Work incentives Protecting Health Coverage for People with Disabilities

Standard

By: Claudia Luna

Extended Medicare Coverage for Working People with Disabilities For beneficiaries receiving SSDI

As long as your disabling condition still meets our rules, you can keep your Medicare coverage for at least 8 ½ years after you return to work. (The 8 ½ years includes your nine month trial work Period)
Your Medicare hospital insurance (Part A) coverage is premium-free. Your Medicare medical insurance (Part B) coverage will also continue. You or a third party (if applicable) will continue to pay for Part B. If your Social Security Disability Insurance cash benefits stop due to your work, you or a third party (if applicable) will be billed every 3 months for your medical insurance premiums. If you are receiving cash benefits, your medical insurance premiums will be deducted monthly from your check.


Continued Medicaid Eligibility (Section 1619(B)) For beneficiaries receiving SSI

One of the biggest concerns SSI beneficiaries have about going to work is the possibility of losing Medicaid coverage. Section 1619(b) of the Social Security Act provides some protection for these beneficiaries. To qualify for continuing Medicaid coverage, a person must

  • Have been eligible for an SSI cash payment for at least 1 month;
  • Meet the disability requirement; 
  • Meet all other non-disability SSI requirements; 
  • Need Medicaid benefits to continue to work; and
  • Have gross earnings that are insufficient to replace SSI, Medicaid and publicly funded attendant care services.

This means that SSI beneficiaries who have earnings too high for a SSI cash payment may be eligible for Medicaid if they meet the above requirements. SSA uses a threshold amount to measure whether a person’s earnings are high enough to replace his/her SSI and Medicaid benefits. This threshold is based on the:

  • amount of earnings which would cause SSI cash payments to stop in the person’s State; and
  • Average Medicaid expenses in that State.

If a SSI beneficiary has gross earnings higher than the threshold amount for his/her State, SSA can figure an individual threshold amount if that person has:

  • Impairment-related work expenses; or
  • Blind work expenses; or
  • A plan to achieve self-support; or
  • Personal attendant whose fees are publicly funded; or
  • Medical expenses above the average State amount.

The state of Florida 2015 annual threshold amounts for disabled and blind beneficiaries is $30,594

If you are a SSI or SSDI beneficiary and needs an individualized analysis of your situation please contact the Community Work Incentives Coordinator or benefits Planner in your area. Please check the SSA Website for more details: http://choosework.net

Deaf Mom-to-be gives Birth in the Wrong Hospital?

Standard

“Hello this is Byron, Cheylla needs your help…”

As a lawyer practicing civil law, you rarely receive a cry for help at 8:45 in the evening from a client. I knew that it was happening again – another client who is Deaf that could not get an interpreter for medical care.

I represent Cheylla Silva in a case against South Miami Hospital that was the subject of an August 30, 2014 Miami Herald article  We ensured – guaranteed – that Cheylla was going to receive a sign language interpreter when she gave birth at South Miami Hospital after her high risk pregnancy, so she would have the ability to understand the doctors and nurses. She would not be forced to contort her body to use a remote interpreter on a monitor that rarely works or pass notes during contractions.

However, it seems the best plans often go astray, especially when a baby was not clued into the fact that there are court cases and agreements and guaranties! The baby decided to come early, and Cheylla was bleeding. The ambulance was called and insisted on bringing her to the closest hospital, Kendall Regional Medical Center. Cheylla and her boyfriend, Byron, pled for an interpreter to every person in the hospital. The nurse asked Byron, if he could be the interpreter, and he said “no, I’m hard of hearing” so they provided the number for an interpreting service, Accessible Communication for the Deaf (ACD).

There was no communication with Cheylla or Byron until Cheylla’s younger brother, who knows a little sign language, arrived at the hospital and asked the nurse about the interpreter and was told but it would take them at least 24 hours to obtain an interpreter. Cheylla was furious. She was bleeding and having contractions, she did not know what was happening or going to happen. Her baby was just not ready. She did not know if she or her baby were going to live. She did not have 24 hours to wait to understand what was happening to her. Byron texted ACD and asked for help. Byron emailed me and pled for help.

At the same time, the head nurse tried, but could not get the video remote interpreter to work and instead, used the interpreter’s number – that Cheylla provided – to get assistance to get the video remote interpreter to work. Thereafter, Lisa Campbell from ACD called me and discussed Cheylla’s needs.

Cheylla has a right to an interpreter when giving birth. She should not be worrying about communication more than the directions that she needed, the pain she was feeling and the questions about her health, the baby’s health that she and her boyfriend would have. There are some basic tenets of care during labor that demand basic reassurances and comfort during this time. There was no other option than for ACD to provide interpreters without promise of payment. Lisa was 45 minutes away, but another ACD interpreter, Brenda Adkinson, was only 15 minutes away, and immediately went to Kendall Regional Medical Center. Brenda stayed until 5:30 the following morning, and then Lisa took over and was there when baby Zoey was born at 8:15a.m.. Interpreters then continued to be provided during her hospitalization.

Picture of Baby Zoey in incubator

Baby Zoey

Baby Zoey was born at four pounds, five ounces, and is a beautiful and healthy baby. Cheylla and Byron are doing fine.

The staff at the maternity ward knew about the article in the Herald about Cheylla, but they could not understand the importance of it since no one else has ever complained. They insisted that they called the HCA Language Line and they said they would get an interpreter in 24 hours. While she was there, ACD Interpreter Brenda Adkinson took the time to educate them:

So I then explained to them that is a misuse of VRI. It is only to be used in a reception desk environment. I said, “can you imagine being hospitalized and having to sit up to communicate? If the patient is in labor, who is going to hold the whole computer system up above the patient’s head to see it? What if Wi-Fi drops? What if you need to call tech support? Will the baby wait until tech support arrives?

A live interpreter guarantees you are able to provide best care to your patient. It is a federal law. It doesn’t come out of your pocket, let the hospital pay, why stress yourself out?

When management of the hospital were made aware of the situation, they immediately agreed to pay for the interpreter fees and agreed that VRI should only be used as an interim measure until a live interpreter arrives.

However, the denial of effective communication for the deaf is systemic. Doctors and hospitals know their duties to communicate with their patients, and many hospitals and doctors continue to ignore this duty, and even refuse to see patients. A lawyer should not be needed in the delivery room!

Byron Mena and Cheylla Silva with newborn baby Zoey

Byron Mena and Cheylla Silva with newborn baby Zoey