Legal Aid Success Stories - Income Maintenance
Noelle’s daughter Poppy was born with Apert’s Syndrome, a rare and complex condition that caused her fingers to be fused together. For Poppy to have full use of her hands, she needed very specialized reconstructive surgery. Noelle connected with a surgeon in Boston who specializes in this type of surgery and who was confident that he could give Poppy ten working fingers.But Noelle’s health plan provider denied the request to use this specialist, citing the cost, and insisted that Noelle use a local surgeon. None of the experienced hand surgeons in Oregon felt confident that they could give Poppy ten fingers. The cycle of requests, denials, and appeals for Poppy’s essential surgery went on for three years, despite the Boston specialist waiving his fees to make the surgery less expensive. Noelle desperately wanted Poppy to have ten working fingers before she began kindergarten, and time was running out.Luckily, Noelle found legal aid, and they began working on the next appeal together. Having an attorney step in to ask questions, request documents, and review processes made all the difference. Just before the appeal hearing, the health plan changed course and gave full permission for the surgery on the East Coast.Now Poppy is thriving with ten fully functional fingers, just in time to start school. To celebrate the one-year anniversary of the surgery, Noelle and Poppy threw a “birthday party” for Poppy’s hands and invited their legal aid lawyer to join the celebration.
Amy, a mother of five, was 28 and apparently healthy when she suddenly collapsed. She woke up in the hospital to learn a tumor in her spine had ruptured one of her spinal bones. Amy lost her job and her savings in her seven-year battle with cancer, and when she went into remission, she still had intense pain in her damaged bones. Then Oregon Health Plan (OHP) mistakenly stopped covering her pain medication, leaving her as ill as she was during chemotherapy. Amy turned to legal aid, and legal aid worked with OHP to restore coverage. Amy said “If [legal aid] hadn’t stepped in, I would still be in horrendous amounts of pain, unable to function.”
A single mom working three jobs, Flora spoke only Spanish and could not read or write. She had always wanted to own her own business and earn enough to send her sons to college. A national janitorial company representative told Flora, through an interpreter, about the opportunity to buy a franchise — she would receive accounts that would generate $3000 per month within six months. Flora relied on the representative’s word and signed the contract, putting some money down and financing the remaining franchise fee with them. More than a year later, Flora was earning less than $700 per month. The company was also deducting “royalties and management fees” and the cost of her cleaning supplies. Flora turned to legal aid in frustration. Legal aid knew that this corporation and others have been sued in other states for classifying janitorial employees as independent business owners. They were able to settle Flora’s case, with the company terminating her franchise agreement and forgiving her outstanding obligations.
Zach is five and has a severe gastrointestinal disorder. He has had eight surgeries so far. “Natalie,” Zach’s mom, worked almost full time while also taking Zach to day-long treatments each week. Social Security benefits helped offset some of the costs. When Zach turned three, he celebrated a milestone—he could take food orally. That’s when Social Security terminated his benefits, despite his doctors’ protests that he was still seriously ill. Natalie tried to hire a lawyer to navigate the complicated bureaucracy, but she couldn’t pay for a lawyer and fees were not available. Legal aid stepped in and benefits were reinstated. Between work, benefits, scrimping, and saving, Natalie was able to relocate closer to a facility with more treatment options, giving Zach a better chance at an active life.
Lynette is a 44 year old busy single mom of a 17 year old daughter. When she had difficulty breathing and started to have chest pains, she went to the hospital and was admitted to the intensive care unit. Lynette thought that the Oregon Health Plan would take care of the bill. She was surprised when the hospital and later a collections agency said that she owed them for some of the treatments she received in the hospital. Lynette’s income covered her rent, utilities and groceries, with almost nothing left over. It would have been impossible to pay the hospital bill and stay current on other bills. She called legal aid, and the attorney worked things out with the hospital. Lynette said, “Legal aid was a godsend to me and I’m not sure what I would have done if they hadn’t been there to help.
Ellen was fired after reporting discrimination in the workplace. As a single mother of two, she was concerned about making ends meet. When she was denied unemployment benefits, she turned to legal aid for help. After a long hearing and testimony from a number of witnesses, Ellen won her appeal. With her unemployment benefits she was able to pay her rent. She now has part time employment. Ellen told the Campaign, “I am really appreciative. Without the help I wasn’t going to win. I was very nervous and didn’t know what to say.”
Julie and Kevin are hardworking parents of four. Their youngest, twin boys, were both born with serious heart problems. Even with two working parents, the family lives on the edge of poverty because of medical costs. Fortunately, they receive help from the Oregon Health Plan (OHP). Things started to unravel when the hospital billed Julie, instead of OHP, for an expensive procedure. Julie contacted the hospital many times to explain that the bill should go to OHP, but the hospital ignored her, and then called a collection agency. Frustrated and unable to get results on her own, Julie finally turned to legal aid. Once legal aid got involved, the hospital called off the collection agency, protecting the family from extreme financial hardship.
Seven years ago Lawrence had a heart attack. At the time he was working nearly full time as a clerk in a grocery store, but he was not offered enough hours to qualify for his employer’s health insurance plan. The heart attack caught Lawrence off guard. He had been having some health issues for a while, but didn’t have the money to go to the doctor. His heart attack required a hospitalization and an expensive regimen of pharmaceuticals and follow-up doctor appointments. Lawrence also had to reduce his hours at work while he recuperated. The medical bills started to pile up. He did his best to pay them, and set up payment plans. The debt was more than he could handle on his limited income though, and soon the bills were sent to collection agencies. Lawrence was incredibly stressed out about making the payments, and the stress was starting to affect his already fragile health. A friend told Lawrence about the Debtor-Creditor Section Legal Aid Bankruptcy Clinic, and he made an appointment to attend. Lawrence was connected with a pro bono attorney who filed a Chapter 7 bankruptcy for him. When his medical debt was discharged, it was as if a huge weight had been lifted off of his shoulders – and his chest. Lawrence said, “my attorney truly saved my life. By helping me with my bankruptcy she has given me a fresh start. I can finally sleep through the night without worrying about how to pay my bills.”
Jennifer is a cancer survivor with three grown children. She was was diagnosed at Stage IV, the most advanced, and got coverage through the Oregon Health Plan (OHP). Today, she has been in remission for four years and has been able to return to work part time, but she must see her doctors every six months. One day, she got a bill from the medical center for a procedure that was done almost two years ago. Jennifer works as much as she can, but still barely keeps food on the table, and she couldn’t afford the bill. When she told them that, they told her she couldn’t see her doctors anymore. They also called a collection agency, and the collection agency sued her. So she called legal aid. Her legal aid lawyer knew that the medical center couldn’t bill her directly, much less after two years had passed, and they had to let her see her doctor—the center agreed to that when they took her as an OHP patient. Once legal aid got involved, the collection agency backed down, and Jennifer was allowed to see her doctor.
John is an 85-year-old World War II veteran who served with distinction. Orphaned at birth in rural Wyoming, John was raised by foster families and joined the military at 16. After military service and a lifetime of work, John applied for Social Security retirement benefits in 1993. His application was denied because he could not produce a birth certificate. John thought he was out of luck until he called legal aid. Legal aid lawyers helped him get benefits. He is now able to pay for rent, food and medical care.
Charlie is 45 years old and disabled. He struggles to make ends meet, and finally found a job delivering newspapers. After he started work, the employer kept lowering the promised rate of pay, and within two weeks he could see the pay wouldn’t even cover his gas money. He quit and asked the employer for his paycheck-—by his calculation, just $175. The employer refused to pay at all and made threats when Charlie protested. Charlie really needed that $175, so he called legal aid. Legal aid discovered that the employer had committed multiple violations of wage and hour laws, and that Charlie was owed far more than $175. A legal aid lawyer got a judgment that fairly compensated Charlie for his work. Afterwards, Charlie said “I feel like I got justice. I wouldn’t have known where to start. I needed help and [legal aid] helped.”
When Stephanie and her three children left an abusive home, the Department of Human Services provided childcare so Stephanie could work. Stephanie had just settled into a steady job, making a just over minimum wage, when DHS began garnishing her paycheck, saying her unemployed husband should have been providing childcare. In fact, he was under a “no contact” order and could not have provided childcare during that time. Stephanie could not afford both food and rent with the garnishment, so she began working 12 hour shifts that kept her away from her children. Legal aid attorneys helped Stephanie stop the garnishment. Now Stephanie can maintain the delicate economic balance that keeps her family in a stable and safe home.