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Any lawyers or disability experts in the house? SSI/SSDI Question

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Bunny Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Nov-12-03 10:53 AM
Original message
Any lawyers or disability experts in the house? SSI/SSDI Question
My kid's dad is 52, been a truck driver all his life, no other skills or training. He has a bad back, and I mean a BAD back (with numerous surgeries, various metal rods, wires, and boxes implanted in him). His X rays make him look like a cyborg!

Well, he "blew his back out" ten days ago, and is just now returning to work, basically against doctor's orders, because he has no other source of income (and no savings). This is not technically a work related injury, BTW, so no Work Comp benefits are pending.

He needs to stop driving, and wants to get on SSDI. What do you think his chances are? And doesn't it take about 6 months to get an answer on your application? Can he get SSI in the meantime, so he has something to live on? Public assistance in PA would only give him about $200/month, which he could not live on.

Does anyone know? Thanks.
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GOPisEvil Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Nov-12-03 10:57 AM
Response to Original message
1. I'm no expert per se, but I have a little experience.
Basically, he has to be unable to do his current job for a period of one year or more. He needs to apply, get examined by the SSA doctors, etc...from what I have seen, most first-time applicants are denied, but certified on appeal. Getting a lawyer who specializes in this type of work helps.

Also, do you mean RSDI and SSI?

Seriously, I'd call the SSA - or a disability attorney. They'd have the best answers. Good luck to him. It can be a long process.
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Bunny Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Nov-12-03 11:03 AM
Response to Reply #1
4. What is the difference between RSDI and SSDI?
I've never heard of RSDI. He will definitely be unable to do his current job for 12 months (in fact for the rest of his life). And his job history, other work skills, and the prevailing job climate in the community are all bad. I had heard that most people get turned down at first, and then have to appeal. I do think he'd eventually be declared eligible for disability, I guess it's a question of how long it would take and what he'd live on till the determination was made.

Thanks for the input!
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GOPisEvil Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Nov-12-03 11:05 AM
Response to Reply #4
5. Retirement, Survivors and Disability Insurance
I think. I'm not as up on SSA benefits as I used to be when I was a case worker, though.
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REP Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Nov-12-03 10:58 AM
Response to Original message
2. Not An Expert
I had to apply for SSD as part of my long-term disability leave. I receive no payments of SSI or SSD while my application is going through the system, and I submitted it more than 6 months ago.
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bratcatinok Donating Member (786 posts) Send PM | Profile | Ignore Wed Nov-12-03 11:01 AM
Response to Original message
3. I'm on SSDI
Edited on Wed Nov-12-03 11:05 AM by bratcatinok
You don't become qualified for SSDI until you've been unemployed for 6 months. In my case they didn't count it against me that I had attempted to go back to work during that 6 month period.

It took me 2 years and 3 months to get approved for SSDI. I used an attorney and we had to appeal twice but once I finally made it in front of a judge I was approved with no problem. Be prepared to be declined because that's almost automatic that you're dad will be denied. My ex-husband has leukemia and they denied him several times. He finally was approved after going through the appeal process also and it took him about 25 months also to be approved. Once you're approved you get a lump sum that is retroactive back to when you become eligible.

I'm unsure of what type of assistance is out there for the 6 month period before you become eligible. My ex had to move in with his mother and she supported him until he received his settlement. I had some savings and also had been receiving long term disability insurance through my employer so that was how I supported myself during the 31 months it took to get the benefits started.

On Edit: Have him contact an attorney who deals with Social Security and SSDI. He won't have to pay them anything until the lump sum payment comes in and then it's automatically paid out by the Social Security system out of the claim.
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Rainbowreflect Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Nov-12-03 11:11 AM
Response to Original message
6. Don't deal with disability directly with my job, but here is what I know.
Without an attorney he will be denied the first time 99% of the time.
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Bunny Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Nov-12-03 11:13 AM
Response to Reply #6
8. So are you saying he should get an attorney for his initial application?
I was wondering about that. I knew he'd need one if he was denied, but you think he should go into the initial application process with the help of an attorney? I'd prefer he do that, if it would cut down on the wait time.
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bratcatinok Donating Member (786 posts) Send PM | Profile | Ignore Wed Nov-12-03 11:15 AM
Response to Reply #8
9. I went into
the initial process with an attorney as did my ex husband. We both were denied even with having an attorney. I'd recommend contacting an attorney.
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Rainbowreflect Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Nov-12-03 12:14 PM
Response to Reply #8
12. If at all possible have him at least contact an attorney.
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scarlet_owl Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Nov-12-03 11:13 AM
Response to Original message
7. I'm on SSI and the whole process took about a month.
I have severe anxiety and depression disorders and I was approved the first time around. I still don't know how that happened, as it usually takes an appeal. Urge him to try. My monthly check is not much ($736), but it helps pay the bills. Good luck to him.

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papau Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Nov-12-03 11:17 AM
Response to Original message
10. Social Security disability requires inability to do ANY job in US economy.
That means jobs a 1000 miles away that you can do will kill the benefit.

The alternative is having a deadly desease preventing you from working where death will be very soon.

Approval of first time claims is around 20%- sometimes a bit less, approval on appeal brings that up near 50% for those claims appealed.

The State welfare programs are all different - each state designs its own. Disability usually gives a better benefit than simple welfare aid.
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otohara Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Nov-12-03 11:58 AM
Response to Original message
11. Here' my advice
have one of your dad's dr.'s write a report, detail his surgeries, etc...end it with "based on everything it is impossible for him to return to work full time" - send that in with application - It helps to send in the doctors report witht he app. otherwise it takes them forever to request all the info. Send in all pertenant info, it's important to find a sypathetic doc to write that final report. Do most of the leg work prior to and send it with - Tell your dad to not do the personal interview in person - do it over the phone.

there are sites you can check on the internet which will help you with the wording to use on application for your dad's injury - - there's not much room on application - use same language driving home the message that it has become "impossible" for your dad to function at home much less being at work.

PM me if you need more help

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happyslug Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Nov-12-03 05:40 PM
Response to Reply #11
17. WRONG
SSA does not believe Medical Doctors have the expertise to say whether someone can work or not. SSA hires "Vocational Experts" (VEs) to testify what jobs a person can do. VEs are in the field of Vocational Rehabilitation and as such know what are the educational, physical and enmotional requirments of various jobs that exist in substantial numbers in the National Economy.

SSA does beleive that Doctors can report the Physical and Psychologicla restrictions of a Claimant. The VE will use those restrictions to testify to what jobs a person with those restrictions can perform.

Thus what you need is a report from you Doctor on what are his physical restrictions AND medical reports on why those restrictions exists. Given his age (52) if the Doctor says based on the X-rays of the back, it is clear that the Claimant can NOT be on his feet more than two hours in an eight hour day, that makes him incapable of doing 'Light' work. Since he is over age 50 once it is shown he can NOT do his past work AND he can not do "Light" work, he is elgible for SSDI.

My point here is the Doctor can NOT say someone can NOT work, but what are the physical restrictions imposed on the claimant do to the underlaying medical problem. Anything more will do him no good.

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corarose Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Nov-12-03 03:40 PM
Response to Original message
13. I am on SSD & I am going to College to get off of it
You need to hire a Lawyer or they will jerk your husband around for years.

My Mom was blind and they didn't give her disability until 3 years before she died and she was in a wheelchair before she died.

Get a Lawyer they know how to fill the paperwork out and do the appeals. You husband will get turned down the first time that he applies everyone does and they do that discourage people so that they will go back to work no matter how much pain they are in.

I applied and I couldn't talk at the time because the Doctor hit my vocal cords when he was putting a large pain injection in. I also couldn't move the left side of my body and they turned me down even tho there Doctors put down that I was disabled.

GET A LAWYER AND LET HIM TAKE HIS FEE OUT.
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corarose Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Nov-12-03 04:21 PM
Response to Original message
14. DON'T GIVE UP!
That's what you tell your husband.

Also, don't sit back and be PROUD we lost our house that way.

You sign up for food stamps, Medicaid, and look into getting help with section 8 if you don't have a house. Go to the catholic church they help and I never knew this until it was too late.

We had a business, a home and several cars and we lost it all.

We had no furniture for about 8 months and my clothes and everything is gone.

GET HELP. ASK QUESTIONS ASK EVERYONE AND DON'T LEAVE ANY AVENUE UNTOUCHED.

I WAS ALMOST HOMELESS!
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corarose Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Nov-12-03 04:22 PM
Response to Original message
15. SORRY FOR ALL OF THESE MESSAGES
Workman's Comp FUCKED ME up.

Tell your kids daddy that the saying goes Don't Count Your Chickens Before They Hatch. Well with Workman's Comp they may never hatch.
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happyslug Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Nov-12-03 04:44 PM
Response to Original message
16. Here is some information on Social Security Disability
Edited on Wed Nov-12-03 05:18 PM by happyslug
He is is over age 50, and that is a magic number for Social Security. What I mean by that people age 50-55 only have to show that:
1. There can NOT do the work they have done over the previous 15 years AND
2. There are NO jobs of a "light" nature they can do.

For people under age 50, the test is Sedentary work, thus it is EASIER for someone over age 50 to get Social Security than someone under age 50.

Now you said he was a truck driver. That is generally considered a “Heavy” Job and with his bad back he will be ruled he can not return to that type of work (especially given the Doctors are recommending surgery).

Thus the big issue in any claim he will make for Social Security Disability is can he do any other job of a Light Nature.

Light work is defined as a person who EITHER is on his feet more than two hours in a eight hour day (and otherwise doing sedentary work) OR someone who frequently lifts 10 pounds and occasionally lifts 20 pounds.

Sedentary Work, Frequent lifting of 0 pounds; Occasional Lifting of 10 pounds AND On one's feet no more than two (2) hours in a eight(8) work day.
Light Work: Frequent Lifting, 10 pounds; Occasional Lifting 20 pounds
Medium Work: Frequent Lifting, 25 pounds; Occasional Lifting 50 pounds
Heavy Work: Frequent Lifting, 50 pounds; Occasional Lifting, 100 pounds

NOTE: All work of a heavier type includes all work of a lighter type. for example "Heavy Work" includes "Medium", "Light" and "Sedentary work, but for purposes of the "Tables" in Appendix 2 of the Social Security Regulations, the only thing considered is the exertional level listed, i.e. to be ruled disabled you must be unable to do "light" work, your ability to do 'Sedentary" work is not considered.


NAMES USED IN REGULATIONS FOR AGE CATEGORIES

Younger individual, Under age 50; 20 CFR § 404.1563(b) § 416.963(b)

Younger individual(45-50), Age 45-50; 20 CFR § 404.1563(b) § 416.963(b)

Person Closely Approaching Advance Age, Age 50-55 20 CFR § 404.1563(c) § 416.963(c)

Person of Advance Age, Age 55-59; 20 CFR § 404.1563(d) § 416.963(d)

Person approaching retirement age, Age 60-64;20 CFR § 404.1563(d) § 416.963(d)



Thus your child’s dad may be elegible depending on how long he can be on his feet in a day. If it is under 2 hours in a 8 hour day he is elegible for Social Security Disability.




I am including with this letter copies of Papers I give to my clients when I discuss SSI with them:
If you have any questions feel free to E-mail me for information and if I can get it to you I will.


THE FOLLOWING PAGES ARE MEANT AS A GUIDE ONLY. THE EXACT SOCIAL SECURITY ADMINISTRATION (SSA) REGULATIONS ARE TO COMPLEX TO BE EXPLAINED IN A SHORT PAPER. THE FOLLOWING PAGES ARE TO GIVE YOU, THE CLAIMANT, AN IDEA OF HOW SSA WILL DETERMINE WHETHER YOU ARE ELIGIBLE FOR BENEFITS.

DISABILITY DECISION TREE USED BY SSA TO DETERMINE DISABILITY:

The following is the systematic method used by SSA to determine whether someone is disabled or not. It is included with this form for your information on HOW SSA will determine if you are disabled or not.

1. Is claimant engaged in substantial gainful activity (SGA)? (20 CFR § 404.1571 et seq). SGA is defined as earning more than $700 per month.
If you are earning, $700 or more per month you are NOT disabled.
If you are earning less than $700 the Claimant Proceeds to Step Two (2).
.
2. DOES CLAIMANT HAVE A SEVERE IMPAIRMENT? (A DEMISE TEST).{(20 CFR § 1520(b)}. This test is designed to eliminate anyone who is not suffering from any impairment. "Demise" is Latin for minor or insignificant. If you are suffering from any impairment that affects your day to day activities you survive Step Two.

3. Does claimant have an impairment that meets a listing? {20 CFR § 404.1520(d)}.
IF YES, Than the claimant is disabled; IF NO, Than you go to Step 3.
The listing of impairments are listed in Appendix 1 to the Social Security Regulations.
If you met the requirements of any listing or combination of listings you are disabled.
If you do not met the requirements of any listing or combinations of listing you proceed to Step Four (4)

4. Is claimant able to perform past relevant work. {20 CFR § 1520 (e)}
If YES, Claimant is NOT Disabled. If NO, go to Step Five (5).

5. a. Does Claimant have a exertional impairment?
If no go to Step 5c, If yes than go to Step 5b
b. Is claimant disabled under the "Tables". SSA refers to Appendix 2 of the SSA regulations as the "Tables". The "Tables" are decisional trees to help ALJs decide whether someone is disabled or not. If you are "disabled" under the "Tables" you are disabled, if not go to step 5c.

THE TABLES (Simplified):
HIGH SCHOOL EDUCATION OR MORE
TO BE DISABLED
AGE 60-65 -TO BE DISABLEDYOU MUST BE INCAPABLE OF DOING "HEAVY WORK".
AGE 55-59 - TO BE DISABLEDYOU MUST BE INCAPABLE OF DOING "MEDIUM WORK".
AGE 50-55 - TO BE DISABLEDYOU MUST BE INCAPABLE OF DOING "LIGHT WORK".
AGE BELOW 50 - TO BE DISABLEDYOU MUST BE INCAPABLE OF DOING "SEDENTARY WORK".
*********************************************************************************
LESS THAN HIGH SCHOOL EDUCATION BUT MORE THAN 7 YEARS OF SCHOOLING.- "LIMITED EDUCATION" - Same as for High School or More Grid.
*********************************************************************************
LESS THAN 7 YEARS OF SCHOOLING.-"MARGINAL EDUCATION" Same Test as for High School or More Grid.
*********************************************************************************
ILLITERATE - TO BE DISABLED - Same as for High School or More Grid.
EXCEPT: The test for "SEDENTARY WORK" starts at age 45.
c. Does claimant have a significant non-exertional impairment? If either yes or no go to Step 5d.

d. Can the claimant perform other work as it is perform in the national economy. {20 CFR § 404.1520 (f)}
If yes, Claimant is NOT disabled.
If no, Claimant is disabled.

This is where they will decide whether your child's father is elegible for SSI.

VOCATIONAL GUIDELINES -_NOTES - 20 CFR § 404 and 416 of Appendix 2

NOTE #1: The regulations are always Changing this is meant as a gudielnes of the regulations NOT the regulations themselves.

Note # 2: The exertional limitations stated in the “Simplified Tables” ONLY APPLIES TO CLAIMANTS WHO SURVIVE TO PARAGRAPH 5d on the Sequential Evaluation Process (page 17). Step 5 is after the ALJ has made a finding of not meeting a listing (Step 3), a finding of in-ability to return to past relevant work (Step 4) and a finding that the claimant is suffering from an severe impairment (Step 2).

Note #3: Age, education, exertional limitations and past work experience are the main factors considered by SSA when SSA determines whether a claimant is capable or not capable of performing work as it is performed in the national economy.

Note # 4: WARNING: If a claimant has a skilled or semi-skilled experience and those skills are transferable to other jobs that exist in the national economy, such a claimant can never be disabled.

Note #5: These Vocational Guidelines is a vocational determination, not a medical determination, but it is a vocational determination based on the testimony of the limitation of the claimant and the medical records. Generally a Vocational Expert (VE) will attend the SSA hearing and will testify to the following:
1. Whether the past relevant work of the claimant is skilled or semi-skilled;
2. Whether the skills are transferable; and
3. What other jobs can a person with the disabilities of the claimant perform.

Note #6: The biggest factors (besides disability) in determining if a claimant is disabled are education and age. The “Simplified Guidelines” attached hereto is a Simplified BREAKDOWN OF THE "TABLES" SET FORTH IN APPENDIX 2 OF THE SSR REGULATIONS.

Note #7: For Simplicity the “Simplified Guidelines” Attached Hereto Assume No Previous Work History and Non-transferable Work Skills. Furthermore All of the “Simplified Guidelines” Assumes "Unskilled" Work Training.

SSI _ supplemental Security Income
RSDI - Retirement, Surviors, Disabilty Income (often called SSD, Social Security Disability a term I will use below):


MAJOR DIFFERENCE BETWEEN SOCIAL SECURITY DISABILITY (SSD) AND SUPPLEMENTAL SECURITY INCOME (SSI). SSD (RSDI) is set by 42 U.S.C.A. § 402, SSI is set by 42 U.S.C.A. § 1381 of the Social Security Act.

Both SSI and SSDI use the same test for Disability ie. Disability is defined as being unable to do any work that exist in substantial Numbers in the National Economy

For SSD Payments Starts Six Months after the date SSA determined you first became disabled.

SSI pays for the first the month you made an Application for SSI or you became Disabiled whichever is later.

SSDI is Payed from Social Security Taxes. SSI is paid from General Funds (Income Taxes).

Both SSI and SSDI are Administrated by Social Security Administration (SSA).

A person on SSDI can be awarded disability for a period prefore he made an application (but not more than a year before), SSI will NOT pay for any period prior to the application date.

SSDI has Spouse/Survivor Benefits, SSI does not.

SSDI Payments are based on his work History and will be Roughly 60% of your his income over the ten years before the onset of your disability

SSI will pay $552.00 ($579.40 if he lived in Pennsylvania, Some state supplment the SSI grant, Pennsylvania does it by $27.40, some states give more, some states less, some states none).

SSDI is NOT Affected by other Income, SSI is REDUCED by any other income.

SSDI check hits on the Third of the Month, SSI payment hits on the First of the Month.

There are NO Asset Limitations for SSDI, but a SSI recipent can only have the following assets, One Automobile, one house he is living in, Household furnishings and $2000 in liquid assets ($3000 for a couple).

Medical Coverage of SSDI is Medicare (after a 18 month weighting period). SSI medical care i provided by Public Welfare.




PLEASE NOTE since the father of your child has a work history I do not believe he will be elgible for SSI, his SSD would exceed any SSI amount he would be entitled to.
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brook Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Nov-12-03 06:36 PM
Response to Reply #16
18. I have a question.
And it sounds as if you might have an answer for me.



I've been wondering if I would be eligible for disability. Briefly, I am 70; on Social Security and Medicare (I have no assets other than my old car) - I work about 5 hours a day - on my feet and moving nearly the whole time -frequent lifting 10 -20 -25 lbs. I make around 700 a mo. and I am working because I would not be able to pay my utilities or eat if I didn't.


I have a painful foot, knee, hip situation and I have severe diverticulitis. The last attack in August had me in the ER and then 10 days on meds and in bed.


I am torn in even thinking about disability - it's always been my style to take care of business myself. But it's getting harder and harder.


I copied off your report above - but wondered if my situation is different from a younger person's - and that my age might preclude me no matter what.
Thanks in advance for any response.

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happyslug Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Nov-13-03 09:27 AM
Response to Reply #18
20. The issue is HOW MUCH Social Security (SS) are you getting.
At age 70 you are viewed a Disabled for Social Security Disability (SSD), but the problem is what you are entitled to for SS is the same as SSD. Thus if you apply for SSD you will get NO increase in benefits.

Now if your SS is BELOW the Supllemental Security Income (SSI) level for your state (Including the state supplement which varys from state to state) than you may be elegible for some SSI (I.e. the SSI for your state less any SS you are getting now).

Remember the Federal SSI grant is $552.00. If your SS exceeds that number I seriously doubt you will get any SSI. I hate to say the above but this is how COngress set up SS, SSD and SSI.
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happyslug Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Nov-13-03 10:34 AM
Response to Reply #20
21. What you are earning affects SSI also
Edited on Thu Nov-13-03 10:37 AM by happyslug
What you are earning does not affect your SSD, but does affect any finding that you are disabled AND SSI.

As to a finding you are disabled, see my previous comment on the Sequential Evaluation Process (SEP), at step one of the SEP if you are earning more than $700 you are NOT disabled and thus not eligible for SSI or SSD (This does not affect you since you are one SS at the present time given your age of 70).

As to SSI eligibility, any earned income is reduced by the $30 and 1/3 rule. First you take your earned income of $700, minus $30 (Leaving $670). Than you take 1/3 of the $670 ($233.33) from the $670 (Leaving $446.66). You than treat the $446.66 like any unearned income you are receiving (including any SS you are receiving), i.e. SSI amount of $552 (plus any state supplement to the SSI grant) less $446.66 (Your Earned income less the $30 and 1/3 rule) less any SS you are receiving. If the amount is Zero or less, than you are NOT entitled to any SSI.

Please note, I do not make up the rules, I just tell you what the rules are. Congress and the states want to keep the costs of SSI low so the above rules are design to keep SSI cost low, not to maximize benefits to seniors.
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Bunny Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Nov-12-03 07:14 PM
Response to Reply #16
19. Wow!
Excellent information! Thanks so much.
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