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SOCIAL SECURITY BENEFITS SSDI and SSI

SOCIAL SECURITY BENEFITS SSDI and SSI. Overview of Disability Programs SSDI & SSI. Social Security Administration. Insurance program based on quarters of coverage-paid by FICA taxes Not based on financial need

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SOCIAL SECURITY BENEFITS SSDI and SSI

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  1. SOCIAL SECURITY BENEFITS SSDI and SSI

  2. Overview of Disability Programs SSDI & SSI Social Security Administration

  3. Insurance program based on quarters of coverage-paid by FICA taxes Not based on financial need Earned quarters--$1090=One quarter Disabled or blind under Social Security rules 5 month waiting period Medicare eligible after entitled for 24 months SOCIAL SECURITY DISABILITY--SSDI

  4. Age 62 and married to worker Any age mothers-worker’s child under age 16 Divorced spouse-married 10 years, age 62 unmarried Surviving divorced spouse-age 60 married 10yrs can be remarried after age 60 Widow (er) married 9 months age 60 Disabled widow (er) age 50 Spouse Benefits

  5. As a child (under 18) auxiliary beneficiary on the record of a parent receiving SSA benefits or deceased-disability not a factor As a Disabled Adult Child (over age 18) on the account of a parent SSI-as a child whose parents meet the income/resource limits-disability is a factor Child Disability Benefits

  6. Federal welfare program based on need Aged, disabled or blind Be a U.S. citizen or qualified alien Income/resources of spouse or parents (if under 18) may affect eligibility No waiting period Automatic Medi-cal eligibility in CA Paid by general taxes not FICA taxes SUPPLEMENTAL SECURITY INCOME SSI

  7. The same for both programs Inability to work is key for adults Inability to function is key for kids Disability must be severe enough to keep adult from doing any substantial work Disability must be expected to last 12 months ….or result in death Disability Definition

  8. Who decides if you’re disabled?

  9. Representative Payees

  10. Generally takes 3-5 months to get decision SSDI benefits begin with the 6th full month of your disability (waiting period) Ex: Disability begins 01/09 and file 02/09 First payment month 07/09 payable in 08/09 SSI benefits payable month after you file SSI review done before first payment If Your Claim is Approved

  11. Initial claims 32% approval rate 1st-Reconsideration: Claim sent back to DDS for another review 8% 2nd- Hearing: Administrative Law Judge 69% 2007 SSA Statistical Report 3rd-Appeals Council Review: Judge reviews ALJ decision 4th Federal Courts: Civil court action All have time periods Appeal Process

  12. SSA Medical Benefits

  13. Most people with disabilities want to work SSA offers a package of work incentives to help them Work incentives allow beneficiaries to: --Test ability to work and --Gradually become self-supporting SSA WORK INCENTIVES

  14. If I start working my benefits will stop or my income will go down-Fear Work incentives allow for continuation of cash benefits for a period of time-Truth I can make more money not working-Myth Going to work will generally increase overall income-Truth I can’t work because I’ll lose my Medical Insurance-Fear Healthcare (Medicare and Medi-cal) can continue even if claimant is working-Truth FEARS, MYTHS, AND TRUTHS ABOUT WORK AND DISABILITY BENEFITS

  15. I’m afraid that if I go to work and my benefits stop, I’ll get sick again and have a hard time getting back on benefits-Fear Expedited Reinstatement can pay up to six months while you wait for decision-Truth I can’t get a good paying job-Myth PASS Program, Ticket to Work and Community Partners can help you-Truth I get and SSA check-Myth SSA benefits are SSDI-Truth FEARS, MYTHS, AND TRUTHS ABOUT WORK AND DISABILITY BENEFITS

  16. Trial Work Period Extended Period of Eligibility-SGA $980/1640 Expedited Reinstatement Continuation of Medicare 301 VR payment Ticket to Work SSDI PRIMARY WORK INCENTIVES

  17. TRIAL WORK PERIOD (TWP) • Allows claimant to test work ability while still receiving full SSDI for 9 months

  18. 2009-$700 constitutes a TWP month We give you a rolling 5 year period to earn the nine months If earning at or above the current SGA level we pay for the tenth month and two additional “grace” months Gives beneficiary a trial run on working TWP

  19. LET’S REVIEW THE NUMBERS… • 9 Trial work months • 3 Grace months • During these months claimant receives full SSDI check and their wages

  20. EXTENDED PERIOD OF ELIGIBILITY Starts at end of TWP and extends for 36 months Claimant whose earnings drop below SGA in any month can get full SSDI payment for that month Automatic reinstatement if work stops IRWE

  21. 9 Trial work months 3 Grace months During these months claimant receives full SSDI check and their wages 36 Extended period of eligibility—During these months claimant is entitled to the full SSDI check any month wages fall below SGA LET’S REVIEW THE NUMBERS…

  22. EXPEDITED REINSTATEMENT • Starts at end of EPE and runs for the following 60 months • Claimant who stopped work due to same disability can be paid while we make a medical decision • Pay up to six months

  23. 9 Trial work months 3 Grace months 36 months Extended period of eligibility 60 monthsExpedited reinstatement 105 months = Almost 9 years that claimant stays connected to SSDI for the cash benefits 301 Pmts LET’S REVIEW THE NUMBERS..

  24. Starts at end of TWP 93 months starting the month after TWP 9 month TWP 93 months after TWP 102 Months of Medicare = 8 ½ years CONTINUATION OF MEDICARE

  25. Ticket is a voucher to receive rehabilitation or training services from Employment Networks (EN) Almost anyone receiving SSDI or SSI disability 18-64 Does not mean SSA believes claimant is no longer disabled TICKET TO WORK ACT OF 1999

  26. Ticket received by an SSDI/SSI claimant Claimant decides if they want to attempt to return to work and use the ticket Claimant contacts MAXIMUS 1-866-968-7842 for information on EN’s Claimant selects EN and they agree on an IWP (Individual Work Plan) TICKET PROCESS OVERVIEW

  27. The Continuing Disability Review (CDR) process has changed Beneficiaries using Ticket will not be selected for a medical CDR SSDI/SSI beneficiaries who have received benefits for 24 months No Med CDR Section 111 Protection Regularly scheduled CDR’s will continue MORE TTW ENHANCEMENTS

  28. $ 500.00 Social Security 20.00 General Exclusion $ 480.00 Countable income $ 500.00 Wages 65.00 Earned Income Exclusion $ 435.00 ÷ 2 = $217.50 Countable income Total C/I $217.50 + $480.00 = $697.50 $870.00 - $697.50 = $172.50 SSI SSI Payment Computation

  29. Impairment related work expenses-IRWE Blind work expenses BWE Earned Income Exclusion Plan to Achieve Self Support-PASS Property Essential to Self support-PESS EXR Continued Medi-cal eligibility-1619b $2899 month Reinstatement eligibility without new application Student Earned income Exclusion 301 pmts SSI WORK INCENTIVES

  30. Tom goes back to work at Petco Park SSI rate CA $935 no countable income $2500 gross wages -$1640 Student Earned Income Exclusion -$85 General & Earned Income Exclusion $775 countable income -$50 IRWE for Drugs -$725 countable income SSI WORK INCENTIVE EXAMPLE

  31. $725 countable income -$362.50 ½ remaining earnings =$362.50 countable income -$100 BWE taxes and lunches at work =$262.50 countable income -$162.50 PASS for books and computer =$100 countable income $935-$100 = $835 SSI + $2500 wages =$3335 Total monthly income SSI WORK INCENTIVES

  32. Online www.socialsecurity.gov Telephone: 1-800-772-1213 In person 8 Branch offices in San Diego County Servicing areas Dealing with Social Security

  33. 1333 Front St San Diego CA 92101 Tel: 619.557.5257 626 L St. Chula Vista CA 91911 Tel: 619.427.7414 846 Arnel St El Cajon CA 92020 Tel: 619.440.2943 2160 S El Camino Real Oceanside CA 92054 Tel: 760.439.8025 8505 Aero Drive San Diego CA 92123 Tel: 858.278.1099 2530 E Plaza Blvd National City CA 91950 Tel: 619.267.1175 7961 University Ave La Mesa CA 91941 Tel: 619.464.8533 367 Via Vera Cruz San Marcos CA 92078 Tel: 760.471.2155 SAN DIEGO SSA OFFICESToll Free 1-800-772-1213

  34. QUESTIONS

  35. Apply for retirement Apply for SSDI Apply for Medicare Part D Request a Social Security statement COA, telephone # Replace Medicare card Check status of online application Request a proof of income letter Get a form 1099/1042S Apply for direct deposit Retirement Estimator E-Serviceswww.socialsecurity.gov

  36. ♦ Toll Free 1.888.674.6250 ♦ Local 619.557.6605 ♦ Fax 619.557.5722 ♦ Mailing Address: 1333 Front Street San Diego CA 92101 ♦ PASS Specialist: Patrick Mattis & Peter Prather HOW TO CONTACT THE PASS CADRE

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