Applying for SSI...need advice

[Mitchell's Mom]

Greetings.

I'm in the process of getting information, researching and so on, but the long and short of it is this:

We have outstripped our pharmacy benefits as of now for difficult child#2's medications. We cannot afford $900 per month just for his medications. The psy. doctor is working with us to get through December, but I'm still going to have to fork out about $250 (usually $50). Even though the benefits start again as of January, by the end of April, we'll have outstripped them again. To that end, I called (among other agencies) Social Security to see if we qualify for SSI Disability for difficult child#2. The person I talked to was very helpful, friendly and gave me a ton of information and indicated that we might actually qualify. I have an appointment. on Dec. 15th to apply. We NEED these benefits. What can I do to get what we need? I am not totally comfortable "playing the system" as it were, but I will do what I need to do, short of outright lying to get it. If anyone has been through this, can you please offer me advice? You are welcome to PM me if you're uncomfortable posting it here.

I am getting records, letters and recommendations from his docs, school and so on. The school is doing a psychiatric. evaluation next week, but the results won't be available by this appointment. Is there anything I can do to tip the scales in our favor? Anything would help!

Thank you in advance and hugs to you.

MM

 

[transformtriumph]

It helps to emphasize how disabled he is compared to his peers. Also, emphasize all the extra services that are needed due to his disability. Make sure it is clear that he must have all these supports because he is disabled.

Get anyone you know to write letters in support of SSI. This includes relatives, neighbors, day care, ministers, etc.

 

[terrip33]

i am also applying for ssi for my 9yr. old daughter who has adhd and bi polar possible aspergers. our insurance is going up sooo high that between that and medications and counciling we cant do it. she needs it but how can we afford it without putting us out on the street? i also have a dec.15 appointment. im new at this stuff. i knw nothing of how to get help for her $$$ wise.

 

[susiestar]

LAdies,

All I know about this comes from my mom. she has multiple health problems and is rather odd in that she has kept copies of all lab work, tests, etc that she has ever had done.

She has graphed these over the years (helped to save her life this way - showed a trend in liver function that indicated a disease) and when she had to retire on disability she dragged it all out.

She did not use a lawyer, though several called her. Her ins co wanted her to use a lawyer.

Whe made a spreadsheet with every dr visit, the diagnosis, the treatment, every surgery, every procedure, every everything on it. All the dr names, dates, diagnosis's, outcomes, etc.......

With multiple feet of surgical scars and all these spreadsheets she got through and was approved on her second appointment, but it took 5 months of prep work before she would make the first appointment.

Hopefully this will give you some idea of the types of info you may need. Organizing it into a readable format is incredibly useful. It shouldn't take as long as none of you have 40+ years of medical records to sort through!!

Good luck and prayers!!

Susie

 

[PattyC]

We just received SSI for my stepson (19 yo). We were told it would be a difficult, long process and he would probably be denied and we would need to appeal. Fortunately, he was awarded the benefits within 2 months.

I can tell you to take in all pertinent information. We had 4 psychiatric. evaluations that had been done over a 5 year period. His diagnosis is Asperger's and Depression. It would probably be difficult to receive the benefits without the full evaluations done. Because of his Asperger's he was in out of home placements for 6 years and I'm sure that had an impact on their decision.

In the state of Maine there is "Medicaid" for children that are at risk of out of home placement. Here it is called the Katie Beckett program. It was developed to help families that didn't meet the criteria for state assistance financially but allows for children to receive all the benefits medically and psychologically in hopes of keeping them at home.

I hope this helps...
Patty

 

[OTE]

The thing they are looking for is that your son does not function as other children his age do. So find as many things as you can to indicate that he does not behave appropriately compared to his peers. Yes, having him in a hospital or residential setting for a period of time will weigh heavily. That is, his behavior was so bad that he couldn't be released to live in a normal family setting. Same with school. If he's in an alternative behavioral school, self-contained class, has one on one aide,.... that will indicate to them that he can't function as a "normal" child his age- ie in a mainstream class. Think of all the things kids his age do... school dances, dating, going to the mall without parental supervision, wake up himself in the am., get dressed, walk to school arriving on time....can he do these things? Make a list, mental or otherwise of behaviors that make him different from his peers.

There's a checklist they'll ask you to fill out based on his age that will list things that are age-appropriate for him to do. They'll have "THEIR" Dr examine him. There will be an IQ type test and list of questions they'll ask him and you- along the same lines as the first checklist.

OOPS... you're talking about a 6 yr old, not a 15 yr old. As I recall the 6 yr old checklist it's things like getting dressed by himself, sharing and getting along with kids in his class, appropriate vocabulary and speech patterns, respecting the property of others and personal space and boundaries, being able to have a playdate, handling anger and frustration appropriately, being able to entertain himself and be left alone for a reasoble period- while you're in the house obviously- without getting into poison, setting fires or otherwise destroying the house.. You might try the ssa.gov website and see if there's a checklist with the electronic application.

Be careful about the appointment date. That's the retro date from which they'll pay your benefits. So don't miss it and make sure they input it into their system as a completed application before you leave.. or reasonably complete... so you get that as the retro date. yes, they screwed me by many months on one kid.

 

[PattyC]

I will add this; The only situation I'm familiar with is my own...We never even had someone from SSI evaluate my stepson. The diagnosis and reports apparently were very detailed and efficient and the decision was based on those reports. I highly recommend you speak with the school evaluator and let them know your intentions with SSI as they will be able to document the longevity of the disorders.

Patty C.

 

[transformtriumph]

Always give more information than they request. Even if they only want the most current evaluation, give them all you have, neatly organized in order.

 

[bigblueagain]

We also did not have anyone evaluate difficult child when we applied. She too had just been hospitalized and had had three full evaluations and a neuropsychologist to boot which probably helped as well. Also when they turn 18 the govt can no longer use parental income to deny. Only her income, which was essentially zero. So as said above, have as much info as possible and DON't blow off any dates they set for you. That they will get the parents for !!!! BLUE

 

[OTE]

please see the post in watercooler on free medications.

 

[AnOkie2]

Bumping to ask....

I've applied for SSI for difficult child, and didn't even to where y'all are talking about because husband makes too much money.

*snort*