Client Approved for Extended Eligibility and Medicare Benefits

Our client, Charisse Wall, suffers from a skin condition known as hidradenitis suppurativa. This condition has caused her to suffer from extensive skin lesions for many years. These serious lesions continue despite extensive surgical treatment, antibiotic treatment, and wound treatment. She has endured multiple surgeries and long hospital stays. Yet, her condition persists.

The Appeals Council had already decided that Ms. Wall was disabled as of August 23, 2013 and that she remained disabled through January 1, 2015. However, a dispute continued over whether Ms. Wall was still considered disabled beginning on January 2, 2015.

Accordingly, we represented her before the Social Security Administration Office of Disability Adjudication and Review so that an administrative law judge could decide two issues. Specifically, the administrative law judge considered: (1) whether Ms. Wall continued to be disabled and to meet the requirements of Section 8.06 in the Listing of Impairments after January 1, 2015; and (2) whether her trial work period had been completed and she should no longer be considered disabled because she is able to engage in substantial gainful activity.

Our Client Remains Disabled and Has Entered the Extended Period of Eligibility

The administrative law judge found that Ms. Wall remained disabled from January 2, 2015 through the date of the decision on July 28, 2017 and that Ms. Wall had finished her trial work period in August 2015. However, since Ms. Wall remained disabled for purposes of Social Security disability she entered an extended period of eligibility when her trial work period ended. That extended period of eligibility began in September 2015 and will continue for 36 months.

During an extended period of eligibility, Ms. Wall may receive Social Security disability benefits for any month during which she is unable to engage in substantial gainful activity because of her disability. These benefits should be provided simply by notifying the Social Security Administration of her earnings and a new application for benefits should not be required. This provides Ms. Wall with three additional years of security as her medical condition sometimes requires extended absences from work – especially during periods of hospitalizations.

Medicare Coverage Continues Because Our Client Remains Disabled

The finding that Ms. Wall has a continuing disability not only makes her eligible for the extended period of eligibility, but also for Medicare benefits. According to the Social Security Administration, a person who has a continuing disabling condition but who can engage in substantial gainful activity may continue to be eligible for Medicare benefits for at least 93 months after the trial work period ends. This provides Ms. Wall with certainty that she will have Medicare health coverage for many years even if she is able to work.

These Important Findings Provide Our Client With Security

The administrative law judge’s finding that Ms. Wall remains disabled has provided her with security. She was able to go back to work despite the risks of extended hospitalizations and lack of affordable medical coverage. It allowed her to enjoy a three-year extended period of eligibility during which she could receive Social Security disability benefits for any month during which she was medically unable to work and it allowed her to continue receiving Medicare benefits for many more years to come.