Thursday, July 25, 2013

With Just One Click . . .

It is unbelievable to me how much stress one inflexible bureaucrat can create. 

My head pounds.
My stomach turns.
My mind races.

My breath has been taken away by a young woman at the Social Security office who has somehow decided Robert no longer qualifies for SSI or Medi-Cal.

She even insinuated I was lying to her.

I stared at her in disbelief.

I am not sure how this happened. All I know is it felt like I had been hit by a mac truck when walking out of the Social Security office. 

I really don’t know where to begin or how to cut this short. 

Bear with me.

When I took over Robert’s care at the end of 2008, he was getting Social Security and SSI benefits as well as Medi-Cal (the California equivalent of Medicaid).

My very first blog post was about the difficulties in changing Robert’s address from one county to another. (Be warned - it is long. This was written before I realized a blog post shouldn’t be as long as a mini-book.)

Things have not changed (with Social Security or my lengthy blog posts).

When Robert first moved to Sacramento, he was in a Skilled Nursing Facility while he recovered from an infection.  Once he was better, he moved into a Residential Care Facility for the Elderly (an Assisted Living Facility) under a waiver program.  He then moved into New (now old) Home.

With each move, I notified all the involved agencies: Social Security, SSI and Medi-Cal. 

Robert’s Social Security and SSI benefits were always adjusted depending on what type of facility he lived in.  His Medi-Cal benefits automatically renewed because he was on SSI.

I became his Representative Payee through Social Security so I could make changes on his behalf and not have to drag the poor guy into the Social Security offices.  I thought this would be an efficient way of dealing with Social Security while avoiding long waits.

After Robert moved into New (now old) Home, his Social Security payments seemed to be too much. Medi-Cal was covering the cost of the Home but still they sent what seemed to me, more money than he needed.

I made sure Robert had everything he needed and wanted but there was money left over each month. I called (several times) to verify the amount Robert should be getting.  Each time, I was told it was the correct amount.

When completing the first year report as the Representative Payee, I called to ask how to account for the savings.  I talked to one person who acted like I was a criminal for saving money. I then talked to the local office who again reassured me the amount was correct and guided me on how to complete the form.  

Call me cynical but it didn’t seem odd to me that the government would pay an amount more than was needed yet discourage people from saving it. However, I didn’t think I should spend the money unnecessarily.  After all, we were considering moving Robert in with us and if there was extra money we could use that for home modifications to accommodate Robert.

In the back of my mind, I also thought that if they were actually overpaying Robert I certainly didn’t want all that money spent. I assumed if there was an error they would eventually want the money back.

I sent in the form and didn’t hear anything about it.

Recently, I completed my second report.  On the form, there is a question about whether or not the consumer had moved within that time period.

Yes! Finally, Robert moved in with us!!  Goodbye, New (now old) Home!! Hello, actual home!

I answered the question affirmatively (although there wasn’t a spot for all those exclamation points).

Again, I accounted for the savings.

Soon after electronically filing the form, I got a call saying I needed to go into the Social Security office to make the address change.

This made no sense to me.  I already made the address change.  In fact, the woman at Social Security that I spoke to in mid-March said she would type up a note and send it to the local office so I wouldn’t have to physically go into the office.  She was such a sweetheart, I talked with her supervisor to give her kudos.

They wanted to see me so I made an appointment and gathered all my paperwork beforehand.  I was anxious about the appointment because I still worried they were overpaying Robert. 

Before leaving work for the appointment, I even joked with my best friend that she’d have to bail me out of Social Security jail.

The woman I met with was no-nonsense.  I tried being friendly while she typed my information into the computer but she didn’t smile or respond. She asked questions about our living arrangements (centering on whether or not Robert ate with us or bought his own food). 

Let’s be clear: the Rocky Road ice cream is Robert’s!

I told her I wasn’t sure why I had to come in because of my conversation with the rep in March and her telling me I wouldn’t have to go into the local office.

Ms. Bureaucrat said, “There’s no record of you ever calling Social Security.” Was that smugness? An accusation?

What?  That’s impossible. I told her who I talked with and what number I called.

She said, “Ma'am, I don’t know Darlene.”

Oh for heaven’s sake! Of course you don’t know Darlene – there’s probably a million people employed by Social Security!  

Did I call the right number?

“Ma’am, that number is for the WHOOOOLE United States.” (Complete with hand gestures to indicate just how big the United States is in case I didn’t know.)

Wow.  She’s not only a bureaucrat but she’s condescending.

I repeated that there have to be notes in Robert’s account that I’ve called.  I explained I called numerous times.

She just stared at me.

She then asked about the savings. I told her I had saved what was not spent each month which added up over the year. I explained that it was put in Robert’s Special Needs Trust so that neither he nor I have access to it because it was over the $2,000 threshold. I told her that it was going to be used for home improvement for Robert.

She repeated that there shouldn’t be any savings and that part of that money was to pay for his housing.  I explained the housing was paid for by his Regional Center or Medi-Cal.

She said that is not possible. Board and Care homes are not covered by Medi-Cal.

Um, well, he lived there for a couple of years and, trust me, I would have heard if they weren’t getting paid.

I told her I could contact Robert’s Regional Center rep and she said she would call him if I had the number.  

To her surprise, I produced it.

She called and left a message while I sat across from her.

She then said because Robert was getting more than the allowable threshold, Robert’s SSI would stop.  I actually didn’t really care about this.  After all, at this point, he’s only getting $35 a month from SSI.  That’s fine.

“And he will lose his Medi-Cal.”


He can’t lose his Medi-cal.  His medical expenses are outrageous between doctor visits, prescriptions, hospital stays and briefs. I don’t care if he loses all of his monetary benefits but he can’t lose the medical.

“Well, he still has Medicare. Plus, you can apply for Medi-Cal through the county.”

She then went on to tell me we would have to pay back the overpayment.

By this time, I was not only stunned but also confused.

Why in the world is he losing his SSI and Medi-Cal?  He has always had these. He’s been disabled since he was a child. 

I don’t understand. She couldn’t/wouldn’t explain to me why he was losing his benefits other than Social Security is paying him more than the threshold. I asked why the amount wasn’t adjusted as it has been in the past so he isn’t over the threshold.

She didn’t answer but jumped up in her seat and said, “Oh, I might be able to stop the SSI in August.” 

With one click she stopped his SSI and Medi-Cal.  She turned to me and said, “I couldn’t stop it in August but it is stopped effective September 1.”

The disappointment in her voice was noticeable.  I think she expected me to tell her how sad I was for her.

With one click (and one very unhelpful bureaucrat), Robert has lost his Medi-Cal benefits.

I will have to appeal her determination once I officially get it while I simultaneously apply for Medi-Cal through the county.

More to come as the situation develops.

For now, I need to take something for my headache.

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