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Social Security Essentials In Brief
John LaMotte Staff Assistant/State
Liaison john.lamotte_at_ssa.gov
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Earning Credits

• 40 Credits for Retirement
• Disability Varies by Age
• Maximum 4 credits in 1 year
• 1,090 earnings 1 credit

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Retirement Benefits

• Worker
• Reduced benefits as early as age 62
• Full benefits at age 65-67
• Increased benefits after full retirement age
  (FRA)
• Wife or Husband
• As early as age 62
• At any age if caring for child under age 16 or
  disabled
• Divorced spouses may qualify if married 10 years
• Child
• Unmarried and up to age 18 or 19 if still in high
  school
• Any age if disabled before age 22

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Survivor Benefits

• Widow(er)
• Reduced benefits as early as age 60 or, if
  disabled, age 50.
• Lesser reduction percentage - 28 _at_ age 60
• At any age if caring for a child of worker under
  age 16 or disabled before age 22
• Divorced widow(er) may qualify if married at
  least 10 years
• Unreduced benefit is usually the same
• as that worker would have received

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Survivor Benefits (cont)

• Child (unmarried)
• Under age 18 or 19 if still in high school
• Any age if disabled before age 22

• 255 Lump Sum Death Benefit
• Surviving spouse or minor/disabled children only

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How Work Affects Retirement Benefits

• Age Earnings Limit Reduction
  Above
• 60 to FRA 14,160 (1,180/mo.) 1
  for every 2
• FRA Year 37,680 (3,140/mo.) 1
  for every 3
• Month of FRA Earnings no longer affect
  benefits
• First Year Wages before filing month may be
  excluded, but additional work must be under the
  monthly limit .
• Limits apply to both workers, dependents
  survivors
• www.ssa.gov/planners/morecalculators.htm
  --estimate how
• work may affect benefits

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Social Security Disability Programs
2009
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Social Security Disability Programs

• Supplemental Security Income (SSI)
• Social Security Disability (SSD)
• - Benefits on wage earners own work
• record
• Disabled Adult Child (DAC) benefits
• through a parents record
• Disabled Widow(er)s Benefits

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Supplemental Security Income

• Needs-based program for people with
• limited income and resources
• Aged - 65 or older
• - Disabled/Blind Any age
• Funded by general tax revenue
• Recipients usually qualify for Medicaid
• - separate application required with
• Ohio Dept. Job Family Services

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Eligibility for SSI - Income

• Earned unearned income treated differently
• If married, income of spouse is considered
• At age 18 or older, income of parents is not
  considered
• Parents income affects eligibility of child

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SSI Income Limits

• If all income is unearned, maximum income allowed
  for an individual 674/month in 2009 (1,011
  couple)
• If income is all earned or a combination of
  earned/unearned, maximum income allowed for an
  individual 1,433/month in 2009
• Limits change each year

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SSI Resource Limits

• Individual 2,000 // Couple 3,000
• Examples
• Cash
• Bank accounts
• Stocks, bonds
• Life Insurance Cash Value
• Vehicles
• Personal property
• Land or real property

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Disabled Adult Child (DAC) Benefits

• Must be
• 18 or older and disabled with condition(s) that
  occurred before age 22
• Unmarried unless to an SSA beneficiary
• No substantial work after age 22

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Social Security Disability

• Income Resources do not affect eligibility
• Requires recent work
• - Age 31 must have 20 credits in last 10 years
• - Fewer number required for younger workers
• May be retroactive up to 1 year
• Dependent benefits may be payable
• - Same Benefits as for a Retired Worker
• Eligible for Medicare after 24 months
• Provisions to assist in returning to work

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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. 980 month
non-blind 1,640 month blind
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Approval vs. Denial Rate

• About 31 of initial claims are approved
• Average SSDI benefit in 2009 1,064/month
• Maximum SSI benefit in 2009 674/month for
  individual 1,011/month for
  disabled couple
• About 65 of initial claims are denied
• Note With 5.8 COLA

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Application Process - SSI

• Complete online Disability Report and transmit to
  Social Security
• Print medical releases and return them to Social
  Security and,
• Make appointment to complete non-medical
• application 1 800 772 1213
• Parent cannot sign documents for an adult
  child unless he/she is a legal guardian

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Application Process - SSD

• All application forms and reports may be
  completed on-line, or
• Make appointment to complete non-medical
• application and/or medical report
• 1 800 772 1213
• Disabled Adult Child (DAC) application is not
  available online

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The Disability Decision Process

• Claim sent to Disability Determination Service
  (DDS) in Columbus for medical decision
• Most cases decided within 100 days
• May expedite decision by submitting medical
  evidence with claim
• If other evidence becomes available while
  decision is pending, call DDS adjudicator at
  1-800-282-4550 for instructions on faxing medical
  evidence

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If Claim is Denied - Appeals

• Applicant receives denial letter
• 60-day appeal period
• Four Levels of Appeal
• Reconsideration
• Administrative Law Judge Hearing
• Appeals Council (Falls Church, VA)
• U.S. District Court
• Appeals may be filed online or by appt

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The iAppeal Process

• Agency continues to move towards fully electronic
  process
• Allows reconsideration/hearing requests AND
  Disability Appeal Report to be transmitted online
• Receipt date of appeal is the date the iAppeal is
  electronically submitted

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Submitting the iAppeal

• The iAppeal can be submitted by
• Claimant or
• Authorized representative or
• Other third party

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Requirements To Use iAppeal

• Have applied for benefits
• Have received a "Notice of Disapproved Claim", a
  "Notice of Reconsideration", or "Notice of
  Federal Reviewing Official Decision", and have
  notice available when beginning this process
• Disagree with medical disability decision
• Live in U.S. or one of its territories

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Advantages of iAppeal

• No lost appeals
• Reduces delays
• Secure
• Instant receipt upon submission
• Saves money by eliminating need for certified
  mail
• Minimizes follow ups to representatives and
  claimants

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Make This Link a Favorite www.socialsecurity.gov/
disability/appeal
Scroll Down
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Working While Disabled

• For information about
• Employment support for people with disabilities,
  visit The Work Site at www.socialsecurity.gov/wo
  rk/index.html
• Social Securitys Ticket to Work program
  www.yourtickettowork.com
• Red Book for Employment Support
  www.socialsecurity.gov/redbook/

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SSI/SSD Shared Work Incentives

• Ticket to Work
• Impairment Related Work Expenses
• Subsidy Special Conditions
• Unsuccessful Work Attempts
• Expedited Reinstatement of Benefits
• Vocational Rehabilitation Continued Payment
  Section 301

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Work Incentives for SSI

• Earned Income Exclusion
• Student Earned Income Exclusion
• Plan to Achieve Self-Support
• Medicaid while working 1619(b) (up to 33,194)
• Automatic Reinstatement (within one year)

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Filing for Benefits
One Option Not making an appointment
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Filing for Benefits

• Better Options
• Via the Internet at www.socialsecurity.gov
• Appointment in the office or over the telephone
• - Call 1-800-772-1213
• When to Contact Social Security
• Up to 3 months before you retire or attain age 62
• If over age 62, contact Social Security in or
  before January of the year you wish to receive
  benefits

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Medicare Coverage

• Part A - Hospital Insurance
• Covers inpatient hospital expenses
• 40 Credits Earned?
• No Premium
• Enroll anytime
• 2009 deductible 1,068

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Medicare Coverage
Part C Advantage Plans

• Replaces Part A B
• Managed Care HMO / PPO or
• Private Fee-for-Service
• Private Company Providers
• May have higher premium
• Must use plans prescription plan
• Defined Service Area
• Lock In Defined periods to switch
• plans, go back to A B

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Medicare Coverage
Part D Prescription Drug Plans

• Part A or B enrollment required
• Comprehensive Drug Benefit
• 60 Plans in Ohio in 2009
• Different formularies, co-pays, pharmacies,
  authorization rules, etc.
• Sign up with Medicare or the Plan itself
• Review Plan every year Nov. 15 Dec. 31

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Medicare Coverage

• Part B ( Supplemental Medical Insurance)
• Covers 80 doctor bills and outpatient medical
  expenses after 135 calendar year deductible
• 2009 Monthly Premium 96.40
• Defined Enrollment Periods (or penalties!)
• Private Medigap policies supplement

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For People Who Already Receive Social Security

• Change an Address
• Replace a Medicare Card
• Request a Form SSA 1099
• Request a Benefit Verification Letter
• Get a Password

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Social Security Resources

• 1-800-772-1213 7 a.m.- 10 p.m. M-F
• Local offices 9 a.m.-4 p.m. M-F
• www.socialsecurity.gov

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Thank You !

• Questions, comments, or concerns?

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