So, the SSA decided I’m disabled. Now what?

 

 

Title XVI Supplemental Security Income:
Explanation of SSI:
Supplemental Security Income (SSI) is a welfare benefit for the disabled which requires you to have income and assets below a low threshold.

Accrual of benefits:
SSI begins to accrue upon the first calendar month following the date of your application; it does not apply retroactively before the date of your application. If the SSA found your onset of disability was on a date after you applied, then SSI begins accruing after your onset date.

Benefit reductions:
Because SSI is a welfare benefit, it is reduced by your other income, including any Title II social security insurance benefits you receive for the same month.

 

Step One: Decide whether to keep your SSI claim
If you applied for SSI more than five months after your onset of disability (see below re Title II accrual date), and your Title II social security benefits pay more than SSI pays, your SSI effectively is reduced to zero. If that is the case, it may be best to withdraw your SSI application so as to avoid delays in processing your Title II benefits. Then again, if you have been collecting cash benefits from, say, your township, the township likely has a lien against your SSI for what it spent. If so, you will need to pursue SSI and, if necessary, the difference will be subtracted from your Title II benefits. We will provide our clients with a form to withdraw when that is our recommended course of action.

 

Step Two: Help the local office process your SSI claim
If you are keeping your SSI claim, you will need to speak with the local office.

SSI Update Interview:
Call your local SSA office to schedule an “SSI Update Interview.” That office will interview you regarding your financial situation since your date of entitlement to SSI, i.e., the date SSI begins accruing. They will want to see, for example, bank statements, rental agreements, and information on life insurance policies that can be turned into cash. This will help them determine if you are financially eligible for SSI, and/or whether any deductions should be made from your SSI benefits.

Representative Payee:
If your hearing decision recommended a representative payee, or if you have certain mental impairments, the local SSA office also will need to interview you to see if you are capable of managing your own money. If they decide you are not capable, they will need to appoint a representative payee. If you have someone in mind who you trust and who is willing to manage your benefits for you, it is helpful to bring that person to the interview with you. This interview can be done at the same time as your SSI Update Interview.

 

Step Three: Receive your money
Within several weeks of your interview(s), you should receive a Notice of Award from the local office for your SSI, showing the amounts you can expect for past due and any future monthly SSI benefits. Around the same time, you should receive a check or automatic bank deposit for at least one-third of your past due SSI benefits. We’d like to know when our clients receive this money.

Thereafter, you should receive monthly payments. If your past due benefits were split into installments, you should receive subsequent installments six months apart.

 

Step Four: Obtain additional cash benefits from the state

Illinois cash benefits:
The State of Illinois provides Aid to the Aged, Blind or Disabled (AABD) cash assistance to those who receive SSI. If you are not already receiving such assistance, I suggest you apply online at [link to DHS Medicaid application] or at your local Illinois Department of Human Services (DHS) Family Community Resource Center. It may be helpful to bring a copy of your SSI notice of award.

Wisconsin cash benefits:
The State of Wisconsin also provides cash assistance to those who receive SSI. However, Wisconsin does not require a separate application for these benefits. Your Wisconsin cash benefits should begin paying you when your federal SSI benefits begin. If you are a Wisconsin resident and these state benefits do not begin on time, I suggest you contact your local Income Maintenance Agency: http://www.dhs.wisconsin.gov/forwardhealth/imagency/index.htm

Additional information

Taxability of benefits:
SSI is not taxable.

 

Periodic reviews:
Please be aware that your eligibility for continuation of benefits will be reviewed every so often. The SSA will send you forms to complete at that time. You must complete these and return them in a timely fashion or your benefits may be terminated for failure to comply.

If you receive a notice of termination of benefits or overpayment with which you do not agree, please feel free to call me about representing you on an appeal and/or request for overpayment waiver.

Cessation of benefits:
You may cease being eligible for benefits if you become able to engage in “substantial gainful activity” i.e., work. For the year 2014, if you earn $1070 gross income (before tax withholding) per month or more as an employee, the SSA will usually find that you are engaging in “substantial gainful activity” and determine that you are no longer disabled. The limits on self-employment income are more complex.

 

Reductions of benefits:
Because SSI is a welfare benefit, it is reduced by certain other income you have, after your first $20 of income per month.

If you receive Title II benefits, your SSI is reduced by the amount of your Title II, after the first $20 of income for the month.

If you are provided free rent and food, your SSI is reduced by one-third, to estimate the value of that rent and food.

If you earn money through working, your SSI is reduced by half your earnings after your first $65 earned per month.

 

Suspension of benefits:
If you stay in a government-run facility (except a publicly operated community residence which serves 16 or fewer residents) as a resident (e.g., of a nursing home) or as an inmate (e.g., of a jail or prison), you must inform the SSA so they may suspend your benefits for the calendar months in which you are in that facility.

 

Other reporting requirements:
Address changes:
To keep receiving benefits, you must keep the SSA notified of any changes in your address within 10 days after the month you move. This is true even if you keep your same bank account and are receiving your benefits through direct deposit. The reason is that SSA must be able to locate you for periodic reviews, and can cease your benefits if they do not locate you.

Improved condition:
If your impairments significantly improve, particularly if they improve to the point you may be capable of holding some type of job, you must inform the SSA so they may order a review of your case and determine whether to terminate your benefits.

Financial situation:
Keep the SSA informed of changes in your income. For example, if you begin working, notify the SSA of the gross income (before taxes) received in any calendar month. In addition, if you stay in a public facility for at least one full calendar month, inform the SSA.
Communications with the SSA:
I have found that when my clients have communicated information to the SSA in person or by phone, the information is often not recorded and there is no proof of giving the information to the SSA. Therefore, I recommend you give all notices (such as work or address information) to the SSA in writing.

If you wish to set up online access via instructions the SSA has or will send you, some information can be communicated on the SSA website, and you should print out proof that your information was received. Other information should be sent by receipted fax, or by certified mail, return receipt requested, and you should keep the certified mail receipt and green card stapled to your copy of the letter you sent the SSA.

In addition, if you have questions to ask the SSA, call your local social security office, not the 800 number.

You may look up contact information for your local social security office here: https://secure.ssa.gov/ICON/main.jsp

 

 

 

 

 

 

 

Title II Social Security Insurance Benefits:
Explanation of Title II:
Title II Insurance benefits requires a wage earner to have worked and paid “premiums” in the form of social security taxes on earnings while working. When you obtain Social Security benefits on your own earnings record, that is, on premiums you paid in the form of social security taxes, your benefits are called Disability Insurance Benefits (DIB). When you obtain benefits on a parent’s earnings record, by proving you have been disabled continuously since before age 22, your benefits are called Disabled Adult Child (DAC) benefits. When you obtain benefits on a deceased spouse or deceased former spouse’s earnings record, and you are between ages 50 and 60, your benefits are called Disabled Widow’s or Widower’s Benefits (DWB).

Accrual of benefits:
The date of disability is not the same as the date your Title II benefits begin to accrue. There is a five-month waiting period in which no benefits will be given; your benefits start in the sixth month after your date of disability onset. If you applied more than 17 months after your onset of disability, your benefits begin accruing 12 months before you applied.

 

Step One: If necessary, work with the local SSA office to process your claim(s)
SSI claim:
If you had both an SSI claim and one or more Title II claims, the local office must notify the Program Service Center as to whether it processed or whether you withdrew the SSI claim.

Representative payee:
If your hearing decision recommended a representative payee, or if you have certain mental impairments, the local SSA office also will need to interview you to see if you are capable of managing your own money. If they decide you are not capable, they will need to appoint a representative payee. If you have someone in mind who you trust and who is willing to manage your benefits for you, it is helpful to bring that person to the interview with you. The local SSA office then will notify the Program Service Center of the results of that interview.

 

Step Two: Receive your money
Usually within a month or two of receiving your case, including any required notifications from the local SSA office, the Program Service Center will send you a Notice of Award. Within a few days of that, you should receive a check or automatic bank deposit representing your past due benefits of Title II DIB, DAC, and/or DWB. We’d like to know when our clients receive this money.

 

Step Three: If you have any children who are disabled or were minors when you became disabled, apply for Auxillary Benefits:
Once you receive your Title II notice of award and/or benefits, you should contact your local SSA office to apply for benefits for your children based on your successful claim. A notice of award and initial check should be issued shortly thereafter. We’d like to know when the children or their representative payees receive this money.

 

Step Four: If you received unemployment benefits during any months you were found to be disabled, notify the unemployment agency
Receipt of unemployment benefits is generally conditional upon your ability to work, while your receipt of social security benefits is conditioned on your inability to work. However, these agencies do not define ability to work the same way. For example, if you were capable of working only part time, you may have been eligible for both benefits. Also, if you were over 50 or 55 years old and the SSA found you disabled based on a maximum capacity of sedentary or light work, you may have been eligible for both benefits.

It is best to notify the Illinois Department of Employment Security or Wisconsin Department of Workforce Development, as appropriate, of your award of benefits from the SSA. You should do so by certified mail, return receipt requested, so you have proof you gave them notice. Ask them to determine if and how much you should repay in unemployment benefits.

 

Step Five: Pursue your health insurance options

∙ Medicare Parts A & B:
Once you have been entitled to social security benefits for 24 months (which may be immediately if you have 24 months of past due benefits), you should be automatically enrolled in Medicare Parts A and B. Part A is free, and Part B has a premium which is deducted from your social security benefit. You can opt out of this coverage if you wish.

Medicare Part D:
You also may sign up for Medicare Part D for prescription drug coverage. Part D is provided by a variety of private insurance companies. You may sign up online at www.Medicare.gov or call 1-800-MEDICARE (1-800-633-4227).

Medigap:
In addition, you may obtain Medicare supplement insurance, known as Medigap. You may learn more about Medigap policies from the Medicare website: http://www.medicare.gov/supplement-other-insurance/medigap/whats-medigap.html

Programs to pay your Medicare premiums:
If your household income is at or below 100%, 120%, or 135% of the federal poverty level (see this link for 2014 figures: http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Eligibility/Downloads/2014-Federal-Poverty-level-charts.pdf), you may be eligible for the state to pay some or all of your Medicare premiums, as well as to participate in a state pharmaceutical assistance program. These programs are known as the Qualified Medicare Beneficiary (QMB), Specified Low Income Medicare Beneficiary (SLIMB) and Qualified Individuals-1 (QI-1) Programs, respectively.

In Illinois, you may apply online at http://www.dhs.state.il.us/onenetlibrary/12/documents/Forms/IL444-2378b.pdf or at your local Illinois Department of Human Services (DHS) Family Community Resource Center. In Wisconsin, you may apply online at https://access.wisconsin.gov/access/accessController?id=0.46824793690124855 or at your local Wisconsin Department of Health Services office. It may be helpful to bring a copy of your Medicare card.

 

Additional information

Taxability of benefits:
A portion of your benefits may be taxable depending on whether they combine with your other taxable income and certain nontaxable income to rise above a certain threshold.

There are a number of provisions in the tax code that might help to reduce your tax liability. Here is a link to some general tax advice from the non-governmental Social Security Advisory Service (SSAS.com): http://www.ssas.com/archives/social-security-income-tax/

You should consult with your tax advisor on this issue, and provide him or her with a copy of your notice of award and the SSAS article.

 

Suspension / Termination of benefits:
Various circumstances can cause you to cease being eligible for benefits. One is if you become able to engage in “substantial gainful activity” i.e., work. For the year 2014, any time you work and earn more than $770 gross income in one month, you must notify the SSA immediately, and give the SSA your original pay stubs for photocopying.

For the year 2014, if you earn $1070 gross income (before tax withholding) per month or more as an employee, the SSA will usually find that you are engaging in “substantial gainful activity” and determine that you are no longer disabled. The limits on self-employment income are more complex. However, you may earn more than these limits during a “trial work period.” If you return to work, please feel free to contact me and I will send you a more detailed explanation of the rules.

Periodic reviews:
Please also be aware that your eligibility for continuation of benefits will be reviewed every so often. The SSA will send you forms to complete at that time. You must complete these and return them in a timely fashion or your benefits may be terminated for failure to comply.

If you receive a notice of termination of benefits or overpayment with which you do not agree, please feel free to call me about representing you on an appeal and/or request for overpayment waiver.

 

Other reporting requirements:
Address changes:
To keep receiving benefits, you must keep the SSA notified of any changes in your address within 10 days after the month you move. This is true even if you keep your same bank account and are receiving your benefits through direct deposit. The reason is that SSA must be able to locate you for periodic reviews, and can cease your benefits if they do not locate you.

Workers’ compensation benefits:
From now on, if you receive workers’ compensation benefits, you must inform the SSA. The best way is to send the local SSA office a copy of the settlement contract or order showing the amount you received, so the SSA may recalculate the amount of benefits due to you. If your settlement contract has a rider, be sure to include the rider in what you give the SSA.

Improved condition:
If your impairments significantly improve, particularly if they improve to the point you may be capable of holding some type of job, you must inform the SSA so they may order a review of your case and determine whether to terminate your benefits.

Imprisonment:
If you are imprisoned for conviction of a felony, you must inform the SSA so they may suspend your benefits for the months in which you are imprisoned.

Receipt of retirement benefits from employment outside Social Security system:
If you or your spouse worked at a job where you did not pay social security taxes on your earnings, and you begin collecting retirement benefits as a former employee or ex-spouse or widow/er, you must inform the SSA so they may recalculate the amount of benefits due to you.

Communications with the SSA:
I have found that when my clients have communicated information to the SSA in person or by phone, the information is often not recorded and there is no proof of giving the information to the SSA. Therefore, I recommend you give all notices (such as work or address information) to the SSA in writing.

If you wish to set up online access via instructions the SSA has or will send you, some information can be communicated on the SSA website, and you should print out proof that your information was received. Other information should be sent by receipted fax, or by certified mail, return receipt requested, and you should keep the certified mail receipt and green card stapled to your copy of the letter you sent the SSA.

In addition, if you have questions to ask the SSA, call your local social security office, not the 800 number.

You may look up contact information for your local social security office here: https://secure.ssa.gov/ICON/main.jsp

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