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Social Security Overview. March 2006. Terminology. Social Security Benefits Title II Supplemental Security Benefits Title 16 SSI. Social Security Benefits Quarters of Coverage. Quarter of coverage in 2006= $970 2005 = $920 Fully insured -- 40 quarters

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terminology
Terminology
  • Social Security Benefits
    • Title II
  • Supplemental Security Benefits
    • Title 16
    • SSI
social security benefits quarters of coverage
Social Security BenefitsQuarters of Coverage
  • Quarter of coverage in 2006= $970
    • 2005 = $920
  • Fully insured -- 40 quarters
    • Or one quarter for each year after age 21
  • Currently insured: 6 quarters within a 13 quarter period ending with the quarter you: a) die or b) become entitled to disability or old age insurance benefits.
retirement
Retirement
  • Must be Fully Insured
  • Early Retirement
    • Age 62
      • 2006- apx. 20% reduction
      • Born 1960 or later – 30% reduction
  • Regular Retirement
    • 2006 – Age 65 and 8 months
      • Maximum benefits $2053
      • Born 1960 or later – age 67
dependent benefits
Dependent Benefits
  • Children
    • Insured entitled to old age or disability benefits or deceased
    • Natural, adopted child, stepchild or grandchild/step grandchild (parents must be deceased or disabled at time insured became eligible for benefits or died)
    • Under 18 or
    • In secondary school under 19 or
    • Disabled before age 22
benefits for spouses
Benefits for Spouses
  • Spouses
    • Insured entitled to old age or disability benefits
    • Valid marriage and
      • married at least one 1 year or
      • child in common
    • Age 62 or older or
    • Caring for child of wage earner who is under age 16 or disabled
  • Divorced Spouses may qualify
widow er s
Widow(er)s
  • Insured was fully insured
  • Valid marriage and
  • Marriage lasted 9 months (some exceptions) or
  • Natural or adoptive parents of a child
  • and age 60 or
  • age 50 – 60 and disabled
    • disability must have began within 7 years of the wage earner's death
  • Unmarried or remarried after age 60 or age 50 if entitled as a disabled widow(er)
benefits for widowed parents
Benefits for Widowed Parents
  • Insured was fully or currently insured at time of death
  • Widow or widower and marriage lasted at least 9 months and
  • Unmarried
  • Caring for child of the insured who is under age 16 or disabled
surviving parents of wage earner
Surviving Parents of Wage Earner
  • Insured was fully insured and is deceased
  • 62 years old
  • Not married since insured person died
  • Must have been dependent on insured for at least half of your support
disabled
Disabled
  • Fully insured
  • Disabled within last date of insurance -- 20 quarters in a 40 quarter period and disabled within that period unless:
    • Under age 31 when become disabled or
    • Previously disabled under age 31 or
    • Statutorily blind and fully insured
slide11
SSI

Age - 65

Disabled

Citizenship Criteria

Needs Based

appeals process
Appeals Process
  • Initial
  • Reconsideration
  • Hearing
  • Appeals Council
  • Federal Court
appeal deadlines
Appeal Deadlines
  • 60 days unless good cause shown
    • SS presumes receipt 5 days from date of mailing
    • 10 day rule for continuing benefits
      • Applies for both reconsideration and hearing request
  • Reopening
    • 12 months of the initial decision for any reason
    • Good Cause
      • 2 years SSI
      • 4 years SS
adult disability definition
Adult Disability Definition
  • The inability to do any substantial gainful activity by reason of any medically determinable physical or mental impairment which:
    • has lasted or can be expected to last for a continuous period of not less than 12 months
    • or can be expected to result in death.
resources used by ssa in disability determinations
Resources Used by SSA in Disability Determinations
  • Listings
  • Grid
  • Bureau of Disability Determinations Services – BDDS
  • Medical Experts
  • Vocational Experts
rules
Rules
  • Statute
    • 42 U.S.C. §§ 401 etseq., 1381 etseq.
  • Regulations
    • 20 C.F.R. §§404 etseq., 416 etseq.
  • Rulings
  • POMS
  • HALLEX
definition of disability for children
Definition of Disabilityfor Children
  • A physical or mental condition (or a combination of conditions) that results in marked and severe functional limitations and:
    • The condition must last or be expected to last at least 12 months or
    • be expected to result in the child's death.
functional equivalence six domains
Functional Equivalence - Six Domains
  • Acquiring and using information
  • Attending and completing tasks
  • Interacting and relating with others
  • Moving about and manipulating objects
  • Caring for yourself
  • Health and physical well-being
functional equivalence
Functional Equivalence
  • Need one extreme limitation or
  • Two marked limitations
  • Can also be functional equivalent if no listing exists for condition or combination of impairments “equals” a listing
medical improvement
Medical Improvement
  • All cases are given a diary date
  • Sequential evaluation different
  • Appeal within 10 days to preserve benefits
drug and alcohol cases
Drug and Alcohol Cases
  • Basis for the disability must be independent of drug or alcohol condition
  • Payee will be appointed
  • Can require treatment
amount of benefits 2006
Amount of Benefits - 2006
  • SSI-
    • $603 individual
    • $904 disabled couple
      • Couple includes “holding yourself out as married”
    • Paid on the first of the month
  • Title 2
    • Maximum $2053
    • Usually at least $20 more than SSI if disabled or aged
    • Medicare deduction – $88.50
      • Don’t forget IDHS programs to pay premium
    • Payments dates vary
reduction nonpayment of benefits ssi
Reduction/Nonpayment of Benefits -SSI
  • Income
    • Unearned income disregard ($20)
    • Child support disregard (1/3 of support)
    • Earned income disregard ($85, and ½ of balance.)
    • Inkind Income
    • Deeming
  • Asset limitation
    • $2000 individual
    • $3000 eligible couple
  • Residents in certain public institutions ($30)
  • Failure to comply with drug or alcohol treatment
  • Fleeing felons
reduction nonpayment of benefits social security
Reduction/Nonpayment of Benefits – Social Security
  • No asset limitation
  • Earned income
    • Does not affect Retirement benefits if 65 or older
  • Disability benefits
    • Trial work period- any 9 months where you earn $620. Extended period of eligibility- 36 months, no payment if earn more than $860
    • Receipt of Other Title 2 benefits -reduced $ for $
  • Workers’ compensation
  • Aliens who leave the country for more than 6 months
  • Failure to comply with drug or alcohol treatment
  • Nonpayment while serving time for a felony
ssi ss protected from garnishment
SSI/SS Protected from Garnishment
  • SS 5 Exceptions:
    • Child Support /Alimony
    • Unpaid Federal Taxes
    • Elect to Have Taxes Withheld
    • Debt Owed to Another Federal Agency (e.g. student loans) ($750 exempt, then 15% maximum)
    • Overdue Federal Taxes (up to 15%)
fugitive felon terminations
FUGITIVE FELON TERMINATIONS
  • 42 U.S.C §1382(e)(4)(A) makes an SSI claimant ineligible if fleeing to avoid prosecution for a felony
  • Extended to SS claimants on 01/01/2005
  • No continuing benefits on appeal
  • Must have “intent” to flee
  • 2nd Circuit: must have a finding from the warrant issuing court on intent
payment of benefits
Payment of Benefits
  • Lump Sums
    • Transitional Assistance and P3 offset- both SSI and SS disability
  • SSI only
    • Reduction for receipt of TANF
    • Restricted account for children’s lump sum
overpayments
Overpayments
  • Reconsideration
    • 60 day time limit
    • Appeals within 30 days stays action until reconsideration issued.
    • Appeals after 30 days stops action until reconsideration issued.
  • Amount Recouped
    • SSI – 10%
    • SS- No limit, but can be negotiated
waivers
Waivers
  • No time limit
  • All recouped money returned if successful
  • Must establish not at fault and
    • Defeat the purposes of the SSI program to collect the overpayment or
      • presumed for an individual receiving SSI
    • Against equity and good conscience or
    • Impede efficient or effective administration of program
ticket to work
Ticket to Work
  • Voluntary program to assist Title II disability and SSI disability recipients
  • Using a ticket will not result in a continuing disability review (“CDR”)
  • No CDR for working after 24 months on benefits
  • Expedited Reinstatement for Individuals whose benefits stop due to working
  • Expanded medical coverage
immigrant restrictions qualified immigrants
Immigrant Restrictions -Qualified Immigrants
  • Legal Permanent Residents
  • Refugees, Asylees, Cuban/Haitian entrants, Amerasians, victims of trafficking, and those whose deportation is being withheld.
  • Lawfully present active duty members of the U.S. Armed Forces and their spouses and dependent children.
  • Lawfully present veterans with an honorable discharge and their spouses and dependent children.
immigrants who arrive after 8 22 1996
Immigrants Who Arrive After 8/22/1996
  • SSI - Distinction between LPRs and other Qualified Immigrants
  • SS - Qualified Immigrants Eligible
lpr s who arrive after 8 22 96
LPR’s Who Arrive After 8/22/96
  • Bar on SSI
    • Only eligible if can be credited with 40 quarters (after a 5 year wait)
      • Credits can be from worker, spouse, or parents while they were children
      • No quarters counted after 12/31/96 if individual received “federal means tested public benefit” during the quarter
        • Includes TANF, Medicaid, KidCare, Food Stamps
family law considerations
Family Law Considerations

SSI:

  • Cannot enforce child support orders
  • Maintenance orders will reduce benefits
  • Risk losing medical card

SS:

  • Can enforce child support order (even when dependant child receives a SS check)
  • Can enforce alimony order
resources
Resources
  • Social Security Website
    • http://www.socialsecurity.gov/
    • Includes Handbook, POMS, Rulings, HALLEX, CFR
  • Dictionary of Occupational Titles (DOT)
  • Diagnostic and Statistical Manual IV-TR
  • Social Security Claims and Procedures - McCormick
  • Medical Proof of Social Security - Hirshman
  • Video tape library