Maxine Riche -- Council Bluffs, IA

Written By: Adam Sege

For 35 years, Maxine Riche guided nursing home patients through their daily routines of getting up, getting dressed, eating and bathing.  It was tough work, but she kept going even as her own health deteriorated.

Maxine broke multiple bones on the job and developed a long list of chronic health problems: osteoporosis, arthritis, high blood pressure, carpal tunnel syndrome, a sore back and neck pain.  Being a Nurse’s Aide was the only job she knew, but in 2006, after coming down with a serious illness and breaking her hand, Maxine was forced to stop working entirely.

With no new income, Maxine couldn’t afford to keep paying her home insurance. Six months after Maxine’s insurance expired, a fire destroyed her home.  For close to two years, she slept in shelters, friends’ homes or in her car.

Maxine applied for Social Security Disability pay, but after a year-long waiting period, her application and a subsequent appeal were both denied.  With no home, no salary and no way to work, Maxine didn’t know who to turn to.

Fortunately, her doctor did.  Determined to get Maxine the disability pay she deserved, Dr. Linda Garcia at the Council Bluffs Community Health Center referred her to Iowa Legal Aid.  Attorney Chris Kerbawy took on the case, and he and Dr. Garcia got to work helping Maxine get the support she had earned from her 35 years on the job.

The Social Security Administration had denied Maxine’s application because it believed she was healthy enough to do “light work” jobs.  But when Dr. Garcia examined Maxine, however, she saw that Maxine was in no shape to exert the 20 pounds of force that categorize “light work.”  In a letter to the SSA, Dr. Garcia documented Maxine’s medical issues and confirmed that her health prevented her from doing “light work.”

When the Iowa Legal Aid team submitted Dr. Garcia’s letter, Chris included a request that the SSA make a decision based on Maxine’s medical records.  Ordinarily, the SSA would have waited for an appeal hearing, a process which would have taken up to two years.  Instead, the agency quickly approved Maxine’s application.

With her application approved, Maxine started receiving more than $800 a month in disability pay.  To cover the months when her application had been pending, the SSA also paid her a back benefit of $18,000.

The new income made an enormous difference for Maxine, but Chris wanted to make sure she had insurance to cover her health care expenses.  Once Maxine was approved for SSD, she became automatically enrolled in Medicaid as well.   But due to a technicality in the coverage rules, she was still paying hundreds of dollars a month for health care out of her SSD paycheck.  To make sure she received the maximum coverage she was entitled to, Chris helped her enroll in Medicaid for Employed People with Disabilities, a state program that covers medical care with few out-of-pocket expenses for disabled people that are capable of doing part-time or volunteer work a few hours per month.  Additionally, once Maxine’s status as disabled was established for two years, she became eligible for Medicare.  She is now dually-enrolled in Medicare and Medicaid, which together provide comprehensive medical coverage.

The work of Iowa Legal Aid also brought thousands of dollars in Medicaid payments to the hospitals and clinics where Maxine was treated while her application for Social Security and Medicaid was pending.  Since billing Medicaid for Maxine’s treatment, the Council Bluffs Community Health Center and the Jennie Edmundson Hospital have already been paid more than $7000 for previously uncompensated care, and could still receive thousands more.

Maxine has recently moved into a new home, and she says getting the disability pay has been an enormous relief. Looking back on her experience with Iowa Legal Aid, she says the world needs more people like Chris Kerbawy.

“He’s one of the nicest people I’ve ever met,” she says. “He has a heart. He cares what happens to people. If I had any trouble at all, if I had to go through this again, I’d call and see if I could see him.”