49 Million People Who Gets Benefits from Social Security? 31 million Retired Workers and 3 million Dependents 6.8 million Disabled Workers and 1.8 million Dependents 4.7 million Widows/ Widowers 1.9 million Children 6/2006

RSDI Retirement, Survivors, Disability Insurance Medicare SSI Supplemental Security Income Medicaid Concurrent Social Securitys Benefit Programs o Based on Work o Pays benefits to the worker and family members if eligible o Financed by FICA taxes o SSI needs based o Low income and resources o SSI pays individual, no family benefits o Aged, disabled or blind o Financed by General Revenue Funds

RSDI Varies - Based on your lifetime earnings Credits Earned (insured Status) SSI $637 max. Other income may reduce benefit Amount of Payment

Your Age When You Retire Affects Your Benefits If Youre A Worker and Retire: At age 62, you get less money permanently At your full retirement age, you get your full benefit You get even more money if you work past your full retirement age

Full Retirement Age

How Social Security Determines Your Benefit Social Security benefits are based on earnings Step 1Your wages are adjusted for inflation Step 2Find the average of your 35 highest earnings years Step 3Result is average indexed monthly earnings

You Can Work & Still Receive Benefits You CanIf You Make More, If You AreMake Up ToSome Benefits Will Be Withheld Under Full Retirement Age $ 13,560/yr. ( $ 1130/mo.) $ 1 for every $ 2 The Year Full Retirement Age is Reached $ 36,120/yr. ($3010/mo.) $ 1 for every $ 3 Month of Full Retirement Age and AboveNo LimitNo Limit You CanIf You Make More, If You AreMake Up ToSome Benefits Will Be Withheld Under Full Retirement Age $ 13,560/yr. ( $ 1130/mo.) $ 1 for every $ 2 The Year Full Retirement Age is Reached $ 36,120/yr. ($3010/mo.) $ 1 for every $ 3 Month of Full Retirement Age and AboveNo LimitNo Limit

In Addition to the Retiree, Who Else Can Get Benefits? In Addition to the Retiree, Who Else Can Get Benefits? Your Spouse Your Child At age 62 At any age if caring for child under 16 or disabled Divorced spouses may qualify At age 62 At any age if caring for child under 16 or disabled Divorced spouses may qualify Not married under 18 (under 19 if still in high school) Not married and disabled before age 22 Not married under 18 (under 19 if still in high school) Not married and disabled before age 22

Who Can Get Survivors Benefits? Reduced benefits at age 60 If disabled as early as age 50 At any age if caring for child under 16 or disabled Divorced widows/widowers may qualify Not married under age 18 (under 19 if still in high school) Not married and disabled before age 22 If Your Child Is: Widow or Widower:

Who Can Get Disability Benefits? Worker At age 62 Must have paid into Social Security five out of last 10 years Must have paid into Social Security five out of last 10 years At any age if caring for child under 16 or disabled At any age if caring for child under 16 or disabled Divorced spouses may qualify Spouse

RSDI Retirement, Survivors, Disability Insurance Medicare SSI Supplemental Security Income Medicaid Concurrent Social Securitys Benefit Programs o Based on Work o Pays benefits to the worker and family members if eligible o Financed by FICA taxes o SSI needs based o Low income and resources o SSI pays individual, no family benefits o Aged, disabled or blind o Financed by General Revenue Funds

Medicare Coverage Part AHospital Insurance Covers most inpatient hospital expenses Deductible $1024 Part BSupplementary Medical Insurance Covers 80% doctor bills & other outpatient medical expenses after 1st $135 in approved charges Monthly Premium $96.40 Part DMedicare Prescription Drug Plan Covers a major portion of prescription drug costs. Monthly Premiums Vary by Plan Part AHospital Insurance Covers most inpatient hospital expenses Deductible $1024 Part BSupplementary Medical Insurance Covers 80% doctor bills & other outpatient medical expenses after 1st $135 in approved charges Monthly Premium $96.40 Part DMedicare Prescription Drug Plan Covers a major portion of prescription drug costs. Monthly Premiums Vary by Plan 65 & older Receiving Social Security disability benefits at least 24 months 65 & older Receiving Social Security disability benefits at least 24 months

Social Security Improves Service to Disabled Military Service Members Expedited processing of disability claims for men and women serving in the U.S. military who become disabled while on active duty The expedited process is for military service members disabled on or after October 1, 2001, and is applicable regardless of where the disability occurs Social Security also expedites survivors claims Development of an easy-to-use website that provides information about Social Security and military service. The website also includes a link to apply for disability benefits online An agreement with the Department of Veterans Affairs (VA) for the VA to electronically provide Social Security with the medical records of veterans applying for disability benefits This agreement enables us to get medical records quicker and more efficiently and helps us expedite the disability determination

Types of Social Security Disability Programs Social Security Disability (work) Social Security Disability Benefits - adults Social Security Disability Benefits - widow(er)s Social Security Disability Benefits – adults disabled since childhood SSI (need) SSI Disability benefits - children SSI Disability benefits - adults

Social Securitys 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 (Definition for adults over age 18) 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 (Definition for adults over age 18)

Disability Application Process 1.Files application with local SSA office Make appt. phone/in office or Online 2. SSA office reviews non-medical issues 3. Determines whether RSDI or SSI or Both and collects medical information 4. SSA office sends file to State Disability Determination Service (DDS) 5. DDS requests medical records/information 6. DDS receives and reviews medical evidence 7. DDS makes medical decision 8. File returns to SSA office - processes to payment 9. Individual has option to file an appeal if denied

5 month Waiting Period April 17 – Susan found disabled May June July Aug Sept October – Eligible for 1 st check, paid in November

Who Can Get SSI? SSI Disability Benefit Paid to adults and children with limited income and resources. No prior history of work is needed. SSI recipients generally qualify for Medicaid, a state-run health assistance program. Paid to adults and children with limited income and resources. No prior history of work is needed. SSI recipients generally qualify for Medicaid, a state-run health assistance program.

Who Can Get SSI? Supplemental Security Income Age 65 or older Blind– any age Disabled– any age Limited Income Limited resources U.S. citizen in most cases Age 65 or older Blind– any age Disabled– any age Limited Income Limited resources U.S. citizen in most cases Financed by General Revenue

SSI Benefits for Disabled Adults Income of spouse considered in determining eligibility Resource limits --$2,000 individual --$3,000 for couple Assets NOT considered: --Home you live in --Your car --Burial plots --Some resources set aside for burial

If Approved Social Security: Benefits will begin with the 6 th full month of disability after the date we find disability began SSI: Benefits begin month after filing for SSI Case is reviewed periodically for both benefits Must notify Social Security of changes, such as return to work

Time Limits If you disagree with the decision, you have 60 Days to file an Appeal

Appeals Appeal Levels : Reconsideration Hearing Appeals Council Federal court review When: 60 days after receipt of decision notice File ONLINE Appeal - – Online Serviceswww.socialsecurity Print Appeal forms –

Continuing Disability Reviews Medical condition reviewed to determine if disability is continuing. Review frequency based on expectation of recovery: –if expected - review 6 to 18 months, –if possible - review 3 to 5 years –if not expected - review 7 years. –Children reviewed every 3 years and at age 18 Medical review under SSI possible even when no payments being made (for MA) Medical review can occur at any time (work)

RSDI Retirement, Survivors, Disability Insurance Medicare SSI Supplemental Security Income Medicaid Concurrent Social Securitys Benefit Programs o Based on Work o Pays benefits to the worker and family members if eligible o Financed by FICA taxes o SSI needs based o Low income and resources o SSI pays individual, no family benefits o Aged, disabled or blind o Financed by General Revenue Funds

SSD and SSI – not working Jim receives both SSD and SSI. He does not work. His monthly SSD check amount is $410 per month. His SSI check is calculated as follows: Step 1:Step 2: $410 SSD $637FBR - 20 general income excl.-390 countable UI $390 $247 SSI payment Total income = $410 SSD, plus $247 SSI = $657.

SSI and wages Steve has a disability and receives SSI. He begins working at K mart earning $300 per month. $ earned income general exclusion earned income exclusion $ by 2 = $ countable income $ FBR countable income $ SSI payment $ wages SSI $ total income MN Work Incentives Connection

SSD & SSI & working Sue receives both SSD of $200, plus SSI every month. Also works at JY Industries and earns $350 per month. The amount of Sues SSI payment is calculated as follows: STEP 3: $ countable UE income countable earned inc. $ total countable income Step 1: $ SSD monthly amount general income exclusion $180 countable unearned income STEP 2: $ wages (earned income) earned income exclusion $ ÷ 2 $ countable earned income STEP 4: $ FBR for countable income $ SSI payment Total = =792

Cant lose Medicaid : SSI and high wages $ FBR countable income 0 SSI payment $ earned income general exclusion earned income exclusion $ by 2=$ cntbl income Steve on full SSI-603/mo.-begins working & earning $1,550 per month. $1, wages and 1619(b)

WORK INCENTIVES aka EMPLOYMENT Supports (see Red Book) SPECIAL Disability RULES that make trying to work less risky by... EXTENDING BENEFITand/or Minimizing THE IMPACT on BENEFIT PAYMENTS Important : SSDI & SSI each have their own set of Work Incentives

What is PA$$? P art of the SSI (needs-based) program. A n agreement between you and SSA. S elf-financed employment plan S pecific job goal needed to begin

SSA St Paul MN PASS Cadre

Resources Return to Work St Paul PASS Cadre MN Work Incentives Connection or Disability Linkage Line

Medicare Prescription Drug Benefit: Application for Extra Help

What is the extra help? Help to pay for Medicare Prescription Drug Benefit Premiums Deductibles Co-payments

Extra Help Categories 1. Full: Full premium assistance 2. Partial: Sliding scale premium Lower deductible & co-payments

Who is eligible for the help? Medicare beneficiaries with limited income and resources Income » ind = $15,600 » couple = $21,000 Assets » ind. $11,990 » couple 23,970

Deemed Population People who are automatically eligible for the extra help 1. Medicare and Medicaid 2. Medicare Savings Programs (QMB, SLMB, QI) 3. Medicare and SSI Do not have to complete an application States work with CMS to process extra help for deemed population

Not Deemed Population All Other Medicare beneficiaries who have limited resources and low income Must apply for extra help

How to Apply for Extra Help Internet application Scannable application Phone with SSA At SSA office Outreach event With SSA or other organization

SSAs Mailing starts May 27, ends mid-August Includes: – Cover letter – Scannable application – Pre-addressed, postage paid return envelope By terminal digits 360,000 in Minnesota 19 Million Nation wide

Submitting the Application File early! Do not send proofs. Mail:Social Security Administration Wilkes-Barre Data Operations Center P.O. Box 1020 Wilkes-Barre, PA Will receive a receipt

Other Extra Help Information Can appoint personal representative to sign up for the extra help SSA will notify beneficiary whether eligible for subsidy Can appeal the decision Decision effective for one year

SSAs Outreach Aggressive outreach campaign to reach: – Medicare beneficiaries – Family and friends – Organizations

For More Information Social Security Administration: – – Center for Medicare and Medicaid Services: – –