The Medicare Disability advantage has two major drawbacks. First, if a doctor determines that a
patient qualifies for the program, an electronic payment is made immediately to the patient’s
account. In the case of missed claims, the waiting time begins over again. This benefit can be
complicated for patients and their family members. Second, if a doctor wrongly denies a claim to
eligibility or any other related claim, this could be a disadvantage. There are many errors that
could occur in processing disability claims.
According to the Frankston NDIS and Insurance Information Institute (MPII), there are at most 20
technical denials and non-response cases for the major US health insurance programs. These
include “filing multiple claim for the same condition”, differentiating between similar procedures,
using improper codes, or requesting benefits that are not available. These and other technical
denials are likely to play a significant role in determining if individuals or families can reapply for
benefits in the coming enrollment season.
Technical denials may occur regardless of whether a physician or program administrator
correctly determines the patient is eligible. This could be due, among other things, to incorrect
data entry or incomplete documentation, insufficient information, or fraudulent claims. States
must notify the Fair Credit Reporting Act that certain actions that could lead to denial of benefits
may be considered fraudulent under the FCRA. If an application has been delayed, the applicant
must appeal within 30 calendar days. However, appeals must be made within the original filing
period.
Individuals who want to have their Social Security Disability benefits reconsidered should contact
the Department of Health and Human Services’ reconsideration team. Each month, the
reconsideration section receives reconsideration requests from a different number. In some
cases, the reconsideration process is complete. In others, additional action may need to be
taken in order for the reconsideration process to be completed. In general, the more time it takes
for a request to be processed at the higher chances that the applicant will be denied benefits.
Individuals and their families need to check the status of their applications on a daily basis in
order to stay informed and ensure that they don’t lose benefits while they wait for a response.
A wide range of conditions and problems can cause disability. Poor health, in addition to other
physical conditions, can have a negative impact on a person’s Social Security Disability benefits.
Many individuals are faced with hardships that prevent them working, earning income or
maintaining employment. Additional to financial issues, medical problems can also affect an
individual’s eligibility.
A poor medical record may be a factor in your disability. This includes any past health issues
that have gotten worse. Chronic illnesses such as diabetes, heart disease, hypertension, and
obesity may negatively affect a person’s eligibility for disability benefits. Chronic conditions such
as diabetes, HIV/AIDS or asthma, along with epilepsy, are also serious. Other issues that may
negatively impact eligibility include drug or alcohol addiction and fetal alcohol syndrome.
Other factors that could impact eligibility include poor medical records, substance abuse, and
disability. Poor medical records can result from medical conditions that developed after an
application was submitted. Substance abuse and disabilities are considered if an applicant has a
history involving drug abuse or other substance use disorders. Social Security Disability benefits
could be negatively affected by substance abuse and disability.
Disability can impact the ability of an applicant to keep employment, increase their risk for living
alone, and cause additional stress. It can even play a part in a couple’s divorce or separation.
Disablity can affect people of all ages, races, and social backgrounds. There are many different
issues that can lead to disablity, and each case is unique
