DEMYSTIFYING SSDI AND SSI FEBRUARY 8, Attorney Katie Alft - Legal Action of Wisconsin, Inc.

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1 DEMYSTIFYING SSDI AND SSI FEBRUARY 8, 2018 Attorney Katie Alft - Legal Action of Wisconsin, Inc.

2 SSDI vs SSI Social Security Disability Insurance Benefits SSDI, Title II, DIB Insurance program based on payroll taxes Non-disability requirements: must be insured Generally must work 5 out of 10 years Creates a period of insured status lasting about 5 years Supplemental Security Income SSI, Title XVI Needs-based (comes out of general federal revenues) Non-disability requirements: income and asset restrictions Assets cannot exceed $2000 Many exemptions Spouse s income may be counted; parents income counted for a child

3 SSDI vs SSI Social Security Disability Insurance Benefits Amount is determined by your retirement amount National average $1173 Potential benefits to children, spouses and ex-spouses Supplemental Security Income Set federal maximum; could receive less based on income and living arrangements 2018 maximum is $750 Household of another/ food or shelter provided: $500 Receives state supplement of $83.78 State childcare supplement of $250/$150

4 SSDI vs SSI Social Security Disability Insurance Benefits Waiting period of 5 month after the month found disabled Benefits can be paid up to 12 months prior to the application date Medicare 2 year waiting period after date of disability; monthly premium Premiums for part B are $134 in 2018 May be eligible for Medicare Premium Assistance/ Medicare Savings Programs Red, white and blue card Supplemental Security Income First payable the month after application Medicaid no waiting period (Medical Assistance, Badgercare) Blue Forward Health card

5 The disability determination process 1: Application and initial determination 2: Request for Reconsideration 3: Administrative Law Judge hearing 4: Appeals Council 5: Federal Court

6 The definition of disabled Unable to engage in substantial work activity due to any medically determinable physical or mental impairment which is expected to result in death, or has lasted/ is expected to last 12 months

7 The 5 Step Sequential Evaluation 1) Are you working? 2) Do you have substantial impairments that meets the duration requirement? 3) Do you meet a Listing? 4) Can you do your past relevant work? 5) Can you do any other work?

8 I m waiting for a hearing what to do? Get medical / mental health treatment! Be open and honest with treatment providers Discuss symptoms and limitations at every appointment Comply with treatment Be aware that substance abuse can make the case difficult to prove, especially in cases based primarily on mental limitations Get a local attorney NOSSCR referral service: Keep your information up-to-date with SSA May try to work at level that won t disqualify you Can become involved in a vocational program

9 My benefits were stopped what to do? Benefit cessation found to be no longer disabled Regular reviews of disability Appeal 10 day deadline to get continuing benefits Reapply if outside of appeal deadline Incarcerated or in an institution If on SSI and benefits stopped for longer than 12 months, must reapply If on SSDI, can go into SSA and benefits will be reinstated If on SSDI, benefits should only stop when convicted and confined

10 My benefits were stopped what to do? Over resource limit (SSI) Can dispute that the resources are not countable, or sometimes are not your resources Joint accounts will be deemed as your resources If resources are countable, notify SSA immediately when under the limit Substantial gainful activity (SSI) Earnings over $1180 per month usually considered substantial

11 I don t have any income, but my SSI is getting reduced why? To get the full amount ($750), you must be living in your own household: you own the home, you have rental liability, or you are paying your fair share of expenses If you live in the household of another and receive food and/or shelter from another, benefits reduced by one-third (to $500) May need to prove you are paying your fair share For back benefits, will need to show an agreement was in effect at the time benefits were pending and that it wasn t contingent on the award of benefits

12 SSA says I owe money what to do? Overpayment: Paid more money than the correct amount for the given period May be fault of recipient or SSA SSI beneficiary Change in income Receives lump sum payment In kind income Over resource limit Marriage or divorce Change in living arrangement Change in benefit status Incarceration or institutionalization SSDI beneficiary Over SGA after trial work period Incarceration (convicted and confined) Change in benefit status due to eligibility under a different earnings record Retirement beneficiary between goes over earnings limit

13 SSA says I owe money what to do? Receive notice requesting entire amount in a lump sum Notice should include: Amount of overpayment Months the overpayment occurred Cause Request for payment in full If currently on benefits, proposed adjustment of future benefits if payment in full not received Right to appeal or request waiver Notice that recovery will begin within 30 days

14 SSA says I owe money what to do? Recovery: SSI: Will automatically take 10% of countable monthly income SSDI/ Retirement: Will withhold entire check Must prove hardship to modify recovery amount SSA s options: Offset against future benefits Settle for less than full amount Refer to IRS to offset against future tax refund Refer to collections Sue in federal court Request repayment from recipient s estate

15 SSA says I owe money what to do? Appeal 60 day deadline Dispute the existence or accuracy of the overpayment Overpayment may lack sufficient information to form an opinion about the accuracy of the overpayment Carries appeal rights Can appeal online, via mail, at SSA Recovery efforts must stop while pending Request a waiver Can be filed at any time Agree with the overpayment but do not think you should have to pay it back because you are without fault and it creates a hardship or is unfair for some other reason Allowed a personal conference with an SSA representative but limited appeal rights Recovery efforts must stop while pending

16 I m on benefits what to do? Report changes in address, phone number, income, living situation, and any changes related to work (starting/ stopping, pay change, work expenses, etc.) If awarded SSI and due substantial back benefits, can request early payment if unable to meet basic needs like food, shelter, clothing If subject to an overpayment, can request lesser amount be taken out if can demonstrate financial hardship Trouble with representative payee can dispute the need to have a rep payee, can request a change in rep payee Always communicate with local SSA office if possible (rather than national number )

17 I m on benefits and want to work can I? Rules different depending on benefit For SSI, first $65 of income doesn t count. After that, monthly payment reduced by half of earned income amount (reduced by $1 for every $2 earned) Unearned income counted dollar for dollar against SSI benefits after $20 disregard For SSDI, earnings $850 and under do not affect benefits Months where earnings exceed $850 count towards a trial work period (TWP) TWP ends after 9 months of earnings above $850 w/in a rolling 60 month timeframe After TWP ends, extended period of eligibility for 36 months where you lose benefits for months with earnings over SGA

18 Local resources NOSSCR referral service Disability Resource Center of Milwaukee County (ages 18-59) SeniorLAW (age 60 and older) Legal Action of Wisconsin, Inc

19 Thank you! Katie Alft