome, Type II
44. Hypoplastic Left Heart Syndrome
45. Idiopathic Pulmonary Fibrosis
46. Infantile Neuroaxonal Dystrophy (INAD)
47. Inflammatory Breast Cancer (IBC)
48. Junctional Epidermolysis Bullosa, Lethal Type
49. Kidney Cancer – inoperable or unresectable
50. Krabbe Disease (KD) – infantile
51. Large Intestine Cancer – with distant metastasis or inoperable, unresectable or recurrent
52. Late Infantile Neuronal Ceroid Lipofuscinoses
53. Left Ventricular Assist Device Recipient (LVAD)
54. Leigh’s Disease
55. Lesch-Nyhan Syndrome (LNS)
56. Liver Cancer
57. Mantle Cell Lymphoma (MCL)
58. Maple Syrup Urine Disease
59. Merosin Deficient Congenital Muscular Dystrophy
60. Metachromatic Leukodystrophy (MLD) – late infantile
61. Mitral Valve Atresia
62. Mixed Dementia
63. Mucosal Malignant Melanoma
64. Neonatal Adrenoleukodystrophy
65. Neuronal Ceroid Lipofuscinoses, infantile type
66. Niemann-Pick Disease (NPD) – Type A
67. Niemann-Pick Type C
68. Non-Small Cell Lung Cancer – with metastases to or beyond the hilar nodes or inoperable, unresectable or recurrent
69. Ornithine Transcarbamylase (OTC) Deficiency
70. Osteogenesis Imperfecta (OI) – Type II
71. Ovarian Cancer – with distant metastases or inoperable or unresectable
72. Pancreatic Cancer
73. Patau Syndrome
74. Peritoneal Mesothelioma
75. Pleural Mesothelioma
76. Primary Cardiac Amyloidosis
77. Primary Progressive Aphasia
78. Progressive Multifocal Leukoencephalopathy
79. Pompe Disease – infantile
80. Pulmonary Atresia
81. Rett (RTT) Syndrome
82. Salivary Tumors
83. Sanfilippo Syndrome
84. Sandhoff Disease
85. Single Ventricle
86. Small Cell Cancer (of the large intestine, ovary, prostate, or uterus)
87. Small Cell Lung Cancer
88. Small Intestine Cancer – with distant metastases or inoperable, unresectable or recurrent
89. Spinal Muscular Atrophy (SMA) – Types 0 And 1
90. Stomach Cancer – with distant metastases or inoperable, unresectable or recurrent
91. Subacute Sclerosis Panencephalitis
92. Tay Sachs Disease
93. Thanatophoric Dysplasia, Type 1
94. Thyroid Cancer
95. Tricuspid Atresia
96. Ullrich Congenital Muscular Dystrophy
97. Ureter Cancer – with distant metastases or inoperable, unresectable or recurrent
98. Walker Warburg Syndrome
99. Wolman Disease
100. Zellweger Syndrome
For more information on health insurance, sign up at the box on the right.
Apply for Health Insurance Programs for Children
What is SCHIP?
SCHIP, or State Children’s Health Insurance Program, provides health insurance to uninsured kids and teens that are not eligible or enrolled in a medical assistance program. Like Medicaid, SCHIP programs are run separately by each state under the guidelines set by the federal Centers for Medicare and Medicaid Services (CMS). States are free to design
SCHIP programs separate from Medicaid or use federal funds to expand their Medicaid Program (Children’s Medicaid), or use a combination of the two.
Why do I need this?
If you can’t afford adequate health insurance for your children, applying for SCHIP ensures that your children’s basic health costs are covered. As of 2008, SCHIP served approximately 7.3 Million children throughout the country.
What are covered by SCHIP?
Although SCHIP programs are run separately by state, federal rules require that States’ SCHIP cover the following:
• Routine check-ups
• Immunizations
• Dental
• Inpatient and outpatient hospital care
• Laboratory and x-ray services
Do I Qualify for SCHIP?
If you cannot afford health insurance for your children but your family earns too much for Medicaid, you may be eligible. Each state has different guidelines. In most cases, SCHIP covers for uninsured children who are 18 years old or younger and belong to families who have a yearly income up to $44,100 (for a family of four). Contact your State’s SCHIP agency for more information. Keep in mind that the annual income limit varies depending on family size.
How do I Apply?
You can find State SCHIP info at: http://www.insurekidsnow.gov/state/index.html. For more information, please click on this link to be taken to the proper directory.
Medicare – Health and Medical Assistance
What is Medicare?
Medicare is a Federal health insurance program that pays for hospital and medical care for qualified elderly and disabled Americans. The program has two main parts (A and B) but also offers additional extensions that provide service flexibility and prescription drugs (C and D).
Medicare Part A (Hospital Insurance) – This helps pay for hospital stays, including coverage for meals, supplies, testing and a semi-private room. Home health care or care in a skilled nursing facility may also be covered. Payroll taxes are usually used, so monthly payroll aren’t necessary.
Medicare Part B (Supplemental Medical Insurance) – This requires a monthly premium of $96.40 (as of 2009) and patients must meet an annual deductible of $135.00 before coverage begins. However, it does cover services such as:
• Durable medical equipment (canes, walkers, scooters, wheelchairs, etc.)
• Physician and nursing services
• X-rays, laboratory and diagnostic tests
• Certain vaccinations
• Blood transfusions
• Renal dialysis
• Outpatient hospital procedures
• Some ambulance transportation
• Immunosuppressive drugs after organ transplants
• Chemotherapy
• Certain hormonal treatments
• Prosthetic devices and eyeglasses
Medicare Part C (Medicare Advantage Plans/ Medicare Plus Choice) – This allows users to change their Medicare plan to address specific needs. Medicare Part C may enlist some private health insurance for additional coverage.
However, specific details will vary, depending on what is needed, and if you are eligible for the service or treatment involved.
Medicare Part D (Prescription Drug Plan) – This is usually administered by one of several private insurance companies, each of which offer plans with different costs and provides coverage for different prescription drugs. This expansion also requires a premium and a deductible. Generally, the pricing in these plans mean that 75% of the prescription drug costs will be paid for by Medicare if you spend between $250 and $2,250 in a year. The next $2,850 spent on drugs won’t be covered. However, Medicare will cover 95% of what is spent past $3,600.
Am I Qualified?
To qualify for Medicare, you must be:
• At least 65 years old
• Under 65 and disabled
• Any age with End-Stage Renal Disease
• A U.S. citizen or permanent legal resident for 5 continuous years
• Eligible for Social Security benefits with at least ten years of payments contributed into the system
How do I apply for Medicare?
If you already are receiving Social Security Benefits, you will automatically be enrolled for Medicare Part A and Part B when you turn 65. If your 65th birthday were on August 27, 2010, your automatic enrollment would be on August 01, 2010.
If you are close to 65 and are not yet receiving social security benefits, you may apply for Medicare A and B at the same time. To ensure that your Part B coverage isn’t delayed, you should enroll at least three months before you turn 65, which would be the beginning of your 7-month Initial Enrolment period.
To apply, you may call social security at 1-800-772-1213 or visit your local social security office. To apply online, you may visit http://www.socialsecurity.gov. For more information, please click on this link to be taken to the proper directory.
A Guide to Qualifying for Medicaid
What is Medicaid?
Medicaid is a government program that provides health-related services to qualified low-income individuals and families who otherwise could not afford adequate health insurance for themselves. It is managed by the Centers of Medicare and
Medicaid Services (CMS), a division of the U.S. Department of Health and Human Services.
Why do I need it?
If you can’t afford adequate health insurance, Medicaid can help you get the medical services you need your family members or yourself.
Federally required and regulated services under Medicaid include:
• Inpatient hospital services
• Outpatient hospital services
• Prenatal care
• Vaccines for children
• Physician services
• Nursing facility services for persons aged 21 or older
• Family planning services and supplies
• Rural health clinic services
• Home health care for persons eligible for skilled-nursing services
• Laboratory and x-ray services
• Pediatric and family nurse practitioner services
• Nurse-midwife services
• Federally qualified health-center (FQHC) services and ambulatory services
• Early and periodic screening, diagnostic, and treatment (EPSDT) services for children under age 21
Outside of Federal requirements, states also provide optional services for their Medicaid programs. The most common optional services include:
• Diagnostic services
• Clinic services
• Intermediate care facilities for the mentally retarded/disabled (ICFs/MR)
• Prescribed drugs and prosthetic devices
• Optometrist services and eyeglasses
• Nursing facility services for children under age 21
• Transportation services
• Rehabilitation and physical therapy services
• Home and community-based care to certain persons with chronic impairments
Do I qualify?
Although Medicaid is overseen at the Federal level, each state administers its own Medicaid program and has its own eligibility standards. The states also determine the type, amount, duration and scope of services. States also set the rate of payment for their services. You must inquire with your own state’s Medicaid program to know specific program guidelines.
Medicaid is for people of lower income who satisfy requirements based on age, pregnancy status, disability status, other assets and citizenship.
States are also required to provide services to individuals that the federal government defines as categorically needy.
These include:
• Individuals who receive federally assisted income-maintenance payments and similar groups who do not receive cash payments
• Individuals who meet the requirements for the Aid to Families with Dependent Children (AFDC) program that was in effect in their state on July 16, 1996
• Children under age 6 whose family income is at or below 133% of the Federal poverty level (FPL)
• Pregnant women with family income below 133% of the FPL
• Supplemental Security Income (SSI) recipients
• Recipients of adoption or foster care assistance under Title IV of the Social Security Act
• Special protected groups such as individuals who lose cash assistance due to earnings from work or from increased Social Security benefits
• Children born after September 30, 1983 who are under age 19 and in families with incomes at or below the FPL
• Certain Medicare beneficiaries
How do I apply?
You must contact your State’s Medicaid agency when applying for the Medicaid program. Click here for more information on State Medicaid Agencies and their websites. For more information, please click on this link to be taken to the proper directory.
Food Assistance for Women, Infants and Children (WIC)
What is the WIC Program?
The Special Supplemental Nutrition Assistance Program for Women Infants and Children (WIC) provides nutritious food, supplement diets, information on healthy eating and referrals to health care to safeguard the health of low-income women, infants and children up to 5 years of age.
Why do I need it?
If you fall into any of the categories of the program and are eligible, the WIC can help prevent health risks you and your young children may face during pregnancy and infancy.
Do I Qualify?
You must meet the following guidelines: category, residential, income and nutritional risk.
Category:
There are three general categories: women who are either pregnant or post-partum, infants and children up to five years of age.
Residential:
You must be a legal resident of the state.
Income:
You must meet the income limits designated by your state. Usually, your state’s income guidelines must be within 100% to 185% the Federal poverty guidelines.
You may be automatically eligible if you are in programs like SNAP, Medicaid or Temporary Assistance for Needy Families (TANF).
Nutritional Risk:
A health expert must determine if you are at risk.
Where do I Apply?
For more information on your local WIC program, please search our directory here.
How to Apply for Food Stamps
What is the Food Stamp Program?
The Food Stamp Program, now known as the Supplemental Nutrition Assistance Program (SNAP), helps low-income individuals and families buy healthy food that they need.
If you qualify for food stamps, you will be given an Electronic Benefits Transfer Card (EBT) that you can use in participating establishments. The EBT card works like a debit card. The amount of benefits you’re given will be added to your account while you are in the program. If you have some benefit “cash” left at the end of the month, that amount will carry over to the following one.
The amount you receive, and how long you will be receiving it, will be based on your application.
Why do I need Food Stamps?
If your food budget is not enough for you and your family, food stamps can help you with the balance. Most groceries and farmers’ markets now accept food stamp EBT cards. You don’t need to worry too much about where you need to shop for food when using SNAP benefits.
Am I Qualified?
Specific requirements vary with each state. However, general eligibility guidelines are as follows:
• You are a U.S. citizen or have a certain legal alien status
• You are a legal resident of your state
• You meet the income and resource limits for your state
For more info, contact your local SNAP office. You can find their number from our directory here.
How do I qualify?
Although SNAP is a Federal government program, it is run by state or local agencies. You can apply in any of the local or social security offices near your area. Some state agencies have online applications.
Usually, each applicant must file an application form, attend an interview and provide proof about your submitted information, like those for household resources, income and SSS numbers of household members.
You should also remember these when filing for SNAP:
If you are employed, you must bring a letter from your employer stating your gross and net wages for the past month.
If you are unemployed, you must bring proof that you were terminated.
If you are a student, you must provide proof of education expenses and other proof of income (grants, loans etc.).
Where Do I Apply?
For more information on your local Food Stamp office or website, please search out directory here.
A Guide to Food Banks in Your Area
What are Food Banks?
If you do not qualify for food stamps, you may still find food assistance in food banks. Food banks are run by non-profit organizations that distribute food (mostly donated) to different agencies. Low-income families or individuals in need of proper nutrition can visit food banks to receive free food.
How do I know if I’m eligible for Food?
Each food bank has unique income requirements for eligibility. If your monthly income meets their standards, you will be able to get food. Income guidelines also depend on your household size.
You can check the income guidelines for your local food bank. Find contact details in our directory.
What other requirements do I need?
For most Food Banks, you will need to bring the following:
- Proper identification
- Proof of monthly or annual income
How often can I visit a Food Bank?
Different Food Banks have different standards. Some Food Banks will allow you to visit at any time they are open. While others have stricter policies that will only allow you to visit once every two or three weeks.
Contact your local Food Bank to find out how many times you can visit. Find contact details here.
How do I contact Food Banks?
For more information, please click on this link to be taken to the proper directory
Disaster Food Assistance
What is the FNS (Food and Nutrition Service) Disaster Assistance Program?
The FNS Disaster Assistance Program provides food assistance to disaster victims who are in critical need of help.
FNS works and coordinates with State, local and voluntary organizations to:
• Provide food for shelters and other mass feeding sites.
• Distribute food packages directly to households in need in limited situations.
• Issue emergency SNAP benefits.
Why do I Need It?
If you or people you know are victims of disasters such as storms, earthquakes, floods or other similar emergencies, you may get much needed assistance through D-SNAP.
How do I contact State Information Hotline Numbers?
For more information, please click on this link to be taken to the proper directory