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  • swukith
    I don’t understand why so many professionals, that deal with MS claims, are so misinformed:

    When I would speak to an Advocate or a SSDI Lawyer, (most that I contacted never responded), those that did respond informed me one of the following:

    • You have to start a new claim & start from scratch
    • There is no such ‘compassionate expedited reinstatement’
    • You can apply for a financial waiver, but it would never be approved 
    • If you requested a reconsideration, then you have to complete forms & follow up yourself
    • If you were able to get that job then you are able to work & just need to look for another position.

    I started researching & studying the Social Security & Social Security Disability websites. I read due to specific effects of an illness or disease, one could request a compassionate expedited reinstatement of medical benefits and monetary benefits would take a little longer to restart. 

    The symptoms, or side effects of the MS that I experience on a regular, uncontrolled basis that q ualifies me for a compassionate expedited:

    Due to the MS I experience:

    • 1. Depression
    • 2.Severe Fatigue
    • 3. Insomnia
    • 4. Vision: Vertigo, light-headedness, light spinning sensation
    • 5. Bowel dysfunction
    • 6. Constipation followed by diarrhea, and bowel & bladder incontinence
    • 7. Vision problems, (Optic neuritis: inflammation of optic nerve), reduced, blurred and or Double vision and when anxiety, upset, etc., also effects or causes contrast sensitivity is severely reducing sharpness of vision

    Some of the dates & facts start getting fuzzy, it’s so hard trying to keep the depression buried while putting details together; provide proof of financial hardship for eligibility:

    Need copies of following paperwork:

    • Fighting to keep the house from bankruptcy 
    • The Utilities, (Gas & electric), from shutting off power
    • The School loans
    • The taxes, (husband’s salary is/was garnished)
    • Husbands monthly net pay, approx $3500
    • Copy of household bills 
    • Husband has COPD
    • Husbands Rx co-pay $4500
    • Husbands monthly Rx $550+
    • 2014 tax refund of $904 never received
    • 2014 last year taxes were done, due to depression I did not realize

     offered a PT Telecommuter position thru an employment agency at United Health Care selling Medicare Supplemental Insurance. The hours were to be approximately 10 – 20 hours January through September, 40+ hours during Medicare Open Enrollment Period.When contacted By Social Security I informed them the job was not yet permeant. The company went through more than 2 major changes, (Separating from Hartford, becoming Catalyst 360, then merging with Optum), and large employee turnover, which effected the hours.

    I was hoping to be offered a permanent “Flex” employee; however, January 24, 2014 I was notified I was not being offered the position and my assignment was no long renewed. I thought I might not get hired, because of my attendance.

     had back-to-back UTI’s for almost 3 years year, starting approx. October 2011. 2012 thru 2014 went to the Urologist almost every 2 weeks, unaware SSD had not reinstated Benefits. (via telephone conversations with Social Security, I thought they were to be instated)Due to taking antibiotics 2 – 4 weeks of the month for almost 2 years, effected my teeth. Almost every filling, cap & crown have fallen out, and every day I dread teeth brushing, because I can barely eat any solid foods. It’s been over a year since I went to Aspen Dental.

    • I need complete set of dentures. photos if neeed.

    Almost 4 years - no medical benefits coverage

    UROLOGIST: 

    • October 2014, I had outpatient procedure, which I was advised I’ll need about every 6 months. 
    • Currently experiencing UTI’s about twice a month
    • Living on the OTC pain relief AZO
    • Also reusing catheters, unable to afford to continue buying new

    GYNECOLOGIST:  

    • October / November 2014 I went to GYO, because at 61 years, I still experience brake through bleeding. 
    • The doctor discovered a Cyst on cervix & recommended outpatient surgery to remove and get biopsy of Uterus lining. Have not been able to do.NEUROLOGIST: 
    • I am suppost to see the doctor every 6 months, unfortunately, due to price, I have not seen my Neurologist over a year.
    • Not taking any MS medication, for almost 4 yrs.
    • Fatigue is severe, preventing me from doing almost anything. I can barely get to the bathroom, never mind taking shower, bath and get dressed 
    • Financially unable to hire CNA for assistance .4   Can you get benefits again if your benefits ended because of work?

    504.I f your benefits ended because you worked and had earnings, you can request to have your benefits started again without having to complete a new application, within 5 years from the month your benefits ended. We call this process "expedited reinstatement" or EXR. It was effective January 1, 2001.

    ·   You can be reinstated via EXR if:

    ·   Your previous benefits ended due to work or earnings;

    ·   You are not performing SGA in the month you request EXR;

    ·   You are unable to perform SGA due to your medical condition;

    ·   Your current disabling impairment(s) is the same as or related to the impairment(s) that was the basis for the previous disability entitlement;

    ·   You request EXR within 60 months of when your previous benefits terminated, or you have good cause for filing your request late; and

    ·   We determine that you are under a disability.

    ·   While we determine whether you can get benefits again, we can give you provisional (temporary) benefits for up to 6 months. These benefits include a cash payment and Medicare coverage. If we deny your request, we usually will not ask you to repay the provisional benefits. If we approve your EXR request, your eligible spouse and dependent children may also get benefits. We can pay you for up to 12 months before your request, if your condition kept you from working during that period. During the first 24 months you are eligible for benefits, we will not pay you for any month(s) you perform SGA, but your Medicare coverage will continue. Once you have received 24 months of benefits, which do not have to be in a row, you get a new trial work period and extended period of eligibility.

    I also understand that ‘Medicare expenses’ would be reimbursed, w/proof. I have receipts and statements.Not sure if this applies due to the side effects of MS that I have.

     

    • ·   If you become disabled again following the expiration of your EPE, you can apply for expedited reinstatement of benefits, as long as it has been less than five years since you were receiving SSD benefits before. If it’s been more than five years since you were last on SSD, then you must reapply.

     

    Waiver for Overpayments:

    If repayment would cause a hardship, and or a financial hardship can can be proven the overpayment can be waived.

     

     I am not receiving any medication for the MS.

    Monthly incontinence expense $150

    Catheters $50 – stretch, don’t use new every time

    (Medicare had pd for 400 month)

    Dental: Need dentures

    Mortgage: Fighting to keep from foreclosure

    School Loans

    Ugi Utilities

    UTI’s

    Living on UTI OTC Pain - AZO STANDARD MAX STRENGTH TABLETS 12 COUNT $8.29

     

    My husband has COPD: $3500 co-pay / monthly Rx $$550 

     

     Depression & Insomnia reasons:

    ·   60 days to file 2015 income taxes

    ·   must call PeopleShare for copies of 2015 & 2016 W-2

    ·   file 2016 taxes

    ·   prepare for 2017 income taxes

    ·   School loan forgiveness 

    ·   modification - house

    ·   Income taxes - 60 days to file, 

    ·   SSD - was given # to call & other instructions for reconsideration, payment waiver & details about med bills, procedures, etc., that I've paid, been paying can't pay...

    ·   over payment waiver + Reimbursement of monthly SSD from 06/2014 

    è  as of now approximately $25,000

    ·   hospital & other medical -> letters of explanation & phone calls to explain why no SSD

    ·   bank... mistake, their fault, w/a mortgage payment, but Citimortgage sold acct to MrCooper & we have cpompleted the 3rd or 4th remodification loan. Remodification load approved, However we have to pay the months not pd, approx. $5000, or foreclosure.

    ·   call IRS - need to trace 2014 income tax refund

     

     

    ********************

      

     

    This message was sent with high importance.

    I have been trying to get in touch with someone for almost a month. I contacted (or tried) T. Shaw @ 866-261-9397 Ext 3-2342. I left a message stating with my 'eyesight' I thought I was to contact within 30 days of receiving the notice & my husband found the paper and saw that I was to contact in 10 days. I have been going to the doctor almost every week for Kidney problems and unable to do anything.

    I need to file for a waiver and reconsideration. I am not working. I was working and hoping to get off SSD, but the position I had was eliminated. It was a Telecommuter position, enabling me to work from home, however, the company decided to reorganize the 'Telecommuter positions' and I was out of a job.

    The only way I could work is if I am able to work from home. I am unable to drive due to the multiple sclerosis and my vision.

    Also, when my disability was approved I was legally blind & informed the disability was approved due to my eye-sight. Nothing has changed.

    • You can apply for a financial waiver, but it would never be approved 
    • If you requested a reconsideration, then you have to complete forms & follow up yourself
    • If you were able to get that job then you are able to work & just need to look for another position.

    I started researching & studying the Social Security & Social Security Disability websites. I read due to specific effects of an illness or disease, one could request a compassionate expedited reinstatement of medical benefits and monetary benefits would take a little longer to restart. 

    The symptoms, or side effects of the MS that I experience on a regular, uncontrolled basis that q ualifies me for a compassionate expedited:

    Due to the MS I experience:

    1. Depression

    2. Severe Fatigue

    3. Insomnia

    4. Vision: Vertigo, light-headedness, light spinning sensation

    5. Bowel dysfunction

    6. Constipation followed by diarrhea, and bowel & bladder incontinence

    7. Vision problems, (Optic neuritis: inflammation of optic nerve), reduced, blurred and or Double vision and when anxiety, upset, etc., also effects or causes contrast sensitivity is severely reducing sharpness of vision

    Some of the dates & facts start getting fuzzy, it’s so hard trying to keep the depression buried while putting details together; provide proof of financial hardship for eligibility:

    Need copies of following paperwork:

    • Fighting to keep the house from bankruptcy 
    • The Utilities, (Gas & electric), from shutting off power
    • The School loans
    • The taxes, (husband’s salary is/was garnished)
    • Husbands monthly net pay, approx $3500
    • Copy of household bills 
    • Husband has COPD
    • Husbands Rx co-pay $4500
    • Husbands monthly Rx $550+
    • 2014 tax refund of $904 never received
    • 2014 last year taxes were done, due to depression I did not realize

     

    P

     

    Around that time I was offered a PT Telecommuter position thru an employment agency at United Health Care selling Medicare Supplemental Insurance. The hours were to be approximately 10 – 20 hours January through September, 40+ hours during Medicare Open Enrollment Period.

    When contacted By Social Security I informed them the job was not yet permeant. The company went through more than 2 major changes, (Separating from Hartford, becoming Catalyst 360, then merging with Optum), and large employee turnover, which effected the hours.

     

    I was hoping to be offered a permanent “Flex” employee; however, January 24, 2014 I was notified I was not being offered the position and my assignment was no long renewed. I thought I might not get hired, because of my attendance.

     

    I had back-to-back UTI’s for almost 3 years year, starting approx. October 2011. 2012 thru 2014 went to the Urologist almost every 2 weeks, unaware SSD had not reinstated Benefits. (via telephone conversations with Social Security, I thought they were to be instated)

     

    Due to taking antibiotics 2 – 4 weeks of the month for almost 2 years, effected my teeth. Almost every filling, cap & crown have fallen out, and every day I dread teeth brushing, because I can barely eat any solid foods. It’s been over a year since I went to Aspen Dental.

    • I need complete set of dentures. photos if neeed.

     

    Almost 4 years - no medical benefits coverage

     

    UROLOGIST: 

    • October 2014, I had outpatient procedure, which I was advised I’ll need about every 6 months. 
    • Currently experiencing UTI’s about twice a month
    • Living on the OTC pain relief AZO
    • Also reusing catheters, unable to afford to continue buying new

     

    GYNECOLOGIST:  

    • October / November 2014 I went to GYO, because at 61 years, I still experience brake through bleeding. 
    • The doctor discovered a Cyst on cervix & recommended outpatient surgery to remove and get biopsy of Uterus lining. Have not been able to do.

     

    NEUROLOGIST: 

    • I am suppost to see the doctor every 6 months, unfortunately, due to price, I have not seen my Neurologist over a year.
    • Not taking any MS medication, for almost 4 yrs.
    • Fatigue is severe, preventing me from doing almost anything. I can barely get to the bathroom, never mind taking shower, bath and get dressed 
    • Financially unable to hire CNA for assistance 

     

    OPTOMOGIST: 

    • November 2017, had eye exam & glasses.

     

    506.4   Can you get benefits again if your benefits ended because of work?

     

    ·   If your benefits ended because you worked and had earnings, you can request to have your benefits started again without having to complete a new application, within 5 years from the month your benefits ended. We call this process "expedited reinstatement" or EXR. It was effective January 1, 2001.

    ·   You can be reinstated via EXR if:

    ·   Your previous benefits ended due to work or earnings;

    ·   You are not performing SGA in the month you request EXR;

    ·   You are unable to perform SGA due to your medical condition;

    ·   Your current disabling impairment(s) is the same as or related to the impairment(s) that was the basis for the previous disability entitlement;

    ·   You request EXR within 60 months of when your previous benefits terminated, or you have good cause for filing your request late; and

    ·   We determine that you are under a disability.

    ·   While we determine whether you can get benefits again, we can give you provisional (temporary) benefits for up to 6 months. These benefits include a cash payment and Medicare coverage. If we deny your request, we usually will not ask you to repay the provisional benefits. If we approve your EXR request, your eligible spouse and dependent children may also get benefits. We can pay you for up to 12 months before your request, if your condition kept you from working during that period. During the first 24 months you are eligible for benefits, we will not pay you for any month(s) you perform SGA, but your Medicare coverage will continue. Once you have received 24 months of benefits, which do not have to be in a row, you get a new trial work period and extended period of eligibility.

     

    I also understand that ‘Medicare expenses’ would be reimbursed, w/proof. I have receipts and statements.

     

     

    Not sure if this applies due to the side effects of MS that I have.

     

    • ·   If you become disabled again following the expiration of your EPE, you can apply for expedited reinstatement of benefits, as long as it has been less than five years since you were receiving SSD benefits before. If it’s been more than five years since you were last on SSD, then you must reapply.

     

    Waiver for Overpayments:

    If repayment would cause a hardship, and or a financial hardship can can be proven the overpayment can be waived.

     

     I am not receiving any medication for the MS.

    Monthly incontinence expense $150

    Catheters $50 – stretch, don’t use new every time

    (Medicare had pd for 400 month)

    Dental: Need dentures

    Mortgage: Fighting to keep from foreclosure

    School Loans

    Ugi Utilities

    UTI’s

    Living on UTI OTC Pain - AZO STANDARD MAX STRENGTH TABLETS 12 COUNT $8.29

     

    My husband has COPD: $3500 co-pay / monthly Rx $$550 

     

     Depression & Insomnia reasons:

    ·   60 days to file 2015 income taxes

    ·   must call PeopleShare for copies of 2015 & 2016 W-2

    ·   file 2016 taxes

    ·   prepare for 2017 income taxes

    ·   School loan forgiveness 

    ·   e-modification - house

    ·   Income taxes - 60 days to file, 

    ·   SSD - was given # to call & other instructions for reconsideration, payment waiver & details about med bills, procedures, etc., that I've paid, been paying can't pay...

    ·   over payment waiver + Reimbursement of monthly SSD from 06/2014 

    è  as of now approximately $25,000

    ·   hospital & other medical -> letters of explanation & phone calls to explain why no SSD

    ·   bank... mistake, their fault, w/a mortgage payment, but Citimortgage sold acct to MrCooper & we have cpompleted the 3rd or 4th remodification loan. Remodification load approved, However we have to pay the months not pd, approx. $5000, or foreclosure.

    ·   call IRS - need to trace 2014 income tax refund

     

     

    ********************

      

    Copy of Email:

     

    Tue 8/30/2016, 7:10 AM

    fsmith@medicare.org

     

    This message was sent with high importance.

    I have been trying to get in touch with someone for almost a month. I contacted (or tried) T. Shaw @ 866-261-9397 Ext 3-2342. I left a message stating with my 'eyesight' I thought I was to contact within 30 days of receiving the notice & my husband found the paper and saw that I was to contact in 10 days. I have been going to the doctor almost every week for Kidney problems and unable to do anything.

    I need to file for a waiver and reconsideration. I am not working. I was working and hoping to get off SSD, but the position I had was eliminated. It was a Telecommuter position, enabling me to work from home, however, the company decided to reorganize the 'Telecommuter positions' and I was out of a job.

    The only way I could work is if I am able to work from home. I am unable to drive due to the multiple sclerosis and my vision.

    Also, when my disability was approved I was legally blind & informed the disability was approved due to my eye-sight. Nothing has changed.

  • MS_Navigators
    Hi there,

    We are aware of a Compassionate Allowances Initiative, which can help expedite the processing of SSDI and SSI claims for individuals with certain diagnoses, such as malignant multiple sclerosis. There is more information about this here on our website.  My understanding is that this is different from expedited reinstatement, which can restart benefits without a new application for those who lost benefits due to earnings from work.  A local Work Incentives Planning and Assistance (WIPA) counselor may be able to help sort this out with you.  You can find local WIPA contact information at https://choosework.ssa.gov/findhelp/