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Some period of time after a claimant begins receiving Social Security Disability Benefits, the Social Security Administration (SSA) generally conducts a Continuing Disability Re-Evaluation (CDR). If you are less than 55 years of age at the time your benefits begin, a review is usually conducted every 3 years. If you are 55 years old or older, or if you have a condition that is unlikely to improve, your CDR will occur approximately every 7 years, until you reach retirement age.

A CDR may also occur if you are receiving Social Security Disability benefits and earning more than “substantial gainful activity” (SGA) per month. In 2016, the SGA amount for disabled non-blind beneficiaries is $1,130 per month. For blind beneficiaries, the amount is $1,820 per month. If you earn more than the SGA, your disability benefits will be in jeopardy. The exception to the SGA limitations is when the beneficiary is enrolled in a return-to-work plan through Social Security, which allows for a trial run of work for the beneficiary.…

Continue Reading Passing a Social Security Continuing Disability Re-Evaluation

In case you were unaware, the fees for all attorneys who represent claimants seeking Social Security Disability Benefits are regulated by federal law. Furthermore, these fees are contingent on the attorney’s ability to successfully get an award of benefits for the claimant. In other words, if the attorney is not able to obtain an award of benefits for the claimant, the attorney does not get a fee.

The statute in question that regulates attorneys fees states that the attorney is entitled to get 25% of the claimant’s retroactive benefits or a flat fee (which currently stands at $6,000), whichever is less. An attorney is not entitled to receive any monies from a claimant’s monthly checks from Social Security.…

Continue Reading Fees and Costs for Attorney Representation for Social Security Disability Benefits

Since 2008, Medicare has refused to reimburse hospitals for the cost of treating patients who suffer avoidable medical complications. Although technically Medicare can actually expel a hospital with high rates of errors from the Medicare program, this is very rarely done.

However, in 2015, the federal government did cut payments to 721 hospitals which possessed documented high rates of infections and other patient injuries in the previous year. Among the 721 institutions were 2 frequently used by patients in Eastern Pennsylvania – the Hospital of the University of Pennsylvania, in Philadelphia, and Geisinger Medical Center in Dansville, Pennsylvania.

Hospital acquired conditions, or HACs, include infections, blood clots, bed sores, and other complications which are considered avoidable. The penalties levied on the 721 hospitals are estimated to be in excess of $300 million. In 2013, approximately 1 in 8 admissions to a hospital included an HAC. Populations at highest risk are the very young and the very old, as well as those who have chronic diseases which would place them at a higher likelihood of developing an HAC.…

Continue Reading Government Cracks Down on Hospitals with High Rates of Complications

For those unsure or unaware, Medicare and Medicaid are both government health insurance programs. However, they are still different programs, and therefore require different eligibility requirements and different coverage. Essentially, Medicare is a government program designed to provide health insurance coverage for the elderly and disabled. On the other hand, Medicaid is a needs program, which means that it exists to cover the healthcare costs for the very low income individuals.

Medicare is a purely federal government program attached to Social Security. It is available to citizens and certain other legal residents at the age of 65, and also covers people who are disabled under the Social Security guidelines. It is a 4-part program which covers hospitalizations through Part A, outpatient and doctors visits through Part B (more about parts A and B), potentially private plans (Medicare Advantage Plans) through Part C, and prescription coverage, through Part D (more about parts C and D).

Medicaid is a joint federal and state program that covers healthcare costs for low income individuals. Additionally, it covers long-term custodial care for poor and elderly individuals. There is a Medicaid program for each state in the U.S., and the federal government funds up to 50% of the costs of each state’s Medicaid program.…

Continue Reading The Key Differences between Medicare and Medicaid

Medicare is often discussed on the news, but very little time is spent explaining how precisely patients can qualify. Medicare Part A covers inpatient hospital stays or care in a skilled nursing facility. Medicare Part B covers outpatient medical care, such as doctor visits. In order to qualify for Medicare Part A and Part B,…

The Spousal Retirement Benefit offered by Social Security is a little known and poorly advertised gender-neutral benefit, which is available to any person who is 62 years old and whose spouse has filed for his or her retirement benefits. The benefit to the spouse is based on the retiring/retired worker’s earnings. The spousal benefit can be as much as half of the retiring worker’s primary insurance amount, depending on the spouse’s age at retirement. If the spouse begins receiving benefits before his or her full retirement age, the spouse will receive a reduced benefit.

If the spouse intending on collecting this spousal benefit has not reached his or her full retirement age yet, this claim will be deemed to be for all benefits available to the claimant. It will also be seen as a request for the spouse’s own retirement, as well as the spousal benefit. If the spouse’s benefit is greater than the retiring or retired worker’s benefit, the spouse cannot receive a spousal benefit.…

Continue Reading The Spousal Retirement Benefit: Social Security’s Best-Kept Secret

Medicare is now in its third year of testing their “Independent at Home” project, which was created by the Affordable Care Act. This program provides Medicare’s frailest senior citizen patients, who all suffer from multiple chronic conditions, with house calls by healthcare professionals.

These are Medicare’s most expensive type of patient, because they are often…