Social Security Overview
Download
Report
Transcript Social Security Overview
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
Fully insured -- 40 quarters
2005 = $920
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
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
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
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
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
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
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
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
SSI
Age - 65
Disabled
Citizenship Criteria
Needs Based
Appeals Process
Initial
Reconsideration
Hearing
Appeals Council
Federal Court
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
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.
Adult Sequential Evaluation
SUBSTANTIAL GAINFUL ACTIVITY
NO
SEVERE IMPAIRMENT
Yes
LISTING
No
PAST WORK
No
Ability to perform other work
Grid
or Vocational Expert
No
Non-exertional
Impairments
Resources Used by SSA in
Disability Determinations
Listings
Grid
Bureau of Disability Determinations
Services – BDDS
Medical Experts
Vocational Experts
Rules
Statute
Regulations
42 U.S.C. §§ 401 et seq., 1381 et seq.
20 C.F.R. §§404 et seq., 416 et seq.
Rulings
POMS
HALLEX
Definition of Disability
for 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.
Children’s Sequential
Evaluation
Substanital Gainful Activity
Severe Impairment
Listing
Functional Equivalent
To Listings
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
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
All cases are given a diary date
Sequential evaluation different
Appeal within 10 days to preserve
benefits
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
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
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
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
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
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
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
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
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
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
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.
Qualified Immigrants Who Arrived on
or Before 8/22/96
Eligible for SSI
Eligible for SS
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
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
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
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