How to fund home modifications for seniors and people with disabilities in New York? Part II

Hello, everyone! As I continue to explore social services and public funding to pay for home modifications, I become more aware of the complexity to get access to this funding. It is this complexity that makes it even more gratifying for me to bring this information to you. Today, I will be talking about Workers’ Compensation, different types of insurance coverage as well as programs available through the Social Security Administration.

Worker’s Compensation
This is usually managed by the State in order to provide financial assistance for individuals injured in the workplace. Funds are provided in order to cover expenses such as: medical needs; vocational rehabilitation; and compensation for loss of function or death benefits to surviving dependents. Furthermore, worker’s compensation programs usually cover expenses related to modifications done to an existing home or a newly purchased accessible home. For more information, click on the links below:
New York Workers’ Compensation Alliance http://www.nyworkerscompensationalliance.org/
New York State Workers’ Compensation Board http://www.wcb.state.ny.us/

Insurance Coverage
There are three major types of insurance that may cover home modifications: Health, Life, and Long- Term Insurance. As more and more insurance companies are seeking ways to decrease health care cost and become more competitive, they are turning to options such as home modifications for answers. Many life and long-term insurance companies are including home modifications in their packages. For instance, “whole” life insurance policies build up cash value over time. These funds can be used at anytime for any purpose and are re-paid at very low rates. However, making an early use of these funds decreases the payout when the policyholder dies. Since not all long-term insurance companies have home modifications and provision of durable medical equipment as part of their policies, it is recommended that you ask your insurer beforehand. Below is a list of long- term insurance companies we have identified as offering home modifications within their insurance policies. For more information, click on the links below:
Genworth Life Insurance Company www.genworth.com
John Hancock Life Insurance Company www.johnhancocklongtermcare.com
State Farm Mutual Insurance Company www.statefarm.com
The Prudential Insurance Company of America www.prudential.com

Impairment Related Work Expenses (IRWE)
The Social Security Administration offers this program to individuals who receive Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). As the name implies, it is used by individuals with disabilities to cover the cost of home modifications needed in order for them to be able to work. If the person works outside their home, IRWE will cover the cost of modifications done to the outside of the house. If the person works from their home, IRWE will cover the cost of modifications done to the inside of the house. In most cases, the out of pocket cost of these services can be deducted from the amount of earnings used to determine SSI benefits. For more information, click on the link below:
http://www.socialsecurity.gov/redbook/eng/ssdi-and-ssi-employments-supports.htm#3

Plan for Achieving Self Support (PASS)
PASS is a Supplemental Security Income (SSI) work incentive program that allows individuals with disabilities to work. It is a written plan of action in order to obtain a particular type of employment or open up a business. The money obtained will not affect your SSI eligibility and if you are already eligible to obtain SSI, your benefits will be increased to reimburse you for the money that you spent on your PASS. For more information about eligibility and/or requirements, click on the link below:
http://www.ssa.gov/ssi/spotlights/spot-plans-self-support.htm

Overall, I think that it is important to understand that obtaining access to some of these programs and services is not clear cut; therefore, it is important to seek the advice of legal and social services professionals who can guide you in the process. Also, it is important that you talk to your doctor about your need for home modifications since many of them are not aware of this option. It is imperative that your doctor collaborates with this process since he/she will ultimately be providing the justification letter for you to get approved for home modifications. On the other hand, some Workers’ compensation administrators may not be too eager to pay for home modifications; however, if you are rightfully entitled to these benefits, home modifications and anything that you need to make you more comfortable and independent should be covered. Next week, we will be talking about tax benefits, reverse mortgages and other sources of funding for home modifications, so stay connected.

By

Miller Calberto, MS, OTR/L, CAPS
Senior partner
Adapting Spaces, LLC
mcalbertotr@adaptingspaces.com
1888-956-0077

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