1. Presented by:
•Crozer-Keystone Healthy Start’s Public Education
Campaign Committee &
•HELP: MLP a Medical-Legal Partnership between
Crozer-Keystone Healthy Start &Widener University
School of Law
Tuesday, May 21, 2013
Legal Rights for People who are Poor
or have Disabilities

2. Agenda
Introduction
 Joanne Craig, Project Director of Crozer-Keystone Healthy Start
 Daniel Atkins, Co-Director of HELP: MLP
The Affordable Care Act: What it means for clients
 Shannon Mace Heller, JD, MPH
Pennsylvania Welfare Sanction Policy
 Laura Handel Schwartz, Esquire
Consumer Law Basics: From mortgage foreclosures to
student loans
 Jordan Mickman, Esquire
SSI and SSDI: The basics of Social Security Disability
 Daniel Atkins, Esquire

3. WELCOME
Joanne Craig
Daniel Atkins

4. HELP: MLP
Health, Education
& Legal assistance
Project: A Medical-
Legal Partnership
(HELP: MLP) is a
collaboration
between Crozer-
Keystone Healthy
Start, Crozer-
Keystone Nurse
Family Partnership
and Widener
University School
of Law.

5. SHANNON MACE, JD, MPH
HELP: MLP
PUBLIC HEALTH LAW SPECIALIST
The Affordable Care Act: What
it means for clients

6. The Affordable Care Act: Agenda
Background of the Affordable Care Act (ACA)
Major Provisions
 Coverage Reform
 Quality/Payment Reform
 Individual Mandate
 Eligibility & Enrollment
 Health Insurance Marketplace
State Implementation
Medicaid Expansion
Takeaways

7. Healthcare in the United States
Fragmented Complex Political
Expensive Unequal Reactive

8. The Promise of the ACA: The Triple Aim

9. Goals of the ACA
Increasing access to care for ALL individuals regardless of
race, ethnicity, gender/sexual identity, income or disability
status
Using data to identify areas of need and drive improvement
within the healthcare system
Providing comprehensive, holistic care to individuals that
address unmet needs including those beyond the traditional
treatment setting
Improving health information technology to reduce
duplication of services, improve exchange of information,
reduce errors and improve individuals’ access to information
Strengthening the healthcare workforce including, increasing
diversity and capacity in underserved areas
Increasing access to prevention and health promotion services

10. ACA Timeline

11. The Affordable Care Act
Five major
components:
Coverage Reform
Quality Reform
Payment Reform
Insurance Reform
Health
Information
Technology
Reform

12. Coverage Reform
Many provisions are already in effect:
Pre-existing condition coverage to age 19
Family coverage to age 26
No annual or lifetime limits
Closing the Medicare Donut Hole
No co-pays/deductibles for prevention/
promotion interventions
Medical loss ratio now at 85 and 80 %

13. Quality & Payment Reform:
A Move to Integrated Care
Patient Centered Medical
Homes (PCMH) and
Health Homes
Accountable Care
Organizations
Establishment of National
Quality Measures
Established the Patient
Centered Outcomes
Research Institute
(PCORI)
Innovation grant funding

14. Individual Mandate
Most controversial
provision of the ACA
Requires individuals to
obtain health insurance or
pay a penalty
Penalties increase each
year
 Exemptions include:
 Religious
 Incarceration
 Undocumented status
Year Amount Owed
2014 $95 per adult; $47 per child
( up to $285 per family or 1.0%
of family income)
2015 $325 per adult; $162. 50 per
child (up to $975 or 2.0%
family income)
2016 $695 per adult; $347.50 per
child (up to $2085 per family
or 2.5% of family income)

15. Eligibility & Enrollment
Major changes to
eligibility &
enrollment
 October 1, 2013 is open
enrollment for Marketplace
 Elimination of income
verification
 Screened for multiple
options through one
application
 Income calculation now
“modified adjusted gross
income” or MAGI

16. Enrollment Timeline

17. Health Insurance Marketplace
States must establish by January 2014 or default to
the Federal government
Several requirements:
 User Friendly
 Phone, In-person, and online services
 Language accessibility
 Must screen and enroll public & private coverage
 Must establish “navigators”
 Transparency
 Self-financing by 2015

19. State Implementation
 The Affordable Care Act and the subsequent U.S. Supreme Court
Decision provides states considerable discretion in how it is
implemented at the state level.
 State decisions include:
 Whether to expand Medicaid eligibility to 138% of the federal
poverty level
 Whether to establish a state-based health insurance marketplace*, a
state-federal partnership marketplace or defer to the federally
facilitated marketplace
 Choosing the benchmark plan for the Essential Health Benefits
package & the benchmark plan for the Medicaid alternative plan for
newly eligible Medicaid enrollees
 Participation in Health Home State Plan for individuals with
chronic illnesses
 Other funding opportunities (Bridge to Reform, Public Health &
Prevention Fund grants, Centers for Medicare & Medicaid
Innovation grants, etc.)
*Previously known as “health insurance exchange.”

21. Pennsylvania:
Federally Facilitated Marketplace

22. Federally Facilitated Marketplace:
Implementation Issues in PA
Infrastructure
 Pennsylvania returned Health Insurance Exchange Establishment
funding to the Federal government
Education and Outreach
 896,000 eligible for tax subsidies through Marketplace in PA
Changes to eligibility calculation
 Movement to Modified Adjusted Gross Income (MAGI)
 $13 million in PA’s Dept. of Public Welfare (DPW) Budget
Qualified Health Plan (QHP) selection (HHS to decide)
 Supplementation of default benchmark plan
Medicaid determination
 State has the option of accepting federal determination as binding or
not

23. For Expansion Against Expansion
Increased access to
coverage & care
Significant funding
source
 100% FMAP 2014, 2015,
2016
 90% 2020 and beyond
Job creator
“The right thing to do”
Too much reliance on
public system
Increased costs due to
administration &
“woodwork effect”
Job killer
Political ideology
Medicaid Expansion in PA: The Debate

24. PA Medicaid Expansion:
Recent Activity
Governor Corbett met
with Sec. Sebelius April 2nd
Considering alternative
options like the Arkansas
Plan
Will not move forward
until “more information
from HHS”
Legislation introduced in
PA Senate

25. Issues without
Expansion
Opportunities with
Expansion
Increase in individuals
seeking services due to
Elimination of
Disproportionate
Share Hospital (DSH)
payments could result
in a loss of $8.1 billion
over next 10 years
Coverage gap for
individuals
Opportunity to expand
insurance coverage to
appx. 650,000 PA
residents
Ensuring access to high
quality health services
Maintaining efficiency
Medicaid Expansion

26. PA Coverage Gap
Source: PA Health Law Project, Medicaid Expansion in Pennsylvania Is
Good For Families (2013).

27. Takeaways
The implementation of the ACA will take place over
many years; however, major provisions take effect in
2014
Many individuals will need assistance navigating the
new Health Insurance Marketplace
Individuals currently receiving Medical Assistance
should not lose coverage
Many advocacy opportunities exist with regard to the
implementation of the ACA

28. The promise
of the ACA:
The Affordable
Care Act has
great potential to
increase health
equity within
Pennsylvania
However, in
order to fulfill
that potential the
state must
implement fully
in a meaningful
way.

29. ACA Resources
Philadelphia Department of Behavioral Health &
Intellectual disABILITY Services, Health Reform & Health
Equity Unit: http://dbhids.org/health-reform-health-
equity-unit
www.Healthcare.gov
Kaiser Health Reform Source: http://kff.org/health-
reform/
Health Reform GPS: www.healthreformgps.org
CMS, Streamlined Application:
http://go.cms.gov/11SGmKF
PA Health Law Project: http://www.phlp.org/home-
page/reform
PA Health Access Network: http://pahealthaccess.org/

30. Thank
you!
Questions?
Contact
information:
Shannon Mace
Heller, JD, MPH
Phone: 215-685-
5411
Email:
sm.helpmlp@gmail.com

31. Laura Handel Schwartz, Esquire
HELP: MLP
Staff Attorney
Pennsylvania Welfare Sanction Policy

32. Welfare Sanction Policy: Agenda
What are sanctions?
Reasons sanctions are issued
Sanction issues
Key concepts
How does the sanction process work?
How will a recipient know she’s being sanctioned?
Importance of fighting sanctions
New penalties
How to fight sanction threats
How to prevent sanction threats
County Assistance Office information

33. What are sanctions?
• Sanctions can affect recipients of cash assistance benefits
administered by the Department of Public Welfare (DPW)
– i.e., recipients of Temporary Assistance for Needy
Families (TANF).
• Sanctions are the denial of welfare benefits for which a
person or family are eligible based on alleged
noncompliance with welfare program rules
• Sanctions can be for employment-, child support-, personal
responsibility- or fraud-related reasons.
• This training will focus on employment-related and
support-related sanctions.

34. What are welfare “sanctions”?
If Temporary Assistance for Needy Family (TANF)
recipients do not follow certain Department of Public
Welfare (DPW) rules and do not have “good cause” or an
exemption, they will be “sanctioned.”
The welfare office will “sanction” a noncompliant benefit
recipient by reducing her monthly cash grant.
 Can reduce just her share or her whole family’s share.
 Reductions can be temporary or permanent.
 Repeated violations can lead to terminations of benefits that are
permanent for either just the noncompliant head of household or her
children as well.

35. Why is this subject important now?
Sanctions are used as a
strategy to reduce
welfare benefit caseload
– related to DPW
philosophy and budget
New sanctions up 130%
from January 2011 to
current date
Sanctions that were in
effect already now up
72%
Image from www.philly.com.

36. Another view: Growth in New Sanctions
 New Sanctions Statewide
 Sanctions in effect Statewide

37. Reasons DPW issues sanctions
TANF recipients can be sanctioned for:
 Failing to cooperate with child support enforcement
 Failing to sign an Agreement of Mutual Responsibility
(AMR)
 Failing to cooperate with work or a “work-related
activity” requirement on an AMR
 Voluntarily quitting a job
 Voluntarily reducing earnings
 Failing to apply for work
 Failing to accept a bona fide offer for a job that the
recipient could do

38. Sanction Issues
 IMPORTANT ISSUES TO BE AWARE OF:
1. Sometimes a recipient does not even realize that she
has been, or is being, sanctioned.
(a) The biggest clue that a recipient has been sanctioned is if her
welfare grant suddenly decreases, or is less than the maximum
for her family size (unless she has earnings or other income
that would explain why the grant is reduced)
1. Sometimes benefit recipients do realize that they are
being sanctioned, but choose to accept the penalty
without an appeal.
(a) This is harmful. If you spot or hear about such a situation,
advise the recipient to appeal immediately.

39. Why do some recipients accept
sanctions without appeal?
 Confusion
 Difference between termination and sanction
 Resignation
 “what can I do? I can’t win.”
 Guilt
 “I did it so I should take my punishment.”
 Belief (justified or not) that no attorneys or
advocates available to help
 “Legal Services probably won’t handle it.”
 “It’s only 30 days.”

40. Key concepts: Willful Noncompliance
Willful Noncompliance
 DPW may only sanction a recipient for violating
rules if “the noncompliance was willful and
without good cause.” (CAH §135.712)
 Corollary: recipient cannot be sanctioned if she had a
good cause reason for why she did not follow a rule.

41. Key Concepts: Good Cause
Asking to be excused from TANF program requirements for
reasons beyond the recipient’s control or because the
requirements would endanger her or unfairly penalize her
for hardship circumstances is called “requesting a waiver”
or “claiming good cause.”
If good cause is established, no sanction should be
imposed, and existing or past sanctions related to that good
cause should be lifted or rescinded.
 An “exemption” or “good cause” can be established
AFTER a sanction is threatened or imposed, as well as
before.

42. Key Concepts:
Reasonable Accommodation
The welfare office is required to make a good faith effort
to assist the client in overcoming whatever problems she
had complying with work requirements (CAH §135.5) or
for accommodating other hardship circumstances that
may arise as a result of:
disability
domestic violence, or
substance abuse

43. How does the sanction process work?
Agreement of Mutual Responsibility (AMR)
Alleged violation
Advanced notice (sanction threat)
Compliance review
 Determining good cause
 Opportunity for advocacy!
Fresh start vs. sanction
Ending the sanction or sending notice of sanction

44. How will a recipient know if she’s being
sanctioned?
For either a child
support or a work-
related sanction, DPW is
required to send advance
notice to the recipient,
telling her she’s about to
be sanctioned.
 Recipient should APPEAL
THIS NOTICE
IMMEDIATELY, and ask
for “aid paid pending.”

45. How will a recipient know if she’s being
sanctioned?
For a work-related sanction, DPW must offer to
conduct a “compliance review” before actually
imposing the sanction.
 If DPW imposes a sanction without first offering a compliance
review, the sanction is illegal – appeal IMMEDIATELY!
 If no notice of sanction is received, sanction has probably been
imposed if the Cash Assistance grant is less than it should be
for the family size/income level.
At the compliance review, the recipient can explain
why she did or did not do something required of her.

46. How will a recipient know if she’s being
sanctioned?
The CAO is required to make a good faith
effort to assist the client in overcoming
whatever problems she had complying with
work requirements (CAH §135.5). As
examples, DPW should:
 Reschedule appointments to better fit recipient’s
schedule
 Provide help with transportation
 Provide help with childcare
 Explore revising her AMR

47. The importance of fighting sanctions
Individuals and families are often sanctioned
incorrectly, as a result of miscommunication,
mental illness, domestic violence, disability, or
other justifiable barriers to compliance.
Sanctions have harsh impacts in both the short
and the long term.
 Child Support-related sanctions
 Work-related sanctions

48. The importance of fighting sanctions
Child Support-related sanctions:
 A TANF applicant/recipient is required to seek child
support and establish paternity unless she has good cause
for not doing so.
 If she does not cooperate with either requirement, the
family’s grant will be reduced by at least 25%.
 This benefit reduction will continue indefinitely, until the
parent cooperates or establishes “good cause.”
 The noncompliant parent stays on the TANF grant (even
though her share of the cash is what’s technically being
taken away), remains subject to the work requirements,
and the benefits still count toward the five year time
limit.

49. The importance of fighting sanctions
Work-related sanctions
 IMPORTANT: with work-related sanctions, it’s a
“three strikes and you’re out”-sanction scheme.
 Note: these sanctions will affect Cash Assistance
benefits, specifically; they should not affect SNAP
or Medical Assistance benefits.

50. New penalties for First Sanction
First Sanction: individual cut off from cash
benefits for 30 days
 Sanction continues until individual demonstrates
compliance for at least one week
 After 90 days, if compliance not demonstrated,
entire family ineligible until compliance
demonstrated for at least one week

51. New penalties for Second Sanction
Second Sanction: individual cut off from
cash benefits for 60 days
 Sanction continues until in compliance for at
least one week
 After 60 days, if compliance not demonstrated,
entire family ineligible until compliance
demonstrated for at least one week

52. New penalties for Third Sanction
Third sanction now makes entire family
permanently ineligible
Be sure to appeal any sanction notice!
Remember “good cause” -- including domestic
violence

53. How to fight sanction threats
Appeal immediately, request “aid paid pending”
outcome of appeal
Explore why non-compliant event occurred
 Common reasons: transportation issues, no child
care, domestic violence, illness, misunderstanding
Explore possibility of “good cause” waiver
 Special note: ANY circumstances beyond recipient’s
control can probably qualify as good cause; use
common sense! If the reason was good and recipient
is acting in good faith, there’s room to advocate
successfully.

54. How to fight sanction threats
Examples of circumstances that qualify for “good cause”
waiver of work requirements (55 PA Code § 165.51):
 Recipient tried to get care for a child or adult with disabilities, but
could not.
 Domestic violence.
 Homelessness.
 Transportation problems.
 Recipient or family member was ill.
 Job or job training was beyond recipient’s ability, and she is willing
to look for another job or do other training.
 Working conditions were substandard or unsafe, or wages paid were
below minimum wage or below the prevailing wage normally paid for
that job.
 Participation in drug or alcohol treatment can be “good cause” if the
treatment program prevents recipient from working at the same
time.
 Other personal emergency.

55. How to fight sanction threats
A recipient with limited English proficiency cannot
be sanctioned for failing to attend an activity or a
meeting if she was given notice of it in a language
she does not understand (Title VI of the Civil
Rights Act of 1964)
DPW cannot sanction recipient for not doing
something she only volunteered to do; may only
sanction for failing to do something she was
required to do (CAH § 135.261)
 Some items in the AMR are mandatory, some are not;
recipient (or her advocate) should always check to see
what the AMR actually says!

56. How to fight sanction threats
“Benefit of the doubt”
policy: DPW is
supposed to give
recipient the benefit of
the doubt when
deciding to approve or
deny someone a
waiver.
 DPW must consider all
facts and circumstances
of the alleged violation,
“especially if the
transgression is
relatively minor… or
isolated in nature” (55
PA Code § 165.52(b))

57. How to fight current or past sanctions
For sanctions that have already been imposed:
 It is sometimes possible to get a sanction lifted while
it is in effect, or even retroactively, if the facts show
that the recipient had good cause at the time of the
violation.
 This is important for two reasons:
 To get back the benefits that the recipient missed
 To get the “strike” removed from her record, if the
sanction was work-related, since these are subject to
the “three strike” system that will result in permanent
penalties.

58. How to prevent sanctions or sanction threats
Recipient should:
 Communicate any problems or potential problems to
caseworker in writing.
 Verify information and get copies of all documents,
especially her AMR!
 When possible, try to get written documentation of
problems that interfere with ability to comply with work
requirements (i.e., illness of self or dependent child).
 Talk to a supervisor if caseworker is unresponsive.
 Notify both CAO and welfare work program contractor if
an appointment must be missed for good cause reasons.
 Notify both CAO and welfare work program contractor if
she gets or loses a job.

59. DPW – local County Assistance Offices:
Delaware County
Crosby District (also
Delaware County
Assistance Office
Headquarters)
701 Crosby Street Suite A,
Chester, PA 19013-6099
Phone: 610-447-5300
FAX: 610-447-5399
Darby District
845 Main Street, Darby, PA
19023
Phone: 610-461-3800
FAX: 610-461-3900
Delaware CAO Headquarters

60. DPW – local County Assistance Offices:
Chester & Philadelphia Counties
Chester County Assistance
Office
100 James Buchanan Drive,
Thorndale, PA 19372-1132
Toll Free: 1-888-814-4698
Phone: 610-466-1000
FAX: 610-466-1130
Philadelphia County Assistance
Office Headquarters
801 Market Street,
Philadelphia, PA 19107
Phone: 215-560-7226
FAX: 215-560-3214
Philadelphia CAO Headquarters

61. Pennsylvania Welfare Sanction Policy
Disclaimer: the information in this presentation
is general legal information and is not intended
as legal advice to be applied to any particular
case.

62. Resources
DPW Cash Assistance Handbook:
http://services.dpw.state.pa.us/oimpolicym
anuals/manuals/bop/ca/
Legal Aid of SE PA = http://www.lasp.org/
or toll-free 1-877-429-5994

63. Thank
You!
For more general
information about this
topic:
Laura Handel Schwartz,
Esq.
E-mail:
LH.helpmlp@gmail.com
For legal assistance or to
make a referral, please
contact Legal Aid of
Southeastern Pennsylvania
(LASP) toll-free at:
1-877-429-5994
Questions?
Referrals?

64. JORDAN MICKMAN, ESQUIRE
HELP: MLP
CONSUMER LAW FELLOW
Consumer Law Basics:
From mortgage foreclosures to
student loans

65. Consumer Law Basics: Agenda
Prioritizing debt
Garnishment
Debt collection harassment
Bankruptcy
Credit reports
Federal student loans
Mortgage foreclosure

66. Prioritizing Debt
Secured vs. Unsecured Debt
Always pay secured debt first
Examples:
 Secured: Mortgages and Car loans
 Unsecured: Credit cards, legal and medical bills, loans
from friends
Exception:
 Utility service (failure to pay cannot result in seizure of
assets to satisfy arrears, but can result in adverse
action)

67. Prioritizing Debt

68. Prioritizing Debt
Debt should not move up in priority based
on creditor’s threats to sue
Do not pay when legal defenses available
Do not pay lower priority debts based on
settlement offer if income is too limited to
pay more important expenses

69. Garnishment in PA
Wages
 Very limited
circumstances
 Child/spousal support
 Federal student loans
 Unpaid rent
 Criminal restitution
 Some taxes
Bank account
 Once judgment
obtained, bank
accounts are fair game
(with some exceptions)
 Wages deposited into
bank account are NOT
protected
 Exception:
 Social Security
payments deposited
into bank account
cannot be garnished

70. Debt Collection Harassment
I’ve stopped paying, but now they won’t
leave me alone. Now what?
What debt collectors CAN do:
 Stop doing business with the consumer
 Report default to credit bureau
 Sue in court
 Just because they can, doesn’t mean they will
 Suing and winning a judgment are not the same if the
consumer shows up to defend

71. Debt Collection Harassment
What debt collectors CANNOT do:
 Abusive, deceptive, and harassing tactics
 Continue contacting consumer after:
 Written request to cease & desist contacting consumer
 Consumer disputes debt in writing
 Communicate with 3rd
parties about a debt w/o the
consumer’s permission
 Exception: can request location info from 3rd
parties
 Call at known inconvenient times or places
 Generally before 8:00 a.m. or after 9:00 p.m.
 Threaten arrest or wage garnishment

72. Avoiding Collection Harassment
Call the creditor first!
 Possibly arrange deferment or repayment agreement
before turned over to collection
Write a letter requesting the collector to stop
collection efforts
 Explain why unable to pay now
 Explain expectations for repayment in the future
 Send by certified mail if possible
Dispute debt within 30 days of first written
collection attempt
File complaint with Govt. agency (FTC, CFPB,
AG) and send the complaint to the collector
Bankruptcy

73. Bankruptcy Basics
What bankruptcy
CAN do:
 Discharge most debts
 Stop foreclosure and
provide chance to
catch up on missed
mortgage payments
 Prevent repossession
of car or other
property
 Stop collection
harassment
 Restore or prevent
shut-off of utility

74. Bankruptcy Basics
What bankruptcy CANNOT do:
 Eliminate security interest of creditors
 Discharge: child support, alimony, most student
loans, criminal fines, certain taxes
 Protect co-signers (if only one co-signer files, the
other is left solely responsible)
 Discharge debts that arise after filing
 Prevent eviction after landlord has judgment for
possession

75. Bankruptcy Basics
Chapter 7 (straight bankruptcy)
 Discharge debts in exchange for giving up non-exempt
property.
Chapter 11 (corporate reorganization)
Chapter 12 (family famers)
Chapter 13 (reorganization)
 File a plan showing how the consumer will repay debts over
a period of 3 to 5 years.
 Can keep valuable property if consumer makes payments
according to the plan
 Must prove to court that consumer has regular income
 Payments usually go UP in chapter 13 plans

76. Credit Reports
Type of info on the
report:
 Name, DOB, SSN, current
and former addresses
 Employment info
 Payment history on credit
accounts
 List of creditors who
requested a copy of the
report
 Public records
(bankruptcy, foreclosure,
judgment)
Who can see it?
 Creditors
 Potential employers
 Insurers
 Govt. agencies trying
to collect child
support
 Landlords

77. One Free Report Each Year
(Experian, Equifax, & Transunion)
Getting a copy:
 Online at:
www.annualcreditreport.
com
 By phone: 877-322-
8228
 By mail: Annual Credit
Report Request Service,
P.O. Box 105281,
Atlanta, GA, 30348-5281
Credit Reports

78. Federal Student Loans
Types of Federal Loans
 Subsidized
 No interest while in school, grace period, or deferment
 Unsubsidized
 Not based on financial need; interest charged at all times
 Plus
 Pay for expenses up to the cost of attendance, minus
other financial aid
 Parent Plus (parent co-signs for dependant children)
 Graduate Plus (no co-signer needed for graduate
school)
 Consolidation
 Combine the above into a single loan

79. Federal Student Loans
Grace Periods:
 Subsidized &
Unsubsidized
 6 month grace
period
 Direct Plus
 No “grace” period
 But:
6 month
automatic
“deferment” for
Graduate Plus and
Parent Plus

80. Repaying Student Loans
Auto Payment = 0.25% reduction in interest
rate
Delinquent vs. Default
 Delinquent: Payment not received by due date
 Default: Payments not made for 9 months
Consequences of Default:
 Acceleration of loan debt
 Tax lien, garnishment, denial of professional
license, ineligible for new student loans

81. Repaying Student Loans
Solutions for Default
 Loan Rehabilitation
 Borrower and Servicer agree on reasonable and
affordable repayment plan
 Make voluntary payments on the agreed-upon
repayment plan (6-9 months usually)
 Loan Consolidation
 First make several voluntary payments
 Then, consolidate defaulted loan
 Loan Consolidation = Paying off old loan, and
issuing new loan

82. Student Loan Repayment Plans

83. Student Loan Repayment Plans
Standard
 10 year repayment plan
 Lowest interest charge
Graduated
 10 year plan; payments grow over time
Extended
 Fixed or graduated payments up to 25 years
Income-Based
Pay As You Earn

84. Income Based Repayment Plan
Maximum monthly payment is 15% of
discretionary income
 Discretionary Income = AGI – 150% of poverty
guideline
 Up to 25 years repayment
 Any balance after 25 years is forgiven
 Must have a partial financial hardship
 Examples:
 Family Size of 1 with AGI of $45,000 has repayment of
$353 per month
 Family Size of 4 with AGI of $45,000 has repayment of
$130 per month

85. Public Service Loan Forgiveness
Criteria:
 Make 120 on-time, full,
scheduled, monthly
payments
 Work full-time at
qualifying public service
org.
 Payments made in
qualifying repayment plan
 IBR or ICR
 Standard technically,
but after 10 years, no
balance to be forgiven!

86. Forgiven, Cancelled, or Discharged
Total and Permanent Disability Discharge
 Unable to engage in substantial gainful activity
by reason of medically determinable physical or
mental impairment that:
 Expected to result in death
 Has lasted, for continuous period of no less than 60
months
 Can be expected to last for 60 months, or
 Unemployable due to service-connected disability (as
determined by VA)

87. Forgiven, Cancelled, or Discharged
Death Discharge
 If the borrower dies, the loan will be discharged
 Parent Plus: If the Parent or the Student dies,
the loan will be discharged
Closed School Discharge
 School closes while you’re enrolled and unable
to complete program
 School closes within 90 days after you withdraw
Teacher Loan Forgiveness
Public Service Loan Forgiveness

88. Mortgage Foreclosure
Housing Counselors!
 Loan Modification / HEMAP
Act 6 (Right to Cure)
 Before filing in court, lender must give at least 30
days notice of intention to foreclose
 Act 6 notice must tell homeowner the amount
needed to repay in order to prevent court filing
Act 91 (HEMAP)
 Emergency mortgage assistance program to non-
FHA borrowers who fall behind through no fault of
their own (unemployment, divorce, medical)

89. Resources
Consumer Complaints
 CFPB:
http://www.consumerfinance.gov/complaint/
 FTC: https://www.ftccomplaintassistant.gov/
 PA Attorney General:
http://www.attorneygeneral.gov/complaints.asp
x?id=451
 Delaware County:
http://www.co.delaware.pa.us/consumeraffairs/
consumer.html

90. Thank
you!
Contact
information:
Jordan Mickman,
Esq.
Phone: 610-497-
7395
Email:
jm.helpmlp@gmail.com
Questions?

91. DANIEL ATKINS, ESQUIRE
HELP: MLP
CO-DIRECTOR
SSI and SSDI: The basics of Social
Security Disability

92. Basics of Social Security Disability: Agenda
Differences between SSI and SSD
Income eligibility
Benefit amounts
Eligibility criteria & determination
 Non-Citizens
 Children
 Adults
Appeals process
Special circumstances
What to look for
Overpayments
Representative Payee

93. Supplemental
Security Income
Social Security
Disability
 A means-tested
public benefit for
people who are poor
and disabled
 Health Insurance:
Medicaid
Insurance for people who
have worked or children of
disabled/deceased workers.
Health Insurance:
Medicare after two year
waiting period.
 Waiting period starts with
month of entitlement (5
months after the onset date).
Basics of SSI/SSD

94. Income eligibility
To qualify for SSI you must have little or no income and few
resources. This means that the value of the things you own must
be less than $2,000 if you are single or less than $3,000 if you
are married. Child support counts. The value of your home does
not count. Usually, the value of your car does not count up to
$4,500. And the value of certain other resources, such as a burial
plot, may not count either.
In-kind income and support counts so if family member
providing or paying for food or shelter, that amount will be
subtracted from monthly SSI amount. Pay for cell phone or cable
directly to vendor. Money to recipient is considered income.

95. Benefit Amounts
SSI
 $710 federal benefit amount. No earlier than application
date.
SSD
 Amount of cash benefit varies.
 Can go back to onset date but can’t be paid more than one
year prior to the application date.
 Five month waiting period from onset to date of
entitlement.

96. Eligibility for Non-Citizens
If you are not a U.S. citizen, but you are a resident,
you still may be able to get SSI.
A non-citizen qualifies if he or she is lawfully
admitted for permanent residence in the U.S. and:
 is a refugee or asylee in his/her first 5 years of U.S.
residency; or
 is an active duty member of, or an honorably discharged
veteran of, the U.S. Armed Forces, or is the spouse or
unmarried dependent minor child of such a person; or
 has worked and earned 40 quarters of credit (10 years)
under Social Security;

97. Disability Eligibility
Evaluation the same for adult SSI and SSD
 Onset differences: SSI can be no earlier than
application date. SSD can go back to onset date,
but no pay more than one year prior to application
date.
5 month waiting period for SSD
If dual application, can get SSI and Medicaid
during waiting period
Different for adults and children

98. Child Disability Standard: 3 Step Analysis

99. Functional Equivalence
 “Marked” in two
domains of
functioning.
 “Marked” means
interferes seriously
with child’s ability
to independently
initiate, sustain or
complete activities.
 Extreme in one
domain .
 “Extreme” =
seriously
interfere . . .

100. 6 Domains of Functioning

101. Adult Disability Standard:
5 Step Analysis
1. SGA- Substantial Gainful
Activity in 2013 > 1040
 If No, proceed. If Yes, lose.
1. Severe Medically
Determinable
Impairment?
 Severe if significantly limits
ability to do basic work
 Not severe if slight
abnormality with no more
than minimal effect on
ability to do basic work.
 If Yes, proceed to step 3.
If No, lose.
3. Meet or equal a listing?
And expected to last 12
months.
 If Yes, win. If No, proceed
to 4.
4. If don’t meet a listing–
can do past work?
 If Yes, lose. If No, proceed to
5.
5. Can you do any other
work?
 If Yes, lose. If No, win.

102. SSA Appeals Process

103. Ineligibility While Incarcerated
SSD and SSI not payable for months
confined to a jail or prison or another public
institution.
No benefits for any month in which you
violate a condition of probation or parole.
Children receiving benefits on your account
can receive benefits when you are in prison.
Upon release, request benefits to re-start by
providing SSA with copy of release
documents.

104. Protecting SSI Eligibility if Windfall
If client going to
come into money–
perhaps a settlement
from a lawsuit, for
instance– refer to a
lawyer for advice on
how to set up a trust
to protect eligibility
for Medicaid/SSI.
Windfalls don’t
impact SSD.

105. What to Look For
Anyone in special education
Child failing in school
Child struggling socially or at home
Any child or adult who has been in-patient for
mental health problems.
Any adult with a serious impairment who has been
out of work for a long time.
Any child with a serious impairment who has
missed school.
Chronic homelessness.

106. Questions to Ask
How is your child doing in school?
How is your child doing socially? At home?
Were you in special education? How far
did you go in school? Where did you go to
school?
How long have you been out of work?
Are you receiving treatment for your mental
health condition?
Have you ever applied for SSI/SSD before?

107. Overpayments
Work or other income not reported
properly.
No longer disabled or eligible.
SSA recovers by withholding of benefits.
Request Waiver if without fault of
beneficiary and hardship to repay. For SSI
recipients, hardship automatic.
Request Reconsideration if overpayment.

108. Representative Payees
If beneficiary cannot manage own money.
SSA must approve.
To change to own payee, doctor must
submit letter supporting ability to manage
money.
Mental illness does not necessarily mean
recipient needs a payee.

109. Summary
SSI SSD
Medical Insurance Medicaid
Medicare two years
after five months after
onset
Financial Criteria
Yes – must meet
income/resource tests
No, but work history
required
Disability Criteria Sequential Evaluation Sequential Evaluation
Benefit Amount
$710 retroactive to date
of application
Depends on how much
claimant paid in and
starts five months after
onset

110. Observations
Don’t Save
Don’t work too
much
Don’t expect much
Don’t expect the
process to be quick
and painless.

111. Resources
Social Security Administration Bluebook (disability
listings):
http://www.ssa.gov/disability/professionals/bluebo
ok/
Social Security Administration Forms page:
http://www.ssa.gov/online/forms.html
Social Security Administration POMS (sub
regulatory materials):
http://policy.ssa.gov/poms.nsf/aboutpoms
National Association of Social Security Claimants
Representatives (NOSSCR): http://www.nosscr.org/

112. Thank
you!
Contact
information:
Daniel Atkins,
Esq.
Phone: 484-557-
0171
Email:
da.helpmlp@gmail.com
Questions?

113. VISIT US ON THE WEB:
WWW.HELPMLP.ORG
Thank you!
http://on.fb.me/10OTObX
@HELPmlp