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Social Security Basics: “How long do I need to be off work?”

By Lauri Watkins on May 13, 2013

If you, or a loved one, are diagnosed with a severe or aggressive condition, you may qualify to be immediately approved!

     One question that I am asked frequently by folks considering applying for Social Security Disability is “How long do I need to be off work?”  This question is based on a slight misunderstanding of the Social Security rules.  Your medical condition, or combination of conditions, that prevents you from working must have lasted or be expected to last a minimum of one year, (or be expected to result in death), in order for you to qualify for Social Security Disability.  That year does not need to have passed, in order for you to file your application.  If your condition is not expected to get better, or if a long course of treatment is planned that would take you out past one year, then you can file your initial application.  If there is clear medical evidence that you will be unable to work for at least a full year, there is no need to wait for the year to elapse before starting!

If you have not been off work for an entire year, but your condition is expected to last at least that long, you should apply right away.

      If your condition is not expected to get better, or if a long course of treatment is planned that would take you out past one year, then you can file your initial application.  If there is clear medical evidence that you will be unable to work for at least a full year, there is no need to wait for the year to elapse before starting!

     If you have not been off work for an entire year, but your condition is expected to last at least that long, you should apply right away. Benefits can’t begin until you have been disabled for five months, and an initial application usually takes 3-5 months (sometimes longer) to process, so the sooner you file your application, the sooner you may get your benefits.

     Of course, Social Security may deny your claim initially anyway, in which case you should appeal the decision.  We have had several clients who hit the one-year duration mark while we were in the appeals process.  A Social Security claim can take up to two years (sometimes longer) from the initial application until adjudication at a hearing, so the sooner you start, the better.

     If your diagnosis is terminal, Social Security will make every effort to expedite the processing of your claim.  I find it heartening that we don’t receive many inquiries for assistance from people with terminal conditions; I take this to mean that Social Security is doing the right thing and approving them right away.

     Social Security has a list of conditions that are automatically approved, called Compassionate Allowances Conditions – if you, or a loved one, are diagnosed with a severe or aggressive condition, you may qualify to be immediately approved!  Check the following list at Social Security’s website:

http://www.ssa.gov/compassionateallowances/conditions.htm

     When you file your application, be sure to point out that you believe your condition is on the list.

     I also receive calls with a variation on this question, from folks who are still working: “How can I get my Social Security started, so I can stop working?”  This call is not from people who are attempting to somehow ‘game’ the system, but rather folks who have been told by their doctors that they should stop working, or people who know that their work activity is exacerbating their medical conditions – but who can’t afford to stop working without a guarantee of income.  Unfortunately, this is one of the many Catch 22s of the Social Security Disability world – there is no way to get your benefits started up, until you stop working*. 

     One of the first things that Social Security will do, when you file your application, is look up your recent and current earnings.  If you are still working at a level considered above SGA (Substantial Gainful Activity), then they will not even order your medical records.  The fact that you are working, proves that you can – whether or not your doctor has said that you shouldn’t, whether or not you are in pain, whether or not working is causing your condition to get worse.

     Please, do not hesitate to contact us if you have questions about Social Security Disability.

 

*There is a level of earnings under which Social Security doesn’t count your income against you; this level is called “Substantial Gainful Activity”, and it can vary from year to year. In 2013, earnings under $1,040 per month are considered less than Substantial Gainful Activity, though any earnings will cause Social Security to more closely scrutinize your claim (considering, for example, whether you could perform your currently part-time job on a full-time basis, etc.).  A year-by-year look at the Substantial Gainful Activity amounts can be found at http://www.ssa.gov/oact/cola/sga.html

 

Photo credit: Viewminder / Foter.com / CC BY-NC-ND

Topics: Social Security

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Media Portrays Social Security as an Avenue to Benefits for the Unemployed – WRONG! It’s Not That Simple…

By Susan C. Andrews on May 9, 2013

The Social Security Administration turns down many worthy applicants when they first apply.

     There is a lot in the news these days about the Social Security Disability Program, with some pundits suggesting people are getting on benefits simply because they are unemployed, or because they claim to be injured or ill when in fact they are able-bodied and fully capable of working. Every day, all day, I work with people filing for Social Security Disability benefits. So I work with the program’s rules – yes, there are rules for deciding these cases – it is not enough just to claim to be disabled. And I come face to face with individuals who are struggling, sometimes with a major health issue such as cancer, or rheumatoid arthritis, or Multiple Sclerosis. Other folks have multiple health problems that have combined to force them from the labor market. All of them have medical records, often reams of them, documenting diagnoses, chronicling surgeries and other treatment regimens. This is one big thing I think the general public does not know: a person must have one or more diagnoses from a qualified physician that could account for the symptoms and limitations he or she is reporting to Social Security. There must be convincing medical documentation. Much of my day is spent obtaining and reviewing the medical records of my clients, and ensuring that the decision-makers at Social Security also see them.

…the medical condition must be not only serious, but also prolonged.

     Many people are not familiar with Social Security’s definition of disability or the program’s rules, so they do not realize that the disabling medical condition or conditions must be serious enough to have prevented the person from working for AT LEAST 12 continuous months. If the individual has not yet been out of the labor market for a period of at least one year, it must be very clear that this will be the case. In situations where there is doubt about this, Social Security typically turns down the claim. I have had callers who have been unable to work for a few months while going through chemotherapy treatment for cancer, but have been able to get back to work in less than one year. They do not qualify for Social Security Disability benefits. So the medical condition must be not only serious, but also prolonged.

     One broadly held belief about Social Security Disability is, in fact, true: The Social Security Administration turns down many worthy applicants when they first apply. It is necessary to appeal (the first appeal is called a Request for Reconsideration). Often, a second denial follows. Then it is necessary to request a hearing in front of a judge. For a person who is too sick to work, not feeling well, and home alone trying to navigate this system, it can be daunting. One of the joys of my practice is our capacity to lend support to such individuals, to take the reins of the case and drive it forward, so my client can concentrate on taking care of herself or himself while I and my staff handle the legal stuff.

     We are able to offer representation to people at any stage in the process, including initial application. We are happy to talk with callers who are weighing their options, and simply need information in order to know whether to apply for benefits in the first place. There is no charge for such calls, so do not hesitate to contact us if you have questions about Social Security Disability.

Photo credit: Thomas Hawk / Foter.com / CC BY-NC

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Skilled Maintenance Services Can Be Covered by Medicare

By Kit Case on March 28, 2013

Today’s post comes from guest author Jon Gelman from Jon Gelman, LLC – Attorney at Law.

A settlement was recently reached in a pending Federal Court case tht will benefit Medicare beneficiaries who require skilled services. The Centers for Medicare and Medicaid Services (CMS) will no longer require that a patient “improve” inorder to be entled to services. Jimmo v. Sebelius, No. 11-cv-17 (D.Vt.), filed January 18, 2011

“New policy provisions will state that skilled nursing and therapy services necessary to maintain a person’s condition can be covered by Medicare.”

See: “Settlement Reached to End Medicare’s “Improvement Standard”

Read more about Social Security

Burn Pit Lung Condition Added to Social Security List of …
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The Social Security Administration has added to its list of compassionate allowances a pulmonary condition that has been identified as arising out of exposures to burn pits fumes and dusts in Iraq and Afghanistan.
http://workers-compensation.blogspot.com/
 
Coordinating Workers Compensation & Social Security: The Inequity
Aug 03, 2012
“If a worker becomes eligible for both workers’ compensation and Social Security disability insurance benefits, one or both of the programs will limit benefits to avoid making excessive payments relative to the worker’s past …
http://workers-compensation.blogspot.com/
 
Workers’ Compensation: Employer Not Permitted to Stop Temporary …
Aug 13, 2012
An employer cannot stop paying workers’ compensation benefits merely because the injured worker was awarded Social Security Disability benefits. In fact, the premature termination of temporary disability benefits was …
http://workers-compensation.blogspot.com/
 
Workers’ Compensation: $85 Million Verdict Against KBR for …
Nov 03, 2012
The Social Security Administration has added to its list of compassionate allowances a pulmonary condition that has been identified as arising out of exposures to burn pits fumes and dusts in Iraq and Afghanistan.
http://workers-compensation.blogspot.com/

 

 

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Social Security Announces 1.7 Percent Benefit Increase for 2013

By Kit Case on January 24, 2013
Roosevelt Signing the Social Security Act in 1935

Today’s post comes from guest author Jon Gelman from Jon Gelman, LLC – Attorney at Law.

Monthly Social Security and Supplemental Security Income (SSI) benefits for nearly 62 million Americans will increase 1.7 percent in 2013, the Social Security Administration announced.

The 1.7 percent cost-of-living adjustment (COLA) will begin with benefits that more than 56 million Social Security beneficiaries receive in January 2013.  Increased payments to more than 8 million SSI beneficiaries will begin on December 31, 2012.

Some other changes that take effect in January of each year are based on the increase in average wages.  Based on that increase, the maximum amount of earnings subject to the Social Security tax (taxable maximum) will increase to $113,700 from $110,100.  Of the estimated 163 million workers who will pay Social Security taxes in 2013, nearly 10 million will pay higher taxes as a result of the increase in the taxable maximum. 

Information about Medicare changes for 2013, when announced, will be available at www.Medicare.gov.  For some beneficiaries, their Social Security increase may be partially or completely offset by increases in Medicare premiums.  

The Social Security Act provides for how the COLA is calculated.  To read more, please visitwww.socialsecurity.gov/cola. 

2013 Social Security Changes

 

Cost-of-Living Adjustment (COLA):

Based on the increase in the Consumer Price Index (CPI-W) from the third quarter of 2011 through the third quarter of 2012, Social Security and Supplemental Security Income (SSI) beneficiaries will receive a 1.7 percent COLA for 2013. Other important 2013 Social Security information is as follows:

Tax Rate:
 2012 2013
Employee 7.65%* 7.65%
Self-Employed 15.30%* 15.30%
NOTE:  The 7.65% tax rate is the combined rate for Social Security and Medicare.  The Social Security portion (OASDI) is 6.20% on earnings up to the applicable taxable maximum amount (see below).  The Medicare portion (HI) is 1.45% on all earnings.
* The Temporary Payroll Tax Cut Continuation Act of 2011 reduced the Social Security payroll tax rate by 2% on the portion of the tax paid by the worker through the end of February 2012.  The Middle Class Tax Relief and Job Creation Act of 2012 extended the reduction through the end of 2012.  Under current law, this temporary reduction expires at the end of December 2012.
 
Maximum Taxable Earnings:
 2012 2013
Social Security (OASDI only) $110,100 $113,700
Medicare (HI only) N o   L i m i t
 
Quarter of Coverage:
 2012 2013

Earnings needed to earn one Social Security Credit

 $1,130 $1,160
 
Retirement Earnings Test Exempt Amounts:
 2012 2013

Under full retirement age

NOTE: One dollar in benefits will be withheld for every $2 in earnings above the limit.

 $14,640/yr.
($1,220/mo.)		 $15,120/yr.
($1,260/mo.)

The year an individual reaches full retirement age

NOTE: Applies only to earnings for months prior to attaining full retirement age. One dollar in benefits will be withheld for every $3 in earnings above the limit.

There is no limit on earnings beginning the month an individual attains full retirement age.

 $38,880/yr.
($3,240/mo.)		 $40,080/yr.
($3,340/mo.)
 
Social Security Disability Thresholds:
 2012 2013

Substantial Gainful Activity (SGA)
     Non-Blind
     Blind

 $1,010/mo.
$1,690/mo.		 $1,040/mo.
$1,740/mo.
Trial Work Period (TWP) $720/mo. $750/mo.
 
Maximum Social Security Benefit: Worker Retiring at Full Retirement Age:
 2012 2013
  $2,513/mo. $2,533/mo.
 
SSI Federal Payment Standard:
 2012 2013
Individual $698/mo. $710/mo.
Couple $1,048/mo. $1,066/mo.
 
SSI Resources Limits:
 2012 2013
Individual $2,000 $2,000
Couple $3,000 $3,000
 
SSI Student Exclusion:
 2012 2013
Monthly limit $1,700 $1,730
Annual limit $6,840 $6,960
 
Estimated Average Monthly Social Security Benefits Payable in January 2013:
 Before
1.7% COLA		 After
1.7% COLA
All Retired Workers $1,240 $1,261
Aged Couple, Both Receiving Benefits $2,014 $2,048
Widowed Mother and Two Children $2,549 $2,592
Aged Widow(er) Alone $1,194 $1,214
Disabled Worker, Spouse and One or More Children $1,887 $1,919
All Disabled Workers $1,113 $1,132
 

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Social Security Statements – Now Available Online (And ONLY Online!)

By Lauri Watkins on May 31, 2012

Many people don’t realize that Social Security stopped mailing out annual Statements in 2011, but indeed they did. Citing budget concerns and a little-used ‘emergency’ ruling stating that it’s okay for the Social Security Administration to stop fulfilling one of its legally-mandated functions if doing so could potentially bankrupt the agency or impair its ability to fulfill its primary function, Social Security stopped sending out individual Social Security Statements. In fact, they also ceased fulfilling requests for statements received by mail or telephone, and disabled their online ordering service. The only way you could obtain your Statement was to go down to your local Social Security Office and tell them you had an ‘urgent need’ for the information!

Now, Social Security has (finally!) rolled out online (and IMMEDIATE) access to your Statement, including your earnings history, estimated benefit amounts, and eligibility information. And fortunately, they have made it incredibly easy!

All you need is:

  • your own personal information (full name, Social Security number, date of birth, mailing address, phone number)
  • and working email address.

Start at Social Security’s website. On the left-hand menu, go to ‘Get Your Social Security Statement Online’, and follow the prompts. Social Security uses a program called Experian to verify your personal data, so be prepared to answer some interesting multiple-choice questions, including

  • phone numbers and addresses that you may have used in the past,
  • dates that you opened specific credit accounts,
  • or where you send your mortgage payment.

You can also choose an added layer of security, by asking Social Security to send a text message to your mobile device anytime you log in to your account.

Note, however, you are actually setting up a ‘my Social Security’ account – - the same type of account that people RECEIVING benefits have – - not just accessing a Statement. Please be prepared to keep track of your login information, as you not only may need to access your Statement again over the years as new earnings are posted, but you may also one day need this account to set up your own Medicare, Retirement, or Disability benefits. Keep this login information in a safe and secure location, and do not share it with others to maintain your security.

Topics: Social Security

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