PACIFIC CLINICS

BENEFITS PRESENTATION
MICHAEL J. VAN ESSEN
Pacific Clinics
Westminster, CA
February 10, 2010
These programs are complicated,

difficult to access and manage.

Finding an experienced Benefits

Advocate to help you navigate the

system is essential.
Forging a chain of supports –

link by link -- will ensure an

uninterrupted stream of income

as well as comprehensive health

care coverage.
Those who are ill and in need
should have all the knowledge
necessary to make well-
informed decisions about
medical and financial Public
Benefits Programs.
Understanding these programs
and how they work in concert
with one another will provide
the disabled with the security
and reliability required to
maintain – at minimum -- a
reasonable quality of life.
 DISABILITY
DOES? =
INABILITY
 There is no single definition of
THE disability that is utilized by all
BASICS Federal, State and Regional
Disability Benefit Programs

CALIFORNIA’S STATE DISABILITY INSURANCE:

1
The state of California’s State Disability Program
usually requires only a statement from any one
of a variety of health care providers.

SOCIAL SECURITY DISABILITY:

Social Security’s Supplemental Security Income

2 (SSI) and Social Security Disability Insurance

(SSDI) Requires an individual must be unable to
perform "substantial gainful activity” for no
less than one year.
 Diagnosis vs. Functional Limitation
THE Medically determinable “marked” or
severe Functional Limitations prohibiting
BASICS an ability to sustain uninterrupted
employment for an indefinite period of
time are necessary to determine a
disability.
 Diagnosis: Fractured Arm
THE Functional
Limitation:
An inability to work due to illness
is a functional limitation
BASICS “I work worked on a loading dock. I hurt my arm in
a motorcycle accident. I can’t lift more than ten 10
lbs.” Functional Limitation.
 WHAT IS A
? “DISABILITY”
 THE DISABILITY &
BASICS EMPLOYMENT

A disability is an inability to obtain

1
employment due to a physical and or
mental illness, injury and/or
condition.

A disability is an inability to
consistently sustain gainful

2 employment over an indefinite period

of time because of an illness, injury
and/or condition.
 These are often visible conditions requiring
TRADITIONAL assistive technology, service animals, etc.
Visual impairment
or
Immobility
VISIBLE Inability to stand
DISABILITIES Inability to control movement
Developmental delay
 These are sometimes referred to as “invisible”
EPISODIC disabilities caused by conditions that manifest
their symptoms unpredictably.
or
SOME EXAMPLES:
CHRONIC Bipolar Disorder, Schizophrenia
DISABILITIES Epilepsy, MS
Lupus , HIV/AIDS
 A disability is not only an illness, injury or
diagnosis but more likely a combination of
any of the above.
The approval of a disability claim requires
SUMMARY the diagnosis(es) as well as the symptoms
and the resulting functional limitations that
prohibit sustained employment for an
indefinite period of time.