Planning for care. For life.

NCA Success Story: Maximizing Third-Party Benefits for Quality of Life

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Third-party benefits are often lifelines for individuals with complex healthcare needs. They not only ensure individuals have access to essential healthcare but also help provide specialized and comprehensive support.

Through National Care Advisors’ Benefits Assessment and Case Management services, we can uniquely assess an individual's third-party benefits and provide recommendations to maximize their utilization for improved quality of life. Whether an individual is applying for benefits for the first time or has had a lapse in eligibility, our team of nurse consultants work with individuals and their families to navigate the various applications and processes.

In this NCA Success Story, we highlight three different cases of individuals and their experiences with third-party benefits.       

Lapsed SSDI Benefits
A professional trustee contacted NCA to assist Michelle and Beth, a mother/daughter duo living in the Midwest. Both were known to have several mental and physical limitations and the trustee had concerns about their home and physical well-being.

Upon our initial visit to the home, the case manager noticed their home to be unkept, and they had personal hygiene issues. Michelle had also reported a recent bedbug infestation in the house. During their visit, our case manager discovered that Michelle had not received her SSDI check for several months. Sitting down with Michelle, they called the Social Security Administration to determine what was needed to resume payments. A representative advised an in-person meeting would be required, and Michelle would need a valid ID. Michelle’s ID had expired several months prior. Beth’s license was also invalid.

The case manager arranged for third-party transportation for Michelle and Beth to meet them at the local DMV. Two hours later, both had renewed state identification cards. The case manager arranged additional transportation to meet them at the SSA office. After waiting with them for nearly 3 hours, the representative corrected Michelle’s issue in 10 minutes. Michelle received ten months of back pay, totaling almost $15,000 dollars.

Her future payments are now set for direct deposit into her bank account, and she and Beth are getting the support needed to have a clean and safe home.

Education Services
Everyone is entitled to a free and appropriate education. NCA’s education consultant team was engaged in an existing case when it was discovered they were not receiving appropriate education services due to their current physical condition. Alyssa had been out of school prior to the COVID-19 pandemic due to continuing issues with her health. Once the school district returned to in-person, Alyssa could still not return to class; however, there was no teacher at the district level to provide inbound instruction.

After several meetings with school and district administration and the collaboration of her physicians and case manager, our education consultant was able to secure over $7,000 in compensatory education funds for Alyssa. These funds can be used for equipment, speech therapy, occupational therapy and additional supplements to Alyssa’s education. This is in addition to the services provided by her individualized education plan (IEP).

Couch Surfing and Homeless
Our case manager first met Mark while he was couch surfing in a friend’s home. He is in his mid-thirties and lives with an intellectual disability.

Shortly after our first interaction with Mark, he moved to a nearby state to be with a new girlfriend. He found an apartment and received less than $400 a month in Social Security Disability Insurance for a Disabled Adult Child and disbursements from a small SNT arranged by his grandparents. Through our third-party benefits assessment, we analyzed Mark’s situation and started to work with him to apply for the state and federal benefits he was eligible for. SSI, Medicaid, SNAP and Low-Income Home Energy Assistance (LIHEAP) benefits were applied for and ultimately approved. Our case manager worked persistently with the local SSA office to provide the necessary information, including a mental IQ exam through an Social Security provider.

Now approved, Mark receives over $500 in local/state benefits, his maximum SSI benefit, and over six months of retroactive pay from when the application was submitted. With his benefits now fully maximized, his budget increased by over $1,200 monthly.

Regardless of whether it is a local, state or federal benefit, our team of Nurse and Education Consultants are experts in evaluating and maximizing third-party benefits for the optimal quality of life of the beneficiary. If you have concerns regarding your client or loved one’s benefits, contact us today to schedule a review.