Personal Injury Law

Our Social Security disability clients are usually dismayed when they learn they must wait two years after being found to be disabled before they can qualify for Medicare health benefits. This is a terribly unfair aspect of Social Security disability, and is explained well in an online article by AP News.

The article explores the ramifications of the delay through the examples of toolmaker John McClain and baker Shalonda Frederick. Here are excerpts from the article:

After reviewing their cases, the government declared McClain and Frederick too sick to work and started issuing them monthly Social Security disability checks. Then they found out they'd have to wait two years to get health care through Medicare. Even though workers and their employers pay the payroll taxes that fund Medicare, federal law requires disabled workers to wait 24-months before they can begin receiving benefits.

McClain and Frederick are far from alone. An estimated 1.8 million disabled workers are languishing in Medicare limbo at any given time. And about one out of eight dies waiting.

As many as one-third of those waiting are uninsured.

"The government is the screwiest insurance company I ever saw," said McClain, of Allen, Texas. "What is it that I was paying for out of my check every pay period? They have taken the charge for Medicare out of my paycheck, and now that I need it, I can't have it."

With President-elect Barack Obama promising to guarantee health care coverage for all, advocates for the disabled are hoping that repeal of the Medicare waiting period is finally at hand.

"The current law is really indefensible," said Sen. Jeff Bingaman, D-N.M. "There is no logic behind requiring people who are determined to be disabled to wait two years before they become eligible for Medicare." Bingaman introduced a bill to phase out the waiting period, and as a senator Obama co-sponsored it.

It turns out there is a simple explanation for the waiting period: cost.

In 1972, Congress and President Richard Nixon agreed to expand Medicare to cover not only seniors but the disabled. They created a waiting period to minimize costs and discourage people from gaming the system.

"When it comes to people dying of cancer, you can't help but be sympathetic," said Sen. Charles Grassley, R-Iowa. "But at a time when we have a big downturn in the economy, it may be questionable what can be done in a lot of these areas." Grassley, the senior Republican on the Senate committee that oversees Medicare, said he hasn't made up his mind about a repeal of the waiting period.