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The Handbook:
Table of Contents
Introduction
Brain Disorders
Coping in Crisis
Medications
Resources for Care
Effects on the Family
Public Health Services
Financial Resources
Working with the System
Appendices:
NAMI Phone Numbers
DuPage Health Services
Chicago Area Hospitals
Community Resources
Legal Resources
Books, Videos, Journals
Hospitalization Form
Judicial Admission Form
Declaration of Treatment
Drug Reimbursement
An Affiliate of the National Alliance on Mental Illness
Federal and State Programs: SSI, SSDI, Medicare, Medicaid
Supplementary Security Income (SSI) and Social Security Disability Insurance (SSDI) programs are designed to provide financial assistance or replace some lost earnings to some disabled people, including the mentally ill. Additional eligibility requirements for SSI also include consideration of income.
In order to qualify for SSDI, you must have worked in 5 of the last 10 years, unless you are under age 31. Contact your nearest Social Security Office for more detailed information and assistance in filing these applications. Applications can now be completed on the phone so that the need to visit the office is virtually eliminated. It is necessary to provide the Social Security Office with the client's Social Security number and a list of doctors, hospitals, or clinics where diagnosis and treatment were received.
Depending on the type of claim filed, you may need to provide other evidence, such as birth certificate or other proof of age, proof of citizenship, information about any sources of financial support, and financial documents, tax returns, bankbooks, insurance policies, car registration and burial fund records. The Social Security representative will advise you of the documents needed to process your claim. It is important that you provide Social Security with all the information pertaining to the disability.
A disabled adult child who was disabled before the age of 22 may be eligible for coverage on a parent's Social Security if the parent is retired, disabled, or deceased. The amount of SSI benefits is more if the mentally ill person lives independently rather than at home. A representative payee designated to receive payments on behalf of the disabled person may be necessary if the disabled person is unable to manage his or her funds. The payee may be a relative or a concerned friend. Occasionally, the Health Department can be the payee for an active client.
If SSI or SSDI benefits are denied, the ruling may be appealed as follows:
- Ask for reconsideration of the ruling,
- Ask for a hearing before an administrative law judge,
- Ask for a review of the decision by the Appeals Council,
- Bring civil action in federal court.
Be careful to file each appeal within 60 days of the denial. Do not be discouraged if you are denied twice. Many claims are not won until you appear before an administrative law judge. Retaining legal counsel experienced in this area of the law may be helpful but is not required. Many attorneys will represent claimants on a contingency basis -- no fee unless the claim is successful.
Medicaid is generally available for those who qualify for SSI. Apply for Medicaid at the local Public Aid Office, 146 W. Roosevelt Road, Villa Park, IL 60181. Call 530-1120. After you have been receiving Social Security Disability Benefits for two years, the Social Security Office will notify you that you are eligible for Medicare. (800) 642-6930. Since laws are always changing, check for changes with the Public Aid Office and one of the Social Security Offices listed above.
Earned Income Tax Credit
If a consumer has earned some money during the year, there is a possibility that he may be eligible for Earned Income Tax Credit (EITC) at tax filing time.
The Earned Income Tax Credit is a refundable tax credit for qualified workers. A qualified worker may be eligible to claim the EITC even if he had no federal income tax withheld and/or owes no federal income tax.
If a person qualifies, he must file a Federal Income Tax Return (1040, 1040A, or 1040EZ) with supporting information. The amount of the tax credit (refund) received is based on how much money was earned. For information and assistance, contact the local Internal Revenue Service (IRS) office or the NAMI DuPage Office.
Free and informative booklets are available at the Social Security offices that serve DuPage County residents:
- 1600 N. Farnsworth Avenue, Aurora, IL 60505
- 230 W. Lake Street, Bloomingdale, IL 60108
- 6330 Belmont Road, Downers Grove, IL 60516
- 1845 W. Grandstand Place, Suite 200, Elgin, IL 60123
The telephone number for these offices is (800) 772-1213.
Another free booklet entitled "SSI and Social Security Disability: Securing and Protecting Your Benefits" can be ordered from Equip for Equality, 11 E. Adams, Suite 1200, Chicago, IL 60603. Phone (312) 341-0022.
Illinois Circuit Breaker and Pharmaceutical Assistance Act
The Illinois Citizens' and Household Person's Property Tax Relief and Pharmaceutical Assistance Act has created a state program that may give qualified individuals some of the money they paid in property taxes, rent, or nursing home charges. It may also help to pay for certain prescription medicines that are needed.
The amount of money received for a circuit breaker grant is determined by a formula that takes into account the amount of property taxes, rent or nursing home charges and total household income. To qualify, one must file Form IL-1363 Circuit Breaker and Pharmaceutical Assistance Claim. Additional information and assistance are available from the Illinois Department of Revenue by calling (800) 624-2459. Representatives are available weekdays from 8:00 A.M. to 5:00 P.M.
State and Local Programs
The Illinois Department of Public Aid may offer interim support while waiting for SSI payments. Application for interim support should always be made when applying for SSI. Frequently, it can take a year or more for the determination to be made if the case is at the hearing level.
Guardianship and Conservatorship
Guardianship is the designation by the County Probate Court of a person to make personal decisions on behalf of another person who is judged to be incapacitated. The guardian makes decisions regarding personal care but is not financially responsible for the costs involved. A parent or other family member may want to seek guardianship for a mentally ill relative because:
- the guardian can help the mentally ill person by seeing that he or she is living in a safe place or receives needed medical attention, or
- the guardian has full access to medical records, information that may otherwise be impossible to obtain.
Conservatorship is the designation by the County Probate Court of a person to assume financial management of income or property. If the disabled person has property worth less than $5,000, or if his income is less than $5,000, a conservator is not necessary. In this case, however, a parent or other person may be designated payee for SSI or other benefits. You may want to contact NAMI DuPage or your attorney to discuss the advantages and disadvantages of Conservatorship/Guardianship.
Wills and Estate Planning
If the mentally ill person qualifies for SSI benefits, it is very important for the family to plan ahead so that the SSI payments and Medicaid will not be lost through inadequate estate planning. By inheriting property or money, the mentally ill person may be disqualified for these entitlements that cover the cost of residential and medical care. Some families have drawn up a will that disqualifies the mentally ill relative; others have set up a Living Trust Fund with another relative as trustee (or co-trustee with a financial institution) on behalf of the mentally ill person. The trust fund must be restricted so that it cannot be used for support and maintenance. A lawyer who specializes in this work should be consulted.
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