Why doesn't Social Security Disability provide automatic medical care when SSI does?

Why do you automatically get medical care on SSI but not disability? Don't you need it just as much if not more if you are disabled?

For those who are unaware, I will first say that individuals who are approved for title 16 SSI disability benefits will get medicaid benefits. SSI is a need-based program that takes into account a person's assets and income. In essence, it is a poverty program and that is why medicaid is involved.

A person who is approved for title II disability benefits, i.e. Social Security Disability benefits, will receive medicare, but not necessarily immediately. There is a two year waiting period that may (or may not) affect when a person may begin to receive medicare coverage. It depends on how far back a person's established date of onset is, and when they first applied for disability benefits.

Suffice it to say, because the application and appeal process can literally go on for years, some individuals who are approved for SSD will have already "served out" the 2 year waiting period and will not actually have to go through the wait for medicare. For some individuals who are approved for SSD, there will be a lengthy wait (ironically, this will tend to the case for individuals who get approved fairly soon after they file an initial claim, without having to go through the appeal process).

But, to answer your question, Yes you do need it just as much. Unfortunately, it is just the way Congress set Social Security Disability up so many years ago. They set up a two year wait for Medicare coverage which is counted from the month you are first eligible to receive a disability payment. They also set up a five month waiting period that essentially confiscates an approved individual's first five months of benefit checks.

I have often wondered why it was ever set up that way. It seems very unfair. Unfortunately, there are few in Congress these days who seem to act as real advocates for individuals who have significant and limiting medical impairments that affect them on a daily basis.

About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here.

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