The NLS Press
A publication of NLSA, serving Allegheny, Beaver, Butler, and Lawrence Counties in Pennsylvania
Volume 2, Issue 2, Fall 2003
SSI Benefits - Why Are They So Important?
by Ilene Glickman, Esq.
Neighborhood Legal Services Association presently represents adults and children in SSI Disability cases. For our clients, the importance of obtaining disability benefits, which provide a regular monthly income, cannot be overestimated. From this steady, if modest, long-term income, clients are able maintain stability for themselves and their families, sometimes for the first time.
Because of the ongoing nature of the benefits, clients can resolve other problems, such as housing and debt management. Often they are eligible for public housing and are able to stretch their check to provide long-term security for themselves and their families. In some cases, getting SSI means that a client has the regular income to finance a chapter 13 bankruptcy, thereby saving his or her home from foreclosure. Clients eligible for SSI also receive far better healthcare benefits than do those receiving medical assistance from the Department of Public Welfare.
Many people who apply for SSI have significant medical bills, and the medical assistance they receive on SSI provides enormous benefits. Although many of these clients have had medical benefits through public assistance, those benefits are not as good as the benefits through SSI.
Specifically, with regard to MA through DPW, there are different categories, and a person's category determines the benefit package. If the individual is receiving general assistance, the medical benefits generally have limitations on such things as prescription drugs, dental coverage, how often a person can see the doctor, and certain services such as alcohol treatment.
On the other hand, on SSI, a person gets the full Medical Assistance package. Benefits include dental, prescription drugs, and no limits on services such as alcohol treatment. This is an enormous aid to a person who is disabled and has multiple medical needs. In fact, when medical treatment costs are factored into the equation, SSI medical coverage can translate into upwards of a $50,000 yearly benefit to clients with high medical bills.
The SSI case rises or falls on the medical records. For legal advocacy to be effective, the medical records must be there. NLSA takes pride in accepting and winning the challenging cases in which those records may be lacking.
One reason for a deficit in the records is that, unfortunately, many of NLSA's clients who are disabled have not seen doctors regularly, frequently because the client has not had access to decent health insurance. In addition, because the medical care is often provided by a revolving door of clinic doctors, all of whom may be good individually but none of whom has enough of a personal relationship with the claimant to know him or her well, it is often difficult to get a doctor to write a narrative addressing the relevant issues. This poses a challenge to our attorneys, since in many close cases a narrative statement from the treating physician can make the difference. Another problem arises from the fact that our clients cannot always articulate why they are disabled. For example, many clients come in complaining of physical ailments and pain. In the course of the interviews, it becomes apparent that while the claimants may, indeed, have these conditions, there may also be psychological issues which they either didn't think they had or didn't think had a bearing on their SSI cases. In these situations, if the client agrees and if there has been no psychological counseling, we make sure to advise the Social Security Administration of this additional impairment and request that they order a consultative psychological examination. In many cases that have been won, the Administrative Law Judge has cited this additional piece of evidence as paramount in supporting the client's claim.
Finally, NLSA tries to deal with the whole person who seeks our help. For example, if a client has housing problems, we will refer him or her to another legal services attorney to prevent eviction while the client is waiting for a decision in the SSI case. We understand the delicate balance of all these factors in our clients' lives.
We also specialize in representing claimants who have applied and been turned down numerous times. Some of these people have exhausted the appeal process; some have simply applied multiple times, starting over each time. In many cases, the reason for their prior denials had to do more with an incomplete medical record than with lack of merit. We have had success in developing the record and winning these cases.
Because of our extensive experience with this client population, NLSA is in a unique position not only to develop and win the cases, but also to provide comprehensive legal assistance to meet the needs of the whole person. It is personally very satisfying to know that our efforts can help clients in a profound and life-changing way.
In this issue:
SSI Benefits - Why Are They So Important
Two New Pro Bono Projects Launched
NLSA Welcomes the Newest Member of Its Staff
Number of Families Living Below Poverty Increases
Main Office: 928 Penn Avenue
Pittsburgh, PA 15222-3799
Telephone: (412) 255-6700
Toll-Free: 1-866-761-6572
Fax: (412) 355-0168
