Balin attorneys use "congressional interest" to aid clients

While the federal government offers multiple programs for disability compensation, bureaucracy can be a challenging obstacle to overcome when awaiting a decision on a case. In these situations, any time a constituent feels like they’re getting a raw deal, they can contact their congressperson and have a pending case marked as one of “congressional interest.”

When a case is flagged with “congressional interest,” three things happen:

1.       The Social Security Administration (SSA) must give high priority to inquiries received from members of Congress and their staff.

2.       The SSA must respond to congressional inquiries promptly, accurately and courteously.

3.       The SSA must communicate any concern about a particular congressional inquiry to the congressperson.

“The local SSA field offices have to report to their bosses every 60 days to show how the inquiry is being addressed,” said Matt Shupe, associate attorney at Balin Law. “If such reports aren’t made or if they have a surplus of these inquiries from a certain region, the SSA is able to follow up with those regions to ensure proper care is provided for applicants.”

Balin has had positive experiences in the past with congressional interest, noting that the SSA has responded promptly to the requests they filed.

“I just had a case we won at the federal court level,” said Shupe, who was waiting between four and six months for even a single document to change hands between the court and the SSA. “We contacted Representative Jim Renacci and asked the case be looked into to make sure it gets remanded as expediently as possible, which it did.”

Balin litigation attorney Andrew November remembers a case that was pending for four years since the filing date.

“That wasn’t unheard of,” November said of the four-year time frame. “But by flagging that case as one of congressional interest, it was nice just to get someone involved. Congresspeople represent a pool of constituents, but most people don’t ever contact their representative. It’s an option for someone to get their representative involved.”

The House of Representatives website offers a handy tool to find your congressperson by ZIP code, but we've compiled a list below for all our office locations.

Mentor/Ashtabula
Dave Joyce - 440.352.3939 (Painesville Office)

Lorain
Jim Jordan - 419.999.6455 (Lima Office)

Canton
Jim Renacci - 440.882.6779 (Parma Office)

Toledo
Marcy Kaptur - 419.259.7500 (Lorain Office)

Cleveland/Akron
Marcia Fudge - 216.522.4900 (Cleveland Office)

Youngstown
Tim Ryan - 330.740.0193 (Youngstown Office)


 

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. 

No Insurance? No Problem!

In order to prove disability, SSA must have access to your medical records. However, many claimants find themselves in a position where, due to the loss of employment, they do not have sufficient insurance coverage and/or funds to see their doctors and generate those much-needed medical records. 

There are other options, however. It may take some persistence, but when it comes to proving disability, finding some type of medical treatment is critical if a claimant wants to prevail and obtain the benefits they need to survive.

Hospital Rating Systems

In the Cleveland area, hospitals like MetroHealth Medical Center have a rating system for patients who cannot afford care. MetroHealth’s website states that they will provide certain basic medically necessary hospital services, as long as the patient is a resident of the state of Ohio, is not currently receiving Medicaid, and meets Federal Poverty Guidelines in regards to income. The hospital also covers other services for Ohioans who are at or below 400 percent of the Federal Poverty Level.

Many major hospitals have similar programs for low income families and adults. Contact your local hospital and ask to speak with the financial assistance department to find out if they offer this type of help.

Free Clinics

Most major cities also have area free clinics that offer many basic services for free or very low cost. Free clinics are typically funded by local donations and are often staffed by student doctors. Most free clinics offer acute, non-emergent care. Some offer on-going preventative care and even dental care. Free clinics are open to anyone who lacks insurance, and/or do not qualify for Medicare or Medicaid.

If you are unsure if there is a free clinic in your area, visit http://www.needymeds.org/free_clinics.taf , which lists free clinics by state.

The Health Department

Similar to free clinics, your local health department may offer either basic low-cost or free medical care. Here in Cleveland, the health department boasts three wellness clinics that offer access to free vaccinations for children, free lead screenings, pregnancy tests, TB tests, family planning and HIV testing. 

The phone number to your local health department can usually be found in the phone book, and most government agencies have websites online explaining the services they provide as well as their contact information.

The Drug Store

It has become a recent trend for drug stores, such as Walgreens and CVS, to start offering some basic services right within their store. Most of these mini-clinics can diagnose, treat, and write prescriptions for common family illnesses, provide routine vaccinations and lab tests, as well as treat minor wounds, abrasions and sprains (minuteclinic.com). 

Most services for people without insurance cost under $100.00, and the clinics are staffed by certified nurse practitioners. Check out the costs and services CVS offers here. See what Walgreens has to offer by clicking here.

No matter where you decide to treat, it is a great favor you do for yourself to have the conditions that disable you not only properly treated, but well-documented by a healthcare professional. This is how SSA sees what’s really going on in your disability claim. If you require further assistance seeking treatment in relation to your disability claim, contact us today to find out how we can help.

 Written by Anna Westfall

We do whatever it takes to win your case!! If you live near Akron, Canton, Youngstown, Lorain, Toledo, Cleveland, Ashtabula or Mentor (or even if you don't!), contact us today to find out how we can help you!