Medical-Legal Project: Holistic Advocacy at Work

The Justice & Diversity Center’s (JDC) holistic approach to legal services often results in clients’ realizing income and health care benefits that were unknown to them. Take, for example, Martha, who sought assistance with an inaccurate phone bill and now has increased her monthly income by 40%.

JDC’s Medical-Legal Project Supervising Attorney Marie Appel was recently reminded how important access to legal services and a review of benefits can be for low-income clients. Martha, an elderly woman with numerous health issues including diabetes, arrived at her scheduled appointment with Appel at Saint Mary’s Sister Mary Philippa Clinic, one of the two Medical-Legal Project locations where JDC provides legal assistance. The other location is Southeast Health Center in the Bayview Hunter’s Point neighborhood.

Martha appeared a bit confused and had difficulty focusing on issues. She couldn’t remember who referred her to Appel but did know that her telephone bill had doubled three years prior and she didn’t understand why. Martha, a retiree surviving on only $708 a month from Social Security was paying $400 in monthly rent leaving her with $308 for food and other bills including her monthly Medicare premium, co-pays and prescription costs. Amazingly Martha was surviving and had not fallen behind on any of her bills. When asked how she was paying her $400 per month rent and managing to buy food and other necessities, the client responded “It’s hard. I have diabetes and am supposed to eat right; it’s hard to buy the food I’m supposed to.”

Review of the telephone bill revealed that a long distance service had been added, possibly without the client’s authorization as she didn’t know she had the service and had never used it. Appel called the telephone provider who, after confirming that the client had never used the service, agreed to remove the service and credit all charges for the service beginning in 2011.

This left the more important issue uncovered in intake: the client’s potential eligibility for an additional income benefit, Supplemental Security Income (SSI). Appel dug deeper into Martha’s finances and found that she was eligible for an additional $179 per month in SSI and Medi-Cal health insurance, which covers co-pays as well as the $100 monthly Medicare premium. Martha is now receiving an additional $179 per month in cash, and Medi-Cal is paying her medical costs, including the $100 monthly Medicare premium. That’s an additional $279 a month, a 40% increase in income that Martha uses for her basic needs. The one hour meeting with the JDC attorney resulted in a refund of telephone charges, increased income and medical coverage.

JDC’s Medical-Legal Project is a collaboration of JDC staff and volunteer attorneys, doctors, nurses and other medical providers working to address patients’ legal needs which have an impact on health, either directly or indirectly. Here, legal intervention provided by JDC’s Medical-Legal Project increased the client’s income which puts the client in a better position to buy healthy food to manage her diabetes and well as alleviate some financial stress.

This is just one example of the difference the Medical-Legal Project has made in the lives of low-income clients at Saint Mary’s Sister Philippa Clinic and Southeast Health Center.

If you are interested in becoming involved with JDC’s Medical-Legal Project, please email