by Cyndi Norwitz
cnorman@best.com
December 1995
Okay, my social worker self is kicking in here. I used to help people fill out Medicaid applications for a living. I have also helped people with SSI and other programs. I may have a few details wrong below. Please let me know about any inaccuracies.
Here are the services available in the United States (with a focus on programs people on immune might use; I am skipping many useful programs such as WIC or state programs for pregnant women, as well as information for immigrants--you can ask me privately if you wish):
Social Security Disability (SSD aka SSDI). Social Security for people whose work life has been cut short by disability or illness. Otherwise same as SS (except your age is factored in so fewer payments into the system because of age don't hurt you).
Supplemental Security Income (SSI). SS for people with no work history or too little for SSD or SS who can not work due to disability or illness (or over 65). Anyone earning less than the SSI amount via SS or SSD can get the difference via SSI. States set the payment amount.
Medicare. Limited health coverage. Different versions available, some for a cost. Available to the elderly or to those on SSI 2 years into the benefits. Not sure about availibility to those on SSD.
Worker's Compensation. I believe this is federal but I am not sure. Your benefits are based on the income you earned on which worker's compensation insurance was paid at the job at which you were injured. You must have an on-the-job injury that prevents or limits you from working for at least 3 days. Any medical expenses are covered. I do not believe that income or assets lower your benefits but your benefits would end if you were able to take a job earning you a similar amount. I know very little about this program except that most details get worked out by attorneys and not by regulations.
Food Stamps (FS). Money or coupons to be used to buy food. States set benefit amounts and may set some requirements. I think this is completely federally funded. Based on income, not ability to work, and single adults with no children are eligible.
Aid to Families with Dependent Children (AFDC). What is usually meant when one says "welfare" but that term means Medicaid, Food Stamps, General Relief, and other programs too. Monthly income to children with one parent in the home whose income is below a certain level or two parents if at least one parent is disabled or unemployed and looking for work. Some (all?) states give benefits to pregnant women with no children. Emancipated minors are eligible. Funds from this program can be used for families with unofficial foster children (including relatives). This program is partially federally funded and there are wide variations in eligibility and benefits from state to state.
Unemployment. You must be able and willing to work and you must be seeking work according to their schedule and requirements. Part-time is okay. Your benefits are based on the income you earned on which unemployment tax was paid within a 12 month period prior to your application (not the 12 months directly prior). Benefits are of a fixed amount. States have differing eligibility (slight) but I think benefits are set and paid for at the federal level.
General Relief (GR). Small monthly cash benefits to adults who do not qualify for other forms of cash assistance or who are in the application process for SSI (you pay back any GR or FS received during the retroactive SS payment period).
Aid for the disabled. Varies from state to state and in many states it is the same thing as GR.
1) Citizenship. American citizens and permanent residents are eligible for all programs. Documented and undocumented immigrants are eligible for a few (varies from state to state).
2) Residency. U.S. residencey for federal programs (usually) and state residency for state programs. Residency means, where do you get your mail. Agencies are not allowed to discriminate against you for being homeless but you do need a mailing address for most programs.
3) Work history. For SS and SSD, you must have a certain number of credits (age-based) to qualify and number of credits determines total payment. You earn credits by reaching a certain income threshold each quarter (3 calender months). Only income on which you or your employer paid SS tax counts.
4) Disability. There is some range here, depending on the program. Medicaid is supposed to use the same standards as SS but I am finding Medicaid in Mass. to be more stringent. If you have a disability from a certain list, you automatically qualify. This is for terminal illness and other major things, and sometimes blindness. There are several levels to pass (this is my paraphrasing, not the official list):
B) Your disability must be severe enough to substantially affect your life.
C) Your disability must last for at least 12 months.
D) Your disability must make it impossible for you to maintain substantial employment (generally defined as earning $500 or more a month).
E) Your inability to work must last for at least 12 months.
6) Assets. Some programs will cut you off if your assets are over a certain level. The level and what counts towards assets vary substantially. Your home rarely counts (you must live in it). Some programs will not count one car, others will exclude the first $1500 or so of the car's value. SS counted my computer but decided it was worth very little. Household items do not count. Cash on hand, stamps, coins, bank accounts, stocks and bonds, etc always count. The level for most programs is about $2000 (for a single person) but some programs, especially GR and FS, can be as low as $150. (FS, GR, SSI, Medicaid, AFDC). Some programs have a waiting period if you transfer assets before applying.
7) Willingness to work, or participate in rehab, etc. This is not the case for SS, SSD, SSI, or any other program where you qualified by being too disabled to work. In California, all FS and GR recipeients must work unless they are disabled (waiting for SSI counts), have (small?) children, or are elderly. Other states have different rules and there are broad changes being implemented everywhere about adult or head of household AFDC recipiants. Work usually includes any of the following: working at least 10 (varies) hours a month at a job of your choosing or one assigned by the agency (volunteer), actively seeking employment (documented like Unemployment requires), going to school or a training program. This is a requirement to *keep* benefits, not to obtain them.
8) Other. I am leaving out some of the obvious requirements you must prove such as age or parentage. Single parents on AFDC must assist the agency in finding the absent parent if they are supposed to pay child support and are not. You must also meet basic requirements such as completing forms on time, meeting with your worker as scheduled (some can be done by phone or mail), providing documentation, including SS cards and birth certificates and photo identification, etc.
Addendum by Karen S Sutherland, kssGU@hamp.hampshire.edu
Cyndi, This is a great idea and should be helpful to many. The section on Workers Comp. is wrong though. Although there is also a Federal workers comp. system for federal employees, states administer and set the regs for their own wc programs. For example, in MA, you must be sick/injured for minimum 5 (not 3) days to collect. Also, in MA, only those medical expenses attributable to the work injury/disease AND which are deemed "reasonable and necessary" -- not by you or your doctor but by the insurance co., with the approval of the Dept. of Industrial Accidents -- are payable...and even then are usually paid only after years of foot dragging by the insurance co. and legal challenges by the injured worker. Income very definitely lowers your benefits, but assets do not.
A brand new, very useful guide has just been published by Western MassCOSH called HURT ON THE JOB: A GUIDE TO THE MASS WORKERS' COMPENSATION SYSTEM. Available in English or Spanish for $12.00. Call 413-731-0760 or email: masscosh@external.umass.edu. Also, The NEW REACTOR just announced publication by the self-help law center in Berkeley, CA of HOW TO HANDLE YOUR WORKMAN'S COMP. CLAIM -- A COMPLETE GUIDE FOR EMPLOYEES. About $32. 800-992-6636.
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