SOCIAL SECURITY BENEFITS

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• SOCIAL SECURITY BENEFITS
• SSDI and SSI

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Social Security Administration

• Overview of
• 
  Disability Programs
• SSDI SSI

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SOCIAL SECURITY DISABILITY--SSDI

• Insurance program based on quarters of
  coverage-paid by FICA taxes
• Not based on financial need
• Earned quarters--1090One quarter
• Disabled or blind under Social Security rules
• 5 month waiting period
• Medicare eligible after entitled for 24 months

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Spouse Benefits

• Age 62 and married to worker
• Any age mothers-workers child under age 16
• Divorced spouse-married 10 years, age 62
  unmarried
• Surviving divorced spouse-age 60 married 10yrs
  can be remarried after age 60
• Widow (er) married 9 months age 60
• Disabled widow (er) age 50

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Child Disability Benefits

• As a child (under 18) auxiliary beneficiary on
  the record of a parent receiving SSA benefits or
  deceased-disability not a factor
• As a Disabled Adult Child (over age 18) on the
  account of a parent
• SSI-as a child whose parents meet the
  income/resource limits-disability is a factor

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SUPPLEMENTAL SECURITY INCOME SSI

• Federal welfare program based on need
• Aged, disabled or blind
• Be a U.S. citizen or qualified alien
• Income/resources of spouse or parents (if under
  18) may affect eligibility
• No waiting period
• Automatic Medi-cal eligibility in CA
• Paid by general taxes not FICA taxes

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Disability Definition

• The same for both programs
• Inability to work is key for adults
• Inability to function is key for kids
• Disability must be severe enough to keep adult
  from doing any substantial work
• Disability must be expected to last 12 months
• .or result in death

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Who decides if youre disabled?
Non-Disability Factors Disability Factors
Social Security caseworker SSI caseworker Appeals and RepPayee paperwork handled by SSA Office Medical folder sent to California Department of Social Services Disability and Adult Services (DDS)
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Representative Payees
Who needs one? Children Drug addicts Alcoholics Adults who are legally incompetent Psychological disorders Who can be one? Parent or family member Legal guardian A close friend Custodian of the person Social Service agency
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If Your Claim is Approved

• Generally takes 3-5 months to get decision
• SSDI benefits begin with the 6th full month of
  your disability (waiting period)
• Ex Disability begins 01/09 and file 02/09 First
  payment month 07/09 payable in 08/09
• SSI benefits payable month after you file
• SSI review done before first payment

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Appeal Process

• Initial claims 32 approval rate
• 1st-Reconsideration Claim sent back to DDS for
  another review 8
• 2nd- Hearing Administrative Law Judge 69 2007
  SSA Statistical Report
• 3rd-Appeals Council Review Judge reviews ALJ
  decision
• 4th Federal Courts Civil court action
• All have time periods

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SSA Medical Benefits
Medicare Part A-D Federal program tied to SSDI and age 65 Entitled age 65 or 25th month after disability benefits Monthly premiums Medi-Cal State program Medicaid California Dept. of Social Services Tied to SSI Hawaii separate application Medi-Cal pays Medicare premiums
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SSA WORK INCENTIVES

• Most people with disabilities want to work
• SSA offers a package of work incentives to help
  them
• Work incentives allow beneficiaries to
• --Test ability to work and
• --Gradually become self-supporting

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FEARS, MYTHS, AND TRUTHS ABOUT WORK AND
DISABILITY BENEFITS

• If I start working my benefits will stop or my
  income will go down-Fear
• Work incentives allow for continuation of cash
  benefits for a period of time-Truth
• I can make more money not working-Myth
• Going to work will generally increase overall
  income-Truth
• I cant work because Ill lose my Medical
  Insurance-Fear
• Healthcare (Medicare and Medi-cal) can continue
  even if claimant is working-Truth

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FEARS, MYTHS, AND TRUTHS ABOUT WORK AND
DISABILITY BENEFITS

• Im afraid that if I go to work and my benefits
  stop, Ill get sick again and have a hard time
  getting back on benefits-Fear
• Expedited Reinstatement can pay up to six months
  while you wait for decision-Truth
• I cant get a good paying job-Myth
• PASS Program, Ticket to Work and Community
  Partners can help you-Truth
• I get and SSA check-Myth
• SSA benefits are SSDI-Truth

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SSDI PRIMARY WORK INCENTIVES

• Trial Work Period
• Extended Period of Eligibility-SGA 980/1640
• Expedited Reinstatement
• Continuation of Medicare
• 301 VR payment
• Ticket to Work

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TRIAL WORK PERIOD (TWP)

• Allows claimant to test work ability while still
  receiving full SSDI for 9 months

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TWP

• 2009-700 constitutes a TWP month
• We give you a rolling 5 year period to earn the
  nine months
• If earning at or above the current SGA level we
  pay for the tenth month and two additional
  grace months
• Gives beneficiary a trial run on working

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LETS REVIEW THE NUMBERS

• 9 Trial work months
• 3 Grace months
• During these months claimant receives full SSDI
  check and their wages

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EXTENDED PERIOD OF ELIGIBILITY

• Starts at end of TWP and extends for 36 months
• Claimant whose earnings drop below SGA in any
  month can get full SSDI payment for that month
• Automatic reinstatement if work stops
• IRWE

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LETS REVIEW THE NUMBERS

• 9 Trial work months
• 3 Grace months
• During these months claimant receives full SSDI
  check and their wages
• 36 Extended period of eligibilityDuring these
  months claimant is entitled to the full SSDI
  check any month wages fall below SGA

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EXPEDITED REINSTATEMENT

• Starts at end of EPE and runs for the following
  60 months
• Claimant who stopped work due to same disability
  can be paid while we make a medical decision
• Pay up to six months

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LETS REVIEW THE NUMBERS..

• 9 Trial work months
• 3 Grace months
• 36 months Extended period of eligibility
• 60 months Expedited reinstatement
• 105 months Almost 9 years that claimant stays
  connected to SSDI for the cash benefits
• 301 Pmts

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CONTINUATION OF MEDICARE

• Starts at end of TWP
• 93 months starting the month after TWP
• 9 month TWP
• 93 months after TWP
• 102 Months of Medicare 8 ½ years

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TICKET TO WORK ACT OF 1999

• Ticket is a voucher to receive rehabilitation or
  training services from Employment Networks (EN)
• Almost anyone receiving SSDI or SSI disability
  18-64
• Does not mean SSA believes claimant is no longer
  disabled

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TICKET PROCESS OVERVIEW

• Ticket received by an SSDI/SSI claimant
• Claimant decides if they want to attempt to
  return to work and use the ticket
• Claimant contacts MAXIMUS 1-866-968-7842 for
  information on ENs
• Claimant selects EN and they agree on an IWP
  (Individual Work Plan)

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TICKET TO WORK ENHANCEMENTS

• WIPA-Work Incentive Planning Assistance
• Provide counseling on SSA work incentive programs
• San Diego-Workforce Partnership 760-871-1974
• PABSS-Protection and Advocacy-provide information
  on vocational rehab and ENs
• Disability Rights CA, Inc. 239-7861

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MORE TTW ENHANCEMENTS

• The Continuing Disability Review (CDR) process
  has changed
• Beneficiaries using Ticket will not be selected
  for a medical CDR
• SSDI/SSI beneficiaries who have received benefits
  for 24 months No Med CDR Section 111 Protection
• Regularly scheduled CDRs will continue

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SSI Payment Computation

• 500.00 Social Security
• 20.00 General Exclusion
• 480.00 Countable income
• 500.00 Wages
• 65.00 Earned Income Exclusion
• 435.00 2 217.50 Countable income
• Total C/I 217.50 480.00 697.50
• 870.00 - 697.50 172.50 SSI

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SSI WORK INCENTIVES

• Impairment related work expenses-IRWE
• Blind work expenses BWE
• Earned Income Exclusion
• Plan to Achieve Self Support-PASS
• Property Essential to Self support-PESS

• EXR
• Continued Medi-cal eligibility-1619b 2899 month
• Reinstatement eligibility without new application
• Student Earned income Exclusion
• 301 pmts

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SSI WORK INCENTIVE EXAMPLE

• Tom goes back to work at Petco Park
• SSI rate CA 935 no countable income
• 2500 gross wages
• -1640 Student Earned Income Exclusion
• -85 General Earned Income Exclusion
• 775 countable income
• -50 IRWE for Drugs
• -725 countable income

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SSI WORK INCENTIVES

• 725 countable income
• -362.50 ½ remaining earnings
• 362.50 countable income
• -100 BWE taxes and lunches at work
• 262.50 countable income
• -162.50 PASS for books and computer
• 100 countable income
• 935-100 835 SSI 2500 wages
• 3335 Total monthly income

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Dealing with Social Security

• Online www.socialsecurity.gov
• Telephone [phone]
• In person
• 8 Branch offices in San Diego County
• Servicing areas

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SAN DIEGO SSA OFFICESToll Free 1-800-772-1213

• 1333 Front St
• San Diego CA 92101
• Tel [phone]
• 626 L St.
• Chula Vista CA 91911
• Tel [phone]
• 846 Arnel St
• El Cajon CA 92020
• Tel [phone]
• 2160 S El Camino Real
• Oceanside CA 92054
• Tel [phone]

• 8505 Aero Drive
• San Diego CA 92123
• Tel [phone]
• 2530 E Plaza Blvd
• National City CA 91950
• Tel [phone]
• 7961 University Ave
• La Mesa CA 91941
• Tel [phone]
• 367 Via Vera Cruz
• San Marcos CA 92078
• Tel [phone]

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QUESTIONS
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E-Serviceswww.socialsecurity.gov

• Apply for retirement
• Apply for SSDI
• Apply for Medicare Part D
• Request a Social Security statement
• COA, telephone
• Replace Medicare card

• Check status of online application
• Request a proof of income letter
• Get a form 1099/1042S
• Apply for direct deposit
• Retirement Estimator

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HOW TO CONTACT THE PASS CADRE

• ? Toll Free 1.888.674.6250
• ? Local 619.557.6605
• ? Fax [phone]
• ? Mailing Address
• 1333 Front Street
• San Diego CA 92101
• ? PASS Specialist
• Patrick Mattis Peter Prather