Transcript GOVERNMENT BENEFITS FOR PERSONS WITH DISABILITIES

SOCIAL SECURITY BENEFITS FOR
PERSONS WITH DISABILITIES
Amy C. O’Hara, Esq.
Littman Krooks LLP
www.littmankrooks.com
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Many people with disabilities are eligible for
benefits under one or more of several
government programs.
The programs are designed to protect the person
with the disability by making sure that the
person’s financial resources are sufficient to
provide the basic necessities of life including
food, shelter and healthcare.
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Programs are grouped into two categories

Needs Based Programs such as Supplemental
Security Income (SSI) and Medicaid that are available
to individuals with disabilities who satisfy certain needs
based requirements related to assets and income.

Social Insurance Programs such as Social Security
Disability Insurance (SSDI) and Medicare that are
available regardless of how much income or assets your
child may have. Your child becomes eligible for these
benefits because of the amounts you or your child may
have paid into the Social Security system.
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Who Operates These Programs?

Some are operated by the Federal Government.

Some are operated by the states.

Others are jointly funded by the Federal Government and
the states.
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Some Basic Rules

If your child had a disability before reaching the age of
22, your child will likely be entitled to SSDI benefits when
you or your spouse die, reach retirement age, or become
disabled.

If your child developed a disability after age 22, Social
Security will be available only if your child had a
significant employment history before becoming disabled.
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Basic Rules (Continued)

If your child has limited income and assets, he or she will
likely be entitled to SSI benefits upon reaching the age of
18. For some lower income families, children under the
age of 18 may also be eligible.

If your child is eligible for SSI benefits, he or she will likely
be eligible for Medicaid.
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Social Security and Medicare

If your child has been eligible for Social Security benefits
for at least two years, he or she will likely be eligible for
Medicare. It does not matter if your child actually received
the benefits just that the eligibility requirements were
satisfied.
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Establishing Disability

In order to qualify for SSI and/or SSDI, your child will need
to be considered to have a disability within the rules of the
Social Security system.

The Social Security regulations define disability as:
“the inability to do any substantial gainful activity by reason
of any medically determinable physical or mental
impairment which can be expected to last for a continuous
period of not less than 12 months.”
(20 CFR Section 404.1505)
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The Evaluation Process

SSA must determine whether the person with a disability is able to earn
more than a threshold amount, which increases each year to account for
inflation.

There is a 5 step analysis:
1.
2.
3.
4.
5.
Is the person working?
Does the disability significantly limit the person’s ability to do basic work
activities: (for example walking, sitting, seeing, and remembering)
If the person’s medical condition is considered severe, the SSA will look
at its list of disabling impairments to consider automatic qualifications.
If the person’s medical condition is severe but is not on the list, the SSA
will examine further when the person can possibly work in the future,
based on past work history.
If none of the above criteria are met, the SSA will consider whether the
disability will affect the person’s ability to sustain work at the
“substantial gainful employment” level in the future.
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Common Reasons for Failing to
Qualify

The single most common reason for failing to qualify for
benefits is a failure to submit information to permit SSA to
determine that a person has a disability within the
meaning of the SSA rules.

If possible, the physician should review the definition
describing your child’s disability as set forth in the SSA
regulations to make sure the report contains the
language that the SSA requires.
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Social Security Disability Insurance
“SSDI”

One of two primary cash benefit programs.

It is generally available for workers who become disabled
prior to attaining age 65, if the worker’s work history
satisfies SSA requirements.

It is also available to children (even adult children) of
retired, disabled or deceased social security participants
if the child had a disability that developed before the child
reached the age of 22.
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SSDI (continued)

The benefit is based on the parent’s work record.

If the parent is retired or disabled, the benefit is ½ of the
parent’s benefit.

If the parent is deceased, the benefit is ¾ of the parent’s
benefit.

Benefits may be reduced if more than one person
receives benefits based on the parent’s work history and
will cease if the person marries someone who is not
entitled to SSA benefits.
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Supplemental Security Income
“SSI”

The SSI program is a needs based program designed to
supplement the income of people who are elderly, blind
or disabled and lack sufficient resources to provide for
their own needs.

The program provides a monthly cash stipend.

Disability is determined in the same manner as SSDI.

There is no requirement that the disability occur before
age 22.
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Additional Information on SSI
Benefits

There are limits on income and resources.

There is a deeming of income and resources.

A portion of your income and resources will generally be
considered available to your child if your child lives with
you and is under age 18.

Once the child reaches age 18, the parents’ assets are
no longer considered available to the child.

There is a reduction in benefits for certain situations.
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MEDICARE

A federal health insurance program. It is designed to pay
the cost of health care for people over the age of 65 and
for people with disabilities who are under the age of 65
and have been eligible to receive SS benefits for at least
two years, or who need kidney dialysis treatments or a
kidney transplant.
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Conclusion

It is important to assess a child’s need for government
programs as early as possible.

It is imperative to explore all potential government
benefits according the needs of the child.

It is imperative that you work with advocacy
organizations, doctors and other professionals to obtain
appropriate documentation.

It is imperative to have proper estate planning and
consider the use of a special needs trust to protect your
child’s assets to government benefits.
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Resources

Social Security Administration - www.socialsecurity.gov

Special Needs Alliance website - www. specialneedsalliance.com

State Department of Health website - www.health.state.ny.us

Littman Krooks – www.littmankrooks.com
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Amy C. O’Hara, Esq.
Littman Krooks LLP
www.littmankrooks.com
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