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Public Assistance Claims

 

Potomac Legal Aid Society’s (Potomac) Public Benefits Program assists eligible clients with the denial; reduction; suspension; or termination of:

    • Temporary Assistance For Needy Families (TANF);
    • Medicaid;
    • Food Stamps;
    • Supplemental Security Income (SSI); and
    • Social Security Disability Income (SSDI).

TANF benefits are paid to support low-income families with children. A person or family can receive a maximum of 60 months of TANF. Eligibility for TANF is dependent upon the number of people in the household and the family’s earned and unearned income. There is a work requirement for some recipients of TANF. Exceptions to the work requirement include: persons over 65 years of age and disabled persons. Persons illegally in the United States are not eligible for TANF. A child born in the United States, however, is eligible for these benefits. For guidelines and full eligibility requirement see http://www.dss.virginia.gov/benefit/tanf/ 

Medicare provides medical coverage for persons 65 years and older and persons receiving Social Security retirement. Coverage is also for persons of any age who are disabled and have obtained the require quarters (credits) for work. (See below) People are also covered who are on dialysis and/or kidney transplants for end stage renal failure. For complete information see http://www.hhs.gov/faq/medicaremedicaid/653.html

Food Stamps Food stamp funds depend on a household’s earned income plus unearned income minus the household’s expenses for child care, rent/mortgage, and utilities. For families with a person 60 years or older, or disabled, there is a deduction for all medical expenses over $35. per month. ////There is a work requirement for the Food Stamp Program. As with the TANF work requirement program, there are exemptions. For complete information regarding eligibility see http://www.fns.usda.gov/fsp/applicant_recipients/eligibility.htm

Social Security Disability (SSDI) is the disability income based on the amount of Federal Insurance Contributions Act (FICA) taxes deducted from an employee’s pay over the years. SSDI eligibility requires the recipient to show, by medical evidence, that she/he is no longer able to perform any job in the national economy due to their impairment(s).  The applicant must have worked and have at least 40 quarters of coverage (this is equal to roughly 10 years of steady employment). A quarter of the coverage is based on a certain amount of income; for example, for 2009 a quarter of coverage equals $1,090. Only 4 quarters can be earned per year. You can work while receiving SSDI, but your income must fall below certain limits. If your income exceeds the limits set each year by the Social Security Administration (SSA), SSDI payments may be terminated. However, there is no limit on the amount or source of unearned income (non-wage). You could, for example, inherit millions of dollars and still retain your SSDI benefits. SSA also provides benefits to divorced, disabled and surviving spouses and children. Review  the web site www.ssa.gov for a complete description of all the SSA programs and benefits available.

Supplemental Security Income (SSI) is the equivalent of a Federal Welfare Program. SSI is administered by the Social Security Administration. It is paid, not on one’s earnings, but directly out of the budgeted general revenue of the federal government. The SSI program assists blind, disabled and elderly persons who have not paid into the SSDI program. It supplements SSDI payments that do not reach the 75% level of the Federal Poverty level for each year, and whose resources do not exceed $2,000 for one person, or $3,000 for two persons. SSI is also paid to disabled children of families with limited incomes. You can work while receiving SSI, but your income—all income over $65. per month will result in a reduction in your monthly SSI check. See www.ssa.gov for complete information regarding SSI.

Your Right to Appeal

The above programs permit you to appeal if your benefits are:

    • denied,
    • reduced,
    • suspended; or
    • terminated.

You are also entitled to a written notice of action from the agency prior to the agency’s denial, reduction, suspension, or termination of benefits. The TANF, and Medicaid programs allow you 30 days from the date of the written notice to make your appeal. Those appeals are called “a request for a fair hearing”.

The Food Stamp program 90 days to request a fair hearing.

The SSDI, SSI programs allow 60 days from the date of the notice of action to appeal. The SSDI/SSI programs offer several layers of appeal. The first is called a “Request for Reconsideration” and the second, a request for a “Hearing With An Administrative Law Judge”.

In all the programs discussed, if you appeal within 10 days of receipt of notice of action, generally your benefits will continue while waiting for the hearing. There are only a few exceptions to this rule.

Eligible applicants, who believe that their benefits were unjustly reduced, suspended, or terminated, or without proper prior notice; can contact Potomac for advice and counsel and options for proceeding.

 

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