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8/9/2019 Pacific Clinics Benefits Advocacy Certification Course Introduction
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PACIFIC CLINICS
BENEFITS PRESENTATION
MICHAEL J. VAN ESSEN
Pacific Clinics
Westminster, CA
February 10, 2010
8/9/2019 Pacific Clinics Benefits Advocacy Certification Course Introduction
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These programs are complicated,
difficult to access and manage.
Finding an experienced Benefits
Advocate to help you navigate the
system is essential.
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Forging a chain of supports
link by link -- will ensure an
uninterrupted stream of income
as well as comprehensive health
care coverage.
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Those who are ill and in needshould have all the knowledge
necessary to make well-
informed decisions about
medical and financial Public
Benefits Programs.
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Understanding these programs
and how they work in concert
with one anotherwill provide
the disabled with the security
and reliability required to
maintain at minimum -- a
reasonable quality of life.
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DISABILITY
=INABILITY
DOES?
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There is no single definition ofdisability that is utilized by allFederal, State and Regional
Disability Benefit Programs
THE
BASICS
CALIFORNIAS STATE DISABILITY INSURANCE:
The state of Californias State Disability Programusually requires only a statement from any one
of a variety of health care providers.
SOCIAL SECURITY DISABILITY:
Social Securitys Supplemental Security Income(SSI) and Social Security Disability Insurance(SSDI) Requires an individual must be unable toperform "substantial gainful activity for no
less than one year.
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Diagnosis vs. Functional Limitation
Medically determinable marked orsevere Functional Limitations prohibitingan ability to sustain uninterruptedemployment for an indefinite period oftime are necessary to determine a
disability.
THEBASICS
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Diagnosis: Fractured Arm
Functional An inability to workdue to illness
Limitation: is a functional limitation
I work worked on a loading dock. I hurt my arm in
a motorcycle accident. I cant lift more than ten 10
lbs. Functional Limitation.
THEBASICS
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WHAT IS ADISABILITY?
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DISABILITY &
EMPLOYMENT
THE
BASICS
A disability is an inability to obtain
employment due to a physical and ormental illness, injury and/orcondition.
A disability is an inability toconsistently sustain gainfulemployment over an indefinite periodof time because of an illness, injuryand/or condition.
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These are often visible conditions requiringassistive technology, service animals, etc.
Visual impairmentImmobility
Inability to stand
Inability to control movement
Developmental delay
TRADITIONAL
orVISIBLE
DISABILITIES
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These are sometimes referred to as invisible
disabilities caused by conditions that manifesttheir symptoms unpredictably.
SOME EXAMPLES:
Bipolar Disorder, Schizophrenia
Epilepsy, MS
Lupus , HIV/AIDS
EPISODIC
orCHRONIC
DISABILITIES
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A disability is not only an illness, injury ordiagnosis but more likely a combination ofany of the above.
The approval of a disability claim requiresthe diagnosis(es) as well as the symptomsand the resulting functional limitations thatprohibit sustained employment for anindefinite period of time.
SUMMARY