*GOVERNMENT BENEFITS & SERVICES INFORMATION

SSI / SSDI

• How do I apply for SSI or SSDI?
• What should I do if my application for SSI or SSDI gets denied?
• What social security benefits do I qualify for?

Medicare/Medicaid

• What is Medicaid and who does it cover?
• What do I do if I am denied Medicaid?
• I have a lot of questions about Medicare, where can I get answers?
• I can't afford my Medicare premiums. What can I do?
• What is the difference between Medicare and Medicaid?

Veterans' Benefits

• Where can I find information about all veterans' benefits?
• What happens if I am denied veterans' benefits?
• I am still on active duty, where can I file a claim for service-connected compensation?

SSI/SSDI

How do I apply for SSI or SSDI?
The Social Security Administration encourages individuals to apply for disability benefits as soon as they become disabled. Applicants can apply online, over the phone, or by calling or visiting a local Social Security office. It is important to have certain information and documents ready for the application. For a checklist of these documents, click here. Having these documents ready can speed up the process, which usually takes three to five months. Finally, applicants must also complete the Adult Disability Report Form, which requests information about your work and disability history, in addition to the application for benefits.

What should I do if my application for SSI or SSDI gets denied?
If an individual's application is denied, he or she has the right to ask the SSA to reconsider the application a second time if he or she disagrees with the decision. If the application was denied because the individual is not disabled under the SSA qualifications, then he can appeal the decision online.

What social security benefits do I qualify for?
There are several tools to help determine an applicant's eligibility for assistance and which type of assistance program best suits their needs.

Generally, the SSA considers you disabled under Social Security rules if:

• You cannot do work that you did before;
• You cannot adjust to other work because of your medical condition(s); and
• Your disability has lasted or is expected to last for at least one year or to result in death.

Social Security program rules assume that working families have access to other resources to provide support during periods of short-term disabilities.

The SSA determines whether applicants fit this definition by applying a step-by-step evaluation process. Some of the qualifications include whether the applicant is working, whether the condition is "severe," whether the condition may be classified as a "disabling condition," whether the applicant can do the work he or she did previously, and whether the applicant can do any other type of work. In addition, there are special situations for which an individual may be eligible if he or she otherwise does not meet the abovementioned list of qualifications. (blind/low vision; disabled windows or widowers; disabled children; wounded warriors). 

Medicare/Medicaid

What is Medicaid and who does it cover?
Medicaid is a joint federal and state program that helps pay medical costs for some people with limited incomes and resources.  Each state sets its own specific guidelines regarding eligibility and services. In Massachusetts, the Medicaid program is known as MassHealth. MassHealth offers health-care benefits directly or by paying part or all of your health-insurance premiums, depending on your particular situation. Eligibility requirements vary depending on the type of health care coverage provided. If you are eligible, you will receive the most complete coverage for which you qualify.

What do I do if I am denied Medicaid?
If you are denied Medicaid and you think that decision is wrong, you have the right to ask for a fair hearing to appeal that decision. MassHealth notices have information on the back that explains how to ask for a fair hearing and how much time you have to ask for one.

I have a lot of questions about Medicare, where can I get answers?
One of the best places to find answers about Medicare is to go to www.Medicare.gov which is the official U.S. Government website for Medicare.  You can also call 1-800-MEDICARE.

Click here to view the MBA'S 2012 Taking Control of Your Future: A Legal Checkup for additional information on elder law.

I can't afford my Medicare premiums. What can I do?
You should call 1-800-MEDICARE and ask about getting help to pay for your Medicare premiums. You should also contact MassHealth at 1-800-841-2900, to see if you qualify for assistance in paying your Medicare premiums.
   
What is the difference between Medicare and Medicaid?
While Medicaid and Medicare sound similar, they are in fact very different programs. Medicaid is a state-run program for low-and medium-income persons, including pregnant women, children under the age of 19, people 65 and over, people who are blind, people who are disabled, and people who need nursing home care. In Massachusetts, applications for Medicaid are made with MassHealth. Medicare is a federal government program for people 65 and over, people of any age who have kidney failure or long term kidney disease, and people who are permanently disabled and cannot work. Medicare is applied for at the local Social Security office. Some people qualify for both Medicaid and Medicare, and Medicaid is sometimes used to help pay for Medicare premiums. People who qualify for both programs are called 'dual eligible.'.

Veterans' Benefits

Where can I find information about all veterans' benefits?
The U.S. Department of Veterans Affairs, Veterans Benefits website is a good place to start, and it provides the VA's booklet, Federal Benefits for Veterans and Dependents. There is also the eBenefits website, which helps veterans apply using the VONAPP and it seems to be more user friendly.

A list of VA facilities in Massachusetts is available here.

What happens if I am denied veterans' benefits?
Veterans and other claimants for VA benefits have the right to appeal decisions made by a VA regional office, medical center or National Cemetery Administration (NCA) office. Typical issues appealed are disability compensation, pension, education benefits, recovery of overpayments, reimbursement for unauthorized medical services, and denial of burial and memorial benefits.

Please note that a claimant has one year from the date of the notification of a VA decision to file an appeal. The first step in the appeal process is for a claimant to file a written notice of disagreement with the VA regional office, medical center or NCA office that made the decision.

Following receipt of the written notice, VA will furnish the claimant a "Statement of the Case" describing what facts, laws, and regulations were used in deciding the case. To complete the request for appeal, the claimant must file a "Substantive Appeal" within 60 days of the mailing of the Statement of the Case, or within one year from the date VA mailed its decision, whichever period ends later.

If an applicant is denied veterans' benefits, but finds new evidence to support the denied claim, then the individual can request to have the claim reopened. The applicant should send a written request to the regional VA office, and he or she should include the new supporting evidence (or information telling VA where the evidence can be obtained). 

I am still on active duty, where can I file a claim for service connected compensation?
Claims can be filed by contacting the VA Regional Office at (800) 827-1000 and once you are connected dial "110."  Typically there is high volume but it is suggested to keep trying until you get connected. 

You can also apply for benefits online through Veterans Online Application (VONAPP).

*These answers do not constitute legal advice and are written for general information purposes only. Individuals should consult with a lawyer for specific legal advice.