When you or someone you care about has suffered a disabling Traumatic Brain Injury (TBI) the financial implications are great. The victim may be the breadwinner for a household or a child whose parents must find ways to pay therapeutic treatment to help the child grow to be a self-sufficient individual. That’s why it is important for families to understand the benefits available to them when TBI results in long-term or permanent disability.
Social Security is more than a retirement fund. It also protects individuals and their dependents from losing income from the death or disability of a family breadwinner. To qualify for benefits, there must be a minimum number of credits earned, based upon many factors.
The Social Security Administration (SSA) sends a yearly summary of benefits that will indicate how much income has been reported. You may also order a free copy of the report by calling the SSA at 800-772-1213.
The disabled may secure two types of federal benefits. The first, Social Security Disability Insurance Benefits (SSD), is paid to the disabled worker and family for reduction or loss of wages. SSD is only payable on disabilities lasting 12 months or longer. The second benefit is Supplemental Security Income (SSI), consisting of payments are monthly to disabled persons with limited income and assets. Any benefits paid to the disabled under Workers Compensation (WC) will reduce the amount paid by the SSA.
The process of securing SSD and SSI benefits is filled with hurdles and barriers. The SSA must secure complete medical records and documentation of disability. Expect the SSA to order an Independent Medical Evaluation (IME) to verify the disability. Denials are common and individuals must be ready to appeal, especially in the case of a catastrophic injury. There are procedures to follow when applying for benefits, appealing a decision and trying to move a claim forward faster when someone has suffered catastrophic TBI.
Medicare and Medicaid
Medicare provides federal health benefits for those on SSD for 24 months or longer. Enrollment is automatic in the 25th month of SSD. Part A coverage is free, but individuals must pay for Part B, often as a deduction from the monthly disability check. Medicare coverage is vital but may not be enough for the severely disabled. Medicaid benefits will help in such situations.
Medicaid is administered by the federal and state governments, but enrollment is not automatic. Those enrolled can receive care from doctors who participate in the program. Medicaid will cover regular skilled nursing home care and home health care.
Many states offer services through the Department or Office of Vocational for disabled adults and children age 17 or older. The disabled may receive therapeutic help and be retrained for jobs that they can perform with their particular disabilities.
The emotional strain TBI puts on families is great enough. If you believe the TBI injury affecting your family was the fault of another, contact our office so we may help you recover compensation to pay for the necessities related to TBI.