Not everyone who is eligible for VA health benefits needs to apply. Some veterans, such as those with certain types of disabilities, are automatically eligible to receive VA health benefits. But it can be a good idea to apply anyway.

If you have questions about VA health care benefits, including whether you are eligible, you may contact the VA by calling 1-877-222-8387. When you call this number, you can ask for the contact information for the Enrollment Coordinator at your local VA health care facility. Finally, you can also visit the VA’s health care websites, which are available at www.va.gov/healthbenefits and www.myhealth.va.gov.

You can complete the application online, in person at a VA health care facility, or over the phone. The application is available online athttps://www.1010ez.med.va.gov/. If your application is accepted and you are enrolled, the VA will send you a personalized handbook that will explain the benefits you may access, and will assign you to a Priority Group. If your application is not accepted, you have the right to appeal. The VA will send you instructions on how to appeal if your application is denied.

The VA provides comprehensive health care benefits. These benefits may include, but are not limited to, inpatient and outpatient services, specialty care, mental health care, homeless services, dental services, home health care, adult day care, and prescription drug coverage. The VA also has its own hospitals, clinics, and other types of dedicated VA health care facilities. Some veterans may be eligible for reimbursement for mileage, lodging, and meals for travel related to obtaining VA health care services.

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If you qualify for VA health care benefits, you will not be forced to only use VA benefits and not others. You can choose to get different health insurance, or use a combination of VA health benefits and other health benefits. You will not be forced to go to VA health care facilities, but may do so if you wish.

The eligibility criteria for the VA health care system are complicated. In general, you must have served in the active military, naval, air service, Reserves, or National Guard and must have been honorably discharged. However, your income, assets, and health status (including level of disability, if any) are also considered in the determination of eligibility for VA benefits. There are 8 different enrollment priority groups. Eligibility for VA health benefits varies from veteran to veteran, depending on each veteran’s unique characteristics and eligibility factors. Depending on your eligibility status, you may be eligible for free health care services, or you may be required to pay a copayment for health care you receive from the VA system. In addition, some veterans’ benefits are available to family members of veterans as well.

If you or your spouse served in the US armed forces, you may be eligible to receive healthcare through the Department of Veterans Affairs (“VA”). The VA provides a comprehensive health care system with a wide range of benefits. The VA health care system will not change when the Affordable Care Act comes into effect in January 2014.

Contact the Eastern Region Legal Intake (ERLI) line at 617-603-1700. ERLI will conduct a telephone intake and can provide legal advice or make appropriate referrals.

Legal guardians have the authority to make general medical decisions for the incapacitated person. Guardians may generally consent to routine, noninvasive, non-experimental treatments for the incapacitated person.

Guardians must seek specific authority from the Court to administer antipsychotic medication to the incapacitated person, or for other extraordinary medical authority. A guardian is obligated to act in the best interest of the incapacitated person.

The power to commit the incapacitated person to a mental health or nursing facility requires special court proceedings in the district court.

There is no filing fee for a guardianship petition. The petitioner must pay for the cost of providing notice to all interested parties, which sometimes requires service by publication in a newspaper selected by the Court. There is a $75 filing fee for a bond with sureties. The Court will not generally require a bond with sureties. Certified Letters of Appointment cost $25 each. A guardian who cannot afford to pay the fees can ask the Court to waive the fees by filing an Affidavit of Indigency.

A petitioner must complete and file numerous court documents and appear at a hearing to be appointed as guardian. A petition for guardianship must be filed by anyone seeking guardianship.

A petition for guardianship must be accompanied by Medical Documentation. In a case where the incapacitated person has a clinically diagnosed intellectual disability, a clinical team report is required. This report must be signed by a physician, a psychologist, and a social worker. The clinical team report is valid for 180 days from the earliest examination date.

For all other cases, a medical certificate is required and must be signed by a physician, psychologist, or psychiatric nurse. A medical certificate is valid for 30 days from the date of examination.

A Court must be satisfied that the incapacitated person is, in fact, incapacitated, and that the proposed person is suitable to serve as the incapacitated person’s guardian.

A guardianship petition must be filed in the Probate Court in the Massachusetts County where the incapacitated person lives. If the incapacitated person does not live in Massachusetts, the petition should be filed in the state or country where the incapacitated person lives.

A guardian must be at least 18 years old, live in the United States, and be competent to care for the incapacitated person. A guardian need not be related to the incapacitated person. An incapacitated person may have co-guardians.

Courts appoint a guardian for a person

who suffers from a clinically diagnosed condition that impairs the person’s ability to make or communicate decisions to such an extent that the individual lacks the ability to attend to their own physical health, safety, or self-care, even with appropriate technological assistance. The Court may appoint a guardian to protect the incapacitated person’s welfare.

Courts will not appoint a guardian for a person who merely shows poor judgment or difficulty making decisions. If the incapacitated person has significant assets, a Conservatorship may also be appropriate and required.

The Court has the power to appoint a lawyer to represent the incapacitated person if they or anyone on their behalf, makes such a request. If a guardian seeks authority to administer anti-psychotic drugs, or for extraordinary medical authority, the Court will appoint counsel to represent the incapacitated person. Such counsel, called Rogers counsel, will require the petitioner to file numerous additional documents.

GUARDIANSHIP OF AN ADULT IN MASSACHUSETTS

Prepared by the Mental Health Legal Advisors Committee December 2015

Guardianship generally

A guardianship is a relationship where one person (the guardian) is appointed by the court to make decisions for another person. A guardian may be appointed for a minor when the parents are deceased or incapacitated, or for an incapacitated adult.

The types of decisions a guardian can make depend on the guardianship order. If the guardianship is plenary (also called full or general), the Incapacitated Person no longer has the authority to make decisions about his or her own healthcare, support, education and welfare. A limited guardianship, however, may allow the Incapacitated Person to participate in decision making to the extent they are able. A limited guardianship can be limited to certain decisions, such as medical decisions, or decisions about where the person will live, and the incapacitated person retains decision making power in all other areas not included in the guardianship. Under Massachusetts law, all guardianship should be limited to the extent possible.1 The court and physician completing the paperwork for a guardianship must consider limits on the guardianship based on the specific strengths and deficits of the Incapacitated Person to preserve the rights of the Incapacitated Person in specific areas.2

A guardian must take into account the preferences of the incapacitated person by following the incapacitated person’s express values and desires.3 A guardian must consider the best interests of the incapacitated person when making such decisions because they are a fiduciary.4 In making the guardianship order the court shall encourage the self-reliance and independence of the incapacitated person while taking into account the person’s limitations.5

If the guardianship is ultimately granted, the guardian reports to the court annually about the incapacitated person

The authority of a guardian differs from a conservator in that a conservator makes legal decisions about a person’s property and financial matters. .

Please note that asking the court for a guardian is an important decision. There are less restrictive means that a concerned person thinking of petitioning for guardianship can use to help an incapacitated person. For more information about less restrictive options, please see MHLAC’s flier entitled “Alternatives to Guardianships and Conservatorships in Massachusetts.”

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Court process

To file for guardianship or to change an existing guardianship order, there are specific forms to use, available at the Massachusetts Probate and Family Court website: http://www.mass.gov/courts/forms/pfc/upc-guardianship-of-adults-and- conservatorship.html.This link has useful information about the court process as well as links to other resources. You can ask the court clerk what paperwork you need to file or questions about court procedure.

How to obtain a guardianship

Either the incapacitated person or a person interested in the incapacitated person’s welfare can file a petition for guardianship. The petition is filed in the Probate and Family Court in the county where the incapacitated person lives.

To petition for guardianship you need to:

•   file the petition for the court to appoint a guardian;
•   submit a medical certificate or clinical team report with the petition. A clinical team report is used for “intellectually disabled” people.
  A medical certificate is used for people with mental illness.

  A medical certificate must be signed by a physician, psychologist or
  psychiatric nurse. A clinical team report must be signed by a physician, psychologist and social worker.

  A medical certificate is valid for 30 days from the date of examination. A clinical team report is valid for six months from the date of examination.

  Therefore, in some cases the medical certificate or clinical team report will need to be updated between filing and the court hearing. This is to ensure that the medical determination is still accurate.

  These are the two main documents needed in order to initiate a guardianship hearing. There are other requirements (such as notice and service of process) that you must meet before a hearing is held. When you file the paperwork, the court clerk can tell you about the other requirements.

  Preparing to defend against a guardianship in court (see also Finding an Attorney, below)

  Before a guardianship can be put in place over a person, there must be a court hearing. To defend against a guardianship, you can prepare for this hearing in the following ways.

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Gather evidence to present at hearing that a person does not need a guardian

In general you should be sure to present evidence regarding the person’s capabilities and ability to make informed decisions. The lists below are not meant to be exhaustive and there are overlaps between the two.

For a person with an intellectual disability, gather evidence of:

•   intellectual functioning;
•   training programs completed in money management, basic

  living skills and sex education etc;

•   activities demonstrating ability to make decisions;
•   employment history;
•   ability to communicate through reading and writing skills;
•   indications of willingness to seek guidance on decisions,

  and names of people willing to give advice;

•   estimate of potential for growth given more education.

  For a person with mental illness, gather evidence of:

•   progress in treatment programs;
•   employment history;
•   level of education;
•   support systems in the environment where the person will

  be or is living including job, school, family, friends,

  outpatient treatment programs;

•   if institutionalized, access to off-grounds privileges,

  decreases in supervision, preparation for discharge to less restrictive environment, participation in work or training programs.

  Have an expert testify at hearing that a person does not need a guardian

  It is crucial to have an expert testify, such as a psychiatrist, social worker or psychologist. The expert should examine the person and form an opinion on his or her ability to manage personal and financial matters. If the person is indigent, a motion to the court may be made for an independent psychiatrist to examine him or her at the court’s expense.

  Gather evidence to present at hearing about the potential guardian Gather evidence such as:

•   the amount of concern and support the potential guardian provides to the respondent;
•   the availability of the potential guardian;

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•   any possible conflicts of interest between the guardian and respondent;
•   any information about hostility or abuse between the potential guardian

  and respondent.

  Then, to the extent that this information helps defend against the guardianship, present it at hearing.

  Consider less restrictive alternatives

  Consider less restrictive means other than guardianship that may be used to help a person make decisions. If a guardianship order is entered it should be the least restrictive order possible while still meeting the needs of the incapacitated person. See http://www.mhlac.org/Library.htm for further information about alternatives.

  How to change a guardian

  To change a guardian, there are two or three steps.



 

File a petition for removal OR a petition for resignation in the same court as the original order.

o A person other than the guardian would file a petition for removal. o A guardian would file a petition for resignation.

On both forms, one can include the name of a proposed new guardian. File a new petition for appointment of a guardian.

Possibly file a new medical certificate or clinical team report, depending on the circumstances.

How to end a guardianship

To end a guardianship for yourself or for another person, you must:
 File a petition for termination with the same court as the original order.

An appropriate medical professional must complete a medical certificate for termination

Finding an Attorney

When defending against a guardianship

The person that the guardianship is being sought for, often called the incapacitated person or respondent, may seek legal representation by:

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•   requesting a court-appointed attorney using this form: http://www.mass.gov/courts/docs/forms/probate-and-family/mpc301- request-for-counsel-fill.pdf (also available at the courthouse). Fill out the form and submit it to the court where the petition for guardianship was filed. Any person can submit this form to the court to request an attorney be appointed. (If the court determines that the respondent is not indigent, the court may allow the appointed attorney to collect fees or other compensation from the respondent’s estate.)
•   finding a private attorney including through the

  o Massachusetts Bar Association Referral Service at (866) MASSLRS or (866) 627-7577 (toll free in Massachusetts) or http://www.massbar.org/for-the-public/need-a-lawyer; or

  o county bar association referral agencies (listed online). When pursuing a guardianship

  The person pursuing a guardian over someone else may seek legal representation by:

•   seeking a private attorney through the Mass Bar Association Referral Service or local county bar association referral service (see above);
•   contacting the Volunteers Lawyer Project (VLP) at (617) 603-1700, which represents petitioners in uncontested guardianship hearings, once one obtains a medical certificate or clinical team report.
•   contacting Senior Partners for Justice (see http://www.spfj.org/gship_help.htm regarding free legal advice and help filling out the guardianship paperwork).

  One may also file the petition and medical certificate or clinical team report without an attorney or find the “Attorney for the Day” at the courthouse and ask for assistance in filling out the paperwork.

  Other resources on adult guardianship

  Resources are available at Massachusetts Legal Services, Information on Adult Guardianships, http://www.masslegalservices.org/disabilityrightsandservices?tid=1478

  Massachusetts Guardianship Association: http://www.massguardianshipassociation.org/

  Rogers Guardianship

  Guardians have the power to make general medical decisions for routine medical practices. However, a guardian may not consent to the administration of antipsychotic

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medications or other extraordinary medical treatment without an explicit authority to do so from the court.

When a hospital or the Department of Mental Health believes that a person is incapable of giving informed consent, that entity can petition the court for a Rogers guardianship (this type of guardianship is named after a case called Rogers v. Department of Mental Health). This order gives the guardian specific authority to consent to extraordinary medical treatment on behalf of the incapacitated person.

The court must first hold a hearing. At the hearing, the court must first make a determination as to whether the alleged incapacitated person is competent to make medical decisions. If the judge finds the person to be incompetent, the judge must make a substituted judgment decision to determine what the person would choose if the person were competent.

The judge must take into account a number of specific factors in order to determine if the person would choose to take a medication(s) if that person were competent. Using the substituted judgment decision-making process to determine what the person would choose, the judge may issue a treatment order and appoint a Rogers monitor who monitors the administration of the court-ordered treatment plan.

A Rogers monitor may be the same person as the person who is the guardian, or a different person (for example, an attorney, social worker or other professional). A judge also may deny a petition for a Rogers guardianship if he or she finds that the incapacitated person would not consent to the proposed treatment if he was competent.

Obtaining a Rogers guardian

•   One files a guardianship petition in the Probate Court in the county where the alleged incapacitated person lives. If the next of kin is known, one must list them on the petition. This way, the next of kin can be made aware of the matter.
•   A physician must file with the court a comprehensive medical certificate.
•   The court schedules a hearing date.
•   If the alleged incapacitated person cannot afford an attorney the court will

  appoint one. This lawyer represents the client’s wishes, not what the attorney

  thinks is in the client’s best interests.

•   After hearing all of the information from both sides, the judge makes a ruling

  about the alleged incapacitated person’s ability to make informed decisions about antipsychotic medication or other extraordinary medical treatment. If the judge determines the person is incompetent, the judge will make a substituted judgment decision regarding the proposed treatment plan. This means that the judge determines what treatment, if any, the person would want were he or she competent, taking into account such factors as:

  o the person’s expressed preferences; o religious beliefs;
  o impact on family;

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o side effects; and

o prognosis without treatment.
 If the court approves a treatment plan, the judge will appoint a monitor,

sometimes referred to as a guardian, to make sure that the plan is being followed. This monitor cannot approve any change in the administration of antipsychotic medications. To make any changes the guardian must go back to court with a proposed modified treatment plan and get court approval.

Resources:

•   Massachusetts Department of Mental Health, Rogers Guardianships, Authorizing the Use of Antipsychotic Medications — Questions and Answers, http://www.namimass.org/wp-content/uploads/brochure_rogers_guardian1.pdf
•   MHLAC, Your Rights Regarding Medication in Massachusetts,http://www.mhlac.org/Docs/your_rights_regarding_medication.pdf
•   Resources are available at Massachusetts Legal Services, Information on Adult Guardianships,http://www.masslegalservices.org/disabilityrightsandservices?tid=1478.

If you are eligible for One Care, MassHealth will send you a letter and a packet of information in the mail. The packet will list the One Care plans available in your city or town. You can choose any One Care plan available in the city or town where you live. The packet will explain how to choose a plan, and you must fill out a form and mail it in to MassHealth to choose a plan. If you do not tell MassHealth which plan you want, MassHealth will automatically enroll you in one.

For the first 90 days after you enroll in a One Care plan, you can continue to receive the same care you have been receiving, and One Care will pay for that care. After 90 days, you will be able to access the care listed in your Personal Care Plan through providers that accept One Care.

One Care covers all the services that are ordinarily covered by MassHealth and Medicare. One Care does not offer you any additional benefits. Some One Care plans also cover community-based behavioral health services. Instead of receiving coverage from both Medicare and MassHealth, however, all of your care will be covered by a single One Care plan. But, please keep in mind that many of your current services may be interrupted or cancelled when you sign up for One Care.

If you are eligible, it is your choice whether you receive your care through One Care or not. However, if you do not want to enroll in OneCare, you must tell MassHealth by calling 800-841-200. Otherwise, you will be automatically enrolled in One Care. If you choose not to enroll in One Care, you will continue receiving health care coverage from Medicare and MassHealth the same way you do now.

Once you join a PACE Elder Service Plan, you must receive all your health services from within your organization. You’ll get your medications, including your Medicare Part D-covered drugs, through the PACE program and will not need to join a separate Medicare Prescription Drug Plan. If you do join a separate Medicare Prescription Plan, you will be disenrolled from your PACE health and prescription drug benefits.

After you decide which PACE Elder Service Plan is right for you, contact the plan directly at the phone number provided above to apply and a staff member will help you enroll.

There are six PACE Elder Service Plan sites in Massachusetts.

• Elder Service Plan of the Cambridge Health Alliance
• Elder Service Plan of the East Boston Neighborhood Health Center
• Elder Service Plan of Harbor Health Services
• Summit ElderCare of the Fallon Community Health Plan
• Elder Service Plan of the North Shore
• Upham’s Elder Service Plan

  Each Elder Service Plan has a specific service area and may offer different benefits and services. The table below summarizes the service areas for the six Elder Service Plan sites. To enroll in a plan, you must live in that plan’s service area.

  If you are eligible for more than one plan, you should compare the benefits and services offered by each plan and find the one that is the best fit for you. To learn more about each Elder Service Plan, you can call the Plan directly or visit its website.

0. The PACE Elder Service Plans are like one-stop shops that cover preventive, primary, acute, and long-term care services. The coordinated care that PACE covers includes:
   • Primary and specialty medical care
   • Emergency care
   • Medical supplies and equipment
   • Prescription drugs
   • Physical, occupational, and recreational therapy
   • Dental, podiatry, vision, and audiology services
   • Nutritional counseling and meals
   • Adult day health care
   • Transportation to the health center
   • Nursing facility care if needed
   • Hospitalization
   • In-home services
   • Family caregiver support

The services are available 24 hours a day, 7 days a week, every day of the year. There are no copayments, deductibles, or other cost-sharing fees. However, you may have to pay a monthly premium.

To be eligible for PACE you must meet the following criteria:

• Are age 55 or older
• Live in the service area of a PACE Elder Service Plan organization (see

  below)

• Are able to live safely in the community
• Are certified by the state as eligible for nursing home care

o This usually means that you need assistance with some activities of daily life, like getting dressed or preparing your meals, and that you also have a skilled need, such as physical therapy. A medical professional will evaluate you based on your health status to determine if the PACE program is right for you.

o Though you must be certified to need nursing home care, the large majority of PACE enrollees do not actually reside in nursing homes, but instead receive their care within their own communities.

• Agree to receive health services exclusively through the Elder Service Plan/PACE organization

If you have MassHealth, you must also meet the following income and asset criteria:

• Your countable income must be less than $2130 per month in 2013
• Your countable assets must be no greater than $2000

  Your spouse’s income and assets are not counted. If you have MassHealth and you meet the criteria above, there are no fees for the program.

  If you do not have MassHealth but you do have Medicare, you may have to pay a monthly premium. However, you will not have to pay any copayments, deductibles, or other cost-sharing fees.

  If you don’t have Medicare or MassHealth, you may be able to pay for PACE privately.

The Elder Service Plans within the Programs of All-Inclusive Care for the Elderly (PACE) provide medical and social services for frail elders 55 years and older. MassHealth and Medicare cover the services that are provided by a team of health professionals so that elders can stay in their homes and communities instead of having to go to a nursing home. This program is meant to provide quality, individualized, and streamlined care for elders in a more cost-effective manner than the typical fee-for-service structure provides.

0. In 2013, there are five programs available in Massachusetts:
   • Commonwealth Care Alliance Senior Care Options
   • NaviCare
   • Senior Whole Health
   • Tufts Health Plan Senior Care Options
   • UnitedHealthcare Senior Care Options

     Each program has a specific service area and may offer different benefits and services. The table below summarizes the service areas for the five SCO programs. You must live in the program’s service area to enroll.

Once you’ve figured out which programs you are eligible for, you can compare the benefits and services offered by each program by visiting its website or calling the program directly. It is important to remember that SCO will only cover care that you receive from providers within the SCO’s network. For example, if you already have a doctor you like, but he or she is not affiliated with the SCO you plan to enroll in, that SCO may not be the best choice for you.

SCO covers the following health care services:

• All the health care services covered by MassHealth Standard
• If you have Medicare, all the health care services covered by Medicare
• Coordination of your health care
• Specialized geriatric support services
• Adult day care
• Comprehensive dental care
• 24-hour access to medical support
• Home care services
• Family caregiver support

  SCO plans combine your Medicare benefits (if you have Medicare), MassHealth benefits, prescription drug plan benefits, and extra SCO services into one plan with one health insurance card. However, the SCO program only covers services provided by your SCO and its network of providers. It will not cover services from other doctors or health care providers, except in an emergency.

  The benefit of SCO is in the coordination of care—your primary care physician will work with you and your team of nurses, specialists, and a geriatric support services coordinator to develop a plan of care that specifically addresses your needs.

To be eligible for SCO you must meet the following criteria:

• Age 65 or older
• Eligible for MassHealth Standard
• Live in the service area of a SCO (see below)
• Do not have end stage renal disease
• Agree to receive covered health services exclusively through their SCO

  options plan

  SCO is open to seniors in all living situations, including people living by themselves, at home with support services, and in long-term care facilities.

  You do not have to have Medicare to be eligible for SCO. If you have MassHealth Standard but do not have Medicare, you can choose a SCO plan. If you do have both MassHealth and Medicare, you can choose a Medicare Advantage Senior Care Options HMO SNP (Special Needs Plan).

Senior Care Options (SCO) is a Medicare-MassHealth partnership that provides services for low-income seniors over the age of 65. The purpose of SCO is to help seniors stay healthy and out of nursing homes by using a coordinated team of health professionals that cares for the seniors at their homes or in long-term care facilities.

For more information you can access SSA’s electronic booklet on SSDI at http://www.ssa.gov/pubs/10029.html. The SSA’s official website contains several helpful resources, including a Benefit Calculator and a Social Security Office Locator. You can also e-mail general questions to Social Security through their online portal, or call Social Security directly. For contact information, please refer to the General Resources section below.

If you would like to keep working, you can do so as long as your income is not too high. Once your income reaches the maximum amount and SSA determines you are able to engage in “substantial gainful activity,” you will lose your SSDI benefits.

When you first start working, you get a trial work period during which you get full SSDI benefits regardless of your income. Your trial work period ends after 9 months. You then get 36 more months, during which you can work and still get SSDI benefits. During these 36 months, called the extended period of eligibility, you get SSDI benefits as long as your earnings that month are less than “substantial.” In 2013, SSA determined that any income above $1040 was “substantial.” Once you earn more than a substantial income in any month, you get a grace period of three months and then you will lose your SSDI benefits.

If you lose your SSDI benefits because you have substantial income, you have five years to ask for your SSDI benefits back if your disability again prevents you from working. During those five years, you do not have to reapply for SSDI or wait for a disability reevaluation and your benefits will be reinstated in an expedited manner.

It is important to note that you should be honest and straightforward about your employment, even if you are being paid “under the table.” If you cannot prove how much you are making, it is often assumed that you are making over the limit and your benefits may be lost. Not documenting how much income you earn may also undercut your credibility, and your credibility may be one of the most important factors in the outcome of an appeal.

You will get SSDI benefits as long as you are disabled under the eligibility criteria above and cannot engage in substantial gainful activity. When you reach retirement age, your benefits are converted to Social Security retirement benefits.

Your case may be reviewed by Social Security any time within 6 months or no sooner than 7 years, depending on whether your specific condition is expected to improve or not. The award letter you receive from Social Security after you first apply will tell you when your first review will take place. The review will involve a request for updated medical information to prove that you are still eligible for SSDI benefits. You will not have to fill out the SSDI application again.

Once you apply, it usually takes about 3-5 months before your benefits start. Your SSDI payments begin on the sixth month after your disability begins. You can check on the status of your SSDI application on the Social Security website at https://secure.ssa.gov/apps6z/IAPS/applicationStatus or you can call Social Security toll-free at 1-800-772-1213 (TTY: 1-800-325-0778).

If you are denied and do not agree with the decision, you can appeal to Social Security. You must appeal in writing within 60 days of receiving your denial. Instructions on how to appeal will be sent with the denial. This next step, known as a reconsideration, involves more paperwork and typically takes 3-4 months. If you are again denied, you can file for a hearing and may also consider seeking the help of an attorney. This process varies widely, but typically takes around 6-8 months.

You can apply online at the SSA’s website at http://www.socialsecurity.gov/applyfordisability/. When applying online, only you can apply for yourself. No one else can apply for you.

You can also apply by phone. You need to first call the Social Security’s toll-free number at 1-800-772-1213 (TTY: 1-800-325-0778) Monday through Friday between 7 AM and 7 PM to schedule an appointment to apply over the telephone.

Lastly, you can also apply in person. Find the Social Security Office nearest you using the Office Locator at https://secure.ssa.gov/apps6z/FOLO/fo001.jsp and call to set up an appointment.

Before you apply, be prepared with the following documentation:

• Social Security number
• Birth certificate or other proof of age 50

• Proof of U.S. citizenship or lawful alien status if you were not born in the U.S.
• Most recent W-2 form, or federal tax return if self-employed
• Military discharge papers if you had military service
• Summary of where you worked and the kind of work you did for the last 15

  years

• Names and dosages of all the medicines you take
• Names, address, and phone numbers of hospitals, clinics, doctors, and

  other health workers who treated you and dates of treatment

• Medical records that you have in your possession
• Laboratory and test results
• Name of your bank and account number, if you want benefits deposited

  directly into your bank account

  If you are applying for family members, you should also have their birth certificates and Social Security numbers, proof of U.S. citizenship or lawful alien status, and, for your spouse, a marriage certificate.

  The most helpful proof of your disability is medical records, particularly any records related to treatment you received for your disability. Even if you don’t like or don’t want to see doctors, it is always important to get the most treatment that you can. Even if your condition is genuine, you will not be able to get very far in the application process without documentation and treatment. It is also helpful to have evidence from former employers that state that you tried to do your job but were unable to because of your disability.

  If you have difficulties with substance abuse, you should try to get clean and look for treatment to increase your chances of obtaining SSDI benefits. If it is found that your substance abuse is the reason that you are disabled and can’t work, you will be denied SSDI benefits. If you have a history of substance abuse, the best way to get benefits is to be clean for a certain period of time.

  For all the documents, you must provide originals or certified copies. You can mail or bring these documents to the Social Security office. Though the office will make copies and return the originals, it is always a good idea to make copies yourself of important documents before handing over the originals.

If you are unable to find any of the necessary documents, begin the application process anyway and work with Social Security to get the rest of the documents that you need. Don’t delay applying because you don’t have all of your documents.

If you need help applying in other languages, you can go online to Social Security’s Multilanguage Gateway athttp://www.ssa.gov/multilanguage/index.htm to see the publications that are available. You can also call Social Security’s toll-free number at 1-800-772-1213 and press “2” for Spanish and “1” for all other languages to be connected to an interpreter. Social Security can also arrange to have an interpreter come to your local office for your appointment.

If you enroll in SSDI, you will receive a monthly Social Security payment as long as you are disabled and cannot work. The amount you receive will depend on your age, the number of years you worked before becoming disabled, and the amount you earned in Social Security covered employment. If you would like to get an estimate of your SSDI benefit amount, you can view your Social Security statement online at the SSA website athttp://www.ssa.gov/planners/benefitcalculators.htm. For more information, you can call the SSA toll-free at 1-800-772-1213.

You might also be eligible for retroactive SSDI benefits up to 12 months if your disability began more than six months before you applied for SSDI. At 24 months of receiving SSDI benefits, you are automatically entitled to coverage under Medicare Parts A and B. Your eligible spouse or child may get a monthly benefit up to half of your monthly benefit. That amount will vary based on your work history.

To be eligible for SSDI, you must:

• Be under 65 years of age
• Have a lawful immigration status

o You do not have to be a citizen, but you must legally be in the United States and have a valid Social Security number. You must have proof of your legal status.

o If you had been working using a false Social Security number, you should contact a legal services organization for help with claiming your past employment. A list of legal services programs that provide free or low cost legal help can be found at http://www.massresources.org/legal-services.html.

• Meet the Social Security five month waiting period (you will start getting benefits for the sixth full month after your disability began)
• File an application for SSDI benefits (see below)
• Be totally disabled according to the Social Security definition of disability

o This means that your disability prevents you from engaging in “substantial gainful activity” for at least 1 year or will result in death. Your disability must either be in the list of SSA’s disabling conditions or must stop you from doing any type of work. It is not enough to show that you are unable to do what did for your previous job. You need to also show that you are not able to do any work on a full time basis.
For example, if your previous job involved heavy lifting but you injured your back, you might still be able to work a full-time position at a desk job. You would not be eligible for SSDI in that situation.

o You can be working part-time, but you must be earning less than $1040 a month.

o SSDI does not give benefits if you are partially disabled or if your disability is short-term. Your disability does not have to be permanent, but must be expected to last at least 12 months or result in death. Once you are no longer considered disabled, your SSDI benefits will stop.

• Have sufficient work history and contribution to the Social Security program. You can access a copy of your Social Security statement online from the SSA at http://www.socialsecurity.gov/mystatement/. You will have to first create a free account and then access your statement with your username and password. If you do not have enough credits, you cannot get SSDI benefits, but you may qualify for Supplemental Security Income, a need-based cash assistance program, if you are disabled. You can go to http://www.massresources.org/ssi to learn more about Supplemental Security Income.

o The table below summarizes what qualifies as sufficient contribution for SSDI for each age group. The age group is determined by the age at which the disability first occurs

Social Security Disability Insurance (SSDI or SSD) is a federal disability insurance program, administered by the Social Security Administration (SSA), for disabled individuals who have paid into the Social Security program. Eligible individuals receive monthly benefits ranging from several hundred to several thousands of dollars because of a combination of work history and a current inability to work.