Social Security Social Security

Essentials In BriefEssentials In Brief

John LaMotteStaff Assistant/State Liaison

john.lamotte@ssa.gov

Earning CreditsEarning Credits

40 Credits for Retirement40 Credits for Retirement

Disability Varies by AgeDisability Varies by Age

Maximum 4 credits in 1 yearMaximum 4 credits in 1 year

$1,090 earnings = 1 credit$1,090 earnings = 1 credit

WorkerWorker Reduced benefits as early as age 62 Reduced benefits as early as age 62 Full benefits at age 65-67Full benefits at age 65-67 Increased benefits after full retirement age (FRA)Increased benefits after full retirement age (FRA)

Wife or HusbandWife or Husband As early as age 62As early as age 62 At any age if caring for child under age 16 or disabledAt any age if caring for child under age 16 or disabled Divorced spouses may qualify if married 10 yearsDivorced spouses may qualify if married 10 years

ChildChild Unmarried and up to age 18 or 19 if still in high schoolUnmarried and up to age 18 or 19 if still in high school Any age if disabled before age 22Any age if disabled before age 22

Retirement BenefitsRetirement Benefits

Survivor BenefitsSurvivor Benefits

Widow(er)Widow(er) Reduced benefits as early as age 60 or, if disabled, age 50. Reduced benefits as early as age 60 or, if disabled, age 50. Lesser reduction percentage - 28% @ age 60Lesser reduction percentage - 28% @ age 60 At any age if caring for a child of worker under age 16 or disabled At any age if caring for a child of worker under age 16 or disabled

before age 22before age 22 Divorced widow(er) may qualify if married at least 10 years Divorced widow(er) may qualify if married at least 10 years Unreduced benefit is Unreduced benefit is usuallyusually the same the same

as that worker would have receivedas that worker would have received

Survivor Benefits Survivor Benefits (cont)(cont)

Child Child (unmarried*)(unmarried*)

Under age 18 or 19 if still in high schoolUnder age 18 or 19 if still in high school Any age if disabled before age 22Any age if disabled before age 22

$255 Lump Sum Death Benefit$255 Lump Sum Death Benefit Surviving spouse or minor/disabled children Surviving spouse or minor/disabled children

onlyonly

Age Earnings Limit Reduction Above 60 to FRA $14,160 ($1,180/mo.) $1 for every $2

FRA Year $37,680 ($3,140/mo.) $1 for every $3

Month of FRA Earnings no longer affect benefits

First Year: Wages before filing month may be excluded, but additional work must be under the monthly limit .

Limits apply to both workers, dependents & survivors

www.ssa.gov/planners/morecalculators.htm --estimate how

work may affect benefits

How Work Affects Retirement Benefits

Social Security Disability Programs

2009

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Social Security Disability Programs

Supplemental Security Income (SSI)

Social Security Disability (SSD)- Benefits on wage earner’s own

work record

– Disabled Adult Child (DAC) benefits through a parent’s record– Disabled Widow(er)’s Benefits

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Supplemental Security Income

Needs-based program for people with limited income and resources Aged - 65 or older

- Disabled/Blind – Any age Funded by general tax revenue Recipients usually qualify for Medicaid - separate application required with Ohio Dept. Job & Family Services

Eligibility for SSI - Income

Earned & unearned income treated differently

If married, income of spouse is considered

At age 18 or older, income of parents is not considered

Parent’s income affects eligibility of child

SSI Income Limits

If all income is unearned, maximum income allowed for an individual = $674/month in 2009 ($1,011 couple)

If income is all earned or a combination of earned/unearned, maximum income allowed for an individual = $1,433/month in 2009

Limits change each year

SSI Resource Limits

Individual = $2,000 // Couple = $3,000 Examples:

– Cash– Bank accounts– Stocks, bonds– Life Insurance Cash Value

– Vehicles*– Personal property*– Land or real property*

Disabled Adult Child (DAC) Benefits

Must be:

18 or older and disabled with condition(s) that occurred before age 22

Unmarried – unless to an SSA beneficiary

No substantial work after age 22

Income & Resources do not affect eligibilityRequires recent work

- Age 31+ must have 20 credits in last 10 years- Fewer number required for younger workers

May be retroactive up to 1 year Dependent benefits may be payable

- Same Benefits as for a Retired Worker

Eligible for Medicare after 24 months Provisions to assist in returning to work

Social Security Disability

Social Security’s Disability Definition Social Security’s Disability Definition

A medical condition preventing substantial work* for at least 12 months or expected to

result in death. The determination also considers age, education & work experience.

* $980 month non-blind; $1,640 month blind

A medical condition preventing substantial work* for at least 12 months or expected to

result in death. The determination also considers age, education & work experience.

* $980 month non-blind; $1,640 month blind

Approval vs. Denial Rate

About 31% of initial claims are approved Average SSDI benefit in 2009* =

$1,064/month Maximum SSI benefit in 2009* =

$674/month for individual $1,011/month for disabled couple

About 65% of initial claims are denied

*Note: With 5.8% COLA

Application Process - SSI

Complete online Disability Report and transmit to Social Security

Print medical releases and return them to Social Security* and,

Make appointment to complete non-medical

application – 1 800 772 1213

*Parent cannot sign documents for an adult child unless he/she is a legal guardian

Application Process - SSD

All application forms and reports may be completed on-line, or

Make appointment to complete non-medical

application and/or medical report

– 1 800 772 1213 Disabled Adult Child (DAC) application is not

available online

The Disability Decision Process

Claim sent to Disability Determination Service (DDS) in Columbus for medical decision

Most cases decided within 100 days May expedite decision by submitting medical

evidence with claim If other evidence becomes available while

decision is pending, call DDS adjudicator at 1-800-282-4550 for instructions on faxing medical evidence

If Claim is Denied - Appeals

Applicant receives denial letter 60-day appeal period Four Levels of Appeal

– Reconsideration– Administrative Law Judge Hearing– Appeals Council (Falls Church, VA)– U.S. District Court

Appeals may be filed online or by appt

The iAppeal ProcessThe iAppeal Process

Agency continues to move towards fully electronic process

Allows reconsideration/hearing requests AND Disability Appeal Report to be transmitted online

Receipt date of appeal is the date the iAppeal is electronically submitted

Submitting the iAppealSubmitting the iAppeal

The iAppeal can be submitted by:

Claimant; or Authorized representative; or

Other third party

Requirements To Use iAppealRequirements To Use iAppeal

Have applied for benefits Have received a "Notice of

Disapproved Claim", a "Notice of Reconsideration", or "Notice of Federal Reviewing Official Decision", and have notice available when beginning this process

Disagree with medical disability decision

Live in U.S. or one of its territories

Advantages of iAppealAdvantages of iAppeal

No lost appeals Reduces delays Secure Instant receipt upon

submission Saves money by eliminating

need for certified mail Minimizes follow ups to

representatives and claimants

Make This Link a Favorite:Make This Link a Favorite: www.socialsecurity.gov/disability/appealwww.socialsecurity.gov/disability/appeal

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Working While Disabled

For information about:

Employment support for people with disabilities, visit The Work Site at www.socialsecurity.gov/work/index.html

Social Security’s Ticket to Work program www.yourtickettowork.com

Red Book for Employment Support www.socialsecurity.gov/redbook/

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SSI/SSD Shared Work Incentives

Ticket to Work

Impairment Related Work Expenses

Subsidy & Special Conditions

Unsuccessful Work Attempts

Expedited Reinstatement of Benefits

Vocational Rehabilitation Continued Payment – Section 301

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Work Incentives for SSI

Earned Income Exclusion

Student Earned Income Exclusion

Plan to Achieve Self-Support

Medicaid while working – 1619(b) (up to $33,194)

Automatic Reinstatement (within one year)

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Filing for Benefits

One Option: Not making an appointment

Better OptionsBetter Options

Via the Internet at Via the Internet at www.socialsecurity.govwww.socialsecurity.gov

Appointment in the office or over the telephoneAppointment in the office or over the telephone

- Call - Call 1-800-772-12131-800-772-1213

When to Contact Social SecurityWhen to Contact Social Security

Up to 3 months before you retire or attain age 62Up to 3 months before you retire or attain age 62

If over age 62, contact Social Security in or before If over age 62, contact Social Security in or before January of the year you wish to receive benefitsJanuary of the year you wish to receive benefits

Filing for BenefitsFiling for Benefits

Medicare CoverageMedicare Coverage

Part A - Part A - Hospital InsuranceHospital Insurance

Covers inpatient hospital expensesCovers inpatient hospital expenses

40 Credits Earned?40 Credits Earned?No PremiumNo PremiumEnroll anytimeEnroll anytime

2009 deductible = $1,0682009 deductible = $1,068

Medicare Coverage

Part C – Advantage Plans Replaces Part A & B Managed Care – HMO / PPO or Private Fee-for-Service Private Company Providers May have higher premium Must use plan’s prescription plan Defined Service Area “Lock In” – Defined periods to switch plans, go back to A & B

Part A or B enrollment requiredPart A or B enrollment required Comprehensive Drug BenefitComprehensive Drug Benefit 60 + Plans in Ohio in 200960 + Plans in Ohio in 2009 Different formularies, co-pays, Different formularies, co-pays,

pharmacies, authorization rules, etc.pharmacies, authorization rules, etc. Sign up with Medicare or the Plan itselfSign up with Medicare or the Plan itself Review Plan every year Nov. 15 – Dec. 31Review Plan every year Nov. 15 – Dec. 31

Medicare Coverage

Part D – Prescription Drug Plans

Medicare CoverageMedicare Coverage

Part B ( Supplemental Medical Insurance)Part B ( Supplemental Medical Insurance)

Covers 80% doctor bills and outpatient Covers 80% doctor bills and outpatient medical expenses after $135 calendar medical expenses after $135 calendar year deductibleyear deductible

2009 Monthly Premium = $96.402009 Monthly Premium = $96.40****

Defined Enrollment Periods Defined Enrollment Periods ((or penalties!)or penalties!)

Private “Medigap” policies supplementPrivate “Medigap” policies supplement

For People Who Already For People Who Already

Receive Receive Social SecuritySocial Security

Change an Address

Replace a Medicare Card

Request a Form SSA 1099

Request a Benefit Verification Letter

Get a Password

Social Security Resources

1-800-772-1213 7 a.m.- 10 p.m. M-F

Local offices 9 a.m.-4 p.m. M-F

www.socialsecurity.gov

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Thank You !Thank You !Questions, comments, or

concerns?