Ohio Medicaid expansion aids Balin Law clients

Earlier this year, Ohio Governor John Kasich expanded Medicaid eligibility for all state residents, adding to several existing financial assistance programs Balin Law clients can apply for while waiting for a ruling on their case.

Prior to the Medicaid expansion, Medicaid eligibility was provided to those with minor children or those found “disabled” by the Ohio Department of Job and Family Services. With the expansion Medicaid is now provided to individuals with income below 140% of the federal poverty guidelines. In signing up for the expanded Medicaid program, applicants have to mark whether or not they are “disabled.” If they mark no, a determination is made strictly upon financial eligibility. And if they mark yes, their application is processed through the existing Department of Job and Family Services program.

Balin Law associate attorney Matt Shupe called the expansion a positive, one that's brought a lot of Balin’s clients off the streets – with a catch. “The definition of ‘disabled’ is wide ranging to say the least,” Shupe said. “The Social Security Administration, Americans with Disabilities Act, and Bureau of Workers Compensation all have different definitions of ‘disabled.’ What ‘disabled’ means under the Ohio Medicaid expansion remains unclear and this lack of clarity makes it difficult to advise clients as to what Medicaid program to apply for.”

Even though so many programs share the same or similar requirements, qualifying for both state and federal programs isn't always easy. A lot of times, judges don't give deference to other agency findings. “They'll rule the findings of other government agencies are not controlling on their court,” said Balin litigation attorney Andrew November. “So many of these programs don't allow a basic narrative to articulate how an individual met the Social Security disability definition and how that was applied to the medical and objective findings.”

Shupe, November and the entire Balin team have extensive experience navigating these cross-court deliberations, serving as staunch advocates for their clients. 

SSI candidates turn to Balin Law, MetroHealth for help

We understand people sometimes find themselves in difficult situations – financially, physically, emotionally or otherwise. It’s our privilege to advocate for them. People who are disabled and have limited resources but not enough of a work history to qualify for Social Security Disability Insurance (SSDI) may qualify for Supplemental Security Income (SSI). The Social Security Administration site is a great resource for SSI information, like this SSI overview page and this page on resources the administration considers when applying for SSI.

 “If you have too much in assets, you don’t qualify for this program which is an additional hurdle,” said Andrew November, associate attorney at Balin Law. “With SSDI, you just have to be disabled.” Some assets, like the home you live in or the land it’s on, grants, and personal effects aren’t counted as a resource, but items like cash, stocks, or “deemed resources” are taken into account during the approval process. “There’s a ‘deeming chart’ that’s used,” said November. “The SSA uses mathematical formulas based on the size of the house and the source of the income for children and from spouse-to-spouse.”

Separate from the assets portion of a case is a client’s access to medical care. “It’s always a large concern,” associate attorney Matthew Shupe said of Balin’s clients. “That involves a lot of education from our staff and attorneys regarding what our clients’ options are for subsidized or free physical and mental healthcare in their area, be that through Medicaid or a financial means-based charity program through various hospital systems in the area.”

With the expansion of Medicaid in Ohio only occurring in January 2013, many of Balin’s clients have turned to the MetroHealth System for health care. “This is the only treatment option for a lot of people,” November said. MetroHealth’s financial assistance program helps patients pay for health care costs, while their shuttle service allows patients to be transported to and from various MetroHealth locations.“ Having limited resources means limited access to medical care,” November said. It doesn’t mean you have limited access to us. Balin Law is here to help – click here for our contact information and call today.

MetroHealth Phone Numbers

Transportation Service - 216-778-5258
Financial Assistance - 216-957-2325
Switchboard - 216-778-7800

For a complete list of MetroHealth contact information, click here.

Partnerships with VA, healthcare providers and veteran facilities critical to Balin's success

Over the past several years, Balin Law owner Paulette Balin presented at various healthcare providers and veteran facilities, ensuring the firm works closely with nurse practitioners, case workers and veterans themselves to build critical relationships that better serve clients and their cases.

“It’s so satisfying to see these health care providers that treat our clients so engaged and interested in what we do in the same way we’re so indebted to veterans and their services,” said Matt Shupe, associate attorney at Balin. “It’s crystal clear how committed they are to their patients.”

Shupe and his team share the same commitment to clients, using every tool at their disposal and exhausting every resource to hopefully earn a win on their clients’ behalf.

“Over-prepare for everything,” Shupe said of Balin’s winning strategy. “Spend more time than it takes. You need to know the case better than the client, the judge and, any experts combined. If you can convey that that is your level of knowledge, it builds confidence in yourself and in the client, too.”

With veteran disability cases, Balin’s attorneys also seek out narrative statements from an individuals’ treating physician citing any physical limitations that support the clients’ claim and the physicians’ own treatment notes.”

Even with all those tools, representation for disabled veterans is newer territory.

When Andrew November, a litigation attorney at Balin, started at the firm in 2009 he found very few attorneys in the state of Ohio even represented veterans.

“The backlog and volume for these veterans to get representation was incredibly frustrating,” November said. “Using our experience as disability attorneys, we thought it would be a natural transition to start representing veterans.”

The VA hasn’t had the high level of development that programs like Social Security have, making partnerships between firms and the VA challenging. This is largely attributed to most employees’ inexperience working with attorneys and the sheer amount of cases they're asked to address daily.

“The VA regional office in Cleveland Ohio handles all claims for the state of Ohio,” November said.“Compare that to the abundance of Social Security offices that are used to breaking up the case load, working with attorneys and supplying documents to us.”

Still, Balin hasn’t let the challenges in working with the VA dissuade them from working to build a meaningful and collaborative partnership.

“What our firm decided to do was learn as much as we can about the law now,” November said. “If we continue to make ourselves known to the VA, we can be better known for representing our country’s veterans on a larger scale."