In closing of the blog i would like to add a few comments. I hope i have not come across as prejudice, i love everyone, race and sex, i just get mental down and exhaustedwhen my own personal family suffers, such as we have in the last 2 years. I believe that the fact that we Chris and myself, have worked and paid in taxes should be an extra qualifying tactic for receiving Medicaid benefits. We did not go there and say hey we don't want to work, so sign us up for Medicaid, i work at a very low paying job, just to have health insurance on my family because i know my husband is sick, and i know we cannot live without health insurance, i just ask for help picking up the balance that our insurance did not pay. I will never forget the way the lady in the Medicaid office looked at us and said but your a family. You doggone right we are. and proud of it. that should not have been a dis-qualifying tactic.
Chris and I have great morals. We believe in God, we believe in family, and marriage vows are not to be broken, after all we did say I Do to: through sickness and health, and for richer and poorer. We have honored these vows and in turn lost everything we worked hard to have. A nice home and 1.5 acres, 2 nice automobiles, the luxury of taking vacations and many other things that we should be enjoying, all because Chris got sick and we would not divorce and lie just to receive a Medical card and Food stamps, and other perks that come with being single, or divorced with child. Pleas don't get me wrong, all these things i mentioned do happen to good people, and some good people can use these benefits to get them through, but what about us, tax payers, happily married and trying to stay alive, what help do we get. I would call this a very crooked system.
Saturday, May 3, 2008
old info i forgot to share
I should back up here a little and tell you about my disability claim and how it is going. Well it isn't !! No word from my lawyer since January, hope she doesn't expect any pay. So since this is election year, why not take advantage of it and use a candidates power to help me. Hey i scratch your back, you scratch mine. its dog eat dog world. Anyway, i shouldn't say that, this person that i asked for help, is actually a good person and a good friend of mine (and my wife has 108 actual registered voters just on her side alone--that couldn't hurt) the candidate that i am speaking of is House Representative Richard Henderson. I called Richard one day, the next day i was setting in his office and he was calling his friend in Frankfort (friend with higher power) I spoke personally to that person, he ask me questions and gave me instructions on what to information to fax to him asap, and he would get the ball rolling on my claim. That afternoon i had all the gathered info and faxed it directly to his office. The very next day, i received a phone call from Tracy, she received all my faxed documents, and she was going to personally look into my case. Within a week, i received a letter from Ben Chandler stated that due to financial lost (losing my home) my claim would be pushed to the top of the list of applications. He also stated that he or Tracy would continue to closely monitor my claim, and if any changes came about they would contact me by phone right away. I was given Tracy's office and ext number and of course Ben's phone number.
Wow, that was a lot i left out, and know after the info i just found about chronic liver disease, i will be calling Tracy on Monday.
I would like to say that i am very thankful for Richard Henderson, during all his campaigning he has stated if he can be of help just call him, but you know everyone says that. Maybe they truly mean it, we just don't take them up on it.
You can bet that Paula and I will be influencing our families to support Richard Henderson, he is a man of his word, he does want to have a voice for the people he serves in Frankfort. Well i do believe the the name Dane Reddix is floating around there somewhere thanks to Richard.
Wow, that was a lot i left out, and know after the info i just found about chronic liver disease, i will be calling Tracy on Monday.
I would like to say that i am very thankful for Richard Henderson, during all his campaigning he has stated if he can be of help just call him, but you know everyone says that. Maybe they truly mean it, we just don't take them up on it.
You can bet that Paula and I will be influencing our families to support Richard Henderson, he is a man of his word, he does want to have a voice for the people he serves in Frankfort. Well i do believe the the name Dane Reddix is floating around there somewhere thanks to Richard.
my opinion again
Okay if you have read any of my latest post, you will see that i have been doing a lot research on my disability and what is taken so long. If it had not been for this blog assignment i can honestly say that i might not have discovered this new information. The government, effect 12/18/07, (right after my hospital stay 12/04/07,) passed a new disability "guideline" if you will, for Liver disease. That's me, that's what i have been complaining about. Hepatitis C, chronic liver failure, ascities, kidney failure due to chronic liver disease, i have all of these, and posted right there on their website "Effect 12/18/07, this are qualifying conditions for disability" I have to get on the phone Monday morning and call Ben Chandler's officer, when i had spoke with him before, he stated that i would be appointed my very own personal case worker, Jacquelin, i will call them, fax to her a copy of this information i found and i will aggravate them to death to do something about my disability.
good to know
Disability Insurance Trust FundUpdated November 9, 2007
The Disability Insurance Trust Fund is a separate account in the United States Treasury. A fixed proportion (dependent on the allocation of tax rates by trust fund) of the taxes received under the Federal Insurance Contributions Act and the Self-Employment Contributions Act are deposited in the fund to the extent that such taxes are not needed immediately to pay expenses. Taxes are deposited into the fund on every business day.
The trust fund provides automatic spending authority to pay monthly benefits to disabled-worker beneficiaries and their spouses and children. With such spending authority, the Social Security Administration does not need to periodically request money from the Congress to pay benefits.
Funds not withdrawn for current expenses (benefits, the financial interchange with the Railroad Retirement program, and administrative expenses) are invested in interest-bearing Federal securities, as required by law; the interest earned is also deposited in the trust fund.
The Disability Insurance (DI) Trust Fund was created with passage of the Social Security Act Amendments of 1956. DI became effective on January 1, 1957.
The Board of Trustees currently consists of 6 members, 4 of whom automatically serve by virtue of their positions in the Federal Government. These 4 are the
Secretary of the Treasury (the Managing Trustee),
Secretary of Labor,
Secretary of Health and Human Services, and
Commissioner of Social SecurityThe other 2 members are appointed by the President, and confirmed by the Senate, as required by the "Social Security Amendments of 1983." These 2 members serve 4-year terms.
info taken from ssa.gov website
The Disability Insurance Trust Fund is a separate account in the United States Treasury. A fixed proportion (dependent on the allocation of tax rates by trust fund) of the taxes received under the Federal Insurance Contributions Act and the Self-Employment Contributions Act are deposited in the fund to the extent that such taxes are not needed immediately to pay expenses. Taxes are deposited into the fund on every business day.
The trust fund provides automatic spending authority to pay monthly benefits to disabled-worker beneficiaries and their spouses and children. With such spending authority, the Social Security Administration does not need to periodically request money from the Congress to pay benefits.
Funds not withdrawn for current expenses (benefits, the financial interchange with the Railroad Retirement program, and administrative expenses) are invested in interest-bearing Federal securities, as required by law; the interest earned is also deposited in the trust fund.
The Disability Insurance (DI) Trust Fund was created with passage of the Social Security Act Amendments of 1956. DI became effective on January 1, 1957.
The Board of Trustees currently consists of 6 members, 4 of whom automatically serve by virtue of their positions in the Federal Government. These 4 are the
Secretary of the Treasury (the Managing Trustee),
Secretary of Labor,
Secretary of Health and Human Services, and
Commissioner of Social SecurityThe other 2 members are appointed by the President, and confirmed by the Senate, as required by the "Social Security Amendments of 1983." These 2 members serve 4-year terms.
info taken from ssa.gov website
press release
News Release SOCIAL SECURITY
Social Security Administration Attacks Disability Backlog
Michael J. Astrue, Commissioner of Social Security, today announced that the Social Security Administration had made progress in the 2007 fiscal year (FY) toward making faster decisions on disability claims.
"Better systems and business processes were essential to the progress we made in 2007," Commissioner Astrue said, "but we cannot overlook the tens of thousands of overtime hours put in by the hardworking men and women of the Social Security Administration."
Commissioner Astrue highlighted the progress made in a number of significant areas:
Social Security issued a final rule on September 5, 2007 extending nationwide its Quick Disability Determination (QDD) process. Under QDD, a predictive model analyzes specific elements of data within the electronic claims file to identify claims where there is a high potential that the claimant is disabled and where evidence of the person’s allegations can be quickly and easily obtained. In New England, where the process was being tested, about 3 percent of all new cases were identified as QDD cases and processed in an average of 11 days. Today, Arizona, New Jersey and North Dakota have started using QDD as part of a staged national roll-out that will be completed early next year.
The Social Security Administration also virtually eliminated its backlog of FY 2007 "aged" disability hearings cases. "Aged" cases, defined as cases pending 1,000 days or more, were reduced from 63,770 cases at the beginning of FY 2007 to 108 cases at the end of September.
To build upon this progress, the agency will redefine "aged" cases as cases pending for at least 900 days and will again attempt to resolve all of these cases by the end of the fiscal year.
The time it takes to process initial disability claims declined 6.3 percent from 88.4 days in FY 2006 to 82.8 days in FY 2007.
Another accomplishment was that Social Security slowed the growth in its pending disability hearings cases by approximately fifty percent. While the overall number of cases pending at the hearing level increased from 715,568 cases to 746,744 cases, the increase of 31,176 cases was about half of the annual increase the agency has typically recorded in this decade.
As another key part of its plan, the Social Security Administration is establishing a National Hearing Center (NHC) so that a centralized cadre of Administrative Law Judges (ALJs) can use video hearing technology to hear cases in the most backlogged parts of the country. The technology now is in place, and the recruiting process for the first NHC judges has begun. The agency also plans to hire about 150 ALJs and some additional hearing office support staff in the spring of 2008 – the only new hiring in FY 2008 as the agency continues to contract through attrition due to many years of congressional budget cuts far below what the President has requested. "Our goal is to build upon this year’s achievements and, with the support of Congress, continue to improve the service we provide to millions of disabled Americans," said Commissioner Astrue. "Without adequate support from Congress, however, we will not be able to make further progress – and we may even lose ground."
info taken from ssa.gov website
Social Security Administration Attacks Disability Backlog
Michael J. Astrue, Commissioner of Social Security, today announced that the Social Security Administration had made progress in the 2007 fiscal year (FY) toward making faster decisions on disability claims.
"Better systems and business processes were essential to the progress we made in 2007," Commissioner Astrue said, "but we cannot overlook the tens of thousands of overtime hours put in by the hardworking men and women of the Social Security Administration."
Commissioner Astrue highlighted the progress made in a number of significant areas:
Social Security issued a final rule on September 5, 2007 extending nationwide its Quick Disability Determination (QDD) process. Under QDD, a predictive model analyzes specific elements of data within the electronic claims file to identify claims where there is a high potential that the claimant is disabled and where evidence of the person’s allegations can be quickly and easily obtained. In New England, where the process was being tested, about 3 percent of all new cases were identified as QDD cases and processed in an average of 11 days. Today, Arizona, New Jersey and North Dakota have started using QDD as part of a staged national roll-out that will be completed early next year.
The Social Security Administration also virtually eliminated its backlog of FY 2007 "aged" disability hearings cases. "Aged" cases, defined as cases pending 1,000 days or more, were reduced from 63,770 cases at the beginning of FY 2007 to 108 cases at the end of September.
To build upon this progress, the agency will redefine "aged" cases as cases pending for at least 900 days and will again attempt to resolve all of these cases by the end of the fiscal year.
The time it takes to process initial disability claims declined 6.3 percent from 88.4 days in FY 2006 to 82.8 days in FY 2007.
Another accomplishment was that Social Security slowed the growth in its pending disability hearings cases by approximately fifty percent. While the overall number of cases pending at the hearing level increased from 715,568 cases to 746,744 cases, the increase of 31,176 cases was about half of the annual increase the agency has typically recorded in this decade.
As another key part of its plan, the Social Security Administration is establishing a National Hearing Center (NHC) so that a centralized cadre of Administrative Law Judges (ALJs) can use video hearing technology to hear cases in the most backlogged parts of the country. The technology now is in place, and the recruiting process for the first NHC judges has begun. The agency also plans to hire about 150 ALJs and some additional hearing office support staff in the spring of 2008 – the only new hiring in FY 2008 as the agency continues to contract through attrition due to many years of congressional budget cuts far below what the President has requested. "Our goal is to build upon this year’s achievements and, with the support of Congress, continue to improve the service we provide to millions of disabled Americans," said Commissioner Astrue. "Without adequate support from Congress, however, we will not be able to make further progress – and we may even lose ground."
info taken from ssa.gov website
how disabilty is determined
How We Decide If You Are Disabled,
Is your condition found in the list of disabling conditions?
For each of the major body systems, we maintain a list of medical conditions that are so severe they automatically mean that you are disabled. If your condition is not on the list, we have to decide if it is of equal severity to a medical condition that is on the list. If it is, we will find that you are disabled. If it is not, we then go to Step 4.
Can you do the work you did previously?
If your condition is severe but not at the same or equal level of severity as a medical condition on the list, then we must determine if it interferes with your ability to do the work you did previously. If it does not, your claim will be denied. If it does, we proceed to Step 5.
Can you do any work?
If you cannot do the work you did in the past, we see if you are able to adjust to other work. We consider your medical conditions and your age, education, past work experience and any transferable skills you may have. If you cannot adjust to other work, your claim will be approved. If you can adjust to other work, your claim will be denied.
info taken from ssa.gov website
Is your condition found in the list of disabling conditions?
For each of the major body systems, we maintain a list of medical conditions that are so severe they automatically mean that you are disabled. If your condition is not on the list, we have to decide if it is of equal severity to a medical condition that is on the list. If it is, we will find that you are disabled. If it is not, we then go to Step 4.
Can you do the work you did previously?
If your condition is severe but not at the same or equal level of severity as a medical condition on the list, then we must determine if it interferes with your ability to do the work you did previously. If it does not, your claim will be denied. If it does, we proceed to Step 5.
Can you do any work?
If you cannot do the work you did in the past, we see if you are able to adjust to other work. We consider your medical conditions and your age, education, past work experience and any transferable skills you may have. If you cannot adjust to other work, your claim will be approved. If you can adjust to other work, your claim will be denied.
info taken from ssa.gov website
new catagory for disability
5.00 Digestive System
Chronic Liver Disease and Liver Transplant are new eligibilty reasons for disability... is there hope for me after all??? This catagory is new as of 12/18/2007
A. What kinds of disorders do we consider in the digestive system? Disorders of the digestive system include gastrointestinal hemorrhage, hepatic (liver) dysfunction, inflammatory bowel disease, short bowel syndrome, and malnutrition. They may also lead to complications, such as obstruction, or be accompanied by manifestations in other body systems.
B. What documentation do we need? We need a record of your medical evidence, including clinical and laboratory findings. The documentation should include appropriate medically acceptable imaging studies and reports of endoscopy, operations, and pathology, as appropriate to each listing, to document the severity and duration of your digestive disorder. Medically acceptable imaging includes, but is not limited to, x-ray imaging, sonography, computerized axial tomography (CAT scan), magnetic resonance imaging (MRI), and radionuclide scans. Appropriate means that the technique used is the proper one to support the evaluation and diagnosis of the disorder. The findings required by these listings must occur within the period we are considering in connection with your application or continuing disability review.
C. How do we consider the effects of treatment?
1. Digestive disorders frequently respond to medical or surgical treatment; therefore, we generally consider the severity and duration of these disorders within the context of prescribed treatment.
2. We assess the effects of treatment, including medication, therapy, surgery, or any other form of treatment you receive, by determining if there are improvements in the symptoms, signs, and laboratory findings of your digestive disorder. We also assess any side effects of your treatment that may further limit your functioning.
3. To assess the effects of your treatment, we may need information about: a. The treatment you have been prescribed (for example, the type of medication or therapy, or your use of parenteral (intravenous) nutrition or supplemental enteral nutrition via a gastrostomy); b. The dosage, method, and frequency of administration; c. Your response to the treatment; d. Any adverse effects of such treatment; and e. The expected duration of the treatment.
4. Because the effects of treatment may be temporary or long-term, in most cases we need information about the impact of your treatment, including its expected duration and side effects, over a sufficient period of time to help us assess its outcome. When adverse effects of treatment contribute to the severity of your impairment(s), we will consider the duration or expected duration of the treatment when we assess the duration of your impairment(s).
5. If you need parenteral (intravenous) nutrition or supplemental enteral nutrition via a gastrostomy to avoid debilitating complications of a digestive disorder, this treatment will not, in itself, indicate that you are unable to do any gainful activity, except under 5.07, short bowel syndrome (see 5.00F).
6. If you have not received ongoing treatment or have not had an ongoing relationship with the medical community despite the existence of a severe impairment(s), we will evaluate the severity and duration of your digestive impairment on the basis of the current medical and other evidence in your case record. If you have not received treatment, you may not be able to show an impairment that meets the criteria of one of the digestive system listings, but your digestive impairment may medically equal a listing or be disabling based on consideration of your residual functional capacity, age, education, and work experience.
D. How do we evaluate chronic liver disease?
1. General. Chronic liver disease is characterized by liver cell necrosis, inflammation, or scarring (fibrosis or cirrhosis), due to any cause, that persists for more than 6 months. Chronic liver disease may result in portal hypertension, cholestasis (suppression of bile flow), extrahepatic manifestations, or liver cancer. (We evaluate liver cancer under 13.19.) Significant loss of liver function may be manifested by hemorrhage from varices or portal hypertensive gastropathy, ascites (accumulation of fluid in the abdominal cavity), hydrothorax (ascitic fluid in the chest cavity), or encephalopathy. There can also be progressive deterioration of laboratory findings that are indicative of liver dysfunction. Liver transplantation is the only definitive cure for end stage liver disease (ESLD).
2. Examples of chronic liver disease include, but are not limited to, chronic hepatitis, alcoholic liver disease, non-alcoholic steatohepatitis (NASH), primary biliary cirrhosis (PBC), primary sclerosing cholangitis (PSC), autoimmune hepatitis, hemochromatosis, drug-induced liver disease, Wilson’s disease, and serum alpha-1 antitrypsin deficiency. Acute hepatic injury is frequently reversible, as in viral, drug-induced, toxin-induced, alcoholic, and ischemic hepatitis. In the absence of evidence of a chronic impairment, episodes of acute liver disease do not meet 5.05.
3. Manifestations of chronic liver disease. a. Symptoms may include, but are not limited to, pruritis (itching), fatigue, nausea, loss of appetite, or sleep disturbances. Symptoms of chronic liver disease may have a poor correlation with the severity of liver disease and functional ability. b. Signs may include, but are not limited to, jaundice, enlargement of the liver and spleen, ascites, peripheral edema, and altered mental status. c. Laboratory findings may include, but are not limited to, increased liver enzymes, increased serum total bilirubin, increased ammonia levels, decreased serum albumin, and abnormal coagulation studies, such as increased International Normalized Ratio (INR) or decreased platelet counts. Abnormally low serum albumin or elevated INR levels indicate loss of synthetic liver function, with increased likelihood of cirrhosis and associated complications. However, other abnormal lab tests, such as liver enzymes, serum total bilirubin, or ammonia levels, may have a poor correlation with the severity of liver disease and functional ability. A liver biopsy may demonstrate the degree of liver cell necrosis, inflammation, fibrosis, and cirrhosis. If you have had a liver biopsy, we will make every reasonable effort to obtain the results; however, we will not purchase a liver biopsy. Imaging studies (CAT scan, ultrasound, MRI) may show the size and consistency (fatty liver, scarring) of the liver and document ascites (see 5.00D6).
4. Chronic viral hepatitis infections. a. General. (i) Chronic viral hepatitis infections are commonly caused by hepatitis C virus (HCV), and to a lesser extent, hepatitis B virus (HBV). Usually, these are slowly progressive disorders that persist over many years during which the symptoms and signs are typically nonspecific, intermittent, and mild (for example, fatigue, difficulty with concentration, or right upper quadrant pain). Laboratory findings (liver enzymes, imaging studies, liver biopsy pathology) and complications are generally similar in HCV and HBV. The spectrum of these chronic viral hepatitis infections ranges widely and includes an asymptomatic state; insidious disease with mild to moderate symptoms associated with fluctuating liver tests; extrahepatic manifestations; cirrhosis, both compensated and decompensated; ESLD with the need for liver transplantation; and liver cancer. Treatment for chronic viral hepatitis infections varies considerably based on medication tolerance, treatment response, adverse effects of treatment, and duration of the treatment. Comorbid disorders, such as HIV infection, may affect the clinical course of viral hepatitis infection(s) or may alter the response to medical treatment. (ii) We evaluate all types of chronic viral hepatitis infections under 5.05 or any listing in an affected body system(s). If your impairment(s) does not meet or medically equal a listing, we will consider the effects of your hepatitis when we assess your residual functional capacity. b. Chronic hepatitis B virus (HBV) infection. (i) Chronic HBV infection is diagnosed by the detection of hepatitis B surface antigen (HBsAg) in the blood for at least 6 months. In addition, detection of the hepatitis B envelope antigen (HBeAg) suggests an increased likelihood of progression to cirrhosis and ESLD. (ii) The therapeutic goal of treatment is to suppress HBV replication and thereby prevent progression to cirrhosis and ESLD. Treatment usually includes a combination of interferon injections and oral antiviral agents. Common adverse effects of treatment are the same as noted in 5.00D4c(ii) for HCV, and generally end within a few days after treatment is discontinued. c. Chronic hepatitis C virus (HCV) infection. (i) Chronic HCV infection is diagnosed by the detection of hepatitis C viral RNA in the blood for at least 6 months. Documentation of the therapeutic response to treatment is also monitored by the quantitative assay of serum HCV RNA (“HCV viral load”). Treatment usually includes a combination of interferon injections and oral ribavirin; whether a therapeutic response has occurred is usually assessed after 12 weeks of treatment by checking the HCV viral load. If there has been a substantial reduction in HCV viral load (also known as early viral response, or EVR), this reduction is predictive of a sustained viral response with completion of treatment. Combined therapy is commonly discontinued after 12 weeks when there is no early viral response, since in that circumstance there is little chance of obtaining a sustained viral response (SVR). Otherwise, treatment is usually continued for a total of 48 weeks. (ii) Combined interferon and ribavirin treatment may have significant adverse effects that may require dosing reduction, planned interruption of treatment, or discontinuation of treatment. Adverse effects may include: Anemia (ribavirin-induced hemolysis), neutropenia, thrombocytopenia, fever, cough, fatigue, myalgia, arthralgia, nausea, loss of appetite, pruritis, and insomnia. Behavioral side effects may also occur. Influenza-like symptoms are generally worse in the first 4 to 6 hours after each interferon injection and during the first weeks of treatment. Adverse effects generally end within a few days after treatment is discontinued. d. Extrahepatic manifestations of HBV and HCV. In addition to their hepatic manifestations, both HBV and HCV may have significant extrahepatic manifestations in a variety of body systems. These include, but are not limited to: Keratoconjunctivitis (sicca syndrome), glomerulonephritis, skin disorders (for example, lichen planus, porphyria cutanea tarda), neuropathy, and immune dysfunction (for example, cryoglobulinemia, Sjögren’s syndrome, and vasculitis). The extrahepatic manifestations of HBV and HCV may not correlate with the severity of your hepatic impairment. If your impairment(s) does not meet or medically equal a listing in an affected body system(s), we will consider the effects of your extrahepatic manifestations when we assess your residual functional capacity. 5. Gastrointestinal hemorrhage (5.02 and 5.05A). Gastrointestinal hemorrhaging can result in hematemesis (vomiting of blood), melena (tarry stools), or hematochezia (bloody stools). Under 5.02, the required transfusions of at least 2 units of blood must be at least 30 days apart and occur at least three times during a consecutive 6-month period. Under 5.05A, hemodynamic instability is diagnosed with signs such as pallor (pale skin), diaphoresis (profuse perspiration), rapid pulse, low blood pressure, postural hypotension (pronounced fall in blood pressure when arising to an upright position from lying down) or syncope (fainting). Hemorrhaging that results in hemodynamic instability is potentially life-threatening and therefore requires hospitalization for transfusion and supportive care. Under 5.05A, we require only one hospitalization for transfusion of at least 2 units of blood.
6. Ascites or hydrothorax (5.05B) indicates significant loss of liver function due to chronic liver disease. We evaluate ascites or hydrothorax that is not attributable to other causes under 5.05B. The required findings must be present on at least two evaluations at least 60 days apart within a consecutive 6-month period and despite continuing treatment as prescribed.
7. Spontaneous bacterial peritonitis (5.05C) is an infectious complication of chronic liver disease. It is diagnosed by ascitic peritoneal fluid that is documented to contain an absolute neutrophil count of at least 250 cells/mm3. The required finding in 5.05C is satisfied with one evaluation documenting peritoneal fluid infection. We do not evaluate other causes of peritonitis that are unrelated to chronic liver disease, such as tuberculosis, malignancy, and perforated bowel, under this listing. We evaluate these other causes of peritonitis under the appropriate body system listings.
8. Hepatorenal syndrome (5.05D) is defined as functional renal failure associated with chronic liver disease in the absence of underlying kidney pathology. Hepatorenal syndrome is documented by elevation of serum creatinine, marked sodium retention, and oliguria (reduced urine output). The requirements of 5.05D are satisfied with documentation of any one of the three laboratory findings on one evaluation. We do not evaluate known causes of renal dysfunction, such as glomerulonephritis, tubular necrosis, drug-induced renal disease, and renal infections, under this listing. We evaluate these other renal impairments under 6.00ff.
9. Hepatopulmonary syndrome (5.05E) is defined as arterial deoxygenation (hypoxemia) that is associated with chronic liver disease due to intrapulmonary arteriovenous shunting and vasodilatation in the absence of other causes of arterial deoxygenation. Clinical manifestations usually include dyspnea, orthodeoxia (increasing hypoxemia with erect position), platypnea (improvement of dyspnea with flat position), cyanosis, and clubbing. The requirements of 5.05E are satisfied with documentation of any one of the findings on one evaluation. In 5.05E1, we require documentation of the altitude of the testing facility because altitude affects the measurement of arterial oxygenation. We will not purchase the specialized studies described in 5.05E2; however, if you have had these studies at a time relevant to your claim, we will make every reasonable effort to obtain the reports for the purpose of establishing whether your impairment meets 5.05E2.
10. Hepatic encephalopathy (5.05F). a. General. Hepatic encephalopathy usually indicates severe loss of hepatocellular function. We define hepatic encephalopathy under 5.05F as a recurrent or chronic neuropsychiatric disorder, characterized by abnormal behavior, cognitive dysfunction, altered state of consciousness, and ultimately coma and death. The diagnosis is established by changes in mental status associated with fleeting neurological signs, including “flapping tremor” (asterixis), characteristic electroencephalographic (EEG) abnormalities, or abnormal laboratory values that indicate loss of synthetic liver function. We will not purchase the EEG testing described in 5.05F3b; however, if you have had this test at a time relevant to your claim, we will make every reasonable effort to obtain the report for the purpose of establishing whether your impairment meets 5.05F. b. Acute encephalopathy. We will not evaluate your acute encephalopathy under 5.05F if it results from conditions other than chronic liver disease, such as vascular events and neoplastic diseases. We will evaluate these other causes of acute encephalopathy under the appropriate body system listings.
11. End stage liver disease (ESLD) documented by scores from the SSA Chronic Liver Disease (SSA CLD) calculation (5.05G).
12. Liver transplantation (5.09) may be performed for metabolic liver disease, progressive liver failure, life-threatening complications of liver disease, hepatic malignancy, and acute fulminant hepatitis (viral, drug-induced, or toxin-induced). We will consider you to be disabled for 1 year from the date of the transplantation. Thereafter, we will evaluate your residual impairment(s) by considering the adequacy of post-transplant liver function, the requirement for post-transplant antiviral therapy, the frequency and severity of rejection episodes, comorbid complications, and all adverse treatment effects.
Chronic liver disease, with: A. Hemorrhaging from esophageal, gastric, or ectopic varices or from portal hypertensive gastropathy, demonstrated by endoscopy, x-ray, or other appropriate medically acceptable imaging, resulting in hemodynamic instability as defined in 5.00D5, and requiring hospitalization for transfusion of at least 2 units of blood. Consider under a disability for 1 year following the last documented transfusion; thereafter, evaluate the residual impairment(s). OR B. Ascites or hydrothorax not attributable to other causes, despite continuing treatment as prescribed, present on at least two evaluations at least 60 days apart within a consecutive 6-month period. Each evaluation must be documented by: 1. Paracentesis or thoracentesis; or 2. Appropriate medically acceptable imaging or physical examination and one of the following: a. Serum albumin of 3.0 g/dL or less; or b. International Normalized Ratio (INR) of at least 1.5. OR C. Spontaneous bacterial peritonitis with peritoneal fluid containing an absolute neutrophil count of at least 250 cells/mm3. OR D. Hepatorenal syndrome as described in 5.00D8, with one of the following: 1. Serum creatinine elevation of at least 2 mg/dL; or 2. Oliguria with 24-hour urine output less than 500 mL; or 3. Sodium retention with urine sodium less than 10 mEq per liter. OR E. Hepatopulmonary syndrome as described in 5.00D9, with: 1. Arterial oxygenation (PaO2) on room air of: a. 60 mm Hg or less, at test sites less than 3000 feet above sea level, or b. 55 mm Hg or less, at test sites from 3000 to 6000 feet, or c. 50 mm Hg or less, at test sites above 6000 feet; or 2. Documentation of intrapulmonary arteriovenous shunting by contrast-enhanced echocardiography or macroaggregated albumin lung perfusion scan. OR F. Hepatic encephalopathy as described in 5.00D10, with 1 and either 2 or 3: 1. Documentation of abnormal behavior, cognitive dysfunction, changes in mental status, or altered state of consciousness (for example, confusion, delirium, stupor, or coma), present on at least two evaluations at least 60 days apart within a consecutive 6-month period; and 2. History of transjugular intrahepatic portosystemic shunt (TIPS) or any surgical portosystemic shunt; or 3. One of the following occurring on at least two evaluations at least 60 days apart within the same consecutive 6-month period as in F1: a. Asterixis or other fluctuating physical neurological abnormalities; or b. Electroencephalogram (EEG) demonstrating triphasic slow wave activity; or c. Serum albumin of 3.0 g/dL or less; or d. International Normalized Ratio (INR) of 1.5 or greater. OR G. End stage liver disease with SSA CLD scores of 22 or greater ).
Chronic Liver Disease and Liver Transplant are new eligibilty reasons for disability... is there hope for me after all??? This catagory is new as of 12/18/2007
A. What kinds of disorders do we consider in the digestive system? Disorders of the digestive system include gastrointestinal hemorrhage, hepatic (liver) dysfunction, inflammatory bowel disease, short bowel syndrome, and malnutrition. They may also lead to complications, such as obstruction, or be accompanied by manifestations in other body systems.
B. What documentation do we need? We need a record of your medical evidence, including clinical and laboratory findings. The documentation should include appropriate medically acceptable imaging studies and reports of endoscopy, operations, and pathology, as appropriate to each listing, to document the severity and duration of your digestive disorder. Medically acceptable imaging includes, but is not limited to, x-ray imaging, sonography, computerized axial tomography (CAT scan), magnetic resonance imaging (MRI), and radionuclide scans. Appropriate means that the technique used is the proper one to support the evaluation and diagnosis of the disorder. The findings required by these listings must occur within the period we are considering in connection with your application or continuing disability review.
C. How do we consider the effects of treatment?
1. Digestive disorders frequently respond to medical or surgical treatment; therefore, we generally consider the severity and duration of these disorders within the context of prescribed treatment.
2. We assess the effects of treatment, including medication, therapy, surgery, or any other form of treatment you receive, by determining if there are improvements in the symptoms, signs, and laboratory findings of your digestive disorder. We also assess any side effects of your treatment that may further limit your functioning.
3. To assess the effects of your treatment, we may need information about: a. The treatment you have been prescribed (for example, the type of medication or therapy, or your use of parenteral (intravenous) nutrition or supplemental enteral nutrition via a gastrostomy); b. The dosage, method, and frequency of administration; c. Your response to the treatment; d. Any adverse effects of such treatment; and e. The expected duration of the treatment.
4. Because the effects of treatment may be temporary or long-term, in most cases we need information about the impact of your treatment, including its expected duration and side effects, over a sufficient period of time to help us assess its outcome. When adverse effects of treatment contribute to the severity of your impairment(s), we will consider the duration or expected duration of the treatment when we assess the duration of your impairment(s).
5. If you need parenteral (intravenous) nutrition or supplemental enteral nutrition via a gastrostomy to avoid debilitating complications of a digestive disorder, this treatment will not, in itself, indicate that you are unable to do any gainful activity, except under 5.07, short bowel syndrome (see 5.00F).
6. If you have not received ongoing treatment or have not had an ongoing relationship with the medical community despite the existence of a severe impairment(s), we will evaluate the severity and duration of your digestive impairment on the basis of the current medical and other evidence in your case record. If you have not received treatment, you may not be able to show an impairment that meets the criteria of one of the digestive system listings, but your digestive impairment may medically equal a listing or be disabling based on consideration of your residual functional capacity, age, education, and work experience.
D. How do we evaluate chronic liver disease?
1. General. Chronic liver disease is characterized by liver cell necrosis, inflammation, or scarring (fibrosis or cirrhosis), due to any cause, that persists for more than 6 months. Chronic liver disease may result in portal hypertension, cholestasis (suppression of bile flow), extrahepatic manifestations, or liver cancer. (We evaluate liver cancer under 13.19.) Significant loss of liver function may be manifested by hemorrhage from varices or portal hypertensive gastropathy, ascites (accumulation of fluid in the abdominal cavity), hydrothorax (ascitic fluid in the chest cavity), or encephalopathy. There can also be progressive deterioration of laboratory findings that are indicative of liver dysfunction. Liver transplantation is the only definitive cure for end stage liver disease (ESLD).
2. Examples of chronic liver disease include, but are not limited to, chronic hepatitis, alcoholic liver disease, non-alcoholic steatohepatitis (NASH), primary biliary cirrhosis (PBC), primary sclerosing cholangitis (PSC), autoimmune hepatitis, hemochromatosis, drug-induced liver disease, Wilson’s disease, and serum alpha-1 antitrypsin deficiency. Acute hepatic injury is frequently reversible, as in viral, drug-induced, toxin-induced, alcoholic, and ischemic hepatitis. In the absence of evidence of a chronic impairment, episodes of acute liver disease do not meet 5.05.
3. Manifestations of chronic liver disease. a. Symptoms may include, but are not limited to, pruritis (itching), fatigue, nausea, loss of appetite, or sleep disturbances. Symptoms of chronic liver disease may have a poor correlation with the severity of liver disease and functional ability. b. Signs may include, but are not limited to, jaundice, enlargement of the liver and spleen, ascites, peripheral edema, and altered mental status. c. Laboratory findings may include, but are not limited to, increased liver enzymes, increased serum total bilirubin, increased ammonia levels, decreased serum albumin, and abnormal coagulation studies, such as increased International Normalized Ratio (INR) or decreased platelet counts. Abnormally low serum albumin or elevated INR levels indicate loss of synthetic liver function, with increased likelihood of cirrhosis and associated complications. However, other abnormal lab tests, such as liver enzymes, serum total bilirubin, or ammonia levels, may have a poor correlation with the severity of liver disease and functional ability. A liver biopsy may demonstrate the degree of liver cell necrosis, inflammation, fibrosis, and cirrhosis. If you have had a liver biopsy, we will make every reasonable effort to obtain the results; however, we will not purchase a liver biopsy. Imaging studies (CAT scan, ultrasound, MRI) may show the size and consistency (fatty liver, scarring) of the liver and document ascites (see 5.00D6).
4. Chronic viral hepatitis infections. a. General. (i) Chronic viral hepatitis infections are commonly caused by hepatitis C virus (HCV), and to a lesser extent, hepatitis B virus (HBV). Usually, these are slowly progressive disorders that persist over many years during which the symptoms and signs are typically nonspecific, intermittent, and mild (for example, fatigue, difficulty with concentration, or right upper quadrant pain). Laboratory findings (liver enzymes, imaging studies, liver biopsy pathology) and complications are generally similar in HCV and HBV. The spectrum of these chronic viral hepatitis infections ranges widely and includes an asymptomatic state; insidious disease with mild to moderate symptoms associated with fluctuating liver tests; extrahepatic manifestations; cirrhosis, both compensated and decompensated; ESLD with the need for liver transplantation; and liver cancer. Treatment for chronic viral hepatitis infections varies considerably based on medication tolerance, treatment response, adverse effects of treatment, and duration of the treatment. Comorbid disorders, such as HIV infection, may affect the clinical course of viral hepatitis infection(s) or may alter the response to medical treatment. (ii) We evaluate all types of chronic viral hepatitis infections under 5.05 or any listing in an affected body system(s). If your impairment(s) does not meet or medically equal a listing, we will consider the effects of your hepatitis when we assess your residual functional capacity. b. Chronic hepatitis B virus (HBV) infection. (i) Chronic HBV infection is diagnosed by the detection of hepatitis B surface antigen (HBsAg) in the blood for at least 6 months. In addition, detection of the hepatitis B envelope antigen (HBeAg) suggests an increased likelihood of progression to cirrhosis and ESLD. (ii) The therapeutic goal of treatment is to suppress HBV replication and thereby prevent progression to cirrhosis and ESLD. Treatment usually includes a combination of interferon injections and oral antiviral agents. Common adverse effects of treatment are the same as noted in 5.00D4c(ii) for HCV, and generally end within a few days after treatment is discontinued. c. Chronic hepatitis C virus (HCV) infection. (i) Chronic HCV infection is diagnosed by the detection of hepatitis C viral RNA in the blood for at least 6 months. Documentation of the therapeutic response to treatment is also monitored by the quantitative assay of serum HCV RNA (“HCV viral load”). Treatment usually includes a combination of interferon injections and oral ribavirin; whether a therapeutic response has occurred is usually assessed after 12 weeks of treatment by checking the HCV viral load. If there has been a substantial reduction in HCV viral load (also known as early viral response, or EVR), this reduction is predictive of a sustained viral response with completion of treatment. Combined therapy is commonly discontinued after 12 weeks when there is no early viral response, since in that circumstance there is little chance of obtaining a sustained viral response (SVR). Otherwise, treatment is usually continued for a total of 48 weeks. (ii) Combined interferon and ribavirin treatment may have significant adverse effects that may require dosing reduction, planned interruption of treatment, or discontinuation of treatment. Adverse effects may include: Anemia (ribavirin-induced hemolysis), neutropenia, thrombocytopenia, fever, cough, fatigue, myalgia, arthralgia, nausea, loss of appetite, pruritis, and insomnia. Behavioral side effects may also occur. Influenza-like symptoms are generally worse in the first 4 to 6 hours after each interferon injection and during the first weeks of treatment. Adverse effects generally end within a few days after treatment is discontinued. d. Extrahepatic manifestations of HBV and HCV. In addition to their hepatic manifestations, both HBV and HCV may have significant extrahepatic manifestations in a variety of body systems. These include, but are not limited to: Keratoconjunctivitis (sicca syndrome), glomerulonephritis, skin disorders (for example, lichen planus, porphyria cutanea tarda), neuropathy, and immune dysfunction (for example, cryoglobulinemia, Sjögren’s syndrome, and vasculitis). The extrahepatic manifestations of HBV and HCV may not correlate with the severity of your hepatic impairment. If your impairment(s) does not meet or medically equal a listing in an affected body system(s), we will consider the effects of your extrahepatic manifestations when we assess your residual functional capacity. 5. Gastrointestinal hemorrhage (5.02 and 5.05A). Gastrointestinal hemorrhaging can result in hematemesis (vomiting of blood), melena (tarry stools), or hematochezia (bloody stools). Under 5.02, the required transfusions of at least 2 units of blood must be at least 30 days apart and occur at least three times during a consecutive 6-month period. Under 5.05A, hemodynamic instability is diagnosed with signs such as pallor (pale skin), diaphoresis (profuse perspiration), rapid pulse, low blood pressure, postural hypotension (pronounced fall in blood pressure when arising to an upright position from lying down) or syncope (fainting). Hemorrhaging that results in hemodynamic instability is potentially life-threatening and therefore requires hospitalization for transfusion and supportive care. Under 5.05A, we require only one hospitalization for transfusion of at least 2 units of blood.
6. Ascites or hydrothorax (5.05B) indicates significant loss of liver function due to chronic liver disease. We evaluate ascites or hydrothorax that is not attributable to other causes under 5.05B. The required findings must be present on at least two evaluations at least 60 days apart within a consecutive 6-month period and despite continuing treatment as prescribed.
7. Spontaneous bacterial peritonitis (5.05C) is an infectious complication of chronic liver disease. It is diagnosed by ascitic peritoneal fluid that is documented to contain an absolute neutrophil count of at least 250 cells/mm3. The required finding in 5.05C is satisfied with one evaluation documenting peritoneal fluid infection. We do not evaluate other causes of peritonitis that are unrelated to chronic liver disease, such as tuberculosis, malignancy, and perforated bowel, under this listing. We evaluate these other causes of peritonitis under the appropriate body system listings.
8. Hepatorenal syndrome (5.05D) is defined as functional renal failure associated with chronic liver disease in the absence of underlying kidney pathology. Hepatorenal syndrome is documented by elevation of serum creatinine, marked sodium retention, and oliguria (reduced urine output). The requirements of 5.05D are satisfied with documentation of any one of the three laboratory findings on one evaluation. We do not evaluate known causes of renal dysfunction, such as glomerulonephritis, tubular necrosis, drug-induced renal disease, and renal infections, under this listing. We evaluate these other renal impairments under 6.00ff.
9. Hepatopulmonary syndrome (5.05E) is defined as arterial deoxygenation (hypoxemia) that is associated with chronic liver disease due to intrapulmonary arteriovenous shunting and vasodilatation in the absence of other causes of arterial deoxygenation. Clinical manifestations usually include dyspnea, orthodeoxia (increasing hypoxemia with erect position), platypnea (improvement of dyspnea with flat position), cyanosis, and clubbing. The requirements of 5.05E are satisfied with documentation of any one of the findings on one evaluation. In 5.05E1, we require documentation of the altitude of the testing facility because altitude affects the measurement of arterial oxygenation. We will not purchase the specialized studies described in 5.05E2; however, if you have had these studies at a time relevant to your claim, we will make every reasonable effort to obtain the reports for the purpose of establishing whether your impairment meets 5.05E2.
10. Hepatic encephalopathy (5.05F). a. General. Hepatic encephalopathy usually indicates severe loss of hepatocellular function. We define hepatic encephalopathy under 5.05F as a recurrent or chronic neuropsychiatric disorder, characterized by abnormal behavior, cognitive dysfunction, altered state of consciousness, and ultimately coma and death. The diagnosis is established by changes in mental status associated with fleeting neurological signs, including “flapping tremor” (asterixis), characteristic electroencephalographic (EEG) abnormalities, or abnormal laboratory values that indicate loss of synthetic liver function. We will not purchase the EEG testing described in 5.05F3b; however, if you have had this test at a time relevant to your claim, we will make every reasonable effort to obtain the report for the purpose of establishing whether your impairment meets 5.05F. b. Acute encephalopathy. We will not evaluate your acute encephalopathy under 5.05F if it results from conditions other than chronic liver disease, such as vascular events and neoplastic diseases. We will evaluate these other causes of acute encephalopathy under the appropriate body system listings.
11. End stage liver disease (ESLD) documented by scores from the SSA Chronic Liver Disease (SSA CLD) calculation (5.05G).
12. Liver transplantation (5.09) may be performed for metabolic liver disease, progressive liver failure, life-threatening complications of liver disease, hepatic malignancy, and acute fulminant hepatitis (viral, drug-induced, or toxin-induced). We will consider you to be disabled for 1 year from the date of the transplantation. Thereafter, we will evaluate your residual impairment(s) by considering the adequacy of post-transplant liver function, the requirement for post-transplant antiviral therapy, the frequency and severity of rejection episodes, comorbid complications, and all adverse treatment effects.
Chronic liver disease, with: A. Hemorrhaging from esophageal, gastric, or ectopic varices or from portal hypertensive gastropathy, demonstrated by endoscopy, x-ray, or other appropriate medically acceptable imaging, resulting in hemodynamic instability as defined in 5.00D5, and requiring hospitalization for transfusion of at least 2 units of blood. Consider under a disability for 1 year following the last documented transfusion; thereafter, evaluate the residual impairment(s). OR B. Ascites or hydrothorax not attributable to other causes, despite continuing treatment as prescribed, present on at least two evaluations at least 60 days apart within a consecutive 6-month period. Each evaluation must be documented by: 1. Paracentesis or thoracentesis; or 2. Appropriate medically acceptable imaging or physical examination and one of the following: a. Serum albumin of 3.0 g/dL or less; or b. International Normalized Ratio (INR) of at least 1.5. OR C. Spontaneous bacterial peritonitis with peritoneal fluid containing an absolute neutrophil count of at least 250 cells/mm3. OR D. Hepatorenal syndrome as described in 5.00D8, with one of the following: 1. Serum creatinine elevation of at least 2 mg/dL; or 2. Oliguria with 24-hour urine output less than 500 mL; or 3. Sodium retention with urine sodium less than 10 mEq per liter. OR E. Hepatopulmonary syndrome as described in 5.00D9, with: 1. Arterial oxygenation (PaO2) on room air of: a. 60 mm Hg or less, at test sites less than 3000 feet above sea level, or b. 55 mm Hg or less, at test sites from 3000 to 6000 feet, or c. 50 mm Hg or less, at test sites above 6000 feet; or 2. Documentation of intrapulmonary arteriovenous shunting by contrast-enhanced echocardiography or macroaggregated albumin lung perfusion scan. OR F. Hepatic encephalopathy as described in 5.00D10, with 1 and either 2 or 3: 1. Documentation of abnormal behavior, cognitive dysfunction, changes in mental status, or altered state of consciousness (for example, confusion, delirium, stupor, or coma), present on at least two evaluations at least 60 days apart within a consecutive 6-month period; and 2. History of transjugular intrahepatic portosystemic shunt (TIPS) or any surgical portosystemic shunt; or 3. One of the following occurring on at least two evaluations at least 60 days apart within the same consecutive 6-month period as in F1: a. Asterixis or other fluctuating physical neurological abnormalities; or b. Electroencephalogram (EEG) demonstrating triphasic slow wave activity; or c. Serum albumin of 3.0 g/dL or less; or d. International Normalized Ratio (INR) of 1.5 or greater. OR G. End stage liver disease with SSA CLD scores of 22 or greater ).
poverty guidelines
2007 POVERTY LEVEL GUIDELINES
ALL STATES (EXCEPT ALASKA AND HAWAII) AND D.C.
Income Guidelines as Published in the Federal Register on January 24, 2007
ANNUAL GUIDELINES
-------------------------------
FAMILY PERCENT OF POVERTY
SIZE 100% 120% 133% 135% 150% 175% 185% 200% 250%
------ --------- --------- --------- --------- --------- --------- --------- --------- ---------
1 10,210.00 12,252.00 13,579.30 13,783.50 15,315.00 17,867.50 18,888.50 20,420.00 25,525.00
2 13,690.00 16,428.00 18,207.70 18,481.50 20,535.00 23,957.50 25,326.50 27,380.00 34,225.00
3 17,170.00 20,604.00 22,836.10 23,179.50 25,755.00 30,047.50 31,764.50 34,340.00 42,925.00
4 20,650.00 24,780.00 27,464.50 27,877.50 30,975.00 36,137.50 38,202.50 41,300.00 51,625.00
5 24,130.00 28,956.00 32,092.90 32,575.50 36,195.00 42,227.50 44,640.50 48,260.00 60,325.00
6 27,610.00 33,132.00 36,721.30 37,273.50 41,415.00 48,317.50 51,078.50 55,220.00 69,025.00
7 31,090.00 37,308.00 41,349.70 41,971.50 46,635.00 54,407.50 57,516.50 62,180.00 77,725.00
8 34,570.00 41,484.00 45,978.10 46,669.50 51,855.00 60,497.50 63,954.50 69,140.00 86,425.00
For family units of more than 8 members, add $3,480 for each additional member.
MONTHLY GUIDELINES
---------------------------------
FAMILY PERCENT OF POVERTY
SIZE 100% 120% 133% 135% 150% 175% 185% 200% 250%
------ -------- -------- -------- -------- -------- -------- -------- -------- --------
1 850.83 1,021.00 1,131.61 1,148.63 1,276.25 1,488.96 1,574.04 1,701.67 2,127.08
2 1,140.83 1,369.00 1,517.31 1,540.13 1,711.25 1,996.46 2,110.54 2,281.67 2,852.08
3 1,430.83 1,717.00 1,903.01 1,931.63 2,146.25 2,503.96 2,647.04 2,861.67 3,577.08
4 1,720.83 2,065.00 2,288.71 2,323.13 2,581.25 3,011.46 3,183.54 3,441.67 4,302.08
5 2,010.83 2,413.00 2,674.41 2,714.63 3,016.25 3,518.96 3,720.04 4,021.67 5,027.08
6 2,300.83 2,761.00 3,060.11 3,106.13 3,451.25 4,026.46 4,256.54 4,601.67 5,752.08
7 2,590.83 3,109.00 3,445.81 3,497.63 3,886.25 4,533.96 4,793.04 5,181.67 6,477.08
8 2,880.83 3,457.00 3,831.51 3,889.13 4,321.25 5,041.46 5,329.54 5,761.67 7,202.08
this guideline was a direct copy from the Medicaid Eligibility homepage.
ALL STATES (EXCEPT ALASKA AND HAWAII) AND D.C.
Income Guidelines as Published in the Federal Register on January 24, 2007
ANNUAL GUIDELINES
-------------------------------
FAMILY PERCENT OF POVERTY
SIZE 100% 120% 133% 135% 150% 175% 185% 200% 250%
------ --------- --------- --------- --------- --------- --------- --------- --------- ---------
1 10,210.00 12,252.00 13,579.30 13,783.50 15,315.00 17,867.50 18,888.50 20,420.00 25,525.00
2 13,690.00 16,428.00 18,207.70 18,481.50 20,535.00 23,957.50 25,326.50 27,380.00 34,225.00
3 17,170.00 20,604.00 22,836.10 23,179.50 25,755.00 30,047.50 31,764.50 34,340.00 42,925.00
4 20,650.00 24,780.00 27,464.50 27,877.50 30,975.00 36,137.50 38,202.50 41,300.00 51,625.00
5 24,130.00 28,956.00 32,092.90 32,575.50 36,195.00 42,227.50 44,640.50 48,260.00 60,325.00
6 27,610.00 33,132.00 36,721.30 37,273.50 41,415.00 48,317.50 51,078.50 55,220.00 69,025.00
7 31,090.00 37,308.00 41,349.70 41,971.50 46,635.00 54,407.50 57,516.50 62,180.00 77,725.00
8 34,570.00 41,484.00 45,978.10 46,669.50 51,855.00 60,497.50 63,954.50 69,140.00 86,425.00
For family units of more than 8 members, add $3,480 for each additional member.
MONTHLY GUIDELINES
---------------------------------
FAMILY PERCENT OF POVERTY
SIZE 100% 120% 133% 135% 150% 175% 185% 200% 250%
------ -------- -------- -------- -------- -------- -------- -------- -------- --------
1 850.83 1,021.00 1,131.61 1,148.63 1,276.25 1,488.96 1,574.04 1,701.67 2,127.08
2 1,140.83 1,369.00 1,517.31 1,540.13 1,711.25 1,996.46 2,110.54 2,281.67 2,852.08
3 1,430.83 1,717.00 1,903.01 1,931.63 2,146.25 2,503.96 2,647.04 2,861.67 3,577.08
4 1,720.83 2,065.00 2,288.71 2,323.13 2,581.25 3,011.46 3,183.54 3,441.67 4,302.08
5 2,010.83 2,413.00 2,674.41 2,714.63 3,016.25 3,518.96 3,720.04 4,021.67 5,027.08
6 2,300.83 2,761.00 3,060.11 3,106.13 3,451.25 4,026.46 4,256.54 4,601.67 5,752.08
7 2,590.83 3,109.00 3,445.81 3,497.63 3,886.25 4,533.96 4,793.04 5,181.67 6,477.08
8 2,880.83 3,457.00 3,831.51 3,889.13 4,321.25 5,041.46 5,329.54 5,761.67 7,202.08
this guideline was a direct copy from the Medicaid Eligibility homepage.
Another "Qualifing" Catagory
The option to have a "medically needy" program allows states to extend Medicaid eligibility to additional qualified persons who may have too much income to qualify under the mandatory or optional categorically needy groups. This option allows them to "spend down" to Medicaid eligibility by incurring medical and/or remedial care expenses to offset their excess income, thereby reducing it to a level below the maximum allowed by that State's Medicaid plan. States may also allow families to establish eligibility as medically needy by paying monthly premiums to the State in an amount equal to the difference between family income (reduced by unpaid expenses, if any, incurred for medical care in previous months) and the income eligibility standard.
Eligibility for the medically needy program does not have to be as extensive as the categorically needy program. However, States which elect to include the medically needy under their plans are required to include certain children under age 18 and pregnant women who, except for income and resources, would be eligible as categorically needy. They may choose to provide coverage to other medically needy persons: aged, blind, and/or disabled persons; certain relatives of children deprived of parental support and care; and certain other financially eligible children up to age 21. In 1995, there were 40 medically needy programs which provided at least some services to recipients.
Eligibility for the medically needy program does not have to be as extensive as the categorically needy program. However, States which elect to include the medically needy under their plans are required to include certain children under age 18 and pregnant women who, except for income and resources, would be eligible as categorically needy. They may choose to provide coverage to other medically needy persons: aged, blind, and/or disabled persons; certain relatives of children deprived of parental support and care; and certain other financially eligible children up to age 21. In 1995, there were 40 medically needy programs which provided at least some services to recipients.
who is "supposedly" eligable
Pregnant Women
Apply as soon as you think you might be pregnant. You may be eligible if you are married or single. If you are on Medicaid when your child is born, both you and your child will be covered. The general income eligiability rules do not apply here, but as i can tell with my research. You qualify if you do NOT have medical insurance coverage.
Children and Teenagers
Apply for Medicaid if you are the parent or guardian of a child who is 18 years old or younger and your family's income is limited, or if your child is sick enough to need nursing home care, but could stay home with good quality care at home. If you are a teenager living on your own, the state may allow you to apply for Medicaid on your own behalf or any adult may apply for you. Many states also cover children up to age 21.
Person who is Aged, Blind, and/or Disabled
Apply if you are aged (65 years old or older), blind, or disabled and have limited income and resources. Apply if you are terminally ill and want to get hospice services, if you are aged, blind, or disabled; live in a nursing home; and have limited income and resources or if you are aged, blind, or disabled and need nursing home care, but can stay at home with special community care services. Apply if you are eligible for Medicare and have limited income and resources.
Other Situations
Apply if you are leaving welfare and need health coverage. Apply if you are a family with children under age 18 and have limited income and resources. (You do not need to be receiving a welfare check.) Apply if you have very high medical bills, which you cannot pay (and you are pregnant, under age 18 or over age 65, blind, or disabled).
Children and Teenagers
Apply for Medicaid if you are the parent or guardian of a child who is 18 years old or younger and your family's income is limited, or if your child is sick enough to need nursing home care, but could stay home with good quality care at home. If you are a teenager living on your own, the state may allow you to apply for Medicaid on your own behalf or any adult may apply for you. Many states also cover children up to age 21.
Person who is Aged, Blind, and/or Disabled
Apply if you are aged (65 years old or older), blind, or disabled and have limited income and resources. Apply if you are terminally ill and want to get hospice services, if you are aged, blind, or disabled; live in a nursing home; and have limited income and resources or if you are aged, blind, or disabled and need nursing home care, but can stay at home with special community care services. Apply if you are eligible for Medicare and have limited income and resources.
Other Situations
Apply if you are leaving welfare and need health coverage. Apply if you are a family with children under age 18 and have limited income and resources. (You do not need to be receiving a welfare check.) Apply if you have very high medical bills, which you cannot pay (and you are pregnant, under age 18 or over age 65, blind, or disabled).
The answer is in the above statement, apply if you have very high medical bills, which you cannot pay.... this is us, but still no were do they mention that if you are married--you need not apply---
Where We Stand
Chris and I have even went to the next level of calling our State Senator Ben Chandler, he has activitly responded, but his answer is i will have to look into the matter and see what i can do. Again, here we go...and wait.....
medicaid, and its coverage and who it is suppose to help.
Medicaid is health insurance that helps people who can't afford medical care and it will pay for some or all of their medical bills. Supposedly, If you can't afford to pay for medical care, Medicaid can make it possible for you to get the care that you need. Medicaid is available only to people with limited income. This is what the Medicaid website stated, but my personally experience, i have learned that this is not true. !! You must meet certain requirements in order to be eligible for Medicaid. Medicaid does not pay money to you; instead, it sends payments directly to your doctors or hospital. Depending on your state's rules, you may also be asked to pay a small part of the cost (called a co payment) for some medical services.
Many groups of people are covered by Medicaid. Even within these groups, though, certain requirements must be met. These may include your age, whether you are pregnant, disabled, blind, or aged; your income and resources (like bank accounts, real property, or other items that can be sold for cash); and whether you are a U.S. citizen or a lawfully admitted immigrant. The rules for counting your income and resources vary from state to state and from group to group. There are special rules for those who live in nursing homes and for disabled children living at home.
Your child may be eligible for coverage if he or she is a U.S. citizen or a lawfully admitted immigrant, even if you are not (however, there is a 5-year limit that applies to lawful permanent residents). Eligibility for children is based on the child's status, not the parent's. Also, if someone else's child lives with you, the child may be eligible even if you are not because your income and resources will not count for the child.
In general, you should apply for Medicaid if your income is limited and you match one of the descriptions of the Eligibility Groups. (Even if you are not sure whether you qualify, if you or someone in your family needs health care, you should apply for Medicaid and have a qualified caseworker in your state evaluate your situation.)
When Eligibility Starts Coverage may back pay to any or all of the three months prior to application, if the individual would have been eligible during the retroactive period. Coverage generally stops at the end of the month in which a person's circumstances change. Most states have additional "state-only" programs to provide medical assistance for specified people with limited incomes and resources who do not qualify for the Medicaid program. No Federal funds are provided for state-only programs.
What is Not Covered, Medicaid does not provide medical assistance for all people with limited incomes and resources. The Medicaid program does not provide health care services for everyone. You must qualify for Medicaid. Low-income is only one test for Medicaid eligibility; assets and resources are also tested against established thresholds. As noted earlier, Medically needy persons who would be categorically eligible. I also found that each individaual county can "bend" the rules to suite the people they think deserve help, this should not be allowed. A large majority of Hispanics have coverage and according the the guidelines I mentioned above, they should not be eligable. This is crazy!! I think the working, person down on their luck or even have medical proof of their illness should be able to receive Medicaid.
Many groups of people are covered by Medicaid. Even within these groups, though, certain requirements must be met. These may include your age, whether you are pregnant, disabled, blind, or aged; your income and resources (like bank accounts, real property, or other items that can be sold for cash); and whether you are a U.S. citizen or a lawfully admitted immigrant. The rules for counting your income and resources vary from state to state and from group to group. There are special rules for those who live in nursing homes and for disabled children living at home.
Your child may be eligible for coverage if he or she is a U.S. citizen or a lawfully admitted immigrant, even if you are not (however, there is a 5-year limit that applies to lawful permanent residents). Eligibility for children is based on the child's status, not the parent's. Also, if someone else's child lives with you, the child may be eligible even if you are not because your income and resources will not count for the child.
In general, you should apply for Medicaid if your income is limited and you match one of the descriptions of the Eligibility Groups. (Even if you are not sure whether you qualify, if you or someone in your family needs health care, you should apply for Medicaid and have a qualified caseworker in your state evaluate your situation.)
When Eligibility Starts Coverage may back pay to any or all of the three months prior to application, if the individual would have been eligible during the retroactive period. Coverage generally stops at the end of the month in which a person's circumstances change. Most states have additional "state-only" programs to provide medical assistance for specified people with limited incomes and resources who do not qualify for the Medicaid program. No Federal funds are provided for state-only programs.
What is Not Covered, Medicaid does not provide medical assistance for all people with limited incomes and resources. The Medicaid program does not provide health care services for everyone. You must qualify for Medicaid. Low-income is only one test for Medicaid eligibility; assets and resources are also tested against established thresholds. As noted earlier, Medically needy persons who would be categorically eligible. I also found that each individaual county can "bend" the rules to suite the people they think deserve help, this should not be allowed. A large majority of Hispanics have coverage and according the the guidelines I mentioned above, they should not be eligable. This is crazy!! I think the working, person down on their luck or even have medical proof of their illness should be able to receive Medicaid.
Wednesday, February 20, 2008
disability and how everyone in the family suffers
why does it take so long to get approved for disability? why is it that the average white caucasion , worked everyday since he was 17, NOT be approved for medical assistance (medicaid) when he comes down with a illness that has no cure. Not to mention, an illness that could have been prevented had the government mandated testing of blood before a transfusion back in the 1960's.
My name is Chris and i received one pint of blood in 1966, at the age of 3 months old. Today at the age of 42, i have severe liver damage and kidney failure due to a disease i contracted in 1966. I have worked all my life, starting as a junior in high school and working up until August 2006, when my illness took over my life. In Feb. 1995, i was diagnosed with Hepatitis C, and have successfully treated Hep C, with medication, until 2007 when my spouses insurance company Bluegrass Family Health of Kentucky, decided it knew more about my health then my doctors did, chose to NOT pay for the Hep. C treatment any longer. The medication, at 3 shots a week, and 6 pills a day was costing an estimated whopper amount of $2800.00 per month. The insurance decided they would no longer pay for this medicine, they stated they did not see any improvement in my health with this treatments, however, they failed to see that my body was steadily fighting the disease and keeping all my bodily functions in tact (ex.liver and kidneys were function, no sign of vasculititis, no swelling and I still worked everyday) The medication was keeping the Hep C in remission. You know like Cancer, a good place to be.
Today I have been fighting the Government for my disability due to my illness. I have been unable to work for the past 18 months, suffered a great financial lost and now trying just to stay above the ground the government doesnt think i qualify for my disabilty. I can no longer support my family, i have suffered great muscle loss, in and out of the hospital, see 3 different speciality doctors, on the average of 4 appointments per month, each doctor and i cannot get disability. What is this all about. I kinda-sorta in a way could look at the government being responsible for my illness, no regualtions on blood transfusions. Today, my wife cannot even donate blood, because of ME ....... but still no disability.
Well, now its mine turn, Paula the wife of 18 years. I have been by Chris' side thru hospital stay, after stay, dr visit after dr visit, even having to learn to give my husband injections not to mention having to do his own personal hygene care because he is not able. And we ask for Medicaid (medical assistance) and were told we did not qualify because "we were a family". You darn right we are a family and we plan to stay that way. When we took our vows April 14, 1990, we stated not to part even during sickness, and poorness, well we have had our share of both. But we refuse to become another number in the divorce statistic. All the assistance we ask for was to pick up the balance our regular health insurance did not cover, what 20% , but "we are a family" so we dont qualify for help. What does it take to make the governement see that both me and my husband and both our parents have worked and payed taxes all our lives and when, born and raised American cannot get help. Somethings just not right here!!
My name is Chris and i received one pint of blood in 1966, at the age of 3 months old. Today at the age of 42, i have severe liver damage and kidney failure due to a disease i contracted in 1966. I have worked all my life, starting as a junior in high school and working up until August 2006, when my illness took over my life. In Feb. 1995, i was diagnosed with Hepatitis C, and have successfully treated Hep C, with medication, until 2007 when my spouses insurance company Bluegrass Family Health of Kentucky, decided it knew more about my health then my doctors did, chose to NOT pay for the Hep. C treatment any longer. The medication, at 3 shots a week, and 6 pills a day was costing an estimated whopper amount of $2800.00 per month. The insurance decided they would no longer pay for this medicine, they stated they did not see any improvement in my health with this treatments, however, they failed to see that my body was steadily fighting the disease and keeping all my bodily functions in tact (ex.liver and kidneys were function, no sign of vasculititis, no swelling and I still worked everyday) The medication was keeping the Hep C in remission. You know like Cancer, a good place to be.
Today I have been fighting the Government for my disability due to my illness. I have been unable to work for the past 18 months, suffered a great financial lost and now trying just to stay above the ground the government doesnt think i qualify for my disabilty. I can no longer support my family, i have suffered great muscle loss, in and out of the hospital, see 3 different speciality doctors, on the average of 4 appointments per month, each doctor and i cannot get disability. What is this all about. I kinda-sorta in a way could look at the government being responsible for my illness, no regualtions on blood transfusions. Today, my wife cannot even donate blood, because of ME ....... but still no disability.
Well, now its mine turn, Paula the wife of 18 years. I have been by Chris' side thru hospital stay, after stay, dr visit after dr visit, even having to learn to give my husband injections not to mention having to do his own personal hygene care because he is not able. And we ask for Medicaid (medical assistance) and were told we did not qualify because "we were a family". You darn right we are a family and we plan to stay that way. When we took our vows April 14, 1990, we stated not to part even during sickness, and poorness, well we have had our share of both. But we refuse to become another number in the divorce statistic. All the assistance we ask for was to pick up the balance our regular health insurance did not cover, what 20% , but "we are a family" so we dont qualify for help. What does it take to make the governement see that both me and my husband and both our parents have worked and payed taxes all our lives and when, born and raised American cannot get help. Somethings just not right here!!
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