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LawTalk
LawTalk, Attorney
Category: Social Security
Satisfied Customers: 27889
Experience:  I have 30 years of legal and litigation experience, including representing clients before the U.S. Social Security Administration.
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My 7 year old son has a central line, an ostomy and has had

Customer Question

My 7 year old son has a central line, an ostomy and has had his stomach removed due to an intestional disease that he was born with. He will be this way for the rest of his life. I have been told if you have a change to your anatomy that you qualify for benefits. We have been denied due to my income. Does income really determine whether or not a person is disabled? What do I need to say to get my son benefits?
Submitted: 1 year ago.
Category: Social Security
Expert:  LawTalk replied 1 year ago.

Good afternoon,

I'm Doug, and I'm very sorry to hear of your son's situation. My goal is to provide you with excellent service today.

The issue here is that I believe there is some confusion as to how the disability of a child qualifies them for benefits.

First of all, a disabled child under the age of 18 is never qualified for social security disability (SSDI) benefits based on their disability.

The disability program for children under 18 is through SSI--Supplemental Security Income. SSI is not social security, but rather a form of federal welfare, based on the disability of a child and the lack of resources/income/assets of that child immediate family. SSI is merely overseen by the social security administration---but when compared to SSDI, the benefits are entirely different.

Many working parents find that their income exceeds the minimum threshold for qualification for SSI benefits. Only a disabled child whose family is essentially "poor" will qualify for both monthly SSI monetary payments to the family as well as MediCaid insurance for the child's health needs.

I understand that you may be disappointed by the Answer you received, as it was not particularly favorable to your situation. Had I been able to provide an Answer which might have given you a successful legal outcome, it would have been my pleasure to do so.

If you have any additional questions, you may of course reply back to me and I will be happy to continue to assist you further until your questions have been answered to your satisfaction.


Kindly take a moment to rate my service to you based on the understanding of the law I provided. Please understand that I have no control over the how the law impacts your particular situation.

Thank you,

Doug



Customer: replied 1 year ago.

My son doesn't eat by mouth nor does he go to the bathroom as normal people do. Is there any medicade waiver programs that you think he would qualify for? His first extended hospitalization, I was off work for 2 months and we were told by SSI, I made too much money last year to qualify for benefits.

Expert:  LawTalk replied 1 year ago.

Good afternoon,

MediCaid waivers are for the most part directed at payment of in-home care services for MediCaid patients to allow them to live at home when otherwise they would be in a nursing home facility---this is essentially a cost savings strategy for the feds. There are no waivers for the type of medical care you are talki9ng about for a child that doesn't already qualify for MediCaid.

Because your child does not qualify for SSI, and therefore for MediCaid, the only other possible program would be if your state operates a State Children's Health Insurance Program.

With the advent of Obamacare, if you do not already have medical coverage you will be able to buy it from the state system and they may not refuse to insure your child because of his preexisting disabilities. However, like so many other programs, Obamacare is really little more than another welfare program for people who aren't poor enough to qualify for MediCaid, but don't make more than 400% of the Federal poverty level. Also, from what I am seeing of the prices for policies for the coverage offered by the Obamacare Exchanges, the coverage is really quite expensive and not much of a savings if you aren't poor to begin with.

I'm really very sorry, and I do empathize with your situation. The fact is that if you earn too much money, there won't be any state or federal medical program or benefit program that your child will qualify for.

Doug

LawTalk, Attorney
Category: Social Security
Satisfied Customers: 27889
Experience: I have 30 years of legal and litigation experience, including representing clients before the U.S. Social Security Administration.
LawTalk and other Social Security Specialists are ready to help you
Expert:  LawTalk replied 1 year ago.
Thank you for your positive rating of my service. It has been my pleasure to assist you and I hope than you will ask for me on JustAnswer should a future need ever arise. I am generally available at least 6 days a week, and often 7, and it would be my privilege to assist you again in the future.

I welcome you to request my assistance in any future legal questions you may have, by simply placing my name in the first sentence of your new question.


Thanks again.

Doug

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I have 30 years of legal and litigation experience, including representing clients before the U.S. Social Security Administration.