IC Patient Almost Loses Benefits

I just got off the phone with “Rita,” an IC patient who has gotten herself into a terrible situation. In 2008, she had to stop working due to her IC and other serious medical conditions. As a resident of California, a State Disability Insurance (SDI) fee was deducted from paychecks yet she chose not to apply for SDI at that time. When I asked her why, she said “I just thought I’d take six months, research it and then find a cure.”

Well, six months slowly changed into years as she lived off of her retirement and savings accounts. She’s now broke, unable to pay many of her bills and has finally realized that disability benefits could have helped. The problem? She waited too long.

Both state and federal disability programs work like most typical insurance programs. You must have recently paid into both systems to be eligible for benefits. If you stop paying into the system, you will eventually lose your eligibility.

In California, you must apply within 49 days of becoming disabled or you could lose your benefits. This makes sense given that the purpose of the state program is to provide “short term” benefits for workers who become ill or injured. State disability is fairly easy to obtain provided that you have a doctor who will vouch for your medical condition. They max out at one year.

Federal Social Security Disability Insurance (SSDI) benefits are designed for workers with severe or fatal illness who are not expected to be able to return to work. They are, in general, much harder to obtain than state benefits and have a more rigorous work history requirement. To be eligible you must have worked and paid into the social security system for approximately ten years (i.e. earned 40 quarters). You must also pass “the recent work test.” This means that you must have RECENTLY paid into the system. If you are 31 or older, you must have worked at least 5 of the last 10 years to keep up your SSD coverage. There are lower standards if you are in your twenties.

The Supplemental Security Income (SSI) program, also administered by the Social Security Administration, may provide help for patients with a minimal employment history. It is based upon your financial needs and income. Unlike the two programs above, SSI is funded through general tax revenues rather than payroll deductions.

In Rita’s case, she is no longer eligible for state benefits and would have failed the recent work test had she waited another few months to apply. Thank goodness she didn’t. She now has a chance to receive benefits and we can only hope that she is approved. She has multiple disabilities and should have applied years ago.

The reason why I’m writing this today is that I think she, like so many other patients, perceived that receiving disability benefits would have been a failure or perhaps shameful. This couldn’t be farther from the truth. If you have been gainfully employed and paid into these systems, you are absolutely entitled to benefit from these programs should you become injured or ill.

Please don’t jeopardize your financial future by trying to live off of your savings rather than applying for benefits. Don’t let pride stand in your way. There is no shame in using disability benefits to help you if IC has prevented you from earning a living. If you have paid into the system, you are entitled to apply for assistance. Go for it!

Learn more about disability insurance: