SSDI/Medicare, I didn't know, Others didn't know, We found out Here!

[TenscTexan]

I am now CRPC or mCRPCa, how ever you want to say it, diagnosed back in April of 2017. I did not realize that I qualified for Social Security Disability Income and Medicare until I read it here. I'm self employed, so after talking with a couple members who had been through it, it seemed an attorney was the way to go, so I got one who made me jump through hoops and then made me do the online application anyway. The process of just getting to a legal assistant and questioning up to this point before they'd accept my case seemed like I was doing their job.

So, March 14th, I started the online application for SSDI. Have all your stuff ready or be ready to go find it. Meds, dates of procedures, doctors, hospitals, any previous surgeries, history, you name it, they want it. It'll take an hour or two as I recall. You'll come to one question before you hit submit, it asks: "Will your diagnosis result in death?" When you click yes, sirens go off and you hit the wheel of fortune. No, a pop up window comes up and tells you to call the SS office and talk to them. So I called them, waited only 15 minutes and some real nice guy walks me through some stuff and tells me how to finish up and go on to the next stage. He says your a slam dunk, you'll cruise through the system in less than 30 days. I finish the second part of the application and wait, but I see this part that asks to "fax" in medical records.

Hey, I've got nothing in the morning tomorrow, I'll just take the medical records there myself. A couple hours of playing with my phone and a live person who has my application, goes over it, looks at my biopsy report, bone scan radiology report. Says I sure am sorry for you sir, I'll put this all together and have it off to Austin by this afternoon, we're all done here.

Today, I've been following the website in anticipation of some news because that is how they update and I'll be damned if I didn't get full benefits approved TODAY!

So from the start of March 14th when I completed the online application, until the approval today, April 4th was 21 days, 15 business days.

If you are CRPC, you qualify, period.

I also understand if you were Stage IV mPC "at" diagnosis, you may also qualify for SSDI, but it may be more tricky. I will post the link if someone doesn't beat me to it of the requirements for SSDI prostate cancer.

All this time, I kept playing stupid with the lawyer like I was having trouble completing the online application never returning her signed forms, but I did send her a nice email thanking her for her services I no longer need.

I vented earlier this week on my one year anniversary, thanks for the support. Maybe mine comes in years and I'll have a whole year of good news!

[Hidden]

Thanks for the post.

Just to assure everyone: if you are stage 4 you qualify. Period. It does take a bit longer than if you are CRPC, but you still get approved. Mine tooks almost 3 months, but that was because I had worked during the period for which I applied for benefits and had to prove to them that I didn't make too much. If you are just quiting work and applying to receive benefits from that day forward, it's simple. It would probably take 2 months in that case. If you worked after diagnosis and want to apply back to when you were diagnosed (up to a max of a year back) then you have to fill out some additional paperwork to show that you were not over their limit. I had to provide more paperwork and discuss things a few times with the people there which was aggravating, but in the end they approved me back to diagnosis so it was worth the hassle. You start Medicare 2 years after the date you start to receive benefits.

I also learned here about it so I think it's a good thing to inform people who might not otherwise know. I had 2 doctors tell me I was not eligible. Both were wrong.

[BigRich in reply to Hidden]

Gregg57

I am mCRPC, but I have Social Security at 62; however, I had to take a 22 % penalty. Do you think I would get more money putting it for Social Security Disability? Also, if your collecting retirement Social Security, can you drop one for the other?

Rich

[Hidden in reply to BigRich]

I'm not sure how that works, if you can switch over from early social security to SSDI. But if you were able, you would get more for sure because SSDI is based on the benefit at full retirement age. And when someone who is on SSDI passes full retirement age, their benefit switches over to retirement social security. The benefit amount doesn't change, but their are no restrictions on earnings.

[BigRich in reply to Hidden]

Thank you for your reply. My plate is so filled now, that sometimes I am overwhelmed with my duties and responsibilities . My wife is frail, and I do all the housework and cooking. I fell on black ice was in a wheel chair, 5 weeks, 2 canes 5 weeks. I walk now but it is difficult to climb the stairs. I push the walking to build myself up, even though I am stiff. We all have our trials and tribulations. I feel blessed that I didn't fracture a hip.

Rich

PS: I will look into Social Security Disability next month.

[Dan59 in reply to BigRich]

Rich, It is. My understanding you can go from early retirement to SSDI, with retro back to the last time you worked, It may just be a phone call, I would make the call and get the ball rolling, Best to you, you have a lot on your plate. Here is a link I found. disabilitysecrets.com/resou...

[BigRich in reply to Dan59]

Thank you very much. I did research; I don't qualify. However, I have a small pension, worked for the outfit for 30 years, and I have SS retirement, I get by; I drive a 14 year old car, and the last suit I bought was in 1971. My wife and I have simple needs and simple wants. Than you for your kindness and concern.

Stay strong,

Rich

[TenscTexan in reply to BigRich]

BigRich, I wouldn't give up that quickly, at least give it a shot. You can do it all on line. But first call the SS office and ask for your DLI, (Date Last Insured). If that date is after your diagnosis, you probably qaulify. When I first started, when I logged in, it said I didn't qualify, but after talking to an attorney, they told me to get the LDI and I squeaked by 6 months. If you been on any kind of gov assistance for any length of time or didn't pay taxes for several years, you may not qualify. They base your eligibility on a points system on how long you have "paid taxes" over a recent period of time. Regardless, if you do the online application and complete it and answer yes to: "Is your diagnosis going to result in death?", someones going to call you within a week and you'll know for sure without going anywhere. It takes a couple hours but it could pay off big time if it is retroactive as I would suspect it would be, plus you'd get a 22% raise.

[BigRich in reply to TenscTexan]

The DLI, I had PCa but not the Stage that would qualify me for disability. I did not get mCRPC until July 2017. I have my DLI, it is too late to apply for these benefits.Thank you for your concern. You are a good human being.

Wish you the best.

Rich

[Dan59 in reply to BigRich]

I agree with Tensctexan, I think you do qualify. And that you should put forth the effort for earlier medicare and for more SS that you paid into. All the best Rich.

Stay Strong

Dan

[BigRich in reply to Dan59]

The DLI prevents me from going further.

Dan you help people. It is a blessing.

Rich

[sdnb in reply to Hidden]

Hello all, I could just cry over all of this news. I will do my very best to present the Readers' Digest version of my late husband's situation. He was diagnosed mCRPC in July 2010. Began various treatments, visited M.D. Anderson and Duke Medical Hospital, etc. but sadly succumbed to this wickedly inhumane illness in October 2015. In about 2013 when he began chemo, I heard that there was a possibility of SSDI, but he "didn't want to mess with it." I was not happy with his decision, but felt perhaps he knew what was best, considering the mounds of paperwork, copies of scans and tests, and the hours waiting to see someone in person to help us. I now feel that he could have qualified for something. He took early retirement in 2004, I believe, so his monthly benefit was less than what it would have been had he completed his full amount of time to retirement.

So, Gregg and others, this crazy question is coming from a distraught, frustrated, and exhausted widow-caregiver of a deceased cancer patient, so I ask that you don't think badly of me.

Can any benefits possibly be retroactive back to 2010, or any point in time where my husband was being treated for mCRPC? Crazy question, right? But it doesn't hurt to ask. To look back on our situation, with the knowledge that my husband could have qualified for some type of disability benefits, but chose not to bother with it, honestly makes my blood boil at him. Pretty bad to think so lowly of a poor deceased spouse, isn't it? It's not even about the financial benefit, but rather the principle of his not trying hard enough.

[TenscTexan in reply to sdnb]

I don't have an answer to your question but I'd say you are certainly deserving of it!

I would think an attorney would be needed to pull that off, but it would be worth it.

[sdnb in reply to TenscTexan]

I appreciate your advice and encouragement. You and Gregg57 both gave me some much needed insight, so now I have a place to start. Thanks!

[Hidden in reply to sdnb]

I certainly understand why you are frustrated with the situation and nobody here will think less of you for that. I agree with you that your spouse should have thought more about that and applied for it. I often think about my surviving family members in my decision process because of things like this. A lot of people don't know how the system works and/or are intimidated by the process. They don't get much help asking other people who don't know either. I had 2 doctors tell me I couldn't get it. That kind of upsets me because I would think they should know that.

I think you should look into this. I would start by getting an appointment with the Social Security adminstraion office nearest you. It's better to go in then trying to call. Go over everything with them and see what they say. I know you can only get back benefits for a maximum of one year. I was lucky I found out before I passed the one year mark from diagnosis. For people who are able to continue working, enjoy what they are doing and making decent money, it might make more sense to keep working for a while rather than collect.

From what I know, you get your social security or the survivor benefit from your husband, whichever is the larger of the two. With SSDI, the surviving spouse can collect the survivor benefit at 60.

Are you getting any kind of survivor benefits from his social security now?

[sdnb in reply to Hidden]

Thank you, Gregg, for all of that information. I do appreciate your explanations. I was a teacher, my husband worked for the Federal Government. Believe it or not, I was the one who earned a slight bit more, so I couldn't receive any of his. Teachers are known for their very low pay, but this shows how little a government employee makes . . . . sad. I don't know if the SSDI would be more than I'm getting now on my own. Truly it is not much considering 35+ years of teaching, with a Master's degree (which are a dime a dozen nowadays). Thanks, again, I will definitely make an eye-to-eye, knee-to-knee appointment with them.

Susan

[sfboy58]

Congratulations! I wasn’t as lucky as you. When I did the application on my own the folks in Austin declined my benefits and I was CRPC with bone metastasis. I have been told that a lot depends on who is reviewing your case in Austin. So I was forced to get a lawyer the second time around. But I did get $10k in back benefits which made using the lawyer worth the cost.

[TenscTexan in reply to sfboy58]

Yea, I think I remember you writing about it. I got lucky, some nice people were involved on some not so busy days at the SS office. I'm not exactly sure of when I'll get back pay, but I'll get some, and I think my monthly's start in June, but the hook of Medicare at the age of 60 in April of 19 is the best perk for me.

[TenscTexan]

The link to the qualification for SSDI is here:

secure.ssa.gov/poms.nsf/lnx...

[MichaelDD]

Good evening and congratulations. I too was successful in 60 days here in CA. Next day I took my paperwork to a close by SS office . My pathology report from surgery (robotic removal of prostate) was copied. I actually had a person call me when I was as approved. For Medicare I was told of a waiting period of 24 months. My "official" date with SSDI is June 2016. The two-year waiting period for Medicare is calculated from your date of SSDI entitlement—when you are eligible to start receiving monthly benefits. This is usually the date your disability began, PLUS five months (due to the five-month waiting period for SSDI) .I will be enrolled December 2018 ( 5 months from June 2016 is Dec 2016. Then 24 months is Dec 2018). Was it explained to you like this? Thanks and the best to you on your fight!

[TenscTexan in reply to MichaelDD]

No it wasn't explained like that, but I think some of your qualification dates are based on your original diagnosis. I know I'm approved, but I'm not sure at this date when exactly my benefits will begin, I was excited it was approved. I do see a deposit of my back pay for six months already, but I don't think I will receive any monthly payments until June.

My biopsy was done in the middle of my back showing prostate cancer metastasized in two locations, then the bone scan radiology report showed widespread disease all over the skeleton. So I qualify for everything listed on the link above from day one.

As far as I understand, my Medicare starts two years after diagnosis, which will be in April of 2019 next year, not two years after approval of SSDI. I'm being approved all the way back to April of 2017. Were you diagnosed mCP or mCRPC, what stage? Although I was originally diagnosed as mCP and after chemo diagnosed mCRPC, they assumed I was always mCRPC.

[Hidden in reply to TenscTexan]

MichaelDD is correct. You start receiving benefits 5 months after your "onset date" which is typically when you were diagnosed, but could be a later date if you had SGA (significant gainful activity). The Medicare eligibility date is 2 years from that point, so the total time is 2 years and 5 months. I was diagnosed in Feb. 2017 so my Medicare eligibility will be July 2019. The system is pretty crappy and there is an ongoing effort by some to get it changed. Probably won't help us though.

[Raymonda100]

Medicare eligibility is not immediate with SSDI eligibility. There is a two-year waiting period.

[Raymonda100]

It is essential to find out if you live in one of the few states that require Medigap insurers to issue policies regardless of pre-existing conditions. Most don’t so most people on Medicare through SSDI cannot get a Medigap (Medicare Supplement) policy. If you have an affordable health insurance policy you should keep it to pay for copayments and coinsurance.

[Hidden in reply to Raymonda100]

These states require the insurance companies to offer at least one kind of Medigap policy to people with Medicare under 65: California, Maryland, Oklahoma, Colorado, Massachusetts, Oregon, Connecticut, Michigan, Pennsylvania, Delaware, Minnesota, South Dakota, Florida, Mississippi, Tennessee, Georgia, Missouri, Texas, Hawaii, New Hampshire, Oklahoma, Illinois, New Jersey, Vermont, Louisiana, New York, Wisconsin, Maine, North Carolina

Medicare Advantage is also an option as far as I know, but not sure how that works with under 65, pre-exsisting conditions, etc. Still trying to learn about all of this.

[Raymonda100 in reply to Hidden]

I recommend not enrolling in an Advantage plan. Once you pass the time allowed to opt out without penalty, and want to go back to traditional Medicare, you will be medically underwritten for a Medigap policy. The other disadvantage of an advantage plan, (typical advertising BS to call them advantage plans), is major restrictions on Choice of providers. Although my sister lives only 20 miles from Duke University hospital system, her advantage plan would not allow her to use Duke physicians, without paying an exorbitant copayment for out of network services.

[Raymonda100 in reply to Raymonda100]

Can you send me the source for your list of states? When I researched this issue six months ago, North Carolina was not one of the states that mandated guaranteed issue for Medigap policies.

[Hidden in reply to Raymonda100]

This is where I saw it. There's no date on the article so it could be outdated information.

specialneedsanswers.com/fil...

And here's another article with a list that includes North Carolina:

ehealthmedicare.com/faq-med...

[Hidden in reply to Raymonda100]

Here's a link for information specifically for North Carolina

medicare-supplement.us/nort...

[Raymonda100 in reply to Hidden]

The site doesn’t say that NC requires guaranteed issue for people under age 65 on SSDI.

[Hidden in reply to Raymonda100]

The only thing I could find is guarantee under 65, but nothing mentioning SSDI.

[Tjc1]

Boy you guys are lucky. Yesterday i sent all my records into the Railroad Retirement Board which is federal also that handles retirement and dissability. Evertime i talk to somebody they stress it will take one year to 18 months to process. I asked why and they said budget cuts and are down to 200 employees from 600 for all railraders in the country.

Ill wait and see. Ill call call call....lol

Thomas

[EdBar]

I went into SSA office to apply and was awarded SSDI without a hitch. I'm stage 4. Takes 2 years after you start receiving benefits to get on Medicare. You need to do you homework when picking out a drug plan and supplemental insurance is available but not cheap if you are younger than 65 and receiving SSDI. Usually you have to pick one with a high deductible but if you have frequent doctors office visits it will likely pay for itself.

Ed

[Dan59]

I made a phone call to SS asking if I would qualify as CRPC stage 4, a month later I got a callback, asked for my Doctors names and permission to get records. They called back 2 weeks later and said I was approved. Never talked to Lawyer, never went to an office.

[erjlg3]

You made me laugh TenscTexan lol 😁. Happy for their prompt action for your approval. I hope you're able to take them broke 😉

Most sincere,

Jackie