SCI Forum Reports
Income, Medical Benefits, and Legal Rights
November 4, 1997
The Social Security Administration pays disability benefits under two programs, said Marguerite David, MSW, of the Veterans Affairs Medical Center. Eligibility for Social Security Disability Insurance (SSDI) is based on the number of years a person has contributed to Social Security. "You paid your premiums while working," said David, and your benefit amount depends on lifetime average earnings. In order to qualify, a disability must be severe enough to keep a person from doing any "substantial" employment (earnings of $500 or more per month) for at least a year. A person may return to work and continue to receive benefits during a nine-month trial work period, after which eligibility will be determined based on earnings. SSDI beneficiaries receive medical coverage under the federal Medicare program. At age 65, SSDI automatically converts to Social Security retirement benefits.
Supplemental Security Income (SSI) is a "safety net" program based on financial need. To be eligible, a person must be disabled as defined for SSDI (above). SSI beneficiaries receive medical coverage under the Medicaid program. The "plan for achieving self-support" rule (known as PASS) permits SSI beneficiaries to set aside money and assets toward a goal of self-support while continuing to collect SSI benefits.
For more information, call the Social Security Administration, 800-772-1213 (toll-free nationwide), or visit the Social Security Disability Benefits website .
The State of Washington has several income and health benefits programs. Temporary Aid to Needy Families (formerly called Aid to Families with Dependent Children) is an income-based program that automatically qualifies the recipient for health benefits under Medicaid. General Assistance for the Unemployed provides financial and medical assistance for some adults who are incapacitated from gainful employment and not eligible for federal programs. Chore Services and an attendant care program called COPES can help low income adults with disabilities live independently. Call the Department of Social and Health Services in Olympia at 800-637-5627 for more information and to locate the nearest regional office.
Individuals who are injured on the job may be eligible for Worker's Compensation income benefits under the State of Washington Department of Labor and Industries. The benefit amount depends on the severity of the disability, and includes a full medical benefit, David said. She advised people to be extremely cautious about choosing a cash settlement from an employer instead of Workers' Compensation after a job-related injury. SCI is associated with high lifelong medical costs, and a one-time settlement doesn't provide for ongoing medical coverage. "Whatever the settlement, it's hardly worth it when medical expenses come along," David said. For information, call the Washington State Department of Labor and Industries at 360-902-5800 (or toll-free in Washington at 800-547-8367).
The U.S. Department of Veterans Affairs has two income programs for veterans with disabilities. Service-connected compensation is available for individuals injured while in "authorized status" (i.e., while performing an authorized activity on duty or on authorized leave) in the military. The veterans pension is an income program for persons who served in the military during a period of war. Both benefits come with medical coverage. Information is available by calling 800-827-1000.
Norma Cole, a social worker at Harborview Medical Center, said that many people with SCI aren't eligible for SSDI because they are young at the time of their injury "and haven't paid much into the system." These people may be eligible for Medicaid, which covers outpatient and inpatient costs fairly well, Cole said. She encouraged people with SCI who are having difficulty getting needed services to contact Paralyzed Veterans of America (PVA). "They will advocate for you even if you're not a vet," she said. "Don't hesitate to call them." The PVA can be reached at 1-800-424-8200.
The Americans with Disabilities Act (ADA), passed in 1990, prohibits discrimination against individuals with disabilities in the areas of employment, transportation, public accommodations (such as restaurants, hotels, and retail stores), state and local governments, and telecommunications. Rachel Miyoshi, a social worker at the University of Washington Medical Center, said that every department within each state government has an ADA coordinator whose job it is to know how the ADA regulations apply to his or her particular agency, and is available to provide information or assistance to consumers. For information, call the US Department of Justice ADA Information Line at 800-514-0301, or visit the ADA Home Page .