Not unless he or she has worked long enough and recent enough prior to the disability. In the case of Robin McCann, she’s worked more than 20 years total, but because she did not work five consecutive years on her last job, she is finding out she does not qualify for any state or federal benefits, having exhausted her COBRA insurance on May 6.
“I never knew none of this!” Robin said. “That shocked me that I couldn’t get TennCare or disability. I’m sure there are a lot of people out there who think they’re going to be able to draw something if something happens, and they may not. They need to check into it.”
Robin and her husband of 14 years, Donnie, have two children and no answers as to how they will cover her mounting medical bills and medicines that total more than $1,000 for two prescriptions.
“The stress level is enormous,” Donnie confessed. “We have thousands and thousands of dollars worth of doctor bills. That leaves us destitute.”
In December 2010 Robin was diagnosed with cardiomyopathy, a disease of the heart muscle that interferes with the heart’s ability to pump blood with sufficient force. She was also diagnosed with congestive heart failure.
“The doctors believe that I caught a virus and it attacked my heart,” Robin said. “It came on suddenly. I had not been sick and I was healthy up until then. Originally, I was diagnosed as having an upper respiratory infection. It kept getting worse and worse so my husband took me to the emergency room at SkyRidge (Medical Center), and they diagnosed me with pneumonia. Then we had to go back to the ER on Dec. 26, 2010, and they told me I had congestive heart failure.”
Her physicians put her on Milrinone, a medication used for patients suffering from heart failure.
“That’s when I went and applied for disability,” Robin said. “I filled out all the paperwork and the doctors at Vanderbilt (hospital) did too. I sent it in and they said I was denied. So I went up there. I asked them how could I possibly be denied? They told me why. It was because I didn’t work five years straight. I had no idea after working all these years if I had to get disability something like that would affect it. It’s crazy!”
“The paper they sent us had age groups and every age group was different,” Donnie recalled. “Like if you’re 18 to 20 you only have to have one year of work history and you can get disability. If you’re 20 to 30 you have to work two years to draw disability, but if you’re in your 40s then you have to work five years in a row to draw disability.”
With her condition getting worse, Donnie said in April 2011 the doctors wanted to try heart surgery and the couple agreed, trying to correct the problem.
“They replaced a mitral valve and repaired the tricuspid valve in her heart,” he said. “After that she got better. She was back to her old self. She had energy and everything! She went back to work and sometime during September or October she started to get sick again. The doctors said her heart had grown and the cardiomyopathy was getting worse. They classified her condition as terminal if she didn’t get a heart transplant. The doctor walked in the room and said, ‘It could take up to three years to get a heart.’ I said, ‘Does she have three years?’ He said, ‘No.’”
Fortunately, Robin, 43, received a heart transplant on Jan. 8, 2012, and the procedure was a success. Only this time when she tried to return to work, she was met with a different reception.
“I went back but there was nothing,” she said. “I put another application in and kept checking back with them. Finally someone told me to come up there because a position had opened up. It was something I was familiar with and could do. I sat there for an hour and no one would talk to me. A man came in and said hello, then told the office lady to tell me he didn’t have time to talk to me. Then they hired a girl who was there the same day I was. I was mad! I was very upset.”
According to Robin, she was led to believe once she was healed she would be given work back at her old job, although nothing was put in writing.
“I’ve been out of work for about three years now,” she said. “I’m able-bodied. I can work and I want to work. But no one will give me a chance. I’d like someone to help me as far as getting a job, getting insurance — just lead me in the right direction as to where we can go to get assistance. Because everywhere I’ve turned and everywhere my husband has turned — there is no help. Maybe someone will hear about our situation and tell us what to do.”
“They told her after she went to the disability office the second time (in 2011) that they could probably get her on SSI (Social Security Income) since she didn’t qualify for disability,” Donnie said. “Then they said I made too much money. I bring home $23,000 a year for a family of four. I’d like to see one of them do it with all of these medical bills and everything else. Her medicine is $170 a month. That was our copay with COBRA,” he stated.
“Our cobra insurance ran out on May 6, so now we have nothing,” Robin added. “I’ve applied for other insurance for people with pre-existing conditions but it’s $579 a month with a $1,000 deductible. Besides, two of my rejection medications that I have to take are not on their prescription plan.”
“One of her prescription medications is $756 and the other is like $650,” Donnie added.
The couple said it’s possible that the new health care reform will help when it goes into effect in 2014, but “We’ve got to make it until then,” Donnie said. “We’ve applied for TennCare but an adult can’t get it unless you’re on disability and SSI.”
“I called a few lawyers and Social Security Advocates and they said that is correct,” Robin said. “I don’t know what we’re supposed to do.”
Jessica Carrasquillo, an accredited disability representative and CEO at Social Security Advocates said, “I suggest if people stop working due to a medical condition that they not wait before filing for disability benefits, because they will run into the same issue the McCanns have run into. File immediately. Better yet, contact us and we’ll handle it for you.”
“There needs to be a standard law for everybody, is what I think,” Donnie said. “If they’re going to let a 20-year-old work one year and get disability, then they ought to let everyone work one year and get disability — if they need it. I mean, Robin needs it!”
According to the official website of the U.S. Social Security Administration, “To qualify for Social Security disability benefits, you must first have worked in jobs covered by Social Security. Then you must have a medical condition that meets Social Security’s definition of disability. In general, we pay monthly cash benefits to people who are unable to work for a year or more because of a disability. Benefits usually continue until you are able to work again on a regular basis. In addition to meeting our definition of disability, you must have worked long enough — and recently enough — under Social Security to qualify for disability benefits.”