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Every September 21st each year is recognized as World Alzheimer’s Day.  Alzheimer’s is a form of dementia that affects memory and impairs daily functions.  Alzheimer’s is the 7th most prevalent cause of death in the United States.  There is no cure although medications do appear to slow the progression at the early stage.  While most sufferers are in the elderly population, there are individuals under the age of 65 who are diagnosed with Alzheimer’s Disease.

Early Onset Alzheimer’s is included under the Compassionate Allowances in Social Security Disability.  With this diagnosis and an application for benefits, an approval will be fast-tracked.  Early Onset Alzheimer’s is a diagnosis of Alzheimer’s in a person under age 65.  Alzheimer’s Disease also meets a Medical Listing under Neurocognitive Disorders 12.02.  However, once a person reaches his/her full retirement age, the individual is no longer eligible for disability.

Alzheimer’s Disease onset usually begins with memory impairment, followed by learning and language deficits.  A person with Alzheimer’s may also exhibit depression, agitation, changes in personality and behavior, restlessness and withdrawal.  A diagnosis is made by clinical and family history and neuropsychological testing.  A clinical diagnosis can only occur post-mortem with a brain biopsy.

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Recently one of my uninsured disability clients told me she was receiving healthcare at Wal-mart.  When I looked it up, incredulously, it turns out Wal-mart is in the healthcare business.  Wal-mart has 4000 stores located in medically underserved communities.  Recently, the retail giant sought to address the needs of those communities’ access to healthcare.

Wal-mart expanded into clinical care by opening centers in Georgia and Texas in 2019.  In September 2019, Wal-mart launched its first clinic, Wal-mart Health in Dallas, Georgia.  Customers who are uninsured pay a flat fee of around $50.  A variety of health care professionals allow patients to bundle services at one time.   Wal-mart Health provides primary care, dental exams, X-rays, hearing services, mental health counseling, pharmacies and optical centers.  Wal-mart Health now has locations in Newnan, Fayetteville, McDonough, Cartersville, Marietta and Woodstock.

In May Wal-mart acquired a telemedicine company MeMD.  Last year, it acquired digital medical management company CareZone.  Wal-mart contends it is focused on “value-based” care.   This week Wal-mart and United Health Group announced a joint program to provide preventative healthcare for millions over age 65.  Fifteen locations will open in Georgia and Florida next year.  The plan is to provide seniors with healthcare through Medicare Advantage plans.

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Despite earlier judicial arguments by Republicans that abortion is a “state’s rights” issue, Senate Republican Lindsey Graham just introduced a national abortion ban at fifteen weeks  The bill includes procedures that are medication only abortions.  Moreover, the national abortion ban does not prevent states from enacting more restrictive abortion legislation.

Conservatives and libertarians traditionally reject federal over-reach.  However, some make exceptions for heavy-handed federal legislation when it involves controlling women’s bodies.  The concept that men, and some women entrenched in the patriarchal traditions, have the right to control a woman’s body over her own consent is, in essence, rape culture.  Allowing that a pregnant woman does not have autonomy over her reproductive choices is analogous to a culture that violates, intimidates and fails to respect her right to consensual sex.   Thus, abortion bans are just codified American rape culture.

This bill, coming just months after the Supreme Court removed a fifty year precedent of a right to abortion in Dobbs v. Jackson, proves that far right activists never intended to stop at state autonomy.  Moreover, we should not expect that this bill will be the limit of further national restrictions on gestational time periods for abortions, consensual sexuality between adults, same sex marriage or right to use contraception by women.

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August is Back to School Month for families with school age children.  The National Retail Federation (NRF) notes that consumers were cutting back on non-essential items or shopping sales in order to afford back to school supplies with the current inflation rate.  For families with disabilities, subsisting on Social Security benefits, this can be especially daunting.  NRF calculates the average cost per family to be $864 this year, mostly owing to inflation.

The Social Security Administration provides income for children through two programs.  SSA pays benefits for minor children of disabled adults who paid into the Title II program through pay roll taxes.  Second, SSA provides direct benefits to disabled children of low income families through its Supplemental Security Income program.  These benefits provide for approximately 4 million children in this country.

For families with a disabled child, the family must be low income to be considered eligible.  Review this chart to see if your family meets the threshold requirements.  The SSI Program provides critical support for 1.2 million children in this country.  Fifteen percent of all SSI recipients are children.   Because eligibility for SSI depends on meeting both medical and financial criteria, the rate of SSI receipt varies geographically depending on local health, economic and demographic factors.  In 2020, Georgia had 42,750 children receiving SSI.

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The Social Security Administration operates a Compassionate Allowance Program that identifies certain medical conditions that it will consider disabling.  These conditions allow SSA to accelerate claims processing for disability.  These medical conditions usually include certain cancers, some being at a later stage, adult brain disorders, and a number of rare diseases that affect children.  Waiting times for approval are reduced by several months if your condition qualifies.

Recently SSA announced 12 new conditions to its list.  These are:   Angioimmunoblastic T-cell Lymphoma, Blastic Plasmacytoid Dendritic Cell Neoplasm, Gerstmann-Straussler-Scheinker Disease, Microvillus Inclusion Disease – Child, Mowat-Wilson Syndrome, Myelodysplastic Syndrome with Excess Blasts, NUT Carcinoma, Pfeiffer Syndrome – Types II and III, Pontocerebellar Hypoplasia, Posterior Cortical Atrophy, Renal Amyloidosis – AL Type, and Sarcomatoid Mesothelioma.

SSA receives information from the public, medical experts, the disability program administrators, research from the National Institute of Health and public hearings to determine if new conditions should to be added to the list.

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Catching COVID-19 a second or more time heightens one’s risk for contracting Long COVID.  A recent Veterans Administration Health Study found that the risk of Long COVID increased with each subsequent re-infection.  Long COVID symptoms include malaise, fatigue, pulmonary problems, neurological issues, cardiovascular abnormalities, gastrointestinal pain and mental health impairments.  The Kaiser Family Foundation reports that Long COVID may affect 10 to 33 million working age adults in the US.

The correlation between Long COVID and re-infection rates is concerning given that the newest Omicron subvariant – BA.5 — readily infects the vaccinated, the boosted and people with prior immunity.  BA.5 currently accounts for 82 percent of all infections in the U.S.  Subvariant BA.5  is particularly proficient in dodging vaccination and prior immunity guardrails.  The swift mutation of the COVID-19 virus and its mutated sub-variants alarms medical professionals attempting to get infections rates under control.  To add to this concern, experts report that subsequent infections may be causing extensive cumulative damage to the body even when the symptoms are mild.   Multiple infections can contribute to death, hospitalizaiton and long term damage to major organs

Long COVID symptoms impact a person’s ability to work.  Over 15 percent of unfilled jobs are now related to Long COVID.  Claims for Long COVID are affecting employer provided disability insurance, worker’s compensation and health insurance.  For those industries particularly prone to employee COVID infections, such as healthcare or manufacturing, they may be disproportionately affected by absenteeism and rising healthcare costs.

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Can you invest your Social Security Disability benefits in a Roth IRA?

Roth IRAs are a type of individual retirement account that can allow you to save earned income while allowing that income to grow.  You can withdraw that income at a certain point of time in the future.  Roth IRAs are meant to be used to invest your after – tax  earnings.

Do Social Security disability benefits qualify as earned income to be invested in a Roth IRA?   The simple answer is NO.  Social Security disability benefits are not considered earned income.  However, if you are working part time  and have a source of income in addition to the benefits that you receive every month, this earned income can be invested in a  Roth IRA retirement account.  One caveat to working under substantial gainful employment (the maximum amount you can earn each month and still be considered disabled) is that these earnings might trigger a continuing disability review by Social Security to see if you are actually still medically disabled.  This is a risk undertaken when working while collecting disability.

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Yesterday the 11th Circuit lifted immediately an injunction from the lower courts on Georgia’s Heartbeat Bill – HB 481, making it law in Georgia.  The statute, known as the “Heartbeat Bill” provides that unborn persons have equal rights with born humans.  An unborn child becomes a person upon a detectable heartbeat determined (unscientifically) to be at six weeks.   Oddly, the bill references the 14th Amendment and its substantive due process inalienable rights of “life, liberty and property”.  Supreme Court Justice Clarence Thomas in his concurring opinion in the Roe v. Wade destruction case Dobbs vs. Jackson Health held that the US Constitution provides no substantive due process rights.  Nevertheless, a fetus now has these rights of equal (actually greater status) than the mother.

Per the statute, abortions after six weeks are illegal.  These exceptions apply.  Abortion is allowed to remove a dead unborn child caused by a spontaneous abortion.  Here is an important word: dead.  Women incurring a miscarriage will not be medically treated to remove the fetus, but rather will continue to have their health weighed against the balance of a heartbeat until death can be determined.  Again, the health of the mother is now, legally, secondary, to a fetus during a miscarriage.

An abortion to remove an ectopic pregnancy is an exception to the abortion rule.  The ectopic pregnancy is a  non-viable pregnancy certain to cause the death of the mother.  Very generous of the legislature.  Wild applause.

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The Trump administration’s anti-fraud program, known as the Civil Monetary Penalty Program, unfairly levied fines against the  poor and elderly.  Without providing due process for the beneficiaries, staff attorneys for the program were directed to assess fines more than the double the amount of the original payment made in error.  Attorneys who objected to the program were fired or demoted.

The program launched investigations into over-payments made to disabilty and retiree beneficiaries.  All of the beneficiaries belonged to a lower socio-economic class.  Many of these beneficiaries were fined outlandish amounts that ran into the thousands of dollars and far exceeded the original overpayment.  The program has recently come under increased scrutiny and criticism, and the Social Security Commissioner has directed the Social Security Inspector General to suspend the program.

It is believed that under the Trump administration’s anti fraud program, approximately 100 beneficiaries were levied fines.  Many of the fines were levied without due process and without enough evidence against these beneficiaries. One woman, who had received about $30,000 in benefits wrongfully, was fined $132,000.   The Social Security Inspector General’s office was aware that many of these beneficiaries would find themselves unable to challenge these fines in court.  Now, an investigation into these fines is on and hopefully, justice will be done to these victims.

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The week between June 12 and June 18 this year was marked as Scleroderma Awareness Week occurred between June 12 and  18.  Scleraderma is an autoimmune condition that is characterized by thickness and tightening of the skin. The skin may look leathery and become darker in colour.  The thickening of the skin may continue internally and may involve the internal organs such as the lungs and kidneys.  Problems with these internal organs may include tightness, scarring, pain and inflammation.

Scleroderma is a chronic disease.  Management of symptoms is typically the only treatment.  Over a period of time, more serious effects, including internal organ damage, cardiovascular problems and joint problems may occur.  All of these symptoms on their own or in combination with each other can make it difficult for a person to continue working at his/her regular job.

Make sure that you are aware of the symptoms of scleroderma, and get the symptoms checked out by your doctor as soon as they occur.  The most important thing to know is that  pain and stiffness are not necessarily the earliest symptoms.  When the condition progresses, the deterioration in skin health could lead to catastrophic adverse health events such as cardiovascular events and renal failure.  In some cases, people do not even realise that they suffer from scleroderma until the disease begins to affect the internal organs.

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