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Topic: How Many Stage 4 Girls are getting SS disability..

Forum: Stage IV/Metastatic Breast Cancer ONLY —

Please respect that this forum is for members with stage IV/metastatic breast cancer only. There is a separate forum for caregivers and friends: Caring for Someone with Stage 4 or Mets.

Metastatic breast cancer (MBC; also called stage IV) is breast cancer that has spread to other parts of the body, most commonly the bones, liver, brain, or lungs. Metastatic breast cancer can be treated but not cured. Metastatic disease is NOT hopeless. There are a wide variety of treatment options for metastatic breast cancer, and new medicines are being tested every day. More and more people are living life to the fullest while being treated for metastatic breast cancer.

Note: Please contact your doctor for any specific concerns about symptoms you are experiencing or your course of treatment.

Learn more about living with MBC.

Intro medically reviewed by: Brian Wojciechowski, M.D.
Last review date: November 22, 2020

Posted on: Sep 19, 2006 06:22AM

Shepgirl wrote:

Seems like a lot of stage 4 US citizens are getting Social Security Disability Insurance payments. So lets see how many there are! If you were denied, please comment if it was for medical issues. My understanding is denials are more "not paid in enough" issues than medical.

PLEASE TAKE POLL ONCE ONLY!
Dx 12/23/2004, IDC, 2cm, Stage IV, Grade 2, 2/22 nodes, mets, ER+/PR-, HER2-
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Jun 19, 2011 12:21PM LindaVA wrote:

That's very generous of you Steven. I think it may be better to start a new post because many members might not know of this valuble resource that you're offering.It may be lost in a post with more than 30 pages.

Personally, I don't like the posts that have so many pages to them. I think they make the discussion boards less useful because good info tends to be buried among pages and pages of replies. This post was started almost 5 years ago so I think its time for a new post on disability issues. 

Bless your wife for sharing you with us. I hope she is doing well.

Linda in Virginia Dx 5/13/2011, Stage IV, ER+/PR-, HER2+
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Jun 19, 2011 02:14PM - edited Jun 19, 2011 02:14PM by Chickadee

You are spot on LindaVA.  I believe that the member who started this post in 2006 may be an angel now as well.  Shepgirl hasn't posted since 2008.  I hope she knew that she did a wonderful thing for so many of us just be starting this thread.

So yes, Steven, start a new one for questions.

I'm in such bad shape, I'm wearing prescription underwear." Phyllis Diller 1917-2012 Dx 9/1/2009, IDC, 1cm, Stage IV, Grade 3, mets, ER+/PR+, HER2-
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Jun 19, 2011 05:42PM Frapp wrote:

Just make sure you let us know where the new one is!!

Dx 12/24/2009, ILC, 6cm+, Stage IV, Grade 2, mets, ER+/PR+, HER2- Dx 12/19/2011, IDC, Stage IV, Grade 3, mets, ER+/PR-, HER2- Dx 9/28/2012, 6cm+, Stage IV, Grade 3, mets, ER+/PR-, HER2- Surgery 11/2/2012 Mastectomy: Left, Right Targeted Therapy 12/20/2012 Afinitor (everolimus)
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Jun 19, 2011 11:19PM NMM wrote:

Chickadee,

This is from SSA website:

***

Earnings trigger a trial work period
During a trial work period, a beneficiary receiving Social Security disability benefits may test his or her ability to work and still be considered disabled. We do not consider services performed during the trial work period as showing that the disability has ended until services have been performed in at least 9 months (not necessarily consecutive) in a rolling 60-month period. In 2010, any month in which earnings exceed $720 is considered a month of services for an individual's trial work period. In 2011, this monthly amount increases to $720.

***

here is link:

www.ssa.gov/oact/cola/twp.html

So making $1000 in any month, regardless of the hours one works, more than 9 times in a rolling 60 month period may effect benefits. But also the regulation also makes clear that unpaid services like volunteering as long as it is a service that people do get paid for can count towards the trial work period.

Example: if a person volunteers to answer phones for some type of charity for 10 hours a week that this charity normally pays $20 to do that job, SSA may consider that as part of trial work period.

So the. answer to your question is yes, working can always cause you a headache. In my experience SSA is big and slow, but at some point the computer notices the data being inputed.

Best chance is to keep earnings below the amount SSA considers the trigger, this year that is $720.

iPad running low battery will follow up later with the difference between a trial work period and an unsuccessful work attempt.

Steven







Dx 6/3/2011, IDC, 2cm, Stage IV, Grade 3, mets, ER+/PR+, HER2-
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Jun 20, 2011 02:10AM NMM wrote:

Dear All

Thanks for the encouragement on starting my own topic. I will do so when I have a minute. For know I will just put up some posts to give feedback if they are helpful.

Here is something that may be of interest from SSA website.

***

Compassionate allowances are a way of quickly identifying diseases and other medical conditions that invariably qualify under the Listing of Impairments based on minimal objective medical information. Compassionate allowances allow Social Security to quickly target the most obviously disabled individuals for allowances based on objective medical information that we can obtain quickly.

www.ssa.gov/compassionateallow...

***

What qualifies for a passionate allowance?

Here is the link to list:

www.ssa.gov/compassionateallow...

Of note number 14 is:

Breast Cancer - with distant metastases or inoperable or unresectable

Finally, here is a link to a section of the POMS Manuel.

Essentially POMS is a non-binding Manuel that takes the law of SSA and writes it in a manner thatnthe field staff in local offices can follow to process claims correctly. This document is how they should handle a claim involving someone who is Stage IV diagnosed.

Before you click though, it ain't pretty. Bottom line SSA does notmlike to make mistakes. Therefore, the fact that an impairment is fast tracked to being approved as disabling may be a good thing as far as getting paid SSA benefits, but like I tell my clients, often whatnisngoodmto help in SSA claim is bad for health overall.

secure.ssa.gov/apps10/poms.nsf...

Steven





Dx 6/3/2011, IDC, 2cm, Stage IV, Grade 3, mets, ER+/PR+, HER2-
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Jun 20, 2011 11:42AM Chickadee wrote:

Thank you for responding.  Your pushed me futher into the SSA webpage when you quoted $720.

I see that there is a difference between that figure and the $1000 threshold to identify substantial Gainful Activity.

No wonder there a legal practice can focus on SS cases.  Very confusing.

I'm in such bad shape, I'm wearing prescription underwear." Phyllis Diller 1917-2012 Dx 9/1/2009, IDC, 1cm, Stage IV, Grade 3, mets, ER+/PR+, HER2-
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Jun 20, 2011 03:36PM NMM wrote:

Chickadee,

 Correct.  Once you exceed the trial work period limitations, SSA then looks at whther or not you are engaged in substantial gainful work activity (SGA).  Which currently the bright line is $1,000.

 But remeber, this is a very large agency.  So making $990 a month does not me a person safe because the regulaitons and rules state that SSA will "generally" not consider amounts below a certain amount ($1,000 this year) as SGA.  But that does not mean they won't

So I guess to put it in list form in order from safest to risky:

A. Do not work.

B.  If you do work keep it under the TWP max. which this year is $720.

C. If you do work above $720 and are out of TWP keep it below SGA levels (this year $1,000) and document how you were able to work.  Here are some examples to show why what a person does is not SGA no matter what they make:

***

Performance of Work Under Special Conditions: One situation under which your SGA-level work may have ended, or may have been reduced to the non-SGA level, as set out above, is "the removal of special conditions related to your impairment that are essential to your further performance of work." That is, you may have worked under conditions especially arranged to accommodate your impairment or you may have worked through an unusual job opportunity, such as in a sheltered workshop. Special or unusual conditions may be evidenced in many ways. For example, you:

May have required and received special assistance from other employees in performing the job; or

Were allowed to work irregular hours or take frequent rest periods; or

Were provided special equipment or were assigned work especially suited to your impairment; or

Were able to work only within a framework of especially arranged circumstances, such as where other persons helped you prepare for or get to and from work; or

Were permitted to perform at a lower standard of productivity or efficiency than other employees; or

Were granted the opportunity to work, despite your medical condition, because of family relationship, past association with the firm, or other altruistic reason.

***

Basically, if the only way yo work is because you are accmodated or treated specialy then SSA may not count that as SGA.  Why?  Because unlike the ADA, SSA does not conisder employer accomodation in the anlysis.  A person must be able to perform work without accomodation for thier disability.

 D. If you do make consistently over $1,000 be upfront with SSA to avoid any overpayment issue and to establish a history of crediblity if you need to re-apply or re-start your benefits.

Again this is not meant to be legal advice but just a more detailed discussionof the issues you have raised.

Steven

Dx 6/3/2011, IDC, 2cm, Stage IV, Grade 3, mets, ER+/PR+, HER2-
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Jun 20, 2011 03:53PM NMM wrote:

Started a topic:

 http://community.breastcancer.org/forum/113/topic/770569

 Steven

Dx 6/3/2011, IDC, 2cm, Stage IV, Grade 3, mets, ER+/PR+, HER2-
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Jun 20, 2011 07:05PM - edited Jun 20, 2011 07:08PM by Chickadee

Clickable link:

http://community.breastcancer.org/forum/113/topic/770569

Thanks Steven.

I'm in such bad shape, I'm wearing prescription underwear." Phyllis Diller 1917-2012 Dx 9/1/2009, IDC, 1cm, Stage IV, Grade 3, mets, ER+/PR+, HER2-
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Jun 20, 2011 11:57PM Melizzard wrote:

Stage IV can be waived to 30-60 days??? Mine sure wasn't. They made me wait 5 months and didn't give me one dime of backpay even though I qualified 5 months prior.

Xxoo
Melissa

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Jun 21, 2011 12:29AM NMM wrote:

Mel,

Sigh. This requires a more detailed post that I wanted to do, but I see this a lot so I will do the quick version.

As I think Chick has pointed out, there is a difference between approved and benefit start date.

Everybody, and I mean everybody, who files a DIB application (that is what y'all call SSDI but is really a DIB app) must wait 5 months from approval to first payment.

Example: Dx 8/09 with illness that is disabling. Applies 6/10 and approved as of 8/09. So this person was approved in June 10 with onset of august. 09. Benefits would start 5 full months later (you never count the month disability began unless disability began on first day of month). Start counting 9/09 to 1/10... And first month of payment is 2/10.

Example: Dx 4/11 applies 5/11 found disabled as of 4/11. So count 5 months. Money won't come 10/11.

Nothing about being screwed That is just the rules.

Steven

Dx 6/3/2011, IDC, 2cm, Stage IV, Grade 3, mets, ER+/PR+, HER2-
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Jun 21, 2011 09:51AM Chickadee wrote:

Steven, your presence here is greatly appreciated.  You are one of our earthbound angels.   There is often a lot of confusion over timelines and definitions.

I'm in such bad shape, I'm wearing prescription underwear." Phyllis Diller 1917-2012 Dx 9/1/2009, IDC, 1cm, Stage IV, Grade 3, mets, ER+/PR+, HER2-
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Jun 21, 2011 12:48PM blondiex46 wrote:

Thank you Steven and tell your wife thanks also...

Original 8/96 - 1cm, chemo, rads. Recurr..9/09...Mets to lungs, chest wall, lymph nodes under arm & chest, cervical & lumbar spine, ribs, hip. Femera, Falsodex, Zometa, Xeloda, Gemzar,Taxotere, Adriamycin,Havalen.WENT OFF CHEMO 7/20/14 Dx 9/1/2009, 3cm, Stage IV, ER+/PR-, HER2-
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Jun 26, 2011 05:18PM - edited Jun 26, 2011 05:20PM by Marybe

In the first 5 year period you can work and earn any amount for 9 months, those 9 months do not have to be consecutive and they will then review whether you are capable of returning to work.

The above I copied and pasted from a post that Chikadee had made.....so am I to understand that for the lst five years, I can earn any amount for 9 months?....meaning I could make $2,000 a month and still get my SSdisablity because of my Stage lV diagnosis.   I have been putting this off forever, went to the SS office when I was on abraxane and feeling so bad two years ago and the woman I spoke to then told me there was no question about me being approved, but I wanted to keep on working and I did.  Now I am on my 5th treatment since then and the reason we keep changing is because they have not worked so I am looking at things a little differently now.....like time is becoming an issue.  I don't want to wait until I am forced to stop working and am in such bad shape I can't do things like traveling.  So I am  just about there.....if I can make an unlimited amount for 9 months that would be wonderful...I would just work my tail off and use it to travel...providing I am feeling up to that.   But now I have another question...I was talking to my neighbor and she told me that she was not allowed to leave the country while she was on disability.....I am quite sure she was on it through her work coverage(she had foot surgery and had to stay totally off her foot for 4 months)  so maybe that is their rule....If I went on SSDi and couldn't leave the country, that would be defeating my whole purpose since I just finally went ahead and got a new passport when I heard what my CA27/29 was.   Oh, and I almost forgot....I read where someone's benefits were changed because of her husband's income....does my husband's income have an effect on this?....if so I probably would not qualify because he gets more from his retirement than I do working, BUT I am the one who pays the mortgage and also take care of most of my own bills.  I really do not recall discussing my husband's income when I went in and talked to someone.  I should have checked this out better and done it a long time ago since I would get more on disability than I would working til I am 69 or whatever, but I didn't just because I have always felt work was good therapy for me. 

Marybe Be you own advocate and keep on your toes. I went from no stage (1990) to Stage lV while under an onco's supervision. Dx 4/1998, IDC, Stage IV, 0/19 nodes, mets, ER+/PR+
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Jun 26, 2011 05:59PM - edited Jun 26, 2011 06:01PM by Chickadee

Marybe, hello there.  Steven's thread on the Insurance section has the answers to lots of your questions.

I'm interested in the work aspect as well and figure that occasionally over the next 5 years I could at least work 30 or 60 days if my SE's are under control and I don't have treatments getting in the way.  Steven made a good point, if we do work under the Ticket to Work or TWP program we always stand the risk of some SS bureaucrat thinking we are capable of substantial work activity.  I think it depends on how you handle it.  If you go back to work and use the 9 months up in one fell swoop then I think your disability would be called into question.

As for your husbands income, it has no impact on SSDI.  It does impact SSI which is the low income insurance program.  SSDI is based on your work history.  Your assets and savings are not considered.  You paid into this and are entitled to it when you meet the standard of being disabled.  The amount will be based on your work history with SSA.

I also noted that if I were to just wait and go on regular SS when I'm 62 in couple years, I would get almost 40% less a month in income then if I go ahead and qualify for SSDI now.  This way I will begin to receive the $$ amount that I would have had to wait until I was 66 to collect.

I'm in such bad shape, I'm wearing prescription underwear." Phyllis Diller 1917-2012 Dx 9/1/2009, IDC, 1cm, Stage IV, Grade 3, mets, ER+/PR+, HER2-
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Jun 26, 2011 07:27PM Marybe wrote:

Thank you Chickadee....I was worried about having to include husband's income.  I also posted on the new thread.  I know it's illegal, but just wish I could find someone to pay me under the table while I go through the waiting period.  I do have the IRA money to fall back on, but know that it is taxable because it's not a Roth.  What's that saying....two things you can't avoid, death and paying taxes. 

Marybe Be you own advocate and keep on your toes. I went from no stage (1990) to Stage lV while under an onco's supervision. Dx 4/1998, IDC, Stage IV, 0/19 nodes, mets, ER+/PR+
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Jun 27, 2011 10:35AM Chickadee wrote:

This(and retirement) is why you saved up that IRA money, isn't it?  If you time this right, once you are declared disabled by SSA, then your tax situation changes and it may be to your benefit.

Of course they'll still tax us, but maybe a bit less.

I'm in such bad shape, I'm wearing prescription underwear." Phyllis Diller 1917-2012 Dx 9/1/2009, IDC, 1cm, Stage IV, Grade 3, mets, ER+/PR+, HER2-
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Jun 27, 2011 11:12AM reesie wrote:

Um.... retirement and 401(k)...Yeah.  Of course as one who works in the industry I should know better, but I still had plenty of time to do that, right?

Marie - It's A Great Day To Be Alive. Dx 10/29/2010 ER+/PR+, HER2- Stage IV mets to bones, liver, lungs, skin, pleural effusions
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Jun 27, 2011 11:30AM Chickadee wrote:

While it's too late for us to start our planning I can only encourage everyone with young adults or teens to start now to nag, nag, nag, them to begin right from the get go with their first job to "Pay Yourself First".   Savings accounts, 401k's, 403b's, Roth's, whatever.  Shoot for 10% a paycheck or set themselves a dollar amount.

This disease is the horrific eventuality none of us planned for but savings can at least cushion the fall.

For those who might read this who are Stage 1 or 2 and even 3, if you are still working, better late than never.

I'm in such bad shape, I'm wearing prescription underwear." Phyllis Diller 1917-2012 Dx 9/1/2009, IDC, 1cm, Stage IV, Grade 3, mets, ER+/PR+, HER2-
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Jun 27, 2011 01:00PM reesie wrote:

It's funny, but I did tell my kids to do it - I said you should at least take advantage of the maximum matched amount. - I always give this advice (and I think they're actually following this one).  But following it myself....I wish I had.

So, like Chickadee said ....  "For those who might read this who are Stage 1 or 2 and even 3, if you are still working, better late than never."

Marie - It's A Great Day To Be Alive. Dx 10/29/2010 ER+/PR+, HER2- Stage IV mets to bones, liver, lungs, skin, pleural effusions
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May 23, 2016 07:45PM robintt wrote:

I just want to thank all of you who have posted in this thread without this topic i never would have even bothered to apply for SSD!!! I applied for SSD in March and my onco's posted that i was stage 4 on my application for SSD since March 2013. I am getting a years worth of back pay but how long does that usually take??? I received my first check this month just need to pay off some med bills and get some dental work done before i can start xgeva 😑

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May 23, 2016 08:05PM - edited May 23, 2016 08:08PM by exbrnxgrl

Robintt

This thread had been inactive since 2011. I think you might get a better response if you started a new thread on the topic. Sadly, many of the members who posted here have passed away

Bilateral mx 9/7/11 with one step ns reconstruction. As of 11/21/11, 2cm met to upper left femur Dx 7/8/2011, IDC, Left, 4cm, Grade 1, 1/15 nodes, mets, ER+/PR+, HER2- Surgery 9/7/2011 Lymph node removal: Left; Mastectomy: Left, Right; Reconstruction (left); Reconstruction (right) Dx 11/2011, IDC, Left, 4cm, Stage IV, Grade 1, 1/15 nodes, mets, ER+/PR+, HER2- Hormonal Therapy 11/21/2011 Arimidex (anastrozole) Radiation Therapy 11/21/2011 Bone Hormonal Therapy 6/19/2014 Femara (letrozole) Hormonal Therapy Aromasin (exemestane)
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May 24, 2016 02:15PM LvinAZ44 wrote:

i applied for ssi in November was approvedin March. It took awhile because I didn't apply for compassionate allowance which takes about 6 weeks first check is next month in going home for a family visit and work part time when I come back I can't stand to sit at work when there is life to live

Today is the tomorrow you worried about yesterday. Dx 3/2011, Right, 3cm, Stage IIIC, Grade 3, 17/24 nodes, ER+/PR+, HER2- Dx 10/30/2015, Right, Stage IV, metastasized to bone/liver/lungs, 17/24 nodes, ER+/PR+, HER2- Radiation Therapy External: Bone
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May 25, 2016 04:22PM pwilmarth wrote:

I applied for SSDI in June of last year and was approved in 10 days. But the first check didn't start until January. I will be 62 in July and I consider myself retired although I do work about 1 day per week and this keeps me under the Substantial Gain Allowance.


I'm glad I did it. I don't think I could handle full time employment and my life is pretty stress free.

Dx 12/1/2014, Left, 6cm+, Stage IV, ER-/PR-, HER2+ (FISH) Surgery 1/12/2015 Mastectomy: Left Chemotherapy 2/24/2015 Taxotere (docetaxel) Targeted Therapy 2/24/2015 Perjeta (pertuzumab) Targeted Therapy 2/24/2015 Herceptin (trastuzumab) Radiation Therapy 7/21/2015 3DCRT: Breast, Lymph nodes Radiation Therapy 10/21/2016 External: Brain Targeted Therapy 11/25/2016 Kadcyla (T-DM1, ado-trastuzumab)
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May 25, 2016 05:31PM artistatheart wrote:

I keep bouncing around the idea. I don't think I am ready yet but when school starts up again in Sept i may feel differently. I have about 2 months of sick days to use then up to 100 days including my sick ones to get half pay. My question is should I go ahead and apply now, just in case. And if I don't want it yet can I defer it but keep the application active?

Dx 7/22/2015, ILC, Left, 4cm, Stage IV, Grade 3, ER+/PR+, HER2- Hormonal Therapy 8/10/2015 Femara (letrozole) Targeted Therapy 8/25/2015 Ibrance (palbociclib) Hormonal Therapy Faslodex (fulvestrant)
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May 25, 2016 08:46PM pwilmarth wrote:

The answer is yes. There are many ways that you can continue to work under SSDI if you decide that you want to. But you want that date of disability in the system because if you decide to go back to work and it doesn't last, you do not have to reapply.

The other issue that people forget is eligibility for Medicare. Once you are disabled for two years, you are eligible for Medicare. And SSDI qualifies you for Medicaid. Medicare guarantees you adequate insurance coverage especially if you elect a secondary insurance provider.

Dx 12/1/2014, Left, 6cm+, Stage IV, ER-/PR-, HER2+ (FISH) Surgery 1/12/2015 Mastectomy: Left Chemotherapy 2/24/2015 Taxotere (docetaxel) Targeted Therapy 2/24/2015 Perjeta (pertuzumab) Targeted Therapy 2/24/2015 Herceptin (trastuzumab) Radiation Therapy 7/21/2015 3DCRT: Breast, Lymph nodes Radiation Therapy 10/21/2016 External: Brain Targeted Therapy 11/25/2016 Kadcyla (T-DM1, ado-trastuzumab)
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May 25, 2016 09:21PM artistatheart wrote:

Thanks pwilmarth, that answers a crucial couple of questions for me!

Dx 7/22/2015, ILC, Left, 4cm, Stage IV, Grade 3, ER+/PR+, HER2- Hormonal Therapy 8/10/2015 Femara (letrozole) Targeted Therapy 8/25/2015 Ibrance (palbociclib) Hormonal Therapy Faslodex (fulvestrant)
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May 25, 2016 10:33PM Longtermsurvivor wrote:

Disclaimer: I am only a human being who's heard and read dozens of stories about these topics. I am not a professional, but an interested observer. Please check out everything with your trusted legal and financial advisors before taking any leaps. You may want to contact your employer's human resources department, an accountant, an elder care attorney and the Social Security Administration (at least to find out if you have enough work quarters and what your disability income rate would be).

Also, this is USA specific and will possibly change if the ACA changes.

SSI & SSDI

Just to clarify - there are two different social security programs for the disabled - Supplemental Security Income (SSI) and Social Security Income (SSDI).

SSI is both needs and assets based, you must meet the disability requirements and have low assets:

SSI Resources Limits for 2016: Individual $2,000, Couple $3,000

https://www.ssa.gov/news/press/factsheets/colafacts2016.html

SSDI is needs based and requires that a certain number of work quarters in a certain time period. Many teachers and public employees have separate disability insurance systems and work earnings aren't credited to Social Security. Also, people who work under the table, for a spouse's/family business or work at home may not have enough earnings credited to be eligible SSDI.

MEDICAID AND MEDICARE

Once SSI is approved, income starts immediately and usually Medicaid coverage does too (no separate application process in most states).

With SSDI there's a 5-month wait period after disability date for income and a further 24 month wait for Medicare coverage after that.

MEDICAID ASSET RESTRICTIONS ELIMINATED, BUT MAYBE NOT FOR DUAL-ELIGIBLES AND LONG-TERM CARE

Medicaid has income restrictions, but not asset restrictions, thanks to the ACA:

One small, but critical, aspect of the Medicaid expansion is the elimination of the Medicaid asset limit. This provision will allow millions of low-income families to both get the health coverage they need and maintain or build a modest savings cushion. The Medicaid expansion has been rejected by half of the states but the elimination of the asset test applies to all states, not only those that have adopted the expansion. States will still have discretion to impose limits on elderly and disabled beneficiaries, but the majority of Medicaid enrollees will now be able to save freely.

Hello 2014, Goodbye Medicaid Asset Limit

By Aleta Sprague

JAN. 2, 2014

https://www.newamerica.org/asset-building/the-ladder/hello-2014-goodbye-medicaid-asset-limit/

Essentially, the Medicaid expansion under the ACA will broaden Medicaid eligibility for low-income, non-elderly adults without regard to assets. A major exception for that age group are those with incomes above the threshold but with high out-of-pocket medical costs. Such individuals will be required to spend their assets down to the existing asset limit, which varies by state and is typically a few thousand dollars.

There are a few other caveats. Existing rules, including the asset tests, will continue to apply for individuals obtaining Medicaid eligibility through another program (e.g. foster care children, or SSI/SSDI recipients) and the elderly.

Bye-Bye Medicaid Asset Test

Austin Frakt

April 13, 2010

http://theincidentaleconomist.com/wordpress/bye-bye-medicaid-asset-test/

DUAL ELIGIBLE BENEFICIARIES (MEDICAID AND MEDICARE)

About 9 million people in the United States are covered by both Medicare and Medicaid, including low-income seniors and younger people with disabilities. These dual eligible beneficiaries have complex and often costly health care needs…

Dual Eligible

http://kff.org/tag/dual-eligible/

Medicaid provides health coverage to more than 4.6 million low-income seniors, nearly all of whom are also enrolled in Medicare. Medicaid also provides coverage to 3.7 million people with disabilities who are enrolled in Medicare. In total, 8.3 million people are "dually eligible" and enrolled in both Medicaid and Medicare, composing more than 17% of all Medicaid enrollees. Individuals who are enrolled in both Medicaid and Medicare, by federal statute, can be covered for both optional and mandatory categories.

Dual Eligibles – Medicaid and Medicare coverage

Seniors & Medicare and Medicaid Enrollees

https://www.medicaid.gov/medicaid-chip-program-information/by-population/medicare-medicaid-enrollees-dual-eligibles/seniors-and-medicare-and-medicaid-enrollees.html

MEDICAID, ASSETS AND LONG-TERM CARE

Also, if you're thinking of going into long-term care or have parent(s) who may need it, the asset spend down rules are stringent and worth planning for years in advance:

In order to be eligible for Medicaid, applicants must have no more than $2,000 in "countable" assets (the dollar figure may be slightly more, depending on the state). Applicants for Medicaid and their spouses may protect savings by spending them on non-countable assets. The following are examples of such expenditures:

prepaying funeral expenses

paying off a mortgage

making repairs to a home

replacing an old automobile

updating home furnishings

paying for more care at home

buying a new home

In the case of married couples, it is often important that any spend-down steps be taken only after the unhealthy spouse moves to a nursing home if this would affect the community spouse's resource allowance.

Spending Down Assets to Qualify for Medicaid

http://www.elderlawanswers.com/spending-down-assets-to-qualify-for-medicaid-12003

Social Security and medical coverage is extremely complex and worth planning for while you are well enough and have the time and focus to do it.

best healing wishes, Stephanie

Grateful to be here. Advanced breast cancer for 25 years, engage holistic approaches. Am dealing with ascites and many mets. Am on hospice.
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May 25, 2016 11:10PM jobur wrote:

Does anyone know of a good thread discussing Medicare Part D for stage IV folks? I am eligible for Medicare in August and currently on Ibrance, so part D will be especially important to me. Thanks!

"What do you know, and what do you just believe?" Linda Hogan "Power" Surgery 7/1/2014 Lumpectomy: Left Dx 8/1/2014, IDC, Left, 1cm, Stage IV, metastasized to bone, Grade 2, 4/7 nodes, mets, ER+/PR+, HER2- Hormonal Therapy 8/4/2014 Arimidex (anastrozole) Hormonal Therapy 4/30/2015 Faslodex (fulvestrant) Targeted Therapy 8/17/2015 Ibrance (palbociclib) Dx 11/20/2018, IDC, 1cm, Stage IV, metastasized to liver, ER+/PR-, HER2- (FISH) Hormonal Therapy 12/4/2018 Aromasin (exemestane) Targeted Therapy 1/1/2019 Afinitor (everolimus) Hormonal Therapy 7/16/2019 Faslodex (fulvestrant) Targeted Therapy 7/17/2019 Piqray (alpelisib) Targeted Therapy 1/12/2021 Nerlynx
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May 25, 2016 11:22PM Longtermsurvivor wrote:

Hi Jobur,

I don't have an answer to your question, because Part D plans and availability vary widely by your state, age and other factors.

A good place to seek answers for your questions about Medicare and supplemental coverage is here:

State Health Insurance Assistance Programs (SHIPs)

SHIPs offer local, personalized counseling and assistance to people with Medicare and their families. SHIPs can help you with things like:

* Your Medicare questions, including your benefits, coverage, premiums, deductibles, and coinsurance

* Complaints and appeals

* Joining or leaving a Medicare Advantage Plan (like an HMO or PPO), any other Medicare health plan, or Medicare Prescription Drug Plan (Part D)

Healing regards, Stephanie

Grateful to be here. Advanced breast cancer for 25 years, engage holistic approaches. Am dealing with ascites and many mets. Am on hospice.

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