I’ve helped several clients with this process and SSI, and have served as a representative. I’m not aware of any reason why you/we can not provide this service to our clients. And congrat’s on getting approved after the hearing! I’m currently working with State of Hawaii and it’s been an awful experience that has gone on for more than a year.

Cyber security coverage is a must, especially if you save anything online – your notes, client medical records, etc. Glad you are considering this now.

Hello Mechelle – so the next question must be: Why did Mayo deny the appt? Was the patient’s insurance not acceptable to Mayo? If not, the next question would be: Can the patient and will Mayo take direct payment from the patient (not a pleasant option). Lastly, who would the original referring provider recommend as an alternative to Mayo – that…[Read more]

It is uncommon and frankly almost unheard of for a patient advocate to be an authorized representative in an SSDI appeal. Circumstances in this case were such that the client did not want an attorney. I believe that a resourceful patient advocate can represent the client before the judge, just as effectively if not more so. If the client wins,…[Read more]

Hi Stephanie,
I do have a cyber security rider on my policy. I too thought it a wise choice. Hope that helps for what it is worth.

Thanks, Avrom! Always good to know who has this experience! Like Stephanie, I’ve had opportunities to work with clients in this area and have referred them to a good local attorney who specializes in this area and works on contingency.

Congrats Avrom!

I’m supporting a client who is in the midst of an SSDI appeal, but he has an attorney working on contingency which works better for him since he’ll only have to pay if he wins the appeal vs. paying me regardless.

Nice to know we can contact you as a resource when needed. Thanks!

Good question Steph. In addition to the cyber secure measures I have for my personal computer (s), my business email platform is through Enguard (EnGuard.com), a US company specializing in HIPPA compliance for the healthcare industry. Rates are very reasonable, services and support are great. They also offer Telehealth at no additional cost.

Great resource and generous offer, Avrom. Thanks for raising the topic. Are others working with clients on SSDI applications/appeals? It would be great to know how common it is for advocates to support clients in this way. Thanks.

Thanks for all the thoughtful discussion! I am baffled how the SNF personnel are not aware of this.

I have two clients who were in SNF rehab units. Both completed 90 days of therapy which was reimbursed by medicare. I was fortunate that in this SNF the PT director was kind, caring and sensitive. He was a strong advocate for the residents and went beyond the call of duty to submit appeals for continued treatment on a regular basis. I too…[Read more]

This sounds like an employer-based, self-funded plan? Employers can pick & choose what to exclude (outside of standard medical care) certain benefits. If so, you’ll have to do the appeals process: usually 2 internal appeals, then this goes to an outside company for external appeals. The external appeal has to be well-documented (medical…[Read more]

PT here. It’s also vitally important that therapists write very customized goals. Sure, we like to write simple goals about decreasing assistance required and increased activity tolerance (can walk 300′ now vs 50′ when they arrived), but there are so many other goals as well:
–can the person learn to direct their care?
–family training
–safe…[Read more]

Good discussion – I too hear “failure to progress” as a reason for discontinuing skilled care. Has anyone talked with one of the advocacy groups – like California or Massachusetts Advocates for Nursing Home Reform or Justice in Aging – about taking the case back to court? Consumers and their loved ones should not be fighting this issue almost 10…[Read more]

In my experience it is critically important to establish the Jimmo expectation at the initial care planning meeting for rehab. I will often take a copy with me to those meetings and therapist and administrators are often shocked to read it. It has also been my experience that the second level appeal is just a new set of eyes, but the real issue is…[Read more]

This is a very important topic. Patients and many SNF staff do NOT know about the Jimmo settlement. I keep a copy of these two documents handy to educate them whenever I’m involved with a client in rehab or discussing discharge plans.…[Read more]