Social Security Essentials In Brief John LaMotte Staff Assistant/State Liaison

Earning Credits  40 Credits for Retirement  Disability Varies by Age  Maximum 4 credits in 1 year  $1,090 earnings = 1 credit

Worker  Reduced benefits as early as age 62  Full benefits at age  Increased benefits after full retirement age (FRA) Wife or Husband  As early as age 62  At any age if caring for child under age 16 or disabled  Divorced spouses may qualify if married 10 years Child  Unmarried and up to age 18 or 19 if still in high school  Any age if disabled before age 22  Any age if disabled before age 22 Retirement Benefits

Survivor Benefits Widow(er)  Reduced benefits as early as age 60 or, if disabled, age 50.  Lesser reduction percentage - age 60  At any age if caring for a child of worker under age 16 or disabled before age 22  Divorced widow(er) may qualify if married at least 10 years  Unreduced benefit is usually the same as that worker would have received as that worker would have received

Survivor Benefits (cont) Child (unmarried*)  Under age 18 or 19 if still in high school  Any age if disabled before age 22 $255 Lump Sum Death Benefit  Surviving spouse or minor/disabled children only

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 --estimate how work may affect benefits How Work Affects Retirement Benefits

Social Security Disability Programs 2009

8 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

9 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 eligibility  Requires 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 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 – *P arent 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 –  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 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 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 iAppeal  The iAppeal can be submitted by:  Claimant; or  Authorized representative; or  Other third party

Requirements 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 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: Scroll Down

26 Working While Disabled For information about:  Employment support for people with disabilities, visit The Work Site at html  Social Security’s Ticket to Work program  Red Book for Employment Support

27 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

28 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)

29 Filing for Benefits One Option: Not making an appointment

Better Options  Via the Internet at  Appointment in the office or over the telephone - Call When to Contact Social Security  Up to 3 months before you retire or attain age 62  If over age 62, contact Social Security in or before January of the year you wish to receive benefits Filing for Benefits

Medicare Coverage Part A - Hospital Insurance  Covers inpatient hospital expenses  40 Credits Earned? No Premium Enroll anytime  2009 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 required  Comprehensive Drug Benefit  60 + Plans in Ohio in 2009  Different formularies, co-pays, pharmacies, authorization rules, etc.  Sign up with Medicare or the Plan itself  Review Plan every year Nov. 15 – Dec. 31 Medicare Coverage Part D – Prescription Drug Plans

Medicare Coverage Part B ( Supplemental Medical Insurance)  Covers 80% doctor bills and outpatient medical expenses after $135 calendar year deductible  2009 Monthly Premium = $96.40 **  Defined Enrollment Periods (or penalties!)  Private “Medigap” policies supplement

For People Who Already Receive Social Security Change an Address Replace a Medicare Card Request a Form SSA 1099 Request a Benefit Verification Letter Get a Password

Social Security Resources  a.m.- 10 p.m. M-F  Local offices 9 a.m.-4 p.m. M-F 

38 Thank You ! Questions, comments, or concerns?