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Applying for Social Security Disability with Hepatitis C

Tuesday, October 15th, 2013

Severe forms of Hepatitis C can make it hard for you to continue working. Fortunately, disability benefits from the Social Security Administration (SSA) are available to provide financial relief.

Hep C qualifies you medically for disability benefits, as long as your medical records meet the listing for the condition in the SSA’s Blue Book and you meet the financial eligibility requirements to receive Social Security Disability (SSD) as well.

Qualifying Financially for Disability

The SSA has two disability programs for which you may qualify with Hep C and both have financial criteria you must meet.

  • Social Security Disability Insurance (SSDI) – you must have worked and paid into the SSDI program through Social Security taxes (FICA), and have built up sufficient work credits. You must additionally have an income below what the SSA considers substantial gainful activity (SGA), which for 2013 is set at $1,040 per month.  For more information on the necessary credits to qualify for SSDI, visit: http://www.disability-benefits-help.org/ssdi/qualify-for-ssdi
  • Supplemental Security Income (SSI) – you must have very limited income and other financial resources or assets. SSI is a need-based program and has very strict financial threshold limits for qualification. Fore more information on asset and income limits fro SSI visit: http://www.disability-benefits-help.org/ssi/qualify-for-ssi

 

Qualifying Medically with Hepatitis C

While Hep C can automatically qualify you for SSD benefits, you must have more than a diagnosis to meet the SSA’s evidentiary requirements. Through your application and medical records, you must show:

  • Your symptoms are severe enough to prevent gainful employment,

And/OR

  •  the effects of your treatments also limit your ability to work and earn a living.

To prove the severity level of your Hep C in order to qualify for disability benefits, you must meet the listing in the SSA’s Blue Book (http://www.ssa.gov/disability/professionals/bluebook/). That listing appears under Section 5.05 and requires one of the following is well documented in your medical records:

  • Gastrointestinal hemorrhaging requiring blood transfusions
  • Chronic development of fluid around the lungs or in the abdomen
  • Recurrent bacterial infections and fluid in the abdomen
  • Kidney failure resulting from cirrhosis
  • Hepatopulmary syndrome
  • Encephalopathy
  • End stage liver failure

Applying for Benefits

You can complete your application in person at your local SSA office or via the SSA’s website (http://www.socialsecurity.gov/pgm/disability.htm), which is usually the faster method for submitting a claim.  If you apply in person, you will need to schedule an appointment. Online applications can be completed at any time.

You should receive a decision on your claim within three to six months. Unfortunately, more than 60% of Initial claims are denied. If your claim is among the denied you will have to file a request for reconsideration with 60 days of receiving your denial notice.

If your reconsideration is denied as well, you will have to request to have a disability hearing with an administrative law judge (ALJ). At the hearing you will be able to present evidence and arguments as to why you need disability benefits. It is in your best interest to hire a disability attorney or advocate who is familiar with the hearing process prior to attending your hearing.

 

Article by Ram Meyyappan
Social Security Disability Help
Feel free to forward any questions related to Hepatitis C and Social Security Disability to ram@ssd-help.org.

American Liver Foundation Financial Resources Guide

Wednesday, January 11th, 2012

Having trouble with health care costs? Here’s a guide that may help you:

http://go.liverfoundation.org/site/DocServer/financial_resources.pdf?docID=5522

Financial Support for Hep C Patients Available through Patient Advocate Foundation

Wednesday, August 31st, 2011

Additional support for patient co-pays for breast cancer, colon cancer and hep C is offered through Patient Advocate Foundation. “For more information about PAF, visit www.patientadvocate.org or call toll free (800) 532-5274. For more information about PAF’s Co-Pay Relief Program visit www.copays.org or call toll free (866) 512-3861.”

http://www.prnewswire.com/news-releases/patient-advocate-foundation-announces-additional-support-for-patient-co-pay-relief-program-serving-breast-cancer-colon-cancer-hepatitis-c-patients-128178718.html

 

Financial Aid for Hep C Treatment

Friday, August 12th, 2011

Financial aid for Victrelis is available through Merck   here

Financial aid for Incivek is available through Vertex  here

Get financial aid for either Victrelis or Incivek through BioPlus.

Read more

Increase Eligibility for Hep C Treatment

Thursday, August 4th, 2011

This study shows that a patient can increase eligibility to receive HCV treatment if enrolled in a counseling and drug treatment program.

Read more

Medco Helps Patients Stick to Treatment Protocol

Thursday, July 7th, 2011

Supposedly Medco is helping patients shave $13K  off their HCV treatment costs by identifying which patients can complete treatment in 24 weeks instead of 48, but this is the timetable that most patients should be able to follow with the new treatments (Incivek and Victrelis).  What is of note here though is that Medco is keeping in touch with patients more and improving their adherence to protocol and thereby increasing their chances of success.

http://www.drugstorenews.com/article/accredo-helps-hepatitis-c-patients-save-13k?utm_source=GoogleNews&utm_medium=Syndication&utm_campaign=ManualSitemap

Physicians Prefer Incivek Over Victrelis

Saturday, July 2nd, 2011

According to a report by the U.S. Physicians and Payer Forum, a majority of physicians will prescribe Incivek than Victrelis because of higher sustained virologic response rates (SVR) for treatment naive patients. However, only 47% of surveyed managed care organizations (MCO’s) planned to reimburse Incivek-based therapy for treatment naive patients. They are more likely to reimburse Incivek-based therapy for nonresponders. MCO’s are also more likely to reimburse Victrelis-based therapy for nonresponders than for treatment naive patients.

http://www.businesswire.com/news/home/20110630005161/en/Two-Thirds-Surveyed-U.S.-Clinicians-Plan-Prescribe-Incivek

Thank You President Obama

Tuesday, March 22nd, 2011

PRESS RELEASE
February 14, 2011
For Immediate Release
Contact:
Martha Saly
mbsaly@nvhr.org
www.NVHR.org

NVHR: Administration’s 2012 Budget Proposal Represents ‘Sea Change’
Budget Proposal Calls for $5 Million Increase

For State-based Surveillance, Screening & Treatment Programs

In National Response to Viral Hepatitis Epidemic

Washington, DC-The Administration’s 2012 budget proposal to increase federal funding for expanded state and locally based viral hepatitis surveillance, screening, and treatment by more than $5 million heralds a sea change in our nation’s national strategy to respond to the viral hepatitis epidemic, the National Viral Hepatitis Roundtable (NVHR) said today.

“On behalf of more than 6 million Americans afflicted with viral hepatitis B and C, NVHR would like to say, ‘Thank you, Mr. President,” said NVHR Director Martha Saly. “With this budget proposal of $25 million, the Administration has recognized that early intervention and prevention are the cornerstones of an effective national viral hepatitis strategy. In the coming months, NVHR looks forward to working closely with the Administration and Members of Congress from both sides of the aisle to make this proposal reality.”

More than 6 million Americans are estimated to be afflicted with viral hepatitis and three-quarters of them don’t know it. Most infected individuals only become aware of their disease after it has progressed to liver failure, cirrhosis, or liver cancer. With the vast majority of liver cancers caused by unchecked viral hepatitis, the Administration’s increased funding proposal for early intervention and treatment promises to help reduce the incidence of liver cancer as well.

The Administration’s budget proposal on viral hepatitis specifically states:

“CDC’s FY 2012 request of $25,000,000 for VH reflects an increase of $5,222,000 above the FY 2010 level. With this increase, CDC will expand and strengthen surveillance capacity in 10 high burden state and local health departments to detect VH transmission, monitor health disparities and implementation and impact of recommended prevention services; develop and execute VH awareness and training programs for public health and clinical care professionals to implement and scale-up VH screening and care referral; and enhance work with global partners to implement VH surveillance and prevention programs in high burden countries.”

The Administration’s budget proposal is the first of many new expected developments on viral hepatitis in 2011. Next month, the US Department of Health & Human Services is expected to unveil a national strategy for the prevention of viral hepatitis and liver cancer. On Capitol Hill, bipartisan legislation that garnered support from over 70 House Members in the 111th Congress is expected to be introduced again. And this summer, two new drug therapies are expected to receive final approval from the Food & Drug Administration (FDA) that will great enhance hepatitis C treatment.

From Sue’s blog at: http://www.hcvstinks.blogspot.com/

Grants Available for HCV Treatment for Patients Co-infected with HIV/HCV

Saturday, November 20th, 2010

If you’ve got both HIV and HCV there may be hope for treatment assistance with a new $1.6 million grant from HRSA (Health  Resources and Service  Administration). And, interesting to note, this article puts the death rate from HCV in the U.S. at 17,000. The last figure I saw was 12,000 from HCV and 16,000 from AIDS. If this 17,000 figure is correct, HCV has now surpassed  AIDS in deaths in the U.S. Comments?

http://www.prnewswire.com/news-releases/hrsa-awards-16-million-to-improve-availability-and-expansion-of-hepatitis-c-hcv-treatment-109299264.html

Funding for Medicare Transplant Patients in Arizona to End Oct. 1st

Saturday, September 25th, 2010

Dear FAIR Foundation members whose focus disease is hepatitis C, lung, pancreas, heart or intestinal illness,

In a shocking display of discrimination against certain resident patients, the State of Arizona’s state funded Medicare program is ceasing funding for many transplant patients listed in the attached chart, including those with hepatitis C and certain pancreas, lung, heart and intestinal illness patients. The state refers to its budgetary problems and says limiting this transplant coverage could save the state $4 million a year. $4 million? Arizona spends $2.7 billion on illegal immigrants ($694.8 million from health care services, [including transplant], $1.6 billion from Arizona’s education system, $339.7 million in law enforcement and court costs, $85.5 million in welfare costs and $155.4 million in other general costs) yet they are denying coverage to legal residents to save $4 million? An absurd, infectious state of affairs, pun intended. Make no mistake, Arizona is just the first State to do this and after implementation of these funding restrictions, the door will be wide open for other states to follow suit. With the major cause of liver transplant being hepatitis C, which will be denied, many patients will die and the financial impact to liver transplant centers would be immense—I suspect some will eventually have to close as well as lung tx programs.

I urge you to take immediate action on this issue and to think outside of the box as to how you can recommend a reversal of this policy, which begins on 10/01/10. Perhaps communicating personally with the AZ Governor’s office (on the web at http://azgovernor.gov/contact.asp. Phone 602-542-4331, by letter to The Honorable Jan Brewer, Governor of Arizona, 1700 West Washington, Phoenix, Arizona 85007) to request a reversal, use calls/letters/emails to UNOS, ALF, NVHR, the Intestinal Transplant Association. American Lung Assoc., AHA, American Pancreatic Association, VA representatives (especially for Vietnam vets), affected pharma companies, Herb K. Schultz, Regional Director U.S. Department of Health and Human Services, Region IX, (415) 437-8502 – Direct Number, (415) 265-7049 – Cell Phone herb.schultz@hhs.gov, etc. with requests that those organizations become proactively involved in various ways, including issuing strong press releases against this policy to bring national attention to this disgusting “rationing of care” that is about to have a birth in the transplant community.

This link is the story on a HCV patient in Arizona who will die due to the State’s cessation of transplant coverage: http://www.myfoxphoenix.com/dpp/health/arizona-ahcccs-coverage-changes-9-1-2010

Details on the state’s legislation that removes coverage, from which the attached chart was taken: www.azahcccs.gov/reporting/legislation/sessions/2010/BenefitChanges.aspx

$2.7 billion AZ expense on illegal immigrants: http://www.foxnews.com/us/2010/05/17/immigration-costs-rising-rapidlty-new-study-says/

Please forward this to your fellow patients, friends and associates so that they may be aware and join in this effort to reverse this outrageous discriminatory practice and stop it from spreading to the other 49 states.


Sincerely,


Dr. Richard Darling, DDS
FAIR President & CEO

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