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PACIFIC CLINICS

BENEFITS PRESENTATION
MICHAEL J. VAN ESSEN Pacific Clinics Westminster, CA February 10, 2010

These programs are complicated,
difficult to access and manage. Finding an experienced Benefits

Advocate to help you navigate the
system is essential.

Forging a chain of supports –

link by link -- will ensure an
uninterrupted stream of income as well as comprehensive health

care coverage.

Those who are ill and in need should have all the knowledge necessary to make wellinformed decisions about medical and financial Public Benefits Programs.

Understanding these programs and how they work in concert with one another will provide the disabled with the security and reliability required to maintain – at minimum -- a reasonable quality of life.

DISABILITY = DOES? INABILITY

THE BASICS

There is no single definition of disability that is utilized by all Federal, State and Regional Disability Benefit Programs

CALIFORNIA’S STATE DISABILITY INSURANCE:

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The state of California’s State Disability Program usually requires only a statement from any one
of a variety of health care providers.

SOCIAL SECURITY DISABILITY:

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Social Security’s Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) Requires an individual must be unable to perform "substantial gainful activity” for no less than one year.

Diagnosis vs. Functional Limitation

THE BASICS

Medically determinable “marked” or severe Functional Limitations prohibiting an ability to sustain uninterrupted employment for an indefinite period of time are necessary to determine a disability.

Diagnosis:

Fractured Arm

THE BASICS

Functional Limitation:

An inability to work due to illness is a functional limitation

“I work worked on a loading dock. I hurt my arm in a motorcycle accident. I can’t lift more than ten 10 lbs.” Functional Limitation.

? “DISABILITY”

WHAT IS A

THE BASICS

DISABILITY & EMPLOYMENT
A disability is an inability to obtain employment due to a physical and or mental illness, injury and/or condition. A disability is an inability to consistently sustain gainful employment over an indefinite period of time because of an illness, injury and/or condition.

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TRADITIONAL or VISIBLE DISABILITIES

These are often visible conditions requiring assistive technology, service animals, etc. Visual impairment Immobility Inability to stand Inability to control movement Developmental delay

EPISODIC or CHRONIC DISABILITIES

These are sometimes referred to as “invisible” disabilities caused by conditions that manifest their symptoms unpredictably.
SOME EXAMPLES: Bipolar Disorder, Schizophrenia Epilepsy, MS Lupus , HIV/AIDS

A disability is not only an illness, injury or diagnosis but more likely a combination of any of the above.

SUMMARY

The approval of a disability claim requires the diagnosis(es) as well as the symptoms and the resulting functional limitations that prohibit sustained employment for an indefinite period of time.