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Social Security Essentials In Brief

Social Security Essentials In Brief. John LaMotte Staff Assistant/State Liaison john.lamotte@ssa.gov. Earning Credits. 40 Credits for Retirement Disability Varies by Age Maximum 4 credits in 1 year $1,090 earnings = 1 credit. Worker Reduced benefits as early as age 62

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Social Security Essentials In Brief

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  1. Social Security Essentials In Brief John LaMotte Staff Assistant/State Liaison john.lamotte@ssa.gov

  2. Earning Credits • 40 Credits for Retirement • Disability Varies by Age • Maximum 4 credits in 1 year • $1,090 earnings = 1 credit

  3. Worker • Reduced benefits as early as age 62 • Full benefits at age 65-67 • Increased benefits after full retirement age (FRA) • Wife or Husband • As early as age 62 • At any age if caring for child under age 16 or disabled • Divorced spouses may qualify if married 10 years • Child • Unmarried and up to age 18 or 19 if still in high school • Any age if disabled before age 22 Retirement Benefits

  4. Survivor Benefits Widow(er) • Reduced benefits as early as age 60 or, if disabled, age 50. • Lesser reduction percentage - 28% @ age 60 • At any age if caring for a child of worker under age 16 or disabled before age 22 • Divorced widow(er) may qualify if married at least 10 years • Unreduced benefit is usually the same as that worker would have received

  5. Survivor Benefits (cont) • Child (unmarried*) • Under age 18 or 19 if still in high school • Any age if disabled before age 22 • $255 Lump Sum Death Benefit • Surviving spouse or minor/disabled children only

  6. How Work Affects Retirement Benefits Age Earnings Limit Reduction Above 60 to FRA $14,160 ($1,180/mo.) $1 for every $2 FRA Year $37,680 ($3,140/mo.) $1 for every $3 Month of FRA Earnings no longer affect benefits • First Year: Wages before filing month may be excluded, but additional work must be under the monthly limit . • Limits apply to both workers, dependents & survivors • www.ssa.gov/planners/morecalculators.htm --estimate how work may affect benefits

  7. Social Security Disability Programs 2009

  8. Social Security Disability Programs • Supplemental Security Income (SSI) • Social Security Disability (SSD) - Benefits on wage earner’s own work record • Disabled Adult Child (DAC) benefits through a parent’s record • Disabled Widow(er)’s Benefits

  9. Supplemental Security Income • Needs-based program for people with limited income and resources • Aged - 65 or older - Disabled/Blind – Any age • Funded by general tax revenue • Recipients usually qualify for Medicaid - separate application required with Ohio Dept. Job & Family Services

  10. Eligibility for SSI - Income • Earned & unearned income treated differently • If married, income of spouse is considered • At age 18 or older, income of parents is not considered • Parent’s income affects eligibility of child

  11. SSI Income Limits • If all income is unearned, maximum income allowed for an individual = $674/month in 2009 ($1,011 couple) • If income is all earned or a combination of earned/unearned, maximum income allowed for an individual = $1,433/month in 2009 • Limits change each year

  12. SSI Resource Limits • Individual = $2,000 // Couple = $3,000 • Examples: • Cash • Bank accounts • Stocks, bonds • Life Insurance Cash Value • Vehicles* • Personal property* • Land or real property*

  13. Disabled Adult Child (DAC) Benefits Must be: • 18 or older and disabled with condition(s) that occurred before age 22 • Unmarried – unless to an SSA beneficiary • No substantial work after age 22

  14. Social Security Disability • Income & Resources do not affect eligibility • Requires recent work - Age 31+ must have 20 credits in last 10 years - Fewer number required for younger workers • May be retroactive up to 1 year • Dependent benefits may be payable - Same Benefits as for a Retired Worker • Eligible for Medicare after 24 months • Provisions to assist in returning to work

  15. Social Security’s Disability Definition Amedical condition preventing substantial work* for at least 12 months or expected to result in death. The determination also considers age, education & work experience. * $980 month non-blind; $1,640 month blind

  16. Approval vs. Denial Rate • About 31% of initial claims are approved • Average SSDI benefit in 2009* = $1,064/month • Maximum SSI benefit in 2009* = $674/month for individual $1,011/month for disabled couple • About 65% of initial claims are denied *Note: With 5.8% COLA

  17. Application Process - SSI • Complete online Disability Report and transmit to Social Security • Print medical releases and return them to Social Security* and, • Make appointment to complete non-medical application – 1 800 772 1213 *Parent cannot sign documents for an adult child unless he/she is a legal guardian

  18. Application Process - SSD • All application forms and reports may be completed on-line, or • Make appointment to complete non-medical application and/or medical report – 1 800 772 1213 • Disabled Adult Child (DAC) application is not available online

  19. The Disability Decision Process • Claim sent to Disability Determination Service (DDS) in Columbus for medical decision • Most cases decided within 100 days • May expedite decision by submitting medical evidence with claim • If other evidence becomes available while decision is pending, call DDS adjudicator at 1-800-282-4550 for instructions on faxing medical evidence

  20. If Claim is Denied - Appeals • Applicant receives denial letter • 60-day appeal period • Four Levels of Appeal • Reconsideration • Administrative Law Judge Hearing • Appeals Council (Falls Church, VA) • U.S. District Court • Appeals may be filed online or by appt

  21. The iAppeal Process • Agency continues to move towards fully electronic process • Allows reconsideration/hearing requests AND Disability Appeal Report to be transmitted online • Receipt date of appeal is the date the iAppeal is electronically submitted

  22. Submitting the iAppeal • The iAppeal can be submitted by: • Claimant; or • Authorized representative; or • Other third party

  23. Requirements To Use iAppeal • Have applied for benefits • Have received a "Notice of Disapproved Claim", a "Notice of Reconsideration", or "Notice of Federal Reviewing Official Decision", and have notice available when beginning this process • Disagree with medical disability decision • Live in U.S. or one of its territories

  24. Advantages of iAppeal • No lost appeals • Reduces delays • Secure • Instant receipt upon submission • Saves money by eliminating need for certified mail • Minimizes follow ups to representatives and claimants

  25. Make This Link a Favorite:www.socialsecurity.gov/disability/appeal Scroll Down

  26. Working While Disabled For information about: • Employment support for people with disabilities, visit The Work Site at www.socialsecurity.gov/work/index.html • Social Security’s Ticket to Work program www.yourtickettowork.com • Red Book for Employment Supportwww.socialsecurity.gov/redbook/

  27. SSI/SSD SharedWork Incentives • Ticket to Work • Impairment Related Work Expenses • Subsidy & Special Conditions • Unsuccessful Work Attempts • Expedited Reinstatement of Benefits • Vocational Rehabilitation Continued Payment – Section 301

  28. Work Incentives for SSI • Earned Income Exclusion • Student Earned Income Exclusion • Plan to Achieve Self-Support • Medicaid while working – 1619(b) (up to $33,194) • Automatic Reinstatement (within one year)

  29. Filing for Benefits One Option: Not making an appointment 29

  30. Better Options • Via the Internet at www.socialsecurity.gov • Appointment in the office or over the telephone - Call 1-800-772-1213 When to Contact Social Security • Up to 3 months before you retire or attain age 62 • If over age 62, contact Social Security in or before January of the year you wish to receive benefits Filing for Benefits

  31. Medicare Coverage Part A - Hospital Insurance • Covers inpatient hospital expenses • 40 Credits Earned? No Premium Enroll anytime • 2009 deductible = $1,068

  32. Medicare Coverage Part C – Advantage Plans • Replaces Part A & B • Managed Care – HMO / PPO or • Private Fee-for-Service • Private Company Providers • May have higher premium • Must use plan’s prescription plan • Defined Service Area • “Lock In” – Defined periods to switch plans, go back to A & B

  33. Medicare Coverage Part D –Prescription Drug Plans • Part A or B enrollment required • Comprehensive Drug Benefit • 60 + Plans in Ohio in 2009 • Different formularies, co-pays, pharmacies, authorization rules, etc. • Sign up with Medicare or the Plan itself • Review Plan every year Nov. 15 – Dec. 31

  34. Medicare Coverage • Part B ( Supplemental Medical Insurance) • Covers 80% doctor bills and outpatient medical expenses after $135 calendar year deductible • 2009 Monthly Premium = $96.40** • Defined Enrollment Periods (or penalties!) • Private “Medigap” policies supplement

  35. For People Who Already Receive Social Security Change an Address Replace a Medicare Card Request a Form SSA 1099 Request a Benefit Verification Letter Get a Password

  36. Social Security Resources • 1-800-772-1213 7 a.m.- 10 p.m. M-F • Local offices 9 a.m.-4 p.m. M-F • www.socialsecurity.gov

  37. Thank You ! Questions, comments, or concerns? 38

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