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Curing legal troubles at the health clinic
Law school program reaches out to patients and their families

Sunday, March 05, 2006
By Anne Rueter , Ann Arbor News

2006, The Ann Arbor News. All rights reserved. Reprinted with permission.

Attorney Debra Chopp and her client, Nerissa Anderson, are two happy women. In December, they had their day in court. Two weeks ago, they learned they won. At stake were disability benefits that have eluded Anderson, 22, cancer survivor, since she was diagnosed at age 14.

To Anderson, the judge's favorable ruling means she can stash away a nest egg. She won't have to worry so much about making ends meet on her husband's earnings as a baker. The Ypsilanti couple have Xavier, 2, and a baby on the way.

"We're going to be able to live a lot better,'' she says. You can hear the relief in her voice. "We won't feel like we're living paycheck to paycheck any more.'' She will receive as-yet-undetermined retroactive benefits back to 2001 and a monthly stipend from now on, for which the court will take her husband's income into account.

To Chopp, staff attorney for the University of Michigan Law School's Pediatric Advocacy Initiative, the ruling is one more sign that she and law students in this two-year-old program can substantially improve the lives of Washtenaw County's low-income residents.

The law school program offers poor families who have health problems free legal help. Hiring an attorney isn't usually an option for these families - Chopp's services might run $200 an hour in a private law firm. Yet legal expertise can be crucial in making health problems manageable, says the program's director, Anne Schroth. For instance, the program has helped parents of children with asthma press landlords to rid apartments of mold, and apply for special education services or disability funds for which their children are eligible.

With Chopp's help, Anderson threaded her way through a maze of regulations governing Social Security disability benefits to win her appeal. But many poor people enter that maze and others like it on their own. They go down what seem to be blind alleys and get discouraged: They may not be aware they can appeal an adverse decision.

Often, as Anderson's case shows, they haven't really hit a dead end.

Persistence pays off

Eight years ago, when Anderson's parents first applied for Supplemental Security Income benefits for their cancer-stricken daughter, they were turned down on the grounds their combined incomes made them too well-off to qualify, Anderson says. When she applied as a young adult, she was denied again.

In her recent successful appeal, an administrative judge ruled Anderson is indeed eligible for monthly SSI payments. Supplemental Security Income is a federal program to supplement the income of aged, blind and disabled people with limited or no income or assets.

The judge agreed that Anderson's health conditions have left her unable to work. Anderson eloquently explained, Chopp says, how she had to leave a job she held briefly and enjoyed at Wal-Mart. Answering Chopp's questions in court, Anderson, who has a tracheotomy tube to help her breathe, explained how dust and exposure to other employees with colds made her come down with repeated respiratory infections that made her too sick to go to work. "The things Debra asked me, I would never have thought to bring up in court,'' she says.

Two rare forms of cancer in her neck and head, plus the effects of years of treatments, left Anderson with impaired breathing, hearing loss and frequent eye swelling - and also a determined spirit. She's proud to tell how, despite extensive cancer treatments in her adolescent years, she eventually graduated from Huron High School with a 3.85 grade average. And how she has been able to conceive and bear children, even though her doctors said she probably never could. Since age 17, her cancer has been in remission.

Linking health with the law

The U-M Law School program is modeled after a trailblazing program at the Boston Medical Center, started by a pediatrician who wanted to help immigrant patients with legal problems.

The law school saw twofold benefits: Area medical clinics could be a pipeline to families who need legal help, and law students could get the chance to work with real clients.

More than a dozen law students now work with health care providers and social workers at two sites, Mott Children's Hospital and the U-M Ypsilanti Health Center, where personnel are encouraged to refer families who need legal help. The program also will soon help clients of the Corner Health Center, a teen health clinic in Ypsilanti. The students and staff are currently handling 45 to 50 open cases. About 145 cases have been closed, Schroth estimates.

The help the legal team provides can be simple - giving information to a mother who wants to get a divorce, but worries about the effect on her sick child - or it can be extensive. Schroth says many poor families need legal help on multiple fronts. They often simultaneously grapple with custody issues, getting help for a disabled child, getting a landlord to clean up mold that makes a child's asthma worse and simply paying the rent. A mother in a perilous domestic violence situation may need legal help fast to deal with a husband who is threatening to take the children.

"They are extremely stressed families,'' says Schroth.

The U-M program works closely with Legal Services of South Central Michigan. Both staffs are experienced with different legal issues, so cases get sorted out accordingly, says Schroth. The need far exceeds the number of attorneys available, she says.

Prescription for health:

a lawyer

Schroth explains the program has another goal: to work with clinicians "so they become better advocates for their patients.'' Her staff, and sometimes the students, gives presentations for health-care providers on topics like immigration and eligibility for public benefits.

Terence Joiner is a pediatrician at the U-M Ypsilanti Health Center. Among his patients, he sees children made homeless by eviction, parents facing family court issues, parents of children with chronic health problems. The law school attorneys and students have helped about a dozen of his patients with legal matters. "Almost all of them have found it very useful,'' he says.

Working in tandem with the legal team, he says, "has made a big difference in our relationships with patients. It makes it easier for some of the families to talk with us about the challenges they have.''

Reporter Anne Rueter can be reached at 734-994-6759 or