Denied SSDI because of income

TSgt Twitch

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Your automatically enrolled but can deny

let me know more on this, because as I understand the tricare rules if you qualify for medicare you have to enroll in a/b and tricare becomes the final payer. if there is some legal way to keep tricare for family and I only and not loose money to MC, I wanna learn about it.
 

moneyblind

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let me know more on this, because as I understand the tricare rules if you qualify for medicare you have to enroll in a/b and tricare becomes the final payer. if there is some legal way to keep tricare for family and I only and not loose money to MC, I wanna learn about it.

Ditto
 

gsfowler

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let me know more on this, because as I understand the tricare rules if you qualify for medicare you have to enroll in a/b and tricare becomes the final payer. if there is some legal way to keep tricare for family and I only and not loose money to MC, I wanna learn about it.

Tricare for Life is the insurance you must elect if you are eligible for Medicare Part A&B. With Tricare for Life, Medicare is the primary payer and Tricare is secondary.

Here is the cost matrix breakdown:
http://www.tricare.mil/~/media/Files/TRICARE/Publications/PubsNotOnPubsPage/TFL_Cost_Matrix.pdf
 

TSgt Twitch

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Tricare for Life is the insurance you must elect if you are eligible for Medicare Part A&B. With Tricare for Life, Medicare is the primary payer and Tricare is secondary.

Here is the cost matrix breakdown:
http://www.tricare.mil/~/media/Files/TRICARE/Publications/PubsNotOnPubsPage/TFL_Cost_Matrix.pdf

before i read the matrix etc.

My understanding of it, is yes I could elect out of medicare A/B, but just being eligible for A, means I have to have it and B. and if I am eligible for B and do not elect to take it, the premium would increase by 10% per year, making it very very expensive if I need B before 65.

( say I get better in 5 years at age 40, go back to work for 22 years and decide I am beyond done because i will have all reayd had at least 1 revision on my fake right hip and my left hip replaced and decide to take early SS at 62, my premium for B would be in essence 50-80% higher for those 3 years just because medicare eligibility stays in place for like a decade even if SSDI is stopped).
 

Warrior644

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Wait wait wait; If i get approved for SSDI, I am forced to use medicaid? WTF, I would be forced to switch my current PCM... I love my PCM and my tricare....

Hmm, for clarification of information only, it's Medicare. No worries, I was previously doing the same thing too! ;)

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer."

Best Wishes!
 

Warrior644

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In my circumstance I was approved late Sep 2012, my first benefits payment was in Nov 2012 (partial month pay for September) and my first regular months payment was Dec 2012. Mid-Dec I received my back pay (Jan 2010-Aug 2012).

Of the back pay 25% was withheld for payments to my SSDI lawyer and if there were any potential overpayments.

Here we are in Mar 2014 and I should be getting the amount withheld paid to me pretty soon (within a week or two).

My dependents also had 25% of their award withheld and it was deposited to them last week.

This us how my own case has broken down, I do not quite understand why or how they have not paid my attorney for 18 months since my decision was awarded, but since it is not coming out of my pocket I never had thought about it.

Indeed, only imagine the SSDI attorney's payment process prior to the SSA mandating the automatic withholding of SSDI 25% maximum fee payment to a SSDI attorney for favorable "disabled" SSA SSDI determinations? ;)

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer."

Best Wishes![/QUOTE]
 
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Combat Eng

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TRICARE beneficiaries who have Medicare Part A, must have Medicare Part B to remain TRICARE-eligible. The only exceptions are if:

  • Your sponsor is on active duty
  • You're enrolled in the US Family Health Plan
  • You're covered by TRICARE Reserve Select
  • You're covered by TRICARE Retired Reserve
 

gsfowler

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before i read the matrix etc.

My understanding of it, is yes I could elect out of medicare A/B, but just being eligible for A, means I have to have it and B. and if I am eligible for B and do not elect to take it, the premium would increase by 10% per year, making it very very expensive if I need B before 65.

( say I get better in 5 years at age 40, go back to work for 22 years and decide I am beyond done because i will have all reayd had at least 1 revision on my fake right hip and my left hip replaced and decide to take early SS at 62, my premium for B would be in essence 50-80% higher for those 3 years just because medicare eligibility stays in place for like a decade even if SSDI is stopped).
When I was awarded SSDI, I was automatically enrolled in Medicare part A and part B (I think you become eligible for part B after being on SSDI for 24 months. Part B is paid for out of the monthly award amount.

Since I was receiving Tricare while on active duty and there was no end sight near, I elected to cancel my part B (there was no need for it, and in addition it is semi-against the rules in the CBWTU to seek healthcare outside of Tricare (so they can keep tabs)).

Nevertheless now that I am in my 90 day countdown, I am going to need to re-enroll in Medicare Part B once I am eligible.

One of the cool things about Medicare is that all if the mainstream HMO/PPO want the Medicare dollars and are willing to enroll you in their plan at no additional cost.

Unfortunately Medicare is only for the disabled person and does not apply to the rest of your family unless they are otherwise eligible.
 

Combat Eng

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I think one has to sit back and think is what I'm paying for part B out of my monthly SSDI, does it average the same what one will pay as co-pay by just having Tricare. But of course everyone is different and has many appointments throughout the month all year so having Medicare as a primary and Tricare covering out of pocket is a plus

Some don't use Tricare at all because they just use the VA or just use Tricare for the medication VA doesn't offer. Like for myself VA doesn't offer Lunesta so i use Tricare to cover the majority of that med

Or some don't live close to a VAMC so they have no other choice, but then take in the fact that VAMC reimburses you for travel
 

Dickie G

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Indeed, only imagine the SSDI attorney's payment process prior to the SSA mandating the automatic withholding of SSDI 25% maximum fee payment to a SSDI attorney for favorable "disabled" SSA SSDI determinations? ;)

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer."

Best Wishes!
[/QUOTE]
Just got a call from the individual who will decide me case. I have a appointment at a shrink on the 20th. I asked him of this is the last thing I need to get my approval and he said yes. Hopefully this is the last thing and I am done.
 

Warrior644

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Just got a call from the individual who will decide me case. I have a appointment at a shrink on the 20th. I asked him of this is the last thing I need to get my approval and he said yes. Hopefully this is the last thing and I am done.

Ah, yes; this is good news in my opinion! ;)

Why? Because your assigned State DDS SSA SSDI disability examiner is definitely performing their assigned duties properly by giving you the fullest opportunity to obtain the "disabled" SSA SSDI determination with the mental health examination.

In retrospect, the results of my SSA SSDI mental health examination was the primary determining medical impairment for a favorable "disabled" SSDI determination with all of the physical limitations as secondary medical impairments.

Indeed, upon receipt of the SSA mental health consultant's report after 20 March 2014, a SSDI final decision shall definitely be forthcoming to you for sure!

From my experiences with the SSA SSDI process, I believe that a tentative SSDI decision has already been assigned, but it can't be finalized until receipt of the official results of your forthcoming mental health examination!

To that extent, indeed, the end is almost near for sure! :cool:

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer."

Best Wishes!
 

Dickie G

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Ah, yes; this is good news in my opinion! ;)

Why? Because your assigned State DDS SSA SSDI disability examiner is definitely performing their assigned duties properly by giving you the fullest opportunity to obtain the "disabled" SSA SSDI determination with the mental health examination.

In retrospect, the results of my SSA SSDI mental health examination was the primary determining medical impairment for a favorable "disabled" SSDI determination with all of the physical limitations as secondary medical impairments.

Indeed, upon receipt of the SSA mental health consultant's report after 20 March 2014, a SSDI final decision shall definitely be forthcoming to you for sure!

From my experiences with the SSA SSDI process, I believe that a tentative SSDI decision has already been assigned, but it can't be finalized until receipt of the official results of your forthcoming mental health examination!

To that extent, indeed, the end is almost near for sure! :cool:

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer."

Best Wishes!
I hope this is the last thing I need to do. I hate seeing these kinds of Dr's. Is there any insite to this exam? Not really sure what to expect. I am going to bring my narsum and VA findings, hope this will help my case.
 

Warrior644

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I hope this is the last thing I need to do. I hate seeing these kinds of Dr's. Is there any insite to this exam? Not really sure what to expect. I am going to bring my narsum and VA findings, hope this will help my case.

Indeed, I totally comprehend your anxiety and mental health examination reluctance at this point in time in reference to the SSA SSDI process albeit please continue to remain focus and positively proactive! :)

From my experiences with the SSA SSDI process, I recall my wife assembling all of my prescription medications in which were hand carried to the SSA sponsored mental health examination; maybe you should do the same in my opinion in addition to the MEB NARSUM + DoVA disability findings documentation.

For me, more specifically in reference to the SSA consultant mental health examination, an Interpretive Report of Wechsler Adult Intelligence Scale - Fourth Edition (WAIS-IV) test was performed due to my constant complains about memory loss and loss of consciousness concerns.

As such, the WAIS-IV test revealed a clear function on a severely regressed level as compared to significantly higher previous levels of cognitive functioning. My SSA consultant was simply great throughout the entire mental health examination albeit please remember that his/her observation of you begins upon their visual confirmation.

Naturally, be honest and sincere with your verbal responses when asked questions by the SSA consultant mental health examiner. At least for me, I know it was a challenge to express my medical conditions symptomatology to a total stranger but I would offer to highly concentrate on the overall objective to receive the "disabled" SSA SSDI determination for sure!

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer."

Best Wishes!
 

Dickie G

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Indeed, I totally comprehend your anxiety and mental health examination reluctance at this point in time in reference to the SSA SSDI process albeit please continue to remain focus and positively proactive! :)

From my experiences with the SSA SSDI process, I recall my wife assembling all of my prescription medications in which were hand carried to the SSA sponsored mental health examination; maybe you should do the same in my opinion in addition to the MEB NARSUM + DoVA disability findings documentation.

For me, more specifically in reference to the SSA consultant mental health examination, an Interpretive Report of Wechsler Adult Intelligence Scale - Fourth Edition (WAIS-IV) test was performed due to my constant complains about memory loss and loss of consciousness concerns.

As such, the WAIS-IV test revealed a clear function on a severely regressed level as compared to significantly higher previous levels of cognitive functioning. My SSA consultant was simply great throughout the entire mental health examination albeit please remember that his/her observation of you begins upon their visual confirmation.

Naturally, be honest and sincere with your verbal responses when asked questions by the SSA consultant mental health examiner. At least for me, I know it was a challenge to express my medical conditions symptomatology to a total stranger but I would offer to highly concentrate on the overall objective to receive the "disabled" SSA SSDI determination for sure!

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer."

Best Wishes!
As always you are giving sound advice and perspective. Much respect
 

Warrior644

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As always you are giving sound advice and perspective. Much respect

Thanks, it's truly well-appreciative to hear for sure! ;) To that extent, you shall do just fine! :)

As such, please remain focus and continue to be positively proactive then victory shall be achieved at the end of the day in my opinion! :cool:

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer."

Best Wishes!
 

Weapons loader

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Quick question to see if anyone can answer, I received a second questionnaire in the mail since the start of my case for SSDI, this one came from Salt Lake City. My initial claim was filed in Anchorage AK, so it seems to me that my claim has moved along down the line. Did anyone else have this happen and is there any significance to it? This one was asking about daily tasks and how well/ difficult they are to accomplish. Thanks

-Shawn
 

Warrior644

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Quick question to see if anyone can answer, I received a second questionnaire in the mail since the start of my case for SSDI, this one came from Salt Lake City. My initial claim was filed in Anchorage AK, so it seems to me that my claim has moved along down the line. Did anyone else have this happen and is there any significance to it? This one was asking about daily tasks and how well/ difficult they are to accomplish. Thanks

-Shawn

Indeed, no worries; you are definitely progressing through the SSA SSDI application process in my opinion. :)

In retrospect, the SSA's State DDS function is to perform an evaluation of medical disability (i.e., claimant is found disabled or not disabled under SSA rules) only for the SSA SSDI case if it meets all regulatory SSA SSDI qualifications.

To that extent, if all SSDI qualifications are validated by the SSA Field Office, then SSA Field Office forwards the SSDI case file to the applicable State DDS.

That said, it seems that your assigned State DDS case examiner witnessed that the SSDI case file was missing the "daily tasks and how well/difficult they are to accomplish" functional questionnaire. Therefore, it's an important document during the evaluation for a medical disability under SSA rules.

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer."

Best Wishes!
 
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