The conventional wisdom about America’s economic safety net is that it catches people when they fall. Carmen Underwood’s experience suggests the net has more holes in it than anyone in policy circles wants to admit — and that the people most likely to slip through are the ones who spent their whole lives playing by the rules.
I met Carmen on a Tuesday afternoon in February 2025, at a CVS on East Jefferson Avenue in Detroit. I was waiting on a prescription when I overheard her at the pharmacist’s counter, quietly asking whether they carried any information on prescription assistance programs. Her voice was steady, matter-of-fact — the voice of someone who had gotten very good at asking uncomfortable questions without flinching.
I introduced myself after she stepped away from the counter. She looked at me a beat too long before agreeing to talk. “I don’t usually tell people my business,” she said. “But maybe somebody ought to hear it.”
A Fall That Changed Everything
Carmen Underwood is 58, a front desk manager at a mid-range hotel in downtown Detroit, where she has worked for eleven years. She earns roughly $31,000 a year — enough to get by, she told me, as long as nothing goes wrong. She is single and the primary caregiver for her 81-year-old mother, who lives with her in a two-bedroom home in the East English Village neighborhood.
In September 2024, something went wrong. A guest had tracked water in from the pool area, and the floor near the check-in desk hadn’t been marked. Carmen slipped, went down hard on her lower back, and was taken by ambulance to Detroit Medical Center. The diagnosis: a herniated disc at L4-L5, plus significant soft tissue damage.
“I had a little arthritis, sure,” Carmen told me when we sat down at a diner near her home two weeks after that pharmacy encounter. “But I wasn’t having any problems before that fall. I was standing at a wet floor with no sign on it. That’s not a pre-existing condition. That’s somebody not doing their job.”
The denial letter arrived on November 7, 2024. According to Carmen, her employer’s insurance carrier — she declined to name the company — concluded that her injury was “not causally related” to the workplace incident. She was told she had the right to appeal but was given no guidance on how to do so.
When One Crisis Becomes Two
Carmen filed her workers comp appeal in December 2024. She was still waiting for a hearing date when, in January 2025, a pipe burst in her basement during a cold snap that sent temperatures to minus-four degrees Fahrenheit. The water damage hit her finished basement — where her mother spent most of her days — and cost an estimated $8,500 to remediate.
She filed a claim with her homeowner’s insurance. The insurer paid out $6,200 after her deductible, then sent a non-renewal notice in March 2025. Carmen was dropped.
Finding replacement coverage proved brutal. The lowest quote she received was $2,400 a year — more than double her previous $1,100 premium. Three carriers declined to quote her at all. “They treat you like a criminal for using insurance you paid for,” she said. “That’s what it’s for.”
She was now managing $31,000 in annual income against medical debt, elevated insurance costs, roughly $800 a month in her mother’s prescription and care-related expenses, and a mortgage payment of $940 a month. The math, as Carmen described it to me, simply did not work.
Looking for Footholds in the System
Carmen is, by her own description, restless. She has never been comfortable waiting. While her workers comp appeal moved through Michigan’s bureaucratic machinery at its own pace, she started researching every program, benefit, and relief option she could find. She kept a legal pad with program names, phone numbers, and eligibility requirements scrawled in two different ink colors.
Some paths closed quickly. Her income — even reduced after her injury kept her on modified duty for six weeks — placed her just above the threshold for several Michigan assistance programs. “I kept hearing ‘you make too much,'” she told me. “I’m making thirty-one thousand dollars and supporting two people, and I make too much.”
What she did find: she qualified for the Earned Income Tax Credit. Her 2024 tax return, filed in February 2025, generated a federal refund of approximately $1,340 — the largest refund she had ever received. She had not claimed the EITC in prior years because, as she put it, “nobody told me I qualified.” According to the IRS, roughly one in five eligible workers fail to claim the EITC each year.
She also connected — through a community health worker at a Detroit nonprofit — with Michigan’s Medicaid program, which covered her mother under the state’s caregiver support provisions. That alone reduced her monthly out-of-pocket prescription costs by approximately $310 a month.
The Side Hustle Math
Carmen has never waited for one income stream to do all the work. Even before her injury, she sold handmade soy candles — she makes them in her kitchen on Sunday mornings — through a small Etsy shop and at a monthly Eastern Market vendor event. After the injury, when modified duty at the hotel cut her hours and reduced her take-home pay by roughly $380 a month for six weeks, the candles kept her grocery budget intact.
She also took on weekend catering work through a friend’s event company, though the back injury has limited how many hours she can realistically stand. “I used to do four, five events a month,” she told me. “Now I do one, maybe two. My back just won’t let me do more.” At roughly $175 per event, that is a real reduction in supplemental income she had come to rely on.
She has also looked into what Benefits.gov lists for caregiver support — there are federal programs under the Older Americans Act that may apply to her situation, though she told me the application process was confusing enough that she put it on her legal pad under the heading “figure out later.” That list, she said, is longer than she would like.
Where Things Stand — and What Still Hurts
When I followed up with Carmen in late March 2026, she had stabilized — but only barely, and not in the way she had hoped. Her workers comp appeal had still not been scheduled for a hearing, more than sixteen months after her injury. She had accepted the $2,400 homeowner’s insurance premium because going without coverage on a mortgaged property was not an option she was willing to consider.
The EITC refund from her 2025 return, filed in January 2026, came in at $1,190 — slightly lower because her hours had recovered somewhat, nudging her income up marginally. She applied the refund directly to the remaining medical debt, which now sits at approximately $1,800. She expects to pay it off by fall 2026 if nothing else breaks.
The outcome is mixed, and Carmen doesn’t dress it up. The Medicaid enrollment for her mother made a real difference. The EITC money helped. But the workers comp denial still feels like an injustice she hasn’t been able to resolve — and without that, she says, she is managing the symptoms of a problem that hasn’t been fixed.
She is still making candles on Sunday mornings. She is still updating her spreadsheet every Sunday night. She has added two new programs to her legal pad that she plans to investigate this spring. Restless, as I said, is the right word for her.
What stays with me from my time with Carmen is not the dollar amounts — though those matter — but the particular exhaustion of someone who did everything right and still ended up spending her late fifties piecing together a financial floor from scraps. The safety net she was promised was there, in pieces. She found most of it herself, one pharmacy counter and one legal pad entry at a time. According to the Department of Labor’s OWCP, workers compensation disputes can take years to resolve through state-level appeals processes — a reality Carmen knows intimately and would rather not.
Her workers comp hearing, whenever it comes, will either validate what she has known since November 2024 or it won’t. Either way, she will update the spreadsheet on Sunday night. The numbers, she told me last time we spoke, are finally starting to add up. Just barely. Just enough.
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