Example

Angelica’s Story

Angelica had been dealing with mental illness for years. When she was hospitalized with schizophrenia at 17, she was covered by her parents’ insurance. At 26, her mental state got worse. She could no longer hold down the part-time jobs she’d been doing. Angelica’s aunt tried to help out by occasionally paying for Angelica’s trips to the psychologist, but Angelica was running out of money and ideas. And she had no health coverage at all.

Her psychologist helped her put it together. “You have a medical condition, a mental health issue, which keeps you from working. The government calls that a disability. Why don’t you go to the local county social services agency and see if they can get some help? I think you should be able to get some cash assistance and medical coverage.”

Applying for Help

Angelica went to her county social services agency and talked to Ms. Pinkerton, one of the employees there. Angelica told Ms. Pinkerton about her medical history and her inability to work. She’d had no work for 3 months and was down to the last $500 in her bank account.

Ms. Pinkerton explained that with her medical and work history, Angelica should be eligible for Social Security disability benefits, either SSDI or SSI. Social Security would check its records to see if Angelica had enough past work to qualify for SSDI; otherwise, SSI would be the appropriate program. “You haven’t been able to work at the SGA level — $1,550/month — for some time now. And with resources of $500, you’re below SSI’s resource limit of $2,000. So you’re a good candidate.”

When Ms. Pinkerton mentioned that the Social Security application process could take several months, Angelica was unhappy. She was out of money right now. Ms. Pinkerton said, “While you are waiting for SSI, you can try applying for some other programs that may be able to help you. I can tell you the documents you need and help you fill out the applications.”

Angelica came back the next day with bank statements, tax records, pay stubs, and contact information for all the doctors and hospitals she’d dealt with. Then Angelica and Ms. Pinkerton sat together and filled out the forms. They filled out all the forms necessary for CalFresh (formerly Food Stamps) as well. Ms. Pinkerton also helped Angelica do the paperwork for Medi-Cal, saying "I think we can get you health coverage through Medi-Cal even before SSI comes through.”

Then, Ms. Pinkerton helped Angelica apply for SSI online. “We want to get your application into their records as quickly as possible, because if it turns out you qualify for SSI, they’ll pay your SSI benefits all the way back to your application date,” Ms. Pinkerton said.

Waiting

In early January, Ms. Pinkerton called Angelica. Angelica had gotten a disability determination from the state and so she was approved for Medi-Cal and CalFresh. “I’m breathing easier, because these will help me until SSI benefits begin” Angelica sighed.

On February 22, Angelica called Ms. Pinkerton, clearly upset. She’d gotten a denial letter from Social Security. Ms. Pinkerton asked Angelica to read the letterhead carefully. It turned out that Social Security Disability Insurance (SSDI) had denied Angelica because she didn’t have enough quarters of work to qualify. “That’s fine,” Ms. Pinkerton explained. “We didn’t expect you to get SSDI anyway, given your work record. We’re really looking for SSI. Social Security has to check to see if you’re eligible for SSDI first before they can consider you for SSI, that’s all. This isn’t a setback. You’ve just got some more waiting to do.”

Award

On April 12, Angelica got her SSI award letter. She qualified for $1,182.94/month in SSI benefits.

Angelica really started to feel good when Ms. Pinkerton told her the rest, “Later, when you’re feeling up to it, you can consider going back to work a few hours a week. You’ll have to report any changes in your income both to this office and to Social Security. But your SSI benefits amount will go down by less than your earnings, so you should always end up better off if you can work. For example, if you were earning $300/month, your SSI benefits amount would only go down by $107. And if you feel bad again and can’t work anymore, it’s pretty easy to get back on SSI at that point. I encourage you to experiment with DB101.org's online Benefits and Work Estimator to get a feel for how earnings and SSI work together. When you are seriously considering going back to work, you should contact a benefits planner for more help.”

“Thanks for everything,” said Angelica.