Definition of "Disabled"
A person is entitled to Social Security Disability (SSD) when he/she is no longer able to perform gainful activity due to any physical or mental impairment which is expected to last for 12 months or result in death,

and the severity of the impairment meets or equals the level of severity described in the Social Security regulations,

or the impairment or disabling condition is of such severity that the person cannot do their previous work, nor any kind of substantial gainful work for someone of the same age, education and work experience.

Paying Into Social Security
A person must have contributed to Social Security payroll taxes over a period of time to meet insured status requirements. The length of time a person must have paid into SSD varies by age. If a person stops working and paying Social Security taxes, the patient must be able to show that their disability was present during the period when no Social Security taxes were paid.

Applying for SSD
Specific criteria for disability due to ALS are included in the Social Security Listing of Impairments. It is important that the patient's physician be familiar with these criteria when completing his/her portion of the application paperwork. Complete the SSD application without delay as soon as the disability criteria are met.

It is important to provide a full and accurate list of all symptoms in the Social Security (SS) application for Disability. A 30 to 60-day disability diary describing each aspect of how ALS affects the patient is a useful adjunct to the SSD application.

It is not uncommon for a claim for SSD to be denied and for the time frame of the initial and subsequent appeals to be lengthy. Many claims are denied because the patient's medical record lacks adequate documentation that fully establishes the severity of the ALS disability. It is important to fully explain the extent of the disability and symptoms to the physician including specific ways that ALS limits daily activities. Be sure the initial application is comprehensive to avoid a denial of benefits.

For obvious reasons, many people with ALS focus on their abilities and what they can do and what they contribute to society. However, when applying for SSD, it is critical to honestly account for all limitations and symptoms in a specific and detailed manner.

Appealing a Denial
If the application for SSD is denied, reapply after determining the reasons the initial application was denied. In some states, Medicare eligibility entitles the person to purchase supplemental insurance - "Medi-gap" - policies, regardless of current health status. "Medi-gap" policies can provide coverage for items that Medicare does not cover such as prescription drugs.

And read the Social Security Administration's information online about the appeals process: Office of Hearings and Appeals

Other Options
Other programs that may assist people with ALS to maintain access to health care insurance coverage, whether or not they are eligible for SSD and Medicare include:

• Title X of the Consolidated Budget Reconciliation Act (COBRA)
• Health Insurance Portability and Accountability Act (HIPAA)
• Family Medical Leave Act (FMLA)