Disability Benefits Application Guide
Contacting the Social Security D. Frequently Asked Questions About Social Security The Social Security Administration (SSA) decides who is eligible for disability payments under rules established in the Social Security Act by the U.S. Congress. In this chapter we describe the two main SSA programs that administer disability payments. We briefly explain the requirements that any claimant must meet to receive benefits. We also provide a number of tips on how to deal with the SSA bureaucracy, including answers to some of the most frequently asked questions about Social Security Disability. Social Security Disability Insurance (SSDI), for workers who have paid into the Social Security trust fund (and their dependents), and SSDI claims are also referred to as Title 2 claims because they are authorized under Title 2 of the Social Security Act. SSI claims may be referred to as Title 16 claims because they are authorized under Title 16 of the Social Security Act....
Applying for Disability Benefits 2 2 D. How Other Disability Payments May Affect Social Security 2 38 2. Railroad Retirement Act and Social Security 3. Black Lung Benefits and Social Security 4. What Payments Do Not Affect Your Social Security Disability Benefits 2 39 You can play an active and important role in ensuring that your claim is processed accurately and quickly. The best advice is to keep thorough records that document the symptoms of your illness or injury and how it affects your daily activities before you apply. Then, provide this information to the Social Security Administration when you file your claim. B. Applying for Disability Benefits You can apply for disability benefits at a local Field Office or contact station. You do not have to call or When you arrive, tell the desk or counter clerk that you want to apply for disability benefits. You'll be scheduled to meet an interviewer, who will inform you of your rights and responsibilities, assist you in completing...
Your Social Security disability benefit will be reduced so that the combined amount of your Social Security benefit plus your workers' compensation and or public disability payment does not exceed 80 of your average current earnings. the average monthly earnings the SSA used to figure your Social Security disability benefit Your monthly Social Security disability benefit, including any benefits payable to your family members, is added to your workers' compensation or other public disability payment. If this sum exceeds 80 of your average current earnings, the excess amount is deducted from your Social Security benefit. But, the amount of the combined benefits will never be less than the total Social Security benefits before they were reduced. The reduction will last until the month you reach age 65 or the month your workers' compensation and or other public disability payment stops, whichever comes first.
SSDI Benefits for Adults Disabled Since B. Applying for SSDI or SSI 1. Disability in Adult Children for About one million children receive disability benefits from the Social Security Administration (SSA). This chapter is for the parents and caregivers of children generally considered to be people under the age of 18 with disabilities, and for the parents and caregivers of adults who have been disabled since childhood. Although some of this information appears in other chapters, we bring it together here to provide one place for important information needed by caregivers of children. The person who handles the benefits on behalf of a child is called, in Social Security lingo, the representative payee, and must be a responsible person. The representative payee is usually a child's parents. You can use the information in this chapter to understand the kinds of Social Security Disability (SSDI) and Supplemental Security Income (SSI) available to an...
Social Security dependents' benefits are available to children under the age of 18 based on the record of a parent who collects Social Security retirement or disability benefits. Social Security survivors' benefits are available also to children under the age of 18 based on the record of a deceased parent who received Social Security retirement or disability benefits. On the record means benefits are paid based on the earnings records of someone else the insured worker who paid enough Social Security taxes to qualify for SSDI benefits. Parent means the biological parent, adoptive parent or stepparent. While this is a book about disability benefits, children eligible for dependents or survivors benefits need not be disabled. A child is eligible for Social Security benefits simply because she is the dependent of someone receiving disability benefits or the surviving child of someone who died while receiving benefits. Once a child is found eligible for these benefits, she can receive...
You can apply for SSDI or SSI benefits for your child by calling or visiting your local SSA office. Bring the child's Social Security card or at least the number and birth certificate with you. If you are applying for SSI for your child, you also will need to provide records that show your income and your assets, as well as those of the child.
A child over 18 years of age who is applying for SSDI disability for the first time or being converted from an SSDI child's benefit will be evaluated using the adult disability criteria. It is important to remember that these claimants are adults, not children, and that their nonmedical eligibility depends on having a parent worker who is insured for SSDI benefits by having paid enough Social Security taxes. Briefly, to qualify for disability, an adult must have a physical or mental impairment that is expected to keep him from doing any substantial work for at least a year or is expected to result in death. Generally, if the claimant holds a job that pays 800 or more per month, the work is considered substantial. (See Chapter 1, Section B, for more on defining disability.) If the DDS cannot match the claimant's impairment with one on the list, the DDS assesses his ability to perform the type of work he did in the past if any. A young adult usually won't have a past work history, so...
Promptly report to the SSA any changes that may affect your or your family members' SSDI benefits. To let the SSA know the new information, you can call 800-772-1213 (voice) or 800-325-0778 (TTY), visit any SSA office (a clerk will help you) or complete and mail in the reporting form you received when you applied for benefits.
Taxpayers must include in their gross income a set percentage of their Social Security benefits if their provisional income exceeds a certain amount. Obviously, you have to know what the government means by provisional income. This is defined as your adjusted gross income plus 50 to 85 percent of your Social Security benefits if, when taken into account, they exceed a certain threshold amount. Up to half of your Social Security benefits can be deemed taxable if your provisional income exceeds the threshold amount of Up to 85 percent of your Social Security benefits can be deemed taxable if your provisional income exceeds the threshold amount of If your provisional income exceeds the threshold amount for the 50 percent calculation, then the amount of Social Security benefits to be included in your taxable income would be the lesser of 50 percent of your Social Security benefits or 50 percent of the amount by which your provisional income exceeded the threshold. If your provisional...
A portion of Social Security benefits may be subject to income taxation. The worksheet in Figure 6.9 will assist in determining that tax. If you assume that Congress could simplify this formula, then you would be missing the point. Congress did not feel comfortable coming directly out and informing people that their Social Security benefits were now going to be taxable. So it started by announcing that a portion of your benefits could be taxable. Later it extended this tax to include even greater amounts of certain retirees' Social Security benefits. There are many that feel that sooner or later Congress will end up taxing all of our Social Security benefits.
Plenty, when you consider that Social Security was a form of tax to begin with. Congress is in effect taxing a tax. Furthermore, it is taxing those retirees who were responsible enough to save for their retirements. Those that only have Social Security benefits to live on do not pay any taxes on their benefits. However, the retirees that saved hard, invested wisely, and acted frugally are being penalized. FIGURE 6.9 Determining Income Tax on Social Security Benefits 1. Social Security benefits for the year__ a. AGI less net Social Security benefits received__ Caution Any increase in income, such as from the sale of stock or a retirement plan distribution, may subject you to an unexpected tax on your Social Security benefits. Many financial experts called the taxation of Social Security benefits a double tax because the government is taxing a benefit that originated from Social Security taxes in the first place. Actually, you could call this taxation of Social Security benefits a...
If you are an SSDI claimant, you may be entitled to retroactive (past) benefits if the SSA finds that your EOD fell on a date earlier than your application date. Even if the SSA makes such a finding, however, the SSA will not automatically pay you benefits from your EOD. The SSA requires that at least five full calendar months, known as the waiting period, pass beyond your EOD before you get any benefits. If you otherwise qualify, the SSA may establish an EOD as far back as 17 months before you apply for benefits, and then count the five-month waiting period. What this means, essentially, is that if you apply for SSDI well after becoming disabled, the SSA will not pay you retroactive benefits for more than 12 months. This is a requirement of federal law, so even if a doctor at the SSA states that you satisfied the medical severity requirements many years in the past, you still cannot have an earlier EOD. EXAMPLE Jerry, a 57-year-old bricklayer and longtime cigarette smoker, stopped...
The SSDI work incentives are fairly extensive. Trial work period. If you return to work, during the first nine months you will continue to receive your SSDI benefits. At the end of nine months of work, the SSA will decide if you are doing substantial gainful activity (SGA) earning an average of at least 800 per month in 2003. If you are self-employed, your income may not be the best measure of whether you are doing SGA. Often, more consideration is given to the amount of time you spend in your business than to the amount of your income. If the SSA believes you are doing SGA, you will receive benefits for three more months and then they will stop. If you are still disabled but you return to work for more than nine months and your benefits stop, you receive a special protection for the next 60 months. During that time, the SSA will pay you your SSDI benefit in any month you earn below the SGA level, even if you stop working for a reason unrelated to your disability for instance, you get...
1 What Is Social Security Disability C. Contacting the Social Security D. Frequently Asked Questions About Social Security Disability 1 11 2 Applying for Disability Benefits B. Applying for Disability D. How Other Disability Payments May Affect Social Security Benefits 2 38 3 Disability Benefits for Children B. Applying for SSDI or SSI
SSI payments are generally only available to people residing in the 50 states, District of Columbia or Northern Mariana Islands. If you receive SSI disability benefits and move, for example, to Mexico or Puerto Rico, you will lose those benefits. There are a few exceptions for some U.S. citizen children and students For adults and children applying for SSDI and for adults applying for SSI, being disabled means that you are unable to engage in any substantial gainful activity because of a medically determinable physical or mental impairment. The disability must have lasted or be expected to last for a continuous period of at least 12 months, or be expected to result in death. Even if you have an impairment that meets the requirements for disability, you won't qualify for SSDI or SSI if you earn more than the SGA level. In this situation, if you stop working and apply for disability payments, you must be able to show that your medical condition became worse or that special help you...
In the mid to late 1990s, there was a continued rapid growth in the use of cards instead of cheques. This point is illustrated in Table 1.1. This table also illustrates that cash payments over the decade and into the new century are fairly stable, and ATM withdrawals have more than doubled. Cash payments remain the dominant payment method, making up three-quarters of all payments, and their dominance will continue, though there might be a slight decline once social security benefits are paid directly into accounts. The use of cheques as a form of payment has fallen dramatically, as households and businesses switch
Federal laws and regulations recognize that your income may have declined between the period when you worked and when you stopped working because of your disability. Because your SSDI benefits depend on your earnings, the SSA recognizes that it is usually to your advantage to have your earning record frozen to reflect the higher income before you were disabled. Therefore, the SSA will exclude from your benefit calculations low income quarters of earnings resulting from a period of disability, unless it's to your financial advantage to include those quarters. (42 U.S.C. 423(a), 426(b)(f) 20 CFR 404.320.) severe your medical disorders. You will be turned down even if you have not paid enough in Social Security taxes to qualify for SSDI.
SUBMITTING MEDICAL EVIDENCE I understand that as a claimant for disability benefits, I am responsible for providing medical evidence showing the nature and extent of my disability. I may be asked either to submit the evidence myself or to assist the Social Security Administration in obtaining the evidence. If such evidence is not sufficient to arrive at a determination, I may be requested by the State Disability Determination Service to have an independent examination at the expense of the Social Security Administration. II. RELEASE OF INFORMATION I authorize any physician, hospital, agency or other organization to disclose to the Social Security Administration, or to the State Agency that may review my claim or continuing disability, any medical record or other information about my disability. I also authorize the Social Security Administration to release medical information from my records, only as necessary to process my claim, as follows
Assets can also include your future expected Social Security benefits and pension payments (if your employer has such a plan). These assets are usually quoted in dollars per month rather than in a lump sum value. I explain in a moment how to account for these monthly benefits when tallying your financial assets.
Table 2-1 provides a place for you to figure your financial assets. Go ahead and write in the spaces provided, unless you plan to lend this book to someone and you don't want to put your money situation on display. Note See Table 4-1 in Chapter 4 to estimate your Social Security benefits. Table 2-1 provides a place for you to figure your financial assets. Go ahead and write in the spaces provided, unless you plan to lend this book to someone and you don't want to put your money situation on display. Note See Table 4-1 in Chapter 4 to estimate your Social Security benefits.
1 am We are applying for Supplemental Security Income and any federally administered State supplementation under title XVI of the Social Security Act, for benefits under the other programs administered by the Social Security Administration, and where applicable, for medical assistance under title XIX of the Social Security Act.
If you qualify based on the criteria listed above, you may receive SSDI payments if you are a U.S. citizen or permanent resident, living in the United States or abroad. If you are neither a citizen nor a permanent resident, you still may be entitled to receive SSDI if you can show that you are lawfully present in the United States. (8 U.S.C. 1611(b)(2).) If you are a citizen when you apply for SSDI, you will have to show proof of your citizenship. Acceptable forms of proof include a birth certificate showing birth within the United States or any of the following Most foreign workers in the United States are covered under the U.S. Social Security program and can potentially qualify for disability benefits. If, however, you are neither a citizen nor a permanent resident, you still may be covered under Social Security Disability. Federal law generally requires that all workers should pay Social Security taxes, and therefore be covered under SSDI for services performed in the United...
If you are applying for SSDI, you set the date of your AOD. But the SSA will not allow benefits for any time when you were engaged in substantial gainful activity and earning too much money to qualify. The ultimate determination of your AOD is made by the SSA, and is influenced both by non-medical eligibility factors (see the next section) and the date the SSA considered you unable to do substantial gainful work.
While Field Offices deal with all kinds of Social Security issues, the DDS is concerned only with determining your medical eligibility for disability benefits. The DDS employees and consultants are hired by the state, not by the SSA. Once the DDS receives your file, representatives there collect more information, especially medical information, and decide whether you are eligible for disability benefits. The DDS sends requests to your treating doctors and hospitals for your medical records, based on the information you provide. Nonmedical information, such as detailed data about your work activities or skills, may also be obtained by the DDS. If the DDS needs more information, the examiner will contact you by telephone or in writing. It is vital that the DDS be able to communicate with you to obtain full and accurate information and, in some cases, to request that you undergo medical examinations or laboratory tests at the expense of the SSA. (The DDS is discussed more fully in...
Public disability payments that may affect your Social Security benefits are those paid under a federal, state or local government plan that covers conditions that are not job related. Examples are civil service disability benefits, military disability benefits, state temporary disability benefits and state or local government retirement benefits based on disability. benefit cases can be legally complex and vary between states, especially when combined with Social Security disability benefits. If you might be eligible for both, consider using the services of an attorney experienced in the interaction of Social Security disability and other programs to make sure you obtain all the benefits you are entitled to.
As explained previously, the SSA considers anyone under age 18 a child. Under SSI, children can qualify for disability based on their own medical problems. Under SSDI, children can receive benefits at any age (paid to the parents) if the parent is a disabled, retired or de ceased worker who has paid sufficient Social Security taxes. Such SSDI children cannot receive benefits based on their own medical problems, no matter how severe. A child of an eligible worker can receive benefits based on her own medical problems, however, once she passes her 18th birthday, as long as she becomes medically disabled before age 22.
To be eligible to collect Social Security benefits, you need to have worked a minimum number of calendar quarters. If you were born after 1928, you need 40 quarters of work credits to qualify for Social Security retirement benefits. The age at which you can start collecting full benefits has increased, and it may increase again. In the good old days (prior to changes made in Social Security regulations in 1983), you could collect full Social Security payments at age 65, assuming you were eligible. Under current rules, if you were born before 1938, you're still eligible to collect full Social Security benefits at age 65. If you were born after 1959, you have to wait until age 67 for full benefits. If you were born between 1938 and 1959, full benefits are payable to you at age 66 (plus or minus some number of months, depending on the year you were born). The amount of Social Security benefits you receive in retirement depends on your average earnings during your working years. Don't...
Do not confuse emergency payments with immediate payments. The SSA will issue immediate payments through a Field Office in critical cases within 24 hours. These payments can be made to both SSI and SSDI claimants who qualify. To qualify, you must have a financial emergency or present a potential public relations problem for the SSA. You must already be receiving SSI or SSDI payments, so immediate payments do not apply to presumptive disability. Critical cases are those involving delayed or interrupted benefit payments. Examples might include the loss of a benefit check in the mail or a natural disaster like a hurricane or tornado wiping out parts of a town and interfering with normal benefit check delivery to a number of people. The maximum amount payable for either SSI or SSDI is 999.
Doctors who do CEs for the SSA are not the same as DDS medical consultants. This can be confusing, because CE doctors may also be consultants for the DDS. When they are performing work for the DDS, they are called DDS medical consultants. Here is the difference. CE doctors examine claimants and send their reports to the SSA with an opinion on what a claimant can do, given the claimant's medical condition. CEs do not necessarily have the training or authority to make a medical disability determination. On the other hand, DDS medical consultants do not actually examine claimants, but do have the authority to make disability determinations based on the special training by the SSA DDS that they must undergo before being allowed to make decisions, as well as ongoing training they receive. However, some DDS medical consultants are less knowledgeable about the Social Security disability program than others, because of lack of personal motivation or only part-time work for the DDS.
Frequent migraine headaches that last hours or even days at time, and which do not respond to treatment by doctors. It is rare to see headaches this severe, but if you have them, the SSA can use them to allow disability benefits. In the case of a disorder like headaches, where a physical examination shows very little abnormality, it is particularly critical that your treating doctor has good records about the severity, duration and frequency of the headaches. These records will provide credibility to your allegation that the headaches are disabling.
Claims examiners sometimes are taught about basic medical principles by the DDS medical consultants. This is to help them better understand the medical issues involved in claims, but does not qualify them to make determinations about the medical severity of your impairments. Unfortunately, this doesn't stop some examiners from trying. Under current regulations, however, examiners cannot make medical determinations, except in some pilot studies involving redesign of the Social Security disability evaluation process. (See Section H, below.)
Medical consultants are the people who ultimately review the medical aspect of your claim for disability benefits. A medical consultant must be a licensed medical doctor, osteopath or psychologist with a Ph.D. If you apply for disability based on physical impairments, a medical doctor or osteopath will evaluate your file. If you apply for disability based on a mental impairment, a psychiatrist (either a medical doctor or osteopath) or a qualified psychologist will evaluate your file.
Good administration of a DDS requires education, knowledge, skill and experience. However, a governor might appoint an unqualified person. For example, the director might have no experience with Social Security disability or fail to have the necessary education. You should be able to find out about the director's qualifications by calling or writing the director himself, or the governor's office. It is in your best interest to know the director's qualifications and to make sure the governor knows what you think.
EXAMPLE You apply for disability benefits, but your only treating source for your back pain is your chiropractor. Any information provided to the SSA by that chiropractor, no matter how detailed, is not sufficient for the SSA to make a disability determination. You will be sent to an acceptable medical source for an examination of your back complaints.
When you file your application for disability benefits, you will be asked about your education. The SSA will accept your word about your educational level, unless you've given them some reason to doubt it such as being a certified public account and saying you never completed the fifth grade. If you have any additional or written documentation about your education that you want in your file, give it to your SSA Field Office and someone there will send it to the DDS or you could send it to the examiner at the DDS handling your claim.
If you are referred to VR and refuse to attend, the SSA can deny you your disability benefits, unless you have good cause for failing to attend. If a problem makes it difficult for you to attend VR, try to find a solution with the state VR agency so you can attend. If you can't work out a solution, the SSA will decide if you have good cause for not attending. You cannot decide that for yourself.
When applying for Social Security disability, most people naturally think about the reasons why they should be granted benefits. You may find it useful, however, to turn the perspective around and understand the reasons why you might be denied benefits. In some cases, the reasons are beyond your control. In other instances, though, you may be able to avoid doing something that results in denial.
The most basic reason to be denied benefits is that you work above the substantial gainful activity (SGA) limit when you apply. This means you earn too much money. If you are an SSDI applicant who is not blind, you are considered above the SGA if you make over 800 per month. If you are a blind SSDI applicant, you are considered above the SGA if you make over 1,330 per month, as of January 2003. (The limit for blind applicants adjusts each year.) Income from investments does not count toward the SGA only work income counts. There is no such thing as partial disability based on how much money you earn. In other words, if you make 800 per month or less as a nonblind person, you will receive the total amount of your disability check. If you make more than the 800 SGA limit, you will receive no benefits (although there are temporary exceptions for those already receiving benefits when they attempt to return to work, as described in Chapter 13). example SSDI recipients usually keep their...
To qualify for SSI or SSDI benefits, the SSA must believe that your impairment is severe enough to last at least 12 months or result in your death. The only exception to this duration requirement is with blind SSI applicants. Many claims often based on bone fractures resulting from acute trauma, such as automobile or motorcycle accidents are denied because they are not likely to cause disability for 12 months. Almost all bone fractures heal in less than a year. If you have severe bone fractures unhealed after six months, however, the SSA is likely to think your impairment will last a year. But each case is evaluated on an individual basis. EXAMPLE Reg has an acute bone fracture from an automobile accident two months ago and he cannot walk. He clearly is severely impaired and unable to work. But his application for SSDI is denied because the DDS assumes that his fracture will heal in less than 12 months.
If you are being treated by a doctor, but fail to follow the doctor's prescribed therapy when you have the ability to do so, you can be denied disability benefits. For the SSA to deny your claim for this reason, the therapy that you fail to follow must be one that is clearly expected to restore your ability to do economically meaningful work (known as Substantial Gainful Activity). For a child applying for SSI, the issue is whether the prescribed therapy will restore the child's
PRIVACY ACT PAPERWORK REDUCTION ACT NOTICE The Social Security Administration is authorized to collect the information on this form under sections 205(a), 223(d) and 1633(a) of the Social Security Act. The information on this form is needed by Social Security to make a decision on your claim. While giving us the information on this form is voluntary, failure to provide all or part of the requested information could prevent an accurate or timely decision on your claim and could result in the loss of benefits. Although the information you furnish on this form is almost never used for any purpose other than making a determination on your disability claim, such information may be disclosed by the Social Security Administration as follows (1) To enable a third party or agency to assist Social Security in establishing rights to Social Security benefits and or coverage (2) to comply with Federal laws requiring the release of information from Social Security records (e.g., the General...
Without enough demand and too much supply, asset prices will sink and the long-standing trend to an earlier retirement will be halted dead in its tracks. When Social Security was passed in 1935, the average retirement age was 69. That age fell to 67 by 1950, and to 62 today. In 2003, for the first time, more Americans chose the reduced Social Security benefits at age 62 than the full benefit that starts at 65. Despite improving health, surveys indicate that the bulk of Americans and Europeans want to retire earlier, not later.
We estimate that it will take you about 30 minutes to complete this form. This includes the time it will take to read the instructions, gather the necessary facts and fill out the form. If you have comments or suggestions on this estimate, or on any other aspect of this form, write to the Social Security Administration, ATTN Reports Clearance Officer, 1-A-21 Operations Bldg., Baltimore, MD 21235-0001, and to the Office of Management and Budget, Paperwork Reduction Project (0960-0144), Washington, D.C. 20503. Send only comments relating to our estimate or other aspects of this form to the offices listed above. All requests for Social Security cards and other claims-related Information should be sent to your local Social Security office, whose address is listed in your telephone directory under the Department of Health and Human Services.
Paperwork Privacy Act Notice The Social Security Administration is authorized to collect the information on this form under sections 205(a), 1631 (e)(A) and (B), and 1872 of the Social Security Act, as amended (42 U.S.C. 405, 1383 and 1395ii). Giving us the information on this form is voluntary. However, if you do not respond, we will make a decision based on the evidence in your file. The Social Security Administration will use the information on this form to fully evaluate your claim for disability benefits. We may routinely give out the information on this form without your consent if
I understand that this report will be used to determine whether to continue or to stop my disability benefits. I also understand that if I am receiving Social Security disability benefits and Supplemental Security Income payments, this questionnaire is applicable to both claims. I agree to notify the Social Security Administration if my medical condition improves or I go to work.
PRIVACY ACT AND PAPERWORK ACT NOTICE The Social Security Act (section 205(a), 702, 1631(e)(1)(A) and (B), and 1869(b)(1) and (c), as appropriate authorized the collection of information on this form. We will use the information on your recent activities, condition, medical treatment, and medications to help us decide if we need to obtain more information. You do not have to give it, but if you do not you may not receive benefits under the Social Security Act. We may give out the information on this form without your written consent if we need to get more information to decide if you are eligible for benefits or if a Federal law requires us to do so. Specifically, we may provide information to another Federal, State, or local government agency which is deciding your eligibility for a government benefit or program to the President or a Congressman inquiring on your behalf to an independent party who needs statistical information for a research paper or audit report on a Social Security...
How much your benefits will be depends first on whether you have an SSDI claim or an SSI claim, because each program uses different formulas to determine benefits. SSDI benefits are higher than SSI benefits. a. SSDI Benefits The SSA will tell you the amount of your benefits when it sends you notice that your claim has been allowed. Your SSDI benefits are calculated using a complicated formula. First, the SSA calculates your average earnings over a period of many years, known as the average indexed monthly earnings (AIME). Your AIME is then used to calculate your primary insurance amount (PIA) the basic figure the SSA uses in finding the actual benefit amount. The PIA is fixed percentages of predetermined dollar amounts of your AIME. The dollar amount increases yearly, but the percentages stay the same. For 2003, for example, the monthly PIA benefit for a disabled worker is as follows
When and how benefits are paid depends on the type of benefit, and whether the payment is by check or direct deposit to a bank account. If you don't have a bank account, your local SSA Field Office can help you find banks that offer low- or no-cost accounts to receive your SSDI or SSI benefits.
Your disability benefits generally continue as long as your impairment has not improved and you cannot work. Because of advances in medical science and rehabilitation techniques, increasing numbers of people with disabilities recover from serious accidents and illnesses. Some people recover enough to return to work. Your case will be reviewed periodically to make sure you're still disabled (see Chapter 14). Your benefits may be reduced or terminated if you marry, receive certain other disability benefits or move to certain countries where payments are prohibited (see Section B5, below). Also, if you are receiving SSDI when you turn 65, your benefits automatically will be changed to retirement benefits, generally for the same amount. If you are receiving benefits as a disabled widow or widower when you turn 60, your benefits will be changed to regular widow or widower benefits.
Medicare coverage does not start right away for SSDI recipients. Instead, you become eligible after you receive SSDI benefits for 24 months. If you have chronic kidney disease requiring regular dialysis, amyotrophic lateral sclerosis or a transplant, however, you may qualify for Medicare almost immediately. SSI recipients have no Medicaid waiting period.
Social Security disability benefits and start to receive a monthly pension which is based in whole or in part on work not covered by the U.S. Social Security system (such as a foreign social security pension), then your U.S. Social Security benefit may be smaller because the SSA may use a secondary formula to figure your U.S. Social Security benefit. For more information, ask at any U.S. embassy or Social Security office. certain Social Security benefits. Specifically, your benefits will not end if you are age 18 or older, disabled, and you marry a person entitled to child's benefits based on disability or a person entitled to old age, divorced wife's, divorced husband's, widow's, widower's, mother's, father's, parent's or disability benefits. Once your benefits end, they cannot start again unless the marriage is declared void. A void marriage is one that was illegal from the outset, such as if you marry someone who is already married. If your marriage ends...
Notify the SSA if your marriage is annulled or you get divorced. Divorce or annulment does not necessarily mean that your SSDI payments will stop. If you are receiving payments based on your own work record, divorce or annulment of your marriage will not affect your payments. Also, if you are a spouse age 62 or older and you were married to the worker for ten years or more, your payments will continue even if you divorce. But still contact the SSA if your name is changed as a result of the divorce so that the SSA can put your new name on your payments.
If you are not a U.S. citizen, and are deported or removed from the U.S. for certain reasons, your Social Security benefits are stopped and cannot be started again unless you are lawfully admitted to the U.S. for permanent residence. Even if you are deported or removed, your dependents can receive benefits if they are U.S. citizens.
Your obligation to report any changes that may affect your SSI benefits is similar to the requirements described for SSDI recipients, with a few differences. For example, residents of California, Hawaii, Massachusetts, Michigan, New York or Vermont have special reporting requirements described in Section C10, below.
Although the SSA already has work incentives as discussed previously, the intent of Congress in passing this law was to further encourage those receiving Social Security disability benefits to return to the workforce by eliminating additional financial obstacles. If your SSDI or SSI is terminated because you are doing SGA, you may request a reinstatement of benefits without filing a new application if you are not able to work on account of your medical condition and you file the reinstatement request within 60 months of when your benefits ended.
For beneficiaries between 16 and 64, the law expands the states' options and funding for Medicaid for workers with disabilities by liberalizing the limits on resources and income and giving working people who have impairments the right to buy Medicaid, even though they are no longer eligible for SSDI or SSI. The states can require individuals to contribute to the cost on a sliding scale based on income. Congress extended premium-free Medicare Part A coverage for SSDI beneficiaries who return to work for eight and one-half years (the prior length was four years). The law allows workers with disabilities who have Medicare coverage and a Medigap policy to suspend the premiums and benefits of the Medigap policy if they have employer-sponsored health coverage.
Several provisions under this law provide for incentive payments to institutions to report SSDI as well as SSI inmates to the SSA, shorten the length of confinement making an inmate ineligible for benefits, and address the issue of sexual predator confinement. The law Extends the incentive payment provisions now in effect for SSI prisoners to SSDI recipients, and authorizes the SSA to report this information to any agency administering a federal or federally assisted cash, food or medical assistance program for purposes of determining program eligibility. These provisions which already applied to SSI claimants allow the SSA to pay 200 to 400 for information as a reward incentive for information that leads to a suspension of prisoner benefits. EXAMPLE An SSDI beneficiary is arrested and confined in jail on March 21. He is not granted bail and is sent to trial. The court convicts the beneficiary on April 15. He is not released from jail once convicted, and is sent to prison on April 16....
The transition from receiving disability benefits to supporting yourself through employment is bound to involve difficulties and frustrations it's no easy task. With any luck, you'll receive the assistance you need from the EN, but it's quite possible that the EN will itself be a cause of your frustration, through errors, decisions you don't agree with or bureaucratic hassles.
If you go back to work, or you begin to earn more money, you must notify your local Social Security office. The Ticket Program does not replace the special rules, called work incentives, that help serve as a bridge between Social Security and SSI disability benefits and financial independence. These work incentives include
We estimate that it will take you about 30 minutes to complete this form. This includes the time it will take to read the instructions, gather the necessary facts and fill out the form. If you have comments or suggestions on this estimate, write to the Social Security Administration, ATTN Reports Clearance Officer, 1-A-21 Operations Bldg., Baltimore, MD 21235-0001. Send only comments relating to our time it takes estimate to the office listed above. All requests for Social Security cards and other claims-related information should be sent to your local Social Security office, whose address is listed under Social Security Administration in the U.S. Government section of your telephone directory.
Many people are perfectly capable of applying for disability benefits themselves and most claimants do just that. They have the time and ability to complete the paperwork, meet with the claims examiner, contact their treating doctors and hospitals for their medical records and follow up on any requests from the claims examiner, medical examiner or medical consultant.
Finding an attorney who handles disability claims isn't difficult. They advertise in the classified ad section of newspapers and in the telephone book. Of course, attorneys vary in their competence, skill and experience. Some attorneys are new to the field of Social Security disability representation of claimants. Disability law is an extremely specialized area. Attorneys cannot quickly review a few law books and capably represent your claim.
In both SSDI and SSI claims, attorneys and nonattorneys who represent disability applicants know that their clients don't have a lot of money to spend, and will usually work for payment subtracted from your past-due benefits if your claim is allowed. This means that, in most instances, if you lose your claim, you don't have to pay your authorized representative. To avoid any misunderstanding, be clear on the nature of the fee arrangement the representative offers before you hire him. However, you should understand that, win or lose, your representative may expect you to pay his out-of-pocket office costs associated with handling your claim. These might include long distance telephone calls, copying birth and death certificates, travel expenses or postage.
Once you begin receiving disability benefits, your case is re-examined periodically through a continuing disability review (CDR). (See Chapter 14 for more on this subject.) The SSA can end your benefits for a variety of reasons, including The next set of blanks concerns the type of benefit involved in your claim. There are boxes under Disability (SSDI claims) and SSI. Those that apply must be checked. I have been advised of my right to have a disability hearing. I understand that a hearing will give me an opportunity to present witnesses and explain in detail to the disability hearing officer, who will decide my case, the reasons why my disability benefits should not end. I understand that this opportunity to be seen and heard could be effective in explaining the facts in my case, since the disability hearing officer would give me an opportunity to present and question witnesses and explain how my impairments prevent me from working and restrict my activities. I have Although the...
A You must use forms provided by the SSA. You can obtain them at your local SSA Field Office or by calling the SSA hotline at 800-772-1213, Monday through Friday (except holidays), from 7 a.m. to 7 p.m. If you are deaf or hard of hearing, TTY service representatives are available at the same times at 800-325-0778. You can also download many necessary forms from the Social Security Administration website at www.ssa.gov. that she accepts the appointment and sign the form. You also must sign the form and give your address, Social Security number and telephone number. If the claimant is not the same person as the wage earner (for SSDI claims), such as a parent signing for a child, the Social Security numbers of both are needed.
With or without a lawyer, you should realize that the material in this book can change between printings. The U.S. Congress and the Social Security Administration are constantly updating and revising the rules that affect you. To assist you, Nolo prints updates to all of its books on its website at www.nolo.com. Go to the Free Information and Tools portion of the homepage and click on Legal Updates, then on the title of this book.
Every person who files a disability claim for SSDI or SSI is responsible for providing medical evidence to the Social Security Administration (SSA) showing that she is impaired. You do not have to physically provide medical reports to the SSA. If you give your permission, the SSA will help you get reports from medical sources that have treated or evaluated you.
Hearing loss is a frequent claim of disability applicants. Many people have hearing loss because of exposure to loud sounds over a period of years. While most people know to wear hearing protection when they shoot firearms, few realize that they should protect their hearing when using lawnmowers, weed-trimmers, leaf-blowers or similar loud equipment. Damage to hearing because of loud sounds is far more common than conductive hearing loss. Some claimants tell the SSA that they can't hear anything even when tested, although they seem to have no abnormalities that would cause a hearing loss and have no prior history of profound deafness. In these cases, the SSA might use auditory evoked response testing to identify abnormalities in the brain's hearing pathways that could explain the loss. If the SSA cannot find a cause for the alleged deafness, the SSA won't grant disability benefits.
To receive disability benefits, it is not enough to have a medical disorder preventing you from working. Other things that make you unable to work may also be considered. First it must be established that you are covered under SSDI or qualified to apply for SSI benefits because of low income and resources. Then you must also satisfy the nonmedical eligibility requirements before your medical disorder is even considered by the SSA. Determining whether or not you satisfy nonmedical requirements is the job of the Field Office. Nonmedical criteria include your age, employment, marital status, Social Security coverage information and other factors. Age, education and work experience are the most important. These are called vocational factors and are discussed in Chapter 9.
RV You must use forms provided by the SSA. You can t-S-J obtain them at your local SSA Field Office or by calling the SSA hotline at 800-772-1213, Monday through Friday (except holidays), from 7 a.m. to 7 p.m. If you are deaf or hard of hearing, TTY service representatives are available at the same times at 800-325-0778. You can also download many necessary forms from the Social Security Administration website at www.ssa.gov. We must regularly review the cases of people getting disability benefits to make sure they are still disabled under our rules. It is time for us to review your case. This letter explains how we plan to start our review of your case.
ALJs are attorneys who work for the SSA's Office of Hearings and Appeals (HA). HA is entirely separate from the division that evaluates initial applications, continuing disability reviews and reconsideration claims. ALJs are not like judges who work in the civil and criminal courts. ALJs' powers reside only within the SSA. Most of their work involves upholding or overturning a decision by a DDS to deny or terminate disability benefits they also hold hearings on non-disability Social Security issues. There is no jury in an ALJ hearing the ALJ, alone, makes the decision to allow or deny you benefits. Form SSA-827 Authorization for Source to Release Information to the Social Security Administration (see Section D1a). You must use forms provided by the SSA. You can obtain them at your local SSA Field Office or by calling the SSA hotline at 800-772-1213, Monday through Friday (except holidays), from 7 a.m. to 7 p.m. If you are deaf or hard of hearing, TTY service representatives are...
PRIVACY ACT PAPERWORK ACT NOTICE The information requested on this form is authorized by the Social Security Act, Sections 205 (a) and 1631 (c) (1) (A) and (B),and regulations at 20 CUR 404.1589 and 416.889. The information provided will be used to further document your claim and permit a determination about your continuing disability. Information requested on this form is voluntary. However, ifyou do not provide the required information, a decision based on the eviden ce in your file can result in a determination th at your period of disability is ceased. Wh ile the information you furnish on this form would almost never be used tor any purpose than in making a detennination about your disability, such information may be disclosed by SSA for the following purposes (l)To assist SSA in determining the right to Social Security benefits for yourself or another person, (2) To facilitate statistical research and audit activities necessary to assure the integrity and improvement of programs...
The qualification for 12 months of disability benefits is automatic and comes with no restrictions whatsoever. For example, you could be feeling great eight months after surgery and your doctor could even tell the SSA she thinks you could work. But you would still qualify under the listing, if you choose to make use of it.
They typically offer slightly higher rates than banks and, best of all, these annuity accounts accumulate interest on a tax-deferred basis. This means that your account earns interest without causing your marginal tax bracket to go up. Money that accumulates free of current income tax will grow much quicker than funds that are taxable each year. These accounts typically accumulate free of current state income tax as well. Many retirees have also figured out that while the interest in these accounts is in the accumulation phase, no 1099 statements are generated. Therefore, the interest from these accounts while accumulating is not taken into account for taxation of your Social Security benefits
You must use forms provided by the SSA. You can obtain them at your local SSA Field Office or by calling the SSA hotline at 800-772-1213, Monday through Friday (except holidays), from 7 a.m. to 7 p.m. If you are deaf or hard of hearing, TTY service representatives are available at the same times at 800-325-0778. You can also download many necessary forms from the Social Security Administration website at www.ssa.gov. The form is not available from the DDS.
Develop a financial plan for investment and consumption over your life-cycle (from the present until your death). Suppose the inflation rate is 2.0 and the real return on a riskfree money market fund is 3.5 . Suppose that a risky diversified fund offers an average real return of 8.0 and a standard deviation of 17.0 , which is equivalent to the post-World War II average real return and standard deviation on a well-diversified portfolio of US stocks. Suppose that federal income taxes have five brackets with the following rates 15.0 , 28.0 , 31.0 , 36.0 , and 39.6 . For current year, the upper cutoff on the first four brackets are 43,050, 104,050, 158,550, and 283,150 and these cutoffs are indexed to inflation. The state tax rate 3.0 , federal FICA-SSI tax rate on salary up to 72,600 is 6.2 , and the federal FICA-Medicare tax rate on any level of salary is 1.45 . Suppose you are currently 25 years old and you expect to earn a salary next year of 70,000. You currently have 0 in a...
Social Security, if you're covered, can provide survivors' benefits to your spouse and children. However, if your surviving spouse is working and earning even a modest amount of money, he or she is going to get few, if any, survivor's benefits. Prior to reaching Social Security's full retirement age (see Chapter 4), your survivor's benefits get reduced by 1 for every 2 you earn above 14,160 (in 2009). This income threshold is higher if you reach full retirement age during the year. For example, for those reaching full retirement age during 2009, their Social Security benefits are reduced by 1 for each 3 they earn above 37,680 until the month in which they reach full retirement age. If either you or your spouse anticipates earning a low enough income to qualify for survivor's benefits, you may want to factor your Social Security survivor's benefits into how much life insurance to buy. Contact the Social Security Administration by phone at 800-772-1213 or visit its Web site at www....
Insurance companies in other fields also have reserves. These reserves, to the extent they depend on expected premium income and expected claims, would be developed in a similar manner. Most insurance companies have reserves for claims that have actually accrued but that have not been filed with the company. They are called incurred but not reported (IBNR) reserves. Other reserves exist as well, depending on the particular business of the particular insurance company. The Social Security Administration does not have computed reserves, but does have trust fund as a reserve.
Develop a spreadsheet model of investment and consumption on a year-by-year basis over an entire lifetime. You need to choose how to divide your salary between providing consumption now vs. savings (to provide for consumption in the future). Your savings are put in a tax-deferred retirement account and each year you need to decide what percentage to contribute to it (or withdraw from it). You avoid paying taxes on contributions to the retirement fund, but you suffer paying taxes when you withdraw from it. Salary less contributions plus withdraws gives you taxable income upon which you pay taxes. The after-tax income plus social security benefits provide for consumption each year. You need to choose what percentage of your retirement funds to invest in the risky diversified fund. The rest of your retirement funds will be invested in the riskfree money market fund and will grow at the Plus Social Security Benefits o Plus Social Security Benefits 0 in working years o...
Social Security retirement benefits are also life annuities, or pensions. The Social Security Administration calculates the retirement benefit according to the requirements of the Social Security laws and regulations. The evaluation of the retirement benefits is similar to the evaluation of private pensions, except that Social Security benefits have annual cost-of-living adjustments. Many public pensions also have cost-of-living adjustments, but most corporate pensions do not. Occasionally some corporations adjust their pensions to reflect some living cost increases.
In addition to the monthly coverage amount, you also need to select the duration for which you want a policy to pay you benefits. You need a policy that pays benefits until you reach an age at which you become financially self-sufficient. For most people, that's around age 65, when their Social Security benefits kick in. If you anticipate needing your employment income past your mid-60s, you may want to obtain disability coverage that pays you until a later age.
Basically, your growth is tax deferred until withdrawn. This places account holders in charge of their tax situation. Investors also like the fact that they can move from one account to another within these annuities without income tax ramifications. Retirees like these accounts because not only is the tax deferred on their growth but the tax-deferred growth is not used in calculating taxation of their Social Security benefits if left on deposit. Chances are if you talk to several different investment advisors, you will receive conflicting viewpoints on these investments. To understand this, we will discuss what a variable annuity is and the pros and cons about it.
As an aside, I have spoken with a representative from the Social Security Administration about this topic. This official indicated that using two social security numbers is at best improper and possibly illegal. A person can be issued more than one social security number only by mistake or miscom-munication (for example, if a person had been issued a number but was not aware of it, and the person then applies for a number, and the Social Security Administration does not notice that a number had already been issued for the same person, then the use of two numbers is merely improper the result of an error). If, however, the person has knowingly employed more than one social security number regardless of whether he had been mistakenly issued two this misuse is illegal.
Call the Social Security Administration's toll-free line (800 772-1213) and ask for an Earnings and Benefit Estimate Statement. The SSA will send you a form asking you how much you earned last year, your estimated earnings for this year, the age you plan to retire, and your estimated future annual earnings.
American Association of University Professors and the American Association of Colleges recommend that educational institutions design pension plans to enable employees to replace about two-thirds of their inflation-adjusted annual disposable salary (averaged over the last few full-time work years) through a combination of pension annuity income and social security benefits (American Association of University Professors 1990). This policy was reaffirmed by a National Academy of Sciences committee in 1991 (Hammond and Morgan 1991). This two-thirds clearly is a one-size-fits-all approach that overlooks variations in life cycle circumstances, though it does provide a starting point for planning purposes. Slightly higher targets were recommended by Palmer (1993), using tax and social security benefit rules and consumer expenditure data. He proposed that required income replacement ratios for individuals and married couples range from 70 to 80 percent of gross preretirement income.2...
There are no specific requirements for brain trauma that will result in allowance of disability benefits. Evaluation is done under whatever criteria apply to the complications in a claim, such as the presence of epilepsy, stroke or organic brain syndrome (Listing 12.02, Chapter 27). The SSA should not deny a claim involving severe brain trauma with the prediction that it will improve to a denial level severity within 12 months. Such predictions are unreliable. If there is any question about whether a brain trauma case will remain severe for 12 months, the SSA should not make any final determination for at least six months after the injury so that an accurate medical assessment can be done.
Contact the Social Security Administration at (800) 772-1213 to see if your spouse and children are entitled to survivors' benefits. However, if your surviving spouse earns more than 20,000 a year, he or she is not entitled to any survivors' benefits coverage. If your family is eligible, have them determine what percentage of your current income the benefits cover. Why Because if the survivors' benefits replace 30 percent of your income, you would have to purchase 30 percent less in life insurance benefits. Got it
A second and even greater benefit is that your funds grow tax-deferred until withdrawn. Your funds could accumulate to a much greater amount inside such a container than if they were taxed every year. These accounts accumulate free from federal income tax and state income taxes. The accumulation values are also not taken into account when computing how much of your Social Security benefits will be taxable.
Step 2 Determine Where the Money Will Come from to Finance Your Projected Future Retirement Income Needs
You can begin to collect reduced Social Security benefits at age 62 or, depending on the year that you were born, full benefits between ages 65 and 67. The easiest way to determine the exact amount of your yearly benefits is to request it from the Social Security Administration.
Unless you were an applied math major in college, however, coming up with a useful retirement plan by using a pencil and a calculator is a complex task. There are so many factors to consider expected rates of investment return, inflation, tax brackets, savings rates, social security benefits, retirement ages, pension benefits, life expectancies and on it goes.
Contacting the Social Security Administration Social Security benefits If you are denied SSDI or SSI, you can appeal that decision. (Appealing is discussed in Chapter 12.) The Office of Hearings and Appeals administers the entire hearings and appeals program for the SSA. Administrative law judges, located in or traveling to major cities throughout the United States and its territories, hold hearings and issue decisions when a claimant appeals a determination. The Appeals Council, located in Falls Church, Virginia, can review hearing decisions. D. Frequently Asked Questions About Social Security Disability Following are some frequently questions asked about SSDI and SSI. 2. When do disability benefits start SSDI claimants may be entitled to retroactive (past) benefits, if they are found to have been disabled before their application date. Actual payments, however, cannot be made until five months pass from the date of the onset of disability. Cash benefit payments cannot be paid...
The SSA has begun a national referral service to assist employers in hiring motivated, qualified workers with disabilities from the Ticket to Work Program. The Ticket to Hire system works like this employer gains various advantages through hiring you via referral from an EN or SVRA, such as tax credits, shortened employee recruiting time and decreased cost of health insurance since you will have extended Medicaid or Medicare coverage for many years, even after your disability benefits stop. Social Security What You Need to Know When You Get Disability Benefits
After the Social Security Administration Field Office finds that you meet the nonmedical eligibility requirements for disability benefits, your file is sent to the state agency responsible for making a decision on your application. This agency is known as the Disability Determination Services, or DDS. Your file will contain your application, the few administrative documents you completed at the SSA Field Office and copies of any medical records or other relevant papers you provided the SSA when you applied.
If you are an adult and your impairment continues to meet or equal the same listing in the Listing of Impairments (see Chapter 7, Step 3), as it did at the time you obtained disability benefits or at your last CPD, then the SSA can simply continue your benefits without having to consider the MIRS. You will continue to receive your benefits even if the requirements of the listing have been changed and you do not meet these requirements of the new listing. This is extremely important to know many disability recipients, especially those with heart or other cardiovascular disease, were granted benefits under lenient listings that are now out of date. An inexperienced or poorly trained DDS medical consultant might overlook this grandfathering clause and terminate your benefits. EXAMPLE Tim was previously granted disability benefits on the basis of diabetes mellitus, which the prior DDS MC believed was equivalent to the level of severity contemplated in the Listing of Impairments. At the...
At that time, social security benefits at age 65 replaced about 20 percent of income in the upper income categories ( 90,000 in 1990 dollars), about 50 percent of income for the middle income range ( 35,000), and about 70 percent of income for those with lower incomes ( 15,000).
You qualify for these first 12 months of disability benefits without any restrictions whatsoever. For example, you could be feeling great eight months after surgery and your doctor could even tell the SSA she thinks you could work. But you would still qualify under the listing, if you wished to make use of your benefits.
Federal law prohibits payment of SSDI or SSI benefits and Medicare or Medicaid coverage based on those benefits to people who are disabled because of drug addiction and or alcoholism (DAA) to the extent that their problems would be reversible by ceasing the addictive activity. In other words, you can be disabled because of irreversible organ damage caused by DAA. See Chapter 11 regarding how the SSA evaluates DAA.
An agency in your State that works with us in administering the Social Security disability program is responsible for making the disability decision on your claim. In some cases, it is necessary for them to get additional information about your condition or to arrange for you to have a medical examination at Government expense. The Social Security Administration is authorized to collect the information on this form under sections 202(b), 202(c), 205(a), and 1872 of the Social Security Act, as amended (42 U.S.C. 402(b), 402(c), 405(a), and 1395(ii). While it is VOLUNTARY, except in the circumstances explained below, for you to furnish the information on this form to Social Security, no benefits may be paid unless an application has been received by a Social Security office. Your response is mandatory where the refusal to disclose certain information affecting your right to payment would reflect a fraudulent intent to secure benefits not authorized by the Social Security Act. The...
Medicare is a federal health insurance program for people 65 or older or who have received SSDI benefits for at least two years. Because children do not get SSDI benefits until they turn 18 (if they qualify at a younger age they are receiving dependents' or survivors' benefits through their parents), no child can get Medicare coverage until he or she is 20 years old. The only exception is for children with chronic renal disease who need a kidney transplant or maintenance dialysis. And those children will be eligible for Medicare only if a parent receives SSDI or has worked enough to be covered by Social Security.
To qualify for SSDI, you must fall into one of the following categories The number of work credits needed for disability benefits depends on your age when you become disabled. Most people need at least 20 credits earned over ten years, ending with the year you become disabled. Younger workers may qualify with fewer credits. In effect, you count backwards from the year that you became disabled to see whether you have the appropriate number of credits. That means that credits from many years before you became disabled are automatically wiped out, or expire. This can lead to a dangerous situation for people who haven't worked for many years before becoming disabled. Their credits may dip below the required amount, and they can lose eligibility for SSDI. The date on which they lose their eligibility is called the date last insured, or DLI often a subject of dispute in Social Security cases. If you think your DLI is too far in the past to qualify you for SSDI, talk to your local SSA Field...