To Straydog, about ssdi in Texas

My daughter Jazzi has a congential heart condition had open heart at 12 day old (Aortic Stenosis), lives up in North Texas and works a part time job and I would like to know if she could qualify for SSDI in the state of Texas.She is 25yrs old right now and for ssdi I was told the age had to be 18 yrs in Texas, is that right?
This is totally for her because she could use medical care once she turn age 26 and I'm not sure she can afford anything on her part time work....She turns 26 in March of 2017.

Hey Char, one of the requirements for SSD is you have to pay in so many quarters which comes out to having worked a little over 10 years. Obviously because of her young age this would not make her eligible. Also, when people are awarded SSD benefits its 24 months before we can get our Medicare benefits. The Medicare is not given immediately. An example, back when I applied for SSD they notified me 6 months later I was approved. It was another 18 months after that before I was eligible for Medicare.

Why is she losing whatever insurance coverage she has when she turns 26 next year? I know she recently married, does the husband not have the option of putting her on his insurance? For whatever reason I thought she was teaching fulltime.

The other thing is her dr would have to say she is totally disabled from performing any type of employment. This would have to come from her cardiologist. Her only option I can think of that she can check on is SSI which is different from SSD. Since she is now married, her husband's income is taken into consideration & could knock her out of receiving that. Even for SSI you have to be unable to do any type of work. Off hand, I do not remember the amount they allow a spouse to make, I know its not much. She can check on this & read about it online at SSA.gov.

Something else for her to consider since she is working part time is seeing if she is eligible for Medicaid.

Take care.

Char, I just went into SSA.gov & clicked on Disability Benefits. There is a chart there that lists the age brackets & years worked paying into Medicare, she may be able to file for SSD. If Jazzi decides to go this route have her go to their website & it explains everything from their definition of disability to filing a claim.

But keep in mind before she can apply she cannot be working & must have a cardiologist say she it totally disabled from performing any type of work, not just teaching. The reason I said a cardiologist is a PCP's opinion would not carry much weight. Although she was born with the heart defect, SSD will not take much of that into consideration, they will be looking at current medical records & testing. Has she been advised by her drs to not work at all? Has her medical status changed in the past year that would prevent her from doing any type of work?

Keep in mind in all probability it takes close to 2 years to get through SSD's system. Her chances are not good at getting awarded benefits immediately. Secondly, if your thoughts are her doing this in order to get Medicare benefits those do not kick in immediately. They also look at a person's age & education also in making a determination. Because of her age they will look at her teaching job as a sedentary position that does not include strenuous physical activity. Another factor is they look to see if a person can be retrained into another line of employment that would fit with their limitations. She has a degree, they can come back & say based on her education she could be retrained for something different.

In some instances people can also get SSI if they qualify & get SSD at the same time. It's determined by the monthly amount they get from SSD. An an example, my sister got SSI for 4 months before she was awarded SSD. When SSD kicked in she lost her SSI because of the amount of her monthly SSD benefit. SSA can tell Jazzi if she would qualify for SSI. SSI works completely different than SSD, but you still have to be disabled to be eligible.

If she decides to keep working & get private insurance on her own, she needs to coordinate this & not let her current insurance through you all expire. She will need to provide a letter stating she has credible coverage which should be available to print out from their website. Also, if her hubby is working part time, they may not offer health insurance to a part time employee. If they do the premiums will be high. All insurance is sky high these days. Another option with both working as they are now, they may be eligible for Medicaid. Medicaid does not have an age limit. I know people my age that have Medicaid. Not every dr accepts Medicaid & its the same with Medicare, not all drs accept it.

Out of curiosity, of course you don't have to answer. But, if I remember correctly the kids live just north of me, not far at all. Where they are is not a big city, why have they not ever considered working in Ft. Worth? The job opportunities in Ft. Worth are much greater than where they are. People commute to Ft. Worth & live where they do because the job market is so much greater & the pay scale is much more. In Ft. Worth we have so many different school districts that hire all of the time. Where they are now the job market will always be somewhat limited. My theory on working was to go where the best working opportunities were at & pay & benefits. I always told my kids this & fortunately they both went into fields that would support them & at retirement.

I get the feeling your main concern is of her losing health insurance next year & I understand that. However, filing for SSD or even SSI is not going to be the quick solution you are looking for her. Unless she has had some drastic change in her health she will be in for a long tough fight. I am really not picking up on that from you at all.

Again, keep in mind she could probably be qualified for Medicaid & again, there is no age limit to be eligible. A phone call or even going online she could find that out. I understand what you were told in Michigan, but that was probably based on her being 100% disabled as an adult too, which she is not since she is working.

I hope I have helped a little. Take care.

Char, in all honesty unless she were to have something severe to happen with her health, God forbid, her odds of SSD are not too great without a specialist deeming her totally disabled. From what you are describing she is not there.

The main thing for her is if she is wanting private health insurance, she needs to not let her coverage she is under now expire because if she were to do that, then she could be hit with pre-existing clauses for a certain period.

Medicaid can be an option for her but again not all drs accept Medicaid & they are limited on scripts per month. But, at the same time its better than nothing.

I was thinking they were living in Denton. I know all about the construction out here, its awful. But they had no choice but to build new highways they had no idea that this area was going to grow like it has the past 20 yrs. Traffic became a gridlock going north or south on I35.

I would suggest that Jazzi send her resume out to all of the school districts including the mid-cities. As I said earlier, we have a lot of different school districts here because its such a large metroplex. I would be surprised if she didn't snag a position because there is always so many positions open because of the size of the area. More & more schools are being built to accommodate the need. What grade does she teach?

Take care.

It looks like the Republican controlled Congress has their sights set on repealing the Affordable Care Act (ObamaCare) as a first agenda item in the early weeks of Jan-17.

It looks like repeal will take place without a replacement plan.

Very uncertain times for the many who will be affected, myself included.

Although I do not receive a federal subsidy, I do have a medical insurance plan through the exchange and depend on the ACA's provision on pre-existing conditions.
- Karen -

Hey, Straydog, stay safe you might get ice on the roads on Saturday, stay home, please stay safe...We've already sent pre cautions to Jazzi...North Texas might have icy conditions. We will be at 34. But anything North of us is expected to go under 30...

Your daughter will have to prove she is not able to perform SGA working any jobs in the national economy in order to be approved for SSDI and/or SSI. With SSI there is also income and resource criteria. SSI is welfare and considered government assistance so her income has to be low. If she is single she is not allowed to have more than $2,000 in resouces. If she is married, her husbands income will count against the SSI. It is unusual for someone to receive SSI when they have a spouse that is working or when they have other income. The medical criteria is the same for SSI and SSDI.

If she is eligible for SSDI with the few work credits she has due to her age and it is not more than $736 a month in 2017 and she meets the SSI financial criteria for SSI, she can receive SSDI and SSI for a total of $726 a month.

There is a 5 month waiting period for SSDI. If someone meets the financial criteria for SSI, they can receive SSI for those 5 months.

Medicaid comes with SSI and Medicare comes with SSDI. Medicare is far better than Medicaid. When someone is low income and they receive Medicare or if they receive SSDI and SSI, they are eligible for Medicaid to pay their Medicare Premiums, co/pays and deductibles. This is called Medicare Savings Program.

With her age and her still being able to work, it will be extremely difficult if not impossible for her to be approved.

SSDI and SSI are both Federal Programs and are the same in all 50 states.

My body is still in shock with the drastic temperature changes last night. It was in the high 70's and within a few hours last night it was in the low 30's.

Post Edited (Mercy&Grace) : 12/18/2016 11:17:09 PM (GMT-7)