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A Friend of Mine Died This Summer
A friend of mine died this summer. She had had one of those systemic cancers and had been sick for about a year and a half.
My friend was diagnosed with her cancer right after she retired from 30 plus years working as a secretary for the small town she lived in and she had everything to live for. She had two adorable grandchildren and they and her daughters, who she got along great with, lived close by.
She and her husband owned a small piece of land on a Northern Minnesota lake and kept an older, small trailer on it where they shared many good times.
After my friend was diagnosed, the doctors recommended a bone marrow transplant. With her type of cancer, bone marrow transplants are highly successful. But, her health insurance wouldn’t pay for it.
The health insurance wouldn’t pay for the bone marrow transplant not because it wasn’t an appropriate medical procedure for her, but because of the cost. Several years ago, in an effort to keep the health insurance affordable, the plan administrators for her health insurance had dropped transplant coverage.
My friend was on Social Security but not yet old enough to be eligible for Medicare which would have paid for the transplant. She and her husband did call Social Security and ask about the possibility of early coverage but were told she couldn’t be covered until 65 – two plus years from when she was diagnosed with cancer.
Several months later one of her daughters talked to me about her mom’s situation and I suggested I call Social Security. I explained that as a lawyer I had represented clients in Social Security disability proceedings and I thought her mom might be eligible for that. I also told her I thought because I understood better how to speak Social Security’s language; I might be able to find out more information than her parents had been able to.
With the daughter’s consent, I call Social Security. And, by asking the question right, I got the answer I expected. Even though she was already collecting Social Security retirement, my friend could apply for Social Security disability and if it was granted, she would be eligible for Medicare and her transplant would be covered.
To be eligibile for Social Security disability, you must be completely unable to work. My friend clearly met that standard because many days she was simply too ill and too weak to even get out of bed.
I offered to help with the application process, but my friend was a very quiet, private person who didn't like to impose on anyone, so she and her husband called Social Security on their own. Almost no one is approved for Social Security disability when they first apply and applying on one’s own likely increases the chance of a turndown so, of course, my friend was rejected.
I referred my friend to a lawyer who was excellent at Social Security disability appeals. At my friend’s funeral, her husband told me she had just been approved for Social Security disability and he thanked me because they were very pleased with the lawyer I had referred them to.
Posted in Health Care | Related Topics: Health Insurance Health Care Reform Medicare/Medicaid
1 Comment
Dan says:
September 13, 2011 at 12:08 pm
I experienced a similar situation with my cousin, whom I cared for the last 5 years of his life. He was unemployed & basically incapacitated from a back injury incurred while on duty in Vietnam and later by cancer. I had urged him early on to apply for SS disability which he desperately needed. My family & I had loaned him money to get by from time to time, but our finances were limited too. He finally applied for SS disability and was turned down immediately. With a lawyer’s help, we subsequently reapplied many times and jumped through all the hoops, seemingly without effect, for about 2 years. My cousin died in the early morning hours of a bleak December day; December 5th actually. On December 6th he got a letter from SS disability informing him that he had been approved to receive benefits.