DISCLAIMER
The information provided herein is very general information some of which
is presented in outline form. Some information may not be updated
for 1999 and some information may apply only to residents of California.
As with all information presented on these web pages, do not rely on this
information as accurate for your specific situation. You should consult
a competent attorney in your state for legal advice. Please also
read our general disclaimer.
There are many important issues that arise after a person begins receiving
Social Security or SSI disability benefits. This manual provides
very general information about issues that may affect you now or in the
future. Please keep in mind that one or more of these concerns may
not apply to you. The questions that arise depend on your specific
circumstances. However, there are certain rules and regulations of
which you should be aware in the upcoming months and years. They
are:
Please contact The Hawkins Center if you need further explanation or if
you would like to discuss your specific situation. You can also obtain
additional information from Social Security's publication, "What
You Need To Know When You Get Disability Benefits."
The Payment Process
Do You Receive SSDI or SSI?
A person who is found by Social Security to be eligible for disability
benefits may receive either Social Security Disability Insurance benefits
(also known as SSDI or Title 2 benefits) or Supplemental Security Income
(SSI or Title 16). Some people receive both types of benefits.
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Social Security Disability Insurance: A person is entitled
to SSDI benefits if he or she has worked approximately five years out of
the last 10 years before becoming disabled. (The rule is different
for people under age 31.) The monthly amount of the benefit depends
on how much you earned when you worked and how many years you had earnings.
The more years worked and the higher your earnings, the higher your monthly
benefit will be. The maximum monthly benefit is approximately $1,450.
Very few people get the maximum benefit.
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Supplemental Security Income: A person is entitled to SSI
if he or she is either 1) not entitled to SSDI because of not meeting the
5 out of 10 year work rule, or, 2) is entitled to SSDI but the monthly
amount of SSDI is lower than the SSI monthly amount. The individual
must also meet income and resource restrictions. For a person who
is self-supporting (that is no one else is paying for your rent, food,
or clothing) the monthly benefit in 1998 is $650.40. This amount
is reduced if you have income or receive money from any other sources.
When Are Benefits Paid?
SSI benefits are paid on the 1st of the month. If the 1st falls on a weekend
or holiday, it will be paid the last working day before the 1st.
SSDI benefits are paid on the 3rd of the month or the last working day
before the 3rd if the 3rd falls on a weekend or holiday for anybody who
filed their application for benefits before May 1, 1997. For people
receiving SSDI benefits who filed their application for benefits on or
after May 1, 1997, SSDI benefits will be paid on the second, third or fourth
Wednesday of the month depending on the date of your birth.
How are Benefits Paid?
The usual method of payment is by direct deposit to your bank account.
See the section entitled Direct Deposit and Bank Accounts
for more information. If you do not have direct deposit, you will
receive a check at your mailing address.
What if a Monthly Payment is not Received?
If a payment is not received, report it to Social Security. It will
take a few days to have the payment reissued, depending on your circumstances.
Direct Deposit and Bank Accounts
Whether you receive SSI or Social Security disability benefits (SSDI),
you can have your monthly payment deposited directly to your bank account.
In fact, Social Security now requires that you use direct deposit if you
have a bank account and you filed your application for benefits after August
1, 1996. As of January 1, 1999, everyone receiving SSI or SSDI will
be required to use direct deposit.
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How to set up direct deposit: Simply call SSA or go to your
local office with your bank account number.
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Changes in your account: Be sure to notify SSA if you close
or change your bank account. Before you close or change your accounts,
make sure you leave SSA enough time to record changes so that your next
monthly payment will be made to the correct account.
Some General Issues about Bank Accounts
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Do not "share" a bank account: If you receive SSI benefits,
do not mix your money with any other person's money in the same bank account.
If you have a payee or you want someone else to have access to your account,
that is fine as long as the payee or other person does not put any of their
own money into the account.
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Can Creditors attach your bank account?: The general answer
is no, creditors cannot attach your bank account for outstanding debts
you owe. Exceptions to this rule:
1. If you receive SSI - There are no exceptions
2. If you receive SSDI - Your account may be attached
to repay delinquent child support or alimony payments and delinquent taxes
Reporting Responsibilities
Now that you are entitled to Social Security or SSI disability benefits
you are required to keep Social Security informed about certain events
or changes in your life. Some of the more important things you must
report to SSA are:
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New address: If you move or your mailing address changes let
SSA know as far in advance as you can.
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New or different bank account: Failure to report this quickly
may result in missing a payment on your direct deposit date.
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New Living Situation: If you have a new living situation,
for example, you now pay rent when before you didn't pay rent, your SSI
benefit amount may change. If you receive SSDI but not SSI your living
situation does not affect your benefits.
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Marriage or Divorce: Marriage, divorce or separation
may affect the amount of benefits to which you are entitled.
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Work: If you start working, even part time, you need to notify
SSA. Keep your pay stubs or other evidence of how much you earn and
report it to SSA each and every month.
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Workers Compensation and State Disability: Report any changes
in workers compensation or State Disability payments, whether the change
is that the benefits stopped, started, increased or decreased. The
change may or may not affect your benefits. Workers Compensation
lump sum settlements must also be reported.
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Other Income: If you receive SSI benefits, you must also report
any other income you receive in addition to wages, workers compensation
and State Disability. Examples include money from an inheritance,
VA benefits, pension benefits or any other type of income. You must
report other income whether it is a one-time payment (for example a settlement
from a lawsuit) or ongoing payments (for example monthly pension benefits).
When to Report the Changes
It is always wise to report changes as soon as you become aware of them.
Address and bank account changes should be planned ahead to the extent
possible so that your monthly benefit check goes to the right location.
All changes are required to be reported within 10 days of the change.
Health Insurance
SSI Recipients
If you are eligible for SSI benefits you are also eligible for MediCal.
You are eligible for MediCal the same date that you become eligible for
SSI benefits, even if those months have already passed.
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Receiving your MediCal card: You will receive your permanent
MediCal card about 2 months after the meeting you had (or will have) at
the Social Security office to process your favorable decision. At the meeting
you can also ask Social Security for a referral to MediCal to get a temporary
card until your permanent MediCal card arrives.
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Paying Past Medical bills: MediCal coverage will extend back
90 days before your application date. This is the date Social Security
determines you became disabled or the date you applied for SSI, whichever
is later. You should bring any outstanding bills from this time period
to your local MediCal office, and an eligibility worker will process them
for payment. If you have medical bills which you paid during this period,
you have to ask your medical provider to return your money and bill MediCal
directly.
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What MediCal Covers: If you have questions about whether a
certain medical treatment is covered by MediCal, you can call the local
MediCal office (through the Department of Social Services and the Department
of Health Services) or your medical provider.
SSDI Recipients
If you are eligible for SSDI benefits you will also be eligible for Medicare.
You do not become eligible for Medicare, however, until 24 months after
you became eligible to receive SSDI cash benefits.
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Medicare Premiums: To receive Medicare Part B, you must pay
$43.80 per month. Social Security will automatically deduct this
amount from your check unless you instruct SSA not to. If you choose
not to pay for Part B coverage, and later decide that you do want it, you
will have to pay penalties in the form of higher premiums to enroll in
Part B. Materials included in this packet explain the differences
between Medicare Part A and Part B.
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Paying Past Medical bills: Medicare will only cover bills
incurred after the 24 month waiting period. You should tell your provider
to coordinate paying these bills with Medicare.
What If I Receive Both SSI and SSDI?
If you receive both SSI and SSDI you will be eligible for both MediCal
and Medicare, as described above. You will not have to pay the Medicare
premium of $43.80, however. If in the future you lose your SSI benefits
because annual cost-of-living increases in your SSDI benefits make you
ineligible for SSI, you will still continue to receive MediCal.
Continuing Disability Review Entitlement
For more extensive information about Continuing Disability Reviews, see
The Hawkins Center's Continuing Disability Review
Manual.
What is a continuing disability review?
When you are awarded disability benefits, the Social Security Administration
will schedule your case for review in the future to determine whether your
condition has improved and whether you remain disabled. If upon review
it is determined that your condition has not improved or, even if it has
improved, that you are still disabled, then your benefits will continue
to be paid. However, if it is determined that your condition has
improved and that you do not continue to meet Social Security's disability
criteria, then your benefits will be stopped. You will have the right
to appeal this decision and if your appeal is filed within 10 days of the
termination notice, your benefits will continue during the appeal.
When will your case be reviewed?
When you are originally found disabled your case will be calendared for
a review in one to five years, depending on the type of disability you
have and the likelihood that your condition will improve. Some people
with permanent conditions that will not improve (for example blindness
or paralysis) will not be reviewed.
How will you know when you are being reviewed?
Social Security will send you a letter telling you that your case is going
to be reviewed. You will be asked to fill out some forms about your
condition and recent medical treatment. You may also be asked to
see a doctor for an evaluation arranged by Social Security.
What can you do to prepare for the review?
You should continue to see your doctor as long as you are on disability.
Even if your doctor tells you that there is no treatment that will help
your condition, you should see your doctor at least every six months to
advise him or her as to how you are doing. If Social Security reviews
your case in a few years and you have not seen a doctor for more than a
year, it could be difficult to prove that your are still disabled. See
The Hawkins Center's Continuing Disability Review
Manual for more information.
Returning to Work
If you decide you want to try to go back to work, you should be aware of
Social Security's rules about work and how it may affect your benefits.
The rules are different depending on whether you receive SSI
benefits or Social Security disability insurance (SSDI)
benefits. Make sure you know which type of benefits you are receiving.
SSI Rules
Earned Income Exclusion – Your monthly benefits will be reduced
if you earn money from work. The amount of the reduction is determined
as follows: The first $65 you earn is not counted (if you have no
other form of income except your SSI and wages from work, the first $85
is not counted). After the first $65 (or $85) is disregarded, your
remaining income is divided in half and that amount is deducted from your
SSI check.
Example: Your only income is SSI in the monthly amount of $640
until you earn $295 the first month you work. Social Security will
not count the first $85 of earnings leaving $210 (295 - 85 = 210).
They will then divide that amount in half which comes to $105. Your
monthly benefit will be reduced to $535 (640 - 105 = 535) Note: this
reduction will occur the second month after the month you earned the money.
If you are a student and work - The rules are a little different.
Consult The Hawkins Center or SSA for
further information.
PASS Plans - This is a program which may allow you to set aside
income that would otherwise lower your SSI benefits to help you achieve
a goal of returning to work. It is a complicated program and your
PASS plan must be approved by SSA before it protects other income.
Consult The Hawkins Center or SSA for
further details.
Continued MediCal eligibility - If you work and your earnings
are so high that applying the rules above you would no longer be eligible
for a monthly SSI payment, you may still be eligible to receive MediCal
benefits. Again, you should consult The Hawkins Center or SSA
for more details.
SSDI Rules
Trial Work Period - You are entitled to try to work for up to 9
months without your work affecting your benefits. These 9 months
are called your Trial Work Period. The months do not have to be consecutive.
Once you have used up 9 trial work months in any 5 year (60 month) period,
you will have used up your Trial Work Period. A month is considered
a trial work month if you earn $200 or more in that month.
Extended Period of Eligibility (EPE) - After you have used up
your Trial Work Period, the next 36 months starting with the month after
your 9th trial work month, are called your EPE. During your EPE,
if you otherwise continue to meet the medical criteria for disability,
any month you earn less than $500 you will still be entitled to your monthly
disability payment. However, any month you earn $500 or more, your
benefits are suspended for that month. Your eligibility is determined
on a month by month basis depending on your income. Once you finish
the EPE, i.e., the 37 month, the first month thereafter that you earn $500
or more your benefits will be terminated and you will have to reapply for
benefits and again prove that you are disabled.
Continuing your Medicare if you work - If you continue to work
and earn more than $500 after your trial work period, even though your
benefits will stop you may still continue to receive Medicare for up to
39 months. Consult us or SSA for further details.
Rules that Apply to Both SSI and SSDI
Impairment Related Work Expenses - The amount of certain expenses
you may incur for items or services that are needed for you to be able
to work, may be deducted from your earnings for purposes of determining
whether you are still disabled or the amount of your benefit reduction
due to wages if you receive SSI. Generally speaking, an expense is
deductible if 1) the expense enables you to work, 2) you need the item
or service in order to be able to work, 3) you pay the expense and it is
not reimbursed from some other source, 4) the expense is reasonable, and
5) the expense was incurred in a month you were working or paid.
Examples: Mileage expenses to and from work are deductible, but
the cost of a car or other vehicle is not; medical devices such as wheelchairs
are deductible so long as the requirements above are met; drugs or other
treatments necessary to allow you to work may also be deductible, though
routine drugs or treatments for minor problems such as allergies, dental
treatment or optician services are not deductible.
Vocational Rehabilitation Services - If you are receiving vocational
rehabilitation services and you improve medically and are no longer disabled,
your benefits may continue. Consult us, your vocational rehabilitation
counselor or SSA for further details.
Reaching Retirement Age
SSDI Beneficiaries
When you reach age 65 Social Security will automatically convert you to
retirement benefits. It has no practical effect for you. The
amount of your check will not change and you will continue to have it deposited
directly to your account. You will also continue to be entitled to
Medicare.
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If you are 62 or older, and you receive workers compensation payments,
you received a workers compensation lump sum settlement in recent years
or you receive State Disability benefits: You may be better off
applying for early retirement benefits rather than receiving disability
benefits. Discuss this issue with your attorney.
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What if you were already receiving early retirement benefits when your
disability was granted? You will be converted to disability which
could mean an increase in your monthly benefit of up to 20%. You
will also be paid the difference between the early retirement that you
have already been paid and the disability you should have been paid for
earlier months. When you turn age 65 you will be converted to retirement
at the full rate rather than the reduced early retirement rate.
SSI Beneficiaries
When you reach age 65 Social Security will automatically convert you to
the "retirement" program. The amount of your monthly payment and
when you receive it will not change.
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If you are insured for Social Security Retirement benefits:
If you worked enough over your lifetime you may be insured for Social Security
Retirement benefits. If you are, you will be required to apply for
these benefits at age 62. Your SSI will be reduced by the amount
of your SS retirement benefit minus $20. That is, between both benefits
you will receive $20 more than you receive from SSI alone.
Overpayments
What is an overpayment?
An overpayment occurs when Social Security pays you money that it should
not have. This can happen for many reasons ranging from a change
in living situation to earning wages from work that were not reported to
Social Security. Social Security will notify you of an overpayment
by sending you a letter with the heading "Notice of Overpayment."
How do I respond to a Notice of Overpayment?
When you receive an overpayment you can appeal the overpayment, ask for
a waiver of the overpayment, or pay the overpayment back. You may
also both appeal and ask for a waiver - you do not have to do one or the
other.
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Appealing an Overpayment: You appeal an overpayment by filing
a Request for Reconsideration. You should appeal if the facts on
which the overpayment is based are wrong. For example, if Social
Security says you worked and earned wages when you did not, the facts are
wrong and you should appeal.
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Requesting a Waiver: A waiver should be requested if you were
overpaid but the overpayment was not your fault and you can not afford
to pay the overpayment back. For example, assume you went to work
and told Social Security you were working and how much you were earning,
but Social Security failed to reduce your benefits as it was supposed to.
Many months later Social Security catches its mistake and you receive a
Notice of Overpayment. The overpayment will be waived (i.e., you will not
have to pay it back) if you can prove 1) that you were not at fault for
causing the overpayment because you did report your work, and, 2) that
you cannot afford to pay the overpayment back because your monthly expenses
are nearly equal to your monthly income.
Paying the Overpayment Back: Social Security will reduce
your monthly benefit to pay the overpayment back. SSI recipients
cannot have a deduction of more than 10% of their monthly benefit (about
$65 for most people). There is no limit on how much can be deducted
from an SSDI recipient's monthly benefit. In either case, you can
negotiate with Social Security about how much the monthly deduction will
be. If you can show that you cannot afford to pay more than a certain
amount per month, Social Security may reduce the collection to that amount.
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The Hawkins Center
A Non-Profit Agency Providing Legal and Support Services
to People with Disabilities
101 Broadway, Suite 1, Richmond, CA 94804, Phone: (510)232-6611,
Fax: (510)232-2271
email: info@hawkinscenter.org
This page was last updated 3/4/99
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