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Social Security Overview

This overview provides detailed information on Social Security Benefits, including Title II (Retirement, Disability) and Title XVI (Supplemental Security Income). It outlines the requirements for fully insured status, contributions needed for coverage, and various benefits available to retirees, disabled individuals, and their dependents. Key points include retirement age specifics, spouse and widow(er) benefits, the appeals process for denied claims, definitions of disability for adults and children, and the amount of benefits as of 2006. Essential guidelines for obtaining benefits and appealing decisions are also shared.

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Social Security Overview

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  1. Social Security Overview March 2006

  2. Terminology • Social Security Benefits • Title II • Supplemental Security Benefits • Title 16 • SSI

  3. 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.

  4. 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

  5. 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

  6. 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

  7. 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)

  8. 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

  9. 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

  10. 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

  11. SSI Age - 65 Disabled Citizenship Criteria Needs Based

  12. Appeals Process • Initial • Reconsideration • Hearing • Appeals Council • Federal Court

  13. 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

  14. 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.

  15. Adult Sequential Evaluation NO Yes No No No

  16. Resources Used by SSA in Disability Determinations • Listings • Grid • Bureau of Disability Determinations Services – BDDS • Medical Experts • Vocational Experts

  17. Rules • Statute • 42 U.S.C. §§ 401 etseq., 1381 etseq. • Regulations • 20 C.F.R. §§404 etseq., 416 etseq. • Rulings • POMS • HALLEX

  18. 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.

  19. Children’s Sequential Evaluation

  20. 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

  21. 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

  22. Medical Improvement • All cases are given a diary date • Sequential evaluation different • Appeal within 10 days to preserve benefits

  23. Drug and Alcohol Cases • Basis for the disability must be independent of drug or alcohol condition • Payee will be appointed • Can require treatment

  24. 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

  25. 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

  26. 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

  27. 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%)

  28. 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

  29. 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

  30. 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

  31. 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

  32. 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

  33. 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.

  34. Qualified Immigrants Who Arrived on or Before 8/22/96 • Eligible for SSI • Eligible for SS

  35. Immigrants Who Arrive After 8/22/1996 • SSI - Distinction between LPRs and other Qualified Immigrants • SS - Qualified Immigrants Eligible

  36. 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

  37. 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

  38. 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

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