Need help desperately , health problem , lawyers, disability issues, etc....
 

Need help and advise from doctor, lawyer, or disability people . Please help !

Dont' want to mention names ,but someone VERY close to me suffers from a serious health problem . This problem has grown over the last few years . They have severe stomach problems and pain that does not seam to be curable. They have been out of work for a while and just started back now . Of course no insurance for a while too ! And won't start for soem time now . Now the problem has reached new heights and this person is no longer able to work .They are still going but they are in terrible pain and always sick ,but yet they push on . Funds are running out . Their home is in jeopardy and if they can't work ,they will loose it . They have a tuff time just getting by period ! And they want to give up ...... I am not going to let that happen !!:mad:

There must be some type of disability compensation that can help save this person and there home . CAn anyone tell me what to do ? WHo to turn to ? PLEASE .

Is there some sort of disability lawyer that someone can recommend that knows how NJ works on this subject ?
I need help with this ! This person needs your help BAD !
I need to know the best way to approach this so as to not get blown off by some ignorant clerk from the state that doesn't care . This is a one shot deal . This persons pride is strong and won't ask for help . IF we get rejected the first time , they won't let me do it again . I am asking though .. :( I need someone who knows. I/We can't afford to go pay 15 people for their opinion that gets us no where . Thank you ,Joe

Joe, insurance is tough to get once you need it. This would be a pre existing condition and any insurance or disablity insurance won't touch it. They'll write the policy, but they'll exclude this problem from being covered becuase it existed prior to having coverage in place.

Call a disability Lawyer.

ttt

They should have been on disability. Have them talk to their doctor. In all honesty, it should have been set up some time ago...

Thanks guys , I am working on this today to try and find someone to talk to about it . I know it should have been done along time ago . But some peoples prides won't let them ask for help or even LET someone help . And on top of that ,they are only 30 years old . they think that only OLD people can ask for help . young people must push on ........:rolleyes: They want to be working but can't . And don't want people thinking of them as lazy like many other people really are that are not working and just taking advanateg of the system .

It's always the same , people that truely need help can't get it .

Those that are just lazy and dont' want to work get all kinds of help .......:mad:

Thanks guys for your input . Joe

This person should definitely talk to their doctor about when this first occurred and if there is any recourse they can use with a past insurance policy, probably not.

One step is to be declared disabled. If someone is declared permanently disabled they are eligible for a lot of benefits including the following:

1) Draw social security income
2) Do not pay state taxes on disability income (some states)
3) Do not pay property taxes (some areas)

These are just a few of the benefits I have heard of from someone who has been declared permanently disabled. I was also told that when applying for the social security that they turn down 99.9% of cases the first time. They have to be resubmitted usually to get an approval.

I had a family member who was disabled from work (due to job related activity) and I am somewhat familiar with this because of helping them fill out paperwork and going through the process.

The first thing you really need to work on is making sure that your buddy understands that this is the rest of his life and he will have to work through the pride issues. I am the same way and god only knows I would be a stubborn SOB before accepting help also. In this situation your buddy needs to realize that if he is truely disabled then he needs to get the assistance that is in place to help him.

This is actually an all too common situation. People who don't need the help don't think twice about asking for it, while people who need the help have too much pride to use the system like it was meant to be used. This is the major difference between those of us with values and those who work the system.

I hope everything works out. Sounds like a case that someone needs some guidance and assistance.

ttt

I sent you a PM.

Julie

Joe, check your PMs

Thanks everyone !I've been getting some private messages , and with the replies here it is very encouraging ! Tghis is a real tuff time .Haven't had time to contact a lawyer yet .been on the phone with doctors mostly . We are going to try acupuncture this weekend . We have to stop the pain somehow . I hope they know what they are doing . Don't want to get our hopes up ..... Thank you everyone ! if anybody has anything to add , PLEASE DO .. Joe

There are new laws that require states to offer insurance even if you do have pre existing conditions. I am currently on such a policy.

The policy itself sucks ($2500 deductible, $400/mo premium, crappy drug benefit etc) But once you surpass the $3500 out of pocket yearly expense, they start to cover almost everything else at 100%.

It's not the best, but it might keep you from having to sell the house :(



But if you can be declared disabled, there are other benefits to add to what Clearcut posted. I think they still give SSI for children of the disabled who are in college full time. There may be limits to that, nowadays tho.



Here is more information on the High Risk Insurance Pools:


http://info.insure.com/health/highriskpool.html

High-risk health insurance pools

A high-risk health insurance pool is one you don't want to jump into — unless you have to. It's considered a last resort for people who have been denied insurance in the traditional marketplace because of health problems, such as cancer, stroke, chronic depression, or heart disease.

Health insurance risk pools are special programs created by state legislatures to provide a safety net for people with pre-existing medical conditions. Each state operates its risk pool differently, although many share common features.

The boards work with insurers to collect premiums, pay claims, and administer the programs. Although the health benefits vary, most are comparable to basic private market plans except for the cost. Typically, pools can charge you between 130 and 200 percent above the standard premium for individual health insurance on the open market in your state.

Despite the expense, there are waiting lists in some states to get into the pools. This is because the only other alternative for many people with costly medical conditions is to go uninsured.

Are you eligible?
Most high-risk health insurance pools have strict eligibility guidelines, so not everyone who has a serious illness qualifies for coverage. You can't apply for health insurance through a high-risk pool if you're eligible for assistance from any other state or federal program such as COBRA, Medicaid, or Medicare. See Know your COBRA rights, Understanding Medicaid, and Understanding Medicare.

Typically you must prove you can't obtain health coverage through private insurers. Acceptable forms of proof include copies of denial letters or involuntary termination notices.

Oh drat. Just checked the next page and found this. I'm sorry -- I thought all states were required to have High Risk pools :(



http://info.insure.com/health/lawtool.cfm

Does New Jersey offer a high-risk health insurance pool?
No.

High-risk pool premium cap: N/A

High-risk health insurance pools are established and maintained by a state to provide health insurance for residents who, because of the existence or history of a medical condition, are unable to buy coverage on the open market and do not have other private insurance or access to an employer-sponsored group health plan. They're called "high-risk" pools because the consumers in them are considered at high risk of incurring hefty medical expenses.

In addition, most states that offer a high-risk pool impose a cap on health insurance premiums bought through the pool. The cap is a fixed percentage above the standard premium charged for individual health coverage on the open market in the state.

Of course ......... NJ controls everyhting !:mad:

Thanks ..

I am not sure how rooted in he is in NJ but I know that a lot of NJ is high price. Is moving a option? Maybe he can move to some place that does not allow insurance companies to discriminate agains pre existing conditions. I know that Mass falls under that. I have a pre existing condition and the Insurance companies HAVE to cover me. Another option and it does not soud like he has the money for this but could he perhaps get a job under your insurance with your work? I know that my father has my brother work for him every am and one of the forms of Payment is health insurance. So maybe you can have him under your policy as a employee. That would not work for me as we have health insurance through my wife. Another option is if you can make up a bus for him get insurance through NASE (national association of the self employeed) . Their web page is www.nase.com

Good luck

Jon

Interesting idea ...Thanks Jon.

Still trying ..........

Also -- Jon is partly right -- the "group" plans are required to insure all employees for pre-existing conditions. Some have a waiting period but there are rules on that too.

The bad part: Individual (family) insurance plans don't fall under this law. If you have a pre-existing condition, the Insurance Co. can just refuse to offer you coverage. That's what they did to me. They bypassed the requirement by declining me from the start. There are no laws that say they must sell you a plan. :(

But this is where the State level High Risk Pools come in - for those who can't get on any plan. The states contract with the exact same insurance companies to offer a "High" Risk policy. The premiums are outrageous.

And so it behooves the Insurance company to "Decline" as many patients as they can -- even if they are just slightly sick -- and force them to go into "high risk pools", where they can make 10 times the premium, and offer huge deductibles.

I was on group plans all my life with never a problem. But as soon as I went off on my own and applied for an individual policy....they DECLINED me and put me in "high risk" simply for a history of migraines and a swollen disc in my neck. :(
:hothead:


But Jon also mentioned getting on with a GROUP plan somewhere. Some insurance companies have no waiting period on pre-existing (some have a 12 month wait). It depends on the policy.

NASE does offer insurance. It may be worth a shot!?

You can request a quote by clicking here:
https://www.nase.org/secured/quote_request2.asp