Information Guide to Social Security
Information Guide to Social Security
General Information
Social Security is a program
that includes payments to:
· retired persons aged at least
65 or older based on date of birth;
·
disabled persons
(of any age);
·
a spouse or a
dependent of someone who gets Social Security; or
· a widow, widower or child of
someone who has died.
Depending on specific circumstances, Social Security
may be available at any age.
The taxes paid to Social Security are split into two
funds; for every tax dollar:
· 85
cents goes to a trust fund that pays monthly benefits to retirees, their
families, and to widows, widowers and children of workers
who
have died
· 15
cents goes to a trust fund that pays benefits to people with disabilities and
their families
The Social Security Administration says that as the
Social Security system is currently structured, benefits will be made to
qualified beneficiaries well into the 21st century.
Social Security Disability Programs
The Social Security Administration (SSA) makes disability
payments under two programs:
Social Security Disability Insurance (SSDI) for people who have a
work history (and their surviving spouses and children) who have Social
Security coverage.
Supplemental Security Income (SSI) for people who have not worked enough in their
lifetime to be eligible for SSDI. (It is possible to receive SSI while
waiting for SSDI to come through).
Disability Requirements
The SSA determines whether or not a person is
qualified for benefits based on his/her disability. Adults must have a physical and/or mental
disorder that keeps them from working for at least 12 months, or is expected to
result in death. Children must have a
physical and/or mental disorder that prevents them from doing things that
children the same age normally do.
To qualify for Social Security disability benefits,
work must have been recently enough or long enough under Social Security. A maximum of four work credits can be earned
per year. Family members qualifying for
benefits under another members work record do not need work credits.
The number of work credits required for disability
benefits depend on the age someone becomes disabled. In general, more work credits are required as
age increases (the rules can be obtained
from a Social Security office).
The decision of whether or not a disability is present
is first reviewed by the Social Security office to make sure basic requirements
have been met for disability benefits.
The case is then sent to the Disability Determination Services (DDS)
office. The DDS will then decide if a
disability exists under the Social Security law.
When a Claim is Approved
The amount of the monthly disability benefit is based
on the lifetime average earnings covered by Social Security. Eligibility for other government benefits can
affect the amount of Social Security benefits received. Back payment will occur from the date the
disability began (as calculated by DDS) to current date, because the wait for
approval can take months.
Continuing Disability Review (CDR)
Once the SSA has determined that someone is eligible
for Social Security benefits based on a disability, the case will be reviewed
from time to time to make sure the disability is still affecting the
possibility of working. The review
process exists to give a disabled person every opportunity to show that the
disability still exists and to assure benefits are not stopped
incorrectly. The frequency of review
will depend on the likelihood of improvement of the disability:
·
If improvement is
expected, the first review will take place 6 to 18 months after the date the
SSA declared a disability
·
If improvement is
possible but cannot be predicted, the case will be reviewed about once every 3
years.
·
If improvement is
not expected, the case will be reviewed once every 5 to 7 years.
Based on the medical records and other information
provided at the time of the review, a decision will be made as to whether or
not the disability still affects the ability to work and Social Security
benefits will either continue or be cut off.
If work is likely, but not to full potential, some benefits may
continue.
The decision to completely terminate benefits will
occur if the person is working again and earning a “substantial” level of
income, this is called Substantial Gainful Activity (SGA). It is important to know the SGA Level Act
because a person can still work part-time and receive benefits as long as their
income does not go over the SGA. Termination
of benefits may also occur if it is decided that the medical condition has
improved to the point that a disability no longer exists to deter one from
working to their full potential.
If the decision to cut off benefits seems unfair or
incorrect it can be appealed based on a four-level process:
Reconsideration
of the case by people not involved in the first review
A Hearing
before an administrative law judge if the reconsideration decision is
unfavorable
Appeals Council
-a review of the hearing decision will be made by the Appeals Council
Federal Court -a
civil action may be brought in a federal court if the Appeals Council either
declines to review the case or makes an unfavorable decision
Representation
Throughout the entire Social Security process, a
representative may be hired to deal with the SSA for the disabled person. An adjudicator is provided by SSA to help a
person navigate the system while in the process of applying for benefits. Multiple representatives may be hired and may
be attorneys or other qualified persons.
Depending on benefits received, some may not charge. Any payment to a representative must be
approved by the SSA first. Some people
may need a “representative payee”, who will manage the benefit payments for
them.
Disability Based on Drug Addiction or Alcoholism
If a disability is based on drug addiction and/or
alcoholism:
Benefits must be paid to a “representative payee”,
someone who will manage the benefit payments for the disabled person.
This “payee” may be any qualified person including a
family member approved by the SSA to act in the disabled persons best
interest. Payments to the “payee” are
determined by the SSA and cannot exceed 10 percent of the monthly benefit or
$50, whichever is less.
Progress in appropriate treatment for the drug
addiction and/or alcoholism must be made if available. The SSA will refer a person to an agency that
will decide on an appropriate treatment program. The agency will also keep records of the
treatment process.
If a disability results from drug addiction and/or
alcoholism, benefits may be received for no more than 36 months. Benefits will not be given if participation
in required treatment programs ceases, and benefits will not be reinstated for
a certain period of time each time treatment begins again.
Signing up for Disability Benefits
Applications for disability benefits can be made at
any Social Security Office by visiting the office. The waiting time can be lengthy.
In order to file claims for disability payments the
following information is beneficial for a faster decision:
Social Security number
Medical records from doctors, therapists, hospitals,
clinics, and caseworkers as well as names, addresses, phone and fax numbers
Laboratory and test results
·
Names of all
medications being taken
·
Names of
employers and job duties of previous 15 years
If filing for a child, all of the previous information
including school records should be obtained.
For additional information or questions,
contact the SSA at 1-800-772-1213
or :
The National Alliance on Mental Illness
NAMI of Greater
Phone: 312-563-0445