By Steve Perrigo, JD

In the rapidly evolving world of healthcare, case management has emerged as a keystone of patient care and advocacy. At the heart of this function is the notion of serving as a bridge for patients – not just to access healthcare resources, but also to reach important financial backstops like disability insurance. The essence of case management as a bridge, or a means to facilitate better health and self-advocacy for individuals, is echoed in the healthcare sector and its professionals.

One critical avenue where this bridge extends is in helping individuals navigate the intricate and often protracted Social Security Disability Insurance (SSDI) application process. Beginning the SSDI application promptly after ceasing work is crucial, especially given the often lengthy claims determination process with the Social Security Administration (SSA).

The application and appeals process can typically take a minimum of three months and, when factoring in appeals, two years or longer to receive approval. This may include a requirement for patients to attend a hearing before an administrative law judge. For those with severe conditions, such as specific rare cancers or heart diseases, the SSA’s compassionate allowances program can expedite applications to a few weeks.

Yet, it's a reality that the majority of initial SSDI applications face denial. This necessitates an appeals process, which can stretch out for many months, leading to a long delay for individuals needing this vital income and who are, typically, experiencing worsening medical conditions.

This is where the value of long-term disability insurance becomes glaringly evident. Long-term disability insurance acts as a crucial financial buffer, especially during the potentially long waiting periods associated with SSDI applications. Monthly benefits through a patient’s long-term disability insurance policy generally start before someone applies for SSDI, offering immediate financial relief.

Case management’s role in this context isn’t just to act as a healthcare navigator, but also as an informative guide through the resources available in order for patients to begin the SSDI process while underscoring the benefits of private disability insurance. By understanding and integrating these aspects, case managers can further enhance the holistic care they provide to individuals.

LTD policies are designed to coordinate directly with SSDI, providing a combination of vital benefits to meet the needs for individuals and their families after a severe medical condition and work stoppage occurs. Individuals can also find disability financial solutions to help them through the waiting period of SSDI review, such as utilities and prescription drug assistance. Connecting patients to resources, shared decision-making initiatives, and Long-Term Services and Supports (LTSS) are important aspects where case management plays a vital role.

In addition, case managers may be tasked with developing Individualized Service Plans (ISPs), which are tailored to meet the unique needs of each individual, encompassing medical, vocational and social services. This also ties into the vocational value of LTD and SSDI coverage, which incorporate return to work assistance and an eye on helping individuals eventually rejoin their prior employer, or take a new position in the workforce.

Case managers, as highlighted by the Case Management Society of America (CMSA), wield communication as a key tool. Their engagement as a bridge to services and resources helps by aligning patients’ preferences within the framework of quality healthcare delivery. They connect individuals with the solutions that best meet a variety of patient needs during times of health transition and medical treatment. And, as one component, disability insurance plays a vital part in the financial and medical stability of patients.

Knowledge and access are the keys that case managers hold, signaling their dynamic place in the medical sector. Disability insurance is just one of the many crucial aspects that case managers must be equipped to guide individuals through, ensuring a more seamless and supportive healthcare experience. Now more than ever, patients need to have the full picture of their health and financial options, and case managers help them fill in these pieces.

Have you submitted? The #CMSA2024 Call for Presentations is your opportunity to share your expertise — groundbreaking ideas, transformative strategies, and thought-provoking research — with the healthcare community. Be a catalyst for change! Visit our submission portal https://cmsa.societyconference.com/ Deadline to submit is October 31!

Bio Steve Perrigo, JD, is vice president, sales and marketing for Allsup and has over two decades of experience and knowledge of the Social Security Administration (SSA) and its programs. He joined Allsup in August 2010 and helps clients understand their options when coordinating private disability insurance benefits with the Social Security program. He focuses on providing clients with solutions that benefit both their businesses and the individuals they serve. Prior to joining Allsup, Steve spent 17 years with the SSA in roles of increasing responsibility.