Understanding SSI & SSDI

Transcription

1 Putting the pieces together... Understanding SSI & SSDI Daniel Fortuño Benefits Education Center 1031 Franklin St Suite B-9 San Francisco, CA Benefits Education Center 2007, Revised, August MDF Annual Conference: San Francisco, CA

2 Public Income Putting the pieces together... Coverage SSA SSDI SSI SSA: Social Security Administration SSI: Supplemental Security Income SSDI: Social Security Disability Insurance 2

3 SSA Definition of Disability SSDI SSI An individual is unable to engage in any Substantial Gainful Activity due to medically determinable physical or mental impairment(s) 3

4 SSA Definition of Disability SSDI SSI The result of that impairment has lasted or is expected to last at least 12 months or is expected to result in death 4

5 SSA Definition of Disability SSDI SSI Social Security considers the inability to perform any kind of work, taking into account age, education, and work experience 5

6 SGA 2012 Substantial Gainful Activity $1,010 $1,690 amount for blind 6

7 Sequential Evaluation Putting the pieces together... Process 1. Working, engaging in SGA? 2. Severe Impairment? 3. Listing Level of Impairment? 7

8 Listing Level of Impairments Blue Book 8

9 Listing Level of Impairments Blue Book 9

10 Listing Level of Impairments Blue Book 10

11 Listing Level of Impairments Blue Book 11

12 Listing Level of Impairments Blue Book 12

13 Listing Level of Impairments Blue Book 13

14 Listing Level of Impairments Blue Book Muscular dystrophy with disorganization of motor function as described in 11.04B. 14

15 Listing Level of Impairments Blue Book 11.04B. Significant and persistent disorganization of motor function in two extremities, resulting in sustained disturbance of gross and dexterous movements, or gait and station (see 11.00C). 15

16 Listing Level of Impairments Blue Book 11.00C. Persistent disorganization of motor function in the form of paresis or paralysis, tremor or other involuntary movements, ataxia and sensory disturbances (any or all of which may be due to cerebral, cerebellar, brain stem, spinal cord, or peripheral nerve dysfunction) which occur singly or in various combinations, frequently provides the sole or partial basis for decision in cases of neurological impairment. 16

17 Listing Level of Impairments Blue Book 11.00C. (cont.) The assessment of impairment depends on the degree of interference with locomotion and/or interference with the use of fingers, hands and arms. 17

18 Compassionate Putting the pieces together... Allowances (CAL) Began Late 2008 Cases Identify Most Obviously Disabled As of 08/11/12 list of 165 Case are to be processed quickly by the Disability Determination Services (DDS) recommended timeframe is 20 days or less 18

19 Compassionate Putting the pieces together... Allowances (CAL) Cases 19

20 Putting the pieces together..ṡequential Evaluation 20

21 Documentation of Putting the pieces together... Disability Blue Book Listing Level of Impairment or Documentation Through Medical Providers Consumers 21

22 Documentation of Putting the pieces together... Disability Medical Providers Applicants 22

23 Document in Putting the pieces together... Log or Diary Symptoms Frequency Duration Severity 23

24 Application Process Social Security Application Medical Evaluator Local Office State Office - Disability Determination Services (DDS) Non-Medical Evaluator 24

25 Online Application 25

26 Online Application 26

27 Determination and Putting the pieces together... Appeal Process Initial Application Re-consideration On the Record Decision Hearing with Administrative Law Judge Appeals Council Review District Court Case

28 Disability Putting the pieces together... Determination Medical Reviews & Diary Dates 1 year 3 years 7 years 28

29 Social Security Programs SSDI SSI 29

30 Social Security Putting the pieces together... Disability Insurance SSDI History Credits Calendar Quarters 30

31 SSDI Credit Requirement Age 18 to 24: 1.5 years (6 credits) of work within previous 3 years Age 24 to 31: 3 years (12 credits) of work within previous 6 years Age 31 to 42: 5 years (20 credits) of work within previous 10 years 31

32 SSDI Credit Requirement Over age 42: 5 years (20 credits) of work the previous 10 years, plus additional credits 32

33 Work Credits in Years Became Disabled At Age or older 9.5 Number of Years of Work Needed

34 Benefit SSDI Benefits Individual Childhood Disabled Beneficiary (CDB) Widow(er) 34

35 Childhood Disabled Beneficiary (CDB) May be eligible for Social Security Disability Insurance (SSDI) if: Disability began before age 22, and Parent is eligible: o Retires, o Disabled according to SSA or, o Dies SSDI 35

36 Widow(er) SSDI Eligible to receive spouse s benefits if greater than what they are eligible for if: Legal widow(er) At least 50 Unmarried or re-married after age 60 Meets Social Security s definition of disability 36

37 SSDI Waiting Period FULL 5 Month Unpaid Waiting Period Eligible Payments Begin 37

38 Social Security Disability Insurance Retroactive Payment for Filing Late 38

39 Social Security Programs SSDI SSI 39

40 Supplemental Putting the pieces together... Security Income SSI Eligibility Requirements: Disability (under age 65) Need 40

41 Financial Eligibility SSI Putting the pieces together... Exempt Resources A home - If individual has an ownership interest and it serves as his/her primary residence 41

42 Financial Eligibility SSI Putting the pieces together... Exempt Resources One automobile of any value (as of March 2005) 42

43 Financial Eligibility SSI Putting the pieces together... Exempt Resources Liquid Assets: Individual $2,000 Couple $3,000 43

44 Additional Exempt Resources SSI Items related to the disability 44

45 Additional Exempt Resources SSI Household goods of any value. (as of March 2005) Note: Collectables are not exempt 45

46 Additional Exempt Resources SSI Whole Life or other insurance policies with cash surrender value or face value of less than $1,500 All term life insurance policies of any value A burial plot, or other burial space, of any value Up to $1,500 per person set aside specifically for burial expenses Insurance Policy 46

47 Benefits 2012 SSI Federal Benefits Rate (FBR) $698 State Supplemental Program (SSP) $ Total $ If Blind $

48 SSI Retroactive payment Integration Waiting Period 48

49 Thank You! Daniel Fortuño Benefits Education Center 1031 Franklin St Suite B 9 San Francisco, CA info@benefitsec.com 49