A Division of Premier Legal Services, LLC

A Paralegal Owned and Operated Company 

The Disability Claims Digest

Volume 15

Copyright 2012

In This Issue
Peruse Our Archived Newsletters
Visit our Disability Forum
What Would You Like to Know?
Apply for Medicare On Line
Getting Help with Medicare Costs
Electronic Payments Will Be Mandatory
Accredited Disability Representative
Extending COBRA Benefits
Evaluating the Severity of Fibromyalgia

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We represent Social Security disability claimants locally, regionally and nationally.

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The Disability Claims Digest





Applying for Medicare


The Online Medicare Application allows you to apply for Medicare benefits if you're age 65 but not yet ready to start receiving retirement benefits. It takes less than 10 minutes to sign up for Medicare.

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Getting Help with Medicare Premiums and Out of Pocket Costs
Social Security and the Centers for Medicare & Medicaid Services are working together to get you Extra Help with your Medicare prescription drug plan costs. If you have limited resources and income, you may qualify for Extra Help with the costs-monthly premiums, annual deductibles, and prescription co-payments-related to a Medicare prescription drug plan. The Extra Help is estimated to be worth about $4,000 per year. To find out if you qualify, Social Security will need to know the value of your savings, investments, real estate (other than your home), and your income. If you are married and living with your spouse, Social Security will need information about both of you.



Welcome to the Fifteenth edition of The Disability Claims Digest. 

In this edition, we will be discussing various topics including Social Security's new ruling concerning the evaluation of Fibromyalgia and Extending Employers' Cobra benefits to bridge the 29 month wait for Medicare coverage after a disability claim is awarded.

As always, we have provided very helpful quick links to websites that we believe offer resourceful information and a plethora of support to disabled individuals, their loved ones and their health care providers.

If you have any questions, comments, concerns or require help with any aspect of a Social Security disability claim, please do not hesitate to contact us at:




Please read on....


Reminder: Electronic Payments of Your Social Security or Retirement Benefits Will Become Mandatory

Just a reminder that electronic payments are not simply the best way to receive Federal benefits - they will soon be the only way. The U.S. Department of the Treasury's new rule phases out paper checks for Federal benefit and non-tax payments by March 1, 2013. In fact, effective May 1, 2011, all new recipients of Federal benefits, including those filing for Social Security and Supplemental Security Income (SSI), must receive their payments electronically unless they meet one of the very limited exceptions.


Electronic payments are safer, easier, more reliable, less costly, and good for the environment. If you have clients who still get Federal benefit checks in the mail, have them visit today to sign up for direct deposit or Direct Express.


We are Pleased to Announce that Our President and Founder is now an Accredited Disability Representative (ADR)

Lisa Wagman, ADR, CP, NJCP, became a fully Accredited Disability Representative in January of 2012. This was attained only after having met the stringent criteria to participate in the Social Security Disability Applicants' Access to Professional Representation Act of 2010 (PRA). Through this process, she became a fully Accredited Disability Representative (ADR) through the National Association of Disability Representatives.


A disability representative must first meet the Social Security Administration's strictest requirements as they pertain to level of skill, education and experience in order to become eligible to qualify under PRA law. A disability representative must then pass a complex written examination implemented by the Social Security Administration to test their knowledge of all aspects of the disability and SSI programs.


As an Accredited Disability Representative (ADR), I will be participating in annual continuing education and will strive to maintain my knowledge and high level of expertise in my field. This will enable me to stay abreast of the constant changes in the law, regulations and rulings, so that I may continue to provide the highest possible quality representation to individuals filing for disability.


To learn more about the ADR program, please peruse the website by clicking Accredited Disability Representative.


Click here to learn more about the National Association of Disability Representatives, and the Social Security Disability Applicants' Access to Professional Representative Act of 2010 (PRA).


Please visit our website for helpful information and guidance regarding the Social Security claims process.
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Can COBRA health insurance benefits be extended beyond the standard 18 month period allowed by law?


When a claimant is awarded Title II disability benefits (Title II) (SSDI), Medicare coverage does not begin for 29 months from the awarded onset date of disability. 


The standard COBRA benefit period upon separation from employment is 18 months. 


Many of our clients ask us what other options they may have to obtain health insurance coverage after COBRA benefits terminate. 


COBRA benefits can be extended for 11 additional months if the following occurs:


1. Social Security awards Title II disability benefits (SSDI) before the 18 month expiration of COBRA;


2. Social Security's award must find that the claimant became disabled within 60 days of the date the individual stopped working;


3. Social Security's favorable award must be submitted to the COBRA insurance company or administrator within 60 days of the date of the award.


If a person opts to extend their Cobra by the additional 11 months, they could be charged up to 150% of the insurance premium during the 11 month period.


For additional information regarding this topic, please click on the following link to review the U.S. Department of Labor website page entitled "An Employees' Guide to Health Benefits Under COBRA":



How is Fibromyalgia Evaluated by Social Security?


It was not long ago that Social Security did not recognize Fibromyalgia as being a severely debilitating disease.  In fact, if Fibromyalgia was the only alleged medical condition that prevented a person from being able to work, generally adjudicators and Administrative Law Judges would deny the claim.


On July 25, 2012, Social Security issued a Ruling, SSR 12-2p, which changes the manner in which Social Security will consider the severity of Fibromyalgia.  As with any alleged medical condition, the medical evidence must establish the existence of a Medically Determinable Impairment (MDI) which could reasonably be expected to produce the pain or other symptoms alleged and they must be documented by an acceptable medical source. 


In order to prove the severity of Fibromyalgia, the medical evidence must establish as follows:


1.  There is a documented history of widespread pain;


2.  There are repeated manifestations of six or more Fibromyalgia symptoms, signs or co-occuring conditions, especially manifested by fatigue, cognitive or memory problems, waking unrefreshed, depression, anxiety disorder or irritable bowel syndrome;


3.  Evidence that other disorders that could cause these repeated manifestations of symptoms, signs or co-occurring conditions were excluded.


For more information concerning the procedure followed by Social Security when considering the severity of Fibromyalgia, click on the link below.


The Federal Register of the United States SSR 12-2p

From The President's
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We hope that the information in this edition of our Disability Digest will prove to be beneficial to you or someone you know who is applying for or receiving Social Security disability or Supplemental Security Income benefits.

It is our mission to help as many people as we can to make their way through the frustrating claims process.  We are here to help anyone who is on this journey.  In addition to excellent representation services, we provide all of our clients with guidance, words of comfort, compassion, encouragement and kindness.

If you know of anyone that may benefit from the information contained in our newsletter, please forward it along to them by using the link below.

Until next time, take care and be well.


Sincerely yours,
Lisa S. Wagman, ADR, CP, NJCP 
Founder and President 
Accredited Disability Representative
Certified Paralegal





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Social Security Disability Benefit Consultants is a subdivision of Premier Legal Services, LLC. We are independent benefit consultants authorized by law to represent claimants before the Social Security Administration from the initial application to the Appeals Council level. We are in no way affiliated with the Social Security Administration directly.

We do not provide any legal advice. Our newsletter is a general service that provides legal information. We are not a law firm. The information contained in this newsletter is general legal information and should not be construed as legal advice to be applied to any specific factual information. We do not endorse any content provided by any linked sites, nor do we assume any responsibility for the interpretation or application of any information originating from such content.
Copyright 2007-2012 by Social Security Disability Benefit Consultants.
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