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Home » Appealing a Denial in SSI Coverage

Appealing a Denial in SSI Coverage

September 23, 2013 by Stephen Unsworth

Ask any elder care lawyer and odds are, he has his share of Social Security Administration horror stories that have affected his clients and their efforts for SSI coverage at some point. From those who were denied and immediately filed an appeal with more documentation only to be turned down again with no meeting to those who have been told many times by an SSA representative that they’ve not received an application, even though that applicant has a stack of signed certified mail receipts, there are many who say their frustration has never been higher than when dealing with the SSA. Those same attorneys will also have a “happily ever after” conclusion to report as well, even if they’ve spent months dedicated to righting the wrong.

Denial in SSI Coverage

There’s no denying there are problems. It’s not until one delves a bit further into the process that the real tragedy is discovered. When these mistakes are improperly handled, it can mean the applicants face homelessness, a lack of health care and poverty. That should never be an option; unfortunately, it happens daily in offices around the country. The National Senior Citizens Law Center recently completed a report on these sad realities. It also provided a solution: a uniform system in place that prevents the types of mistakes that can very well mean life or death for those affected.

By the Numbers

There are more than 8 million Americans who are receiving federal benefits from SSA. Most are over the age of 65 and/or struggling with disabilities. At just $710 maximum payments in a month, the odds are already stacked against them. In fact, the current Acting Commissioner of the Social Security Administration recently testified in front of Congress and said, “While the SSI program was never simple, it has become increasingly complex over the years.” He also pointed out that individuals on SSI cannot own more than $2,000 in assets – and most own far less than that (up t0 and including nothing). Worse, there’s been significant turnover in many of these federal offices, which leaves applicants even more vulnerable.

Delays of Months

Another problem is that if an applicant is deemed unqualified for the program, it can mean months of waiting. The delays in just acknowledging that the appeal request had been received are simply unacceptable. If those acknowledgments came faster, it would allow many to continue receiving their benefits.

The report reads, in part, “If an individual experiences a suspension or reduction in their SSI benefits, but is unable to challenge the decision effectively at reconsideration, that individual is denied due process of law. He/she is not helped if the subsequent stages of the appeals process are not functioning properly.” Many offices have been found to be lacking in the basic compliance guidelines.

For these reasons – and countless others, it’s important to not face these hurdles alone. An elder care or estate planning lawyer might not be able to move mountains overnight, but they can go to bat for their clients to ensure as fair treatment as possible. For instance, did you know that you’re entitled to meet with a representative to discuss a denial? It’s a constitutional right to request – and expect – a follow up meeting. Not only that, but if you request a conference, your benefits must continue coming until a formal notice is issued (another failure that many employees must be held accountable).

As you might have guessed, this is just the tip of the iceberg. Speak with an experienced estate planning lawyer to discuss your options – the peace of mind and legal direction can mean the difference in approval and denial.

  • Author
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Stephen Unsworth
Stephen Unsworth
Stephen A. Unsworth is admitted to practice in both Vermont and Maine, and has more than 30 years of experience in estate planning and business law. His mission is to provide quality estate planning services, including assistance with Living Trusts, Wills, Medicaid Planning, Probate, Trust Administration, Powers of Attorney, Special Needs Planning, and Family Limited Partnerships.
Stephen Unsworth
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Filed Under: Incapacity Planning Tagged With: Elder Law, estate planning lawyer, ssi coverage, ssi benefits, disabilities, national senior citizens law center

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