Medicare: Modifying Coverage for Type 2 Diabetes Surgery

Bariatric surgery, also known as weight-loss surgery, involves various surgical procedures of the gastrointestinal tract to decrease nutrient absorption and intake, such as stomach stapling and reducing the stomach size. This type of surgery is oftentimes used for those who are severely obese. Up until recently, Medicare covered bariatric surgery for those with Type 2 diabetes. Now Medicare has announced that they will only be covering the surgery for those with Type 2 diabetes if they have a body mass index (BMI) of 35 and over; a BMI of 40 and over is regarded as morbidly obese.

The following article talks about Medicare ’s decision not to cover bariatric surgery for those with a BMI under 35 and speaks with Medicare spokesman Don McLeod. The article also discusses the reasons for the agency’s decision, the cost of the surgery, and speaks about various studies and trials that have been held over the last year involving those who are morbidly obese.

Medicare Likely to Drop Coverage of Surgery for Combating Diabetes




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Do You Qualify For SSDI Benefits from SSA? (Social Security Disability Insurance)

If you are about to undertake the process of applying for Social Security disability insurance (SSDI) there are a few things to know in advance about whether or not you qualify. There are certain requirements that must be met to be awarded disability benefits. Since the process is so in-depth and can be quite lengthy, it helps to know in advance if you can potentially qualify for disability before you begin the process. Being awarded benefits can take as little as 3 to 4 months, and can possibly take up to 6 months, a year or even longer than a year in some cases.

Here are some qualifying factors for SSDI that you should take into account before applying:

1) You must have a physical or mental medical condition that prevents you from working. This must be proved by medical documentation that outlines exactly how you are disabled and the limitations that apply. There are exceptions to this rule. If you have an ability to work, you must not make more than $860 per month. If you make more than $860 per month you will not be qualified for SSDI.

2) Your medical condition must be expected to result in death or it must have already lasted, or be expected to last, for over a year. If the condition will not result in death and cannot be expected to definitely last for at least a year, you will not be qualified for SSDI.

3) In addition to having a medical condition which prevents you from working and is expected to result in death or last for at least a year, you must have also paid social security payroll taxes. If you have not paid these taxes over a specific period of time, you may not be insured and may not qualify for SSDI.

4) While you may not be able to engage your previous work due to your disability, you also must not be able to engage in any work you have held over the last 15 years, or any other type of work that is available to you. When determining what type of work you may be able to do the Social Security administration takes your past experience, skill set, age and education level into account. If there is another type of work you are qualified for and can do regardless of your disability, you may not be qualified for SSDI.

5) One last thing to consider is whether or not your disability is listed in the SSA’s list of disabling impairments. If your disability is listed you may be automatically disabled. If you disability is not listed, do not give up hope; Social Security may decide that you disability is equal to an impairment on the list.




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Social Security Disability Benefits Resource Center

Finally – Disability Benefits!

There are many people waiting patiently in the backlog of Social Security disability claims. While it can take as little as 3-4 months to get an approval for some claims, others take a year, 2 years, or even more. For some, that can turn into a very long appeal process that leaves them without money for food, bills, medicines and housing. In Indiana alone it was estimated that over 65 percent of the people who filed an initial claim in 2007 were denied.

The following article tells the story of one woman in Indiana, Shelia Dorrel, who finally got her Social Security disability benefits. According to the article Sheila Dorrel had been trying to receive her benefits for almost three years, while barely surviving using food stamps, monetary help from her daughters, and a hardship public housing waiver. The article speaks with Ms. Dorrel and her daughters about the long waiting time and their excitement over the unexpected that finally granted her benefits.


Unexpected Call, Disability Benefits Granted



For information on Social Security Disability, visit the

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Social Security and Compassionate Allowances

The Social Security Administration (SSA) has finally become compassionate to those who are waiting unduly long periods to receive their rightful disability benefits. They have just announced their new ‘Compassionate Allowances’ program that will hopefully get the SSA in a position to process disability claims for those with severe illnesses much quicker.

The program, which is one element in a two-part initiative, will be working hand-in-hand with the Quick Disability Determination process. This may allow the SSA to make claim determinations on severe cancers and rare illnesses in only a few days, as opposed to months and sometimes years. The SSA has released an initial list of 50 impairments that will be receiving a quick decision, without long wait times, disablity hearings and disability appeals.

This educational article explains the initiative, speaks with Social Security Commissioner Michael J. Astrue about this new process, and offers a link to the 50 impairments that will be covered under the ‘Compassionate Allowances’ program.

Social Security Announces Nationwide Launch of Compassionate Allowances


For information on Social Security Disability, visit the

Social Security Disability Benefits Resource Center

How Do You Win An SSI or Social Security Disability Hearing?

Many think there is some secret way to win an SSI hearing, however there is no secret way. Frankly, you can win your SSI hearing by being thoroughly prepared for your hearing before the administrative law judge. Now you may be asking yourself, how can I be thoroughly prepared to win my SSI hearing?

You can prepare yourself for your social security disability or SSI hearing by obtaining a Social Security disability representative. Individuals who retain a Social Security representative are more likely to win their SSI or social security disability hearing than those who attempt to represent themselves (national statistics indicate individual’s who have representative win more disability hearings) at their SSI hearing. Social Security representatives are familiar with Social Security disability rules and guidelines; consequently they are able to present the facts of your disability claim in a way that is more favorable you.

Additionally, your Social Security representative will obtain any current medical records, physician statements, or any other information that may aid in winning your social security disability or SSI hearing.

Other than obtaining a Social Security representative, what can you do to win your social security disability or SSI hearing? You should show up at your hearing on time, since most administrative law judges have little patience for tardiness. Also, you should wear appropriate attire for your social security disability or SSI hearing, dress as you would for any other important court appearance. Lastly, be prepared to answer questions about your disabling condition or conditions, and how the limitations imposed by your condition have prevented you from performing routine daily activities including work activities.

For the most part, your social security disability or SSI hearing will be your best chance to win disability benefits. Administrative law judges have more leeway in making their disability determinations than state disability agencies. You should do all that you can to improve your chances of winning your hearing. If you follow the above mentioned tips, you may dramatically improve the likelihood of winning your SSI hearing.



For information on Social Security Disability, visit the

Social Security Disability Benefits Resource Center

Social Security Disabled Benefits

The social security administration (SSA) considers individuals to be disabled if they can demonstrate through solid medical documentation (medical records) that they have a severe impairment which prevents them from participating in substantial gainful activity (SGA), and that this condition is expected to last for at least 12 months.

What does it mean to be unable to “participate in substantial gainful activity”? It means that you are unable to earn a minimum amount each month (the 2009 SGA amount is $980 and was $940 in 2008, but is recalculated by the SSA annually to account for inflation, cost of living increases, etc.).

If your medical records show that you have a severe impairment that prevents you from earning the SGA, then you may qualify for disability. However, this is if and only if you can prove that your impairment prevents you from performing not only your current job, but any other work for which you may be qualified for disability.

As you can probably guess, it’s the “any other work” clause that prevents most claimants from being approved for disability benefits. “Any other work” includes any type of work that you have done in the past 15 years (what social security calls the “relevant period” of employment); however, it also includes any job that the disability examiner thinks you are qualified to perform, given your past work history, job skills, age, education, and of course your current physical or mental limitations.

The fact that social security is required by law to take a claimant’s age and educational background into consideration before suggesting other types of employment does ensure some measure of fairness. After all, it’s just common sense that companies are less likely to hire older workers due to insurance costs, earlier retirement from the company, etc., and few would argue that those who have more education generally have more job opportunities. It’s also important to note that a disability examiner is not allowed to suggest types of work that are not supported by the information on your residual functional capacity (RFC) form. The RFC spells out exactly what types of activities a person can and cannot due as a result of their impairment, so even if you are young, educated, and have mastered certain job skills in the past, an examiner cannot recommend any type of employment that includes duties your RFC says you are incapable of performing.

Unfortunately, it is still entirely possible that you will get denied for disability because the examiner says you are able to perform a job that is not even available in your area, which is why if your claim gets turned down it is best to get legal representation and appeal the decision to an administrative judge—sometimes it takes an attorney pointing out the obvious to a disability judge (e.g., there are no publishing jobs in Paris, Texas) before a deserving claimant will be declared disabled and finally begin to see some financial relief.





For information on Social Security Disability, visit the

Social Security Disability Benefits Resource Center