Demystifying

Our law office represents a lot of clients who used to receive Social Security disability payments, but for some reason are no longer found disabled by Social Security. This can and does happen and those who are currently receiving Social Security disability should know that Social Security may check-up with you in a few years to determine whether you are still disabled. The process for reviewing Social Security disability recipients is known as a Continuing Disability Review. Social Security states that the “Social Security Administration reviews disability cases periodically if the person with a disability still meets SSA disability rules.”  A CDR that examines whether a Social Security disability recipient has shown medical improvement to a degree that benefits are no longer appropriate, are broken down into three categories including: A recipient where medical improvement is expected (CDR is done one to two years after the disability approval). A recipient where medical improvement is possible (CDR is done three to five years after the disability approval). A recipient where medical improvement is NOT expected (CDR is done five to seven years after the disability approval). Some Social Security recipients, who’ve been collecting payments for years, may report that Social Security has never done a CDR. This is quite possible because the CDR backlog at Social Security has been increasing since 2002, but that could change. In 2012 Congress supplied $1.4 billion to Social Security for “integrity funding.” Most of this money is expected to fund the 1.5 million CDR claims that are currently backlogged. Social Security recipients who are under the age of 50 and whose disabilities have been identified for either “expected” or “possible” improvement face the greatest chance of being selected for a full medical review. If a recipient’s case was chosen for a CDR and Social Security determined that recipient is no longer disabled, the recipient will receive a termination of benefits notice. The recipient will have 15 days to appeal the decision and would be able to continue to collect benefits while the decision is made on the appeal. To learn more about the CDR process click here.  

Most years the Supplemental Security Income maximum  benefit increases. Supplemental Security Income benefits automatically increased in 2013 because there was an increase in the Consumer Price Index (CPI) from the third quarter of 2010 to the third quarter of 2012.  As of January 1, 2013, the federal benefit rate is $710 for an individual and $1,066 for a couple. Supplemental Security Income benefit amounts and state supplemental payment amounts vary based upon income, living arrangements, and other factors. The current living arrangement is another factor used to determine how much SSI a person can get. Supplemental Security Income benefits may vary depending on where you live such as a house, apartment, or mobile home, or in someone else’s household. Other possible living situations include group care or board, care facility or in an institution. Social Security may reduce SSI benefits because of living arrangements in the following circumstances: If a person lives in another person’s house, apartment, or mobile home, and pays less than their fair share of food or housing costs; or live in your own house, apartment, or mobile home, and someone else pays for all or part of your food, rent, mortgage, or other things like electricity and heating fuel; or are in a hospital or nursing home for the whole month and Medicaid pays for over one half of the cost of your care; or are a minor child and private insurance and Medicaid together pay over half your bill; or are in a public or private medical treatment facility and Medicaid is paying for more than half the cost of your care.  If you live in a funded facility for one whole month, your SSI benefit is limited to $30 (plus any supplementary state payment).  Social Security may lower the benefit amount if you have other income. If a person is homeless Social Security calculates the benefit amount the same as a person who lives in their own house, apartment, or mobile home. If a person lives in a homeless shelter or public shelter for a period of six out of nine months a person can receive up to the maximum SSI benefit payable in the state of Minnesota.

The Social Security Administration (SSA) provides disability benefits to those who are blind and are unable to work. If you are blind and have worked in the past under the SSA’s rules you may qualify for Disability Insurance Benefits (DIB). If you are blind and do not qualify for DIB benefits, you may still be eligible for Supplemental Security Income (SSI) benefits if you meet the financial need requirements. For a single person to qualify for SSI your countable resources must be under $2000. For a married person, their countable resources must remain under $3000. The SSA considers someone to be legally blind if your vision cannot be corrected to better than 20/200 in your best eye or if your visual field is less than 20 degrees in your better eye. If you do not meet the SSA’s definition of legally blind you may still be found disabled if vision problems alone, or in combination with other health conditions, prevent you from maintaining gainful employment. If you are legally blind and applying for SSI benefits you may be eligible to receive Presumptive Blindness payments while the SSA evaluates your claim. Presumptive Blindness payments can be paid for up to six months while the application is processed. The SSA will also allow you to request any correspondence that is sent to be provided in different formats. For example, they can mail letters in larger fonts or in Braille. The SSA will also provide information on audio CDs. To request this service you can call the SSA at (800) 772-123 or go online to their website at www.ssa.gov/notices. For more information on claim processing and services for the blind or visually impaired please refer to the SSA’s publication “If You Are Blind Or Have Low Vision – How We Can Help.”

A number of contributing factors have resulted in an increase in the number of Social Security disability claims filed over the last 40 years. In 1970 there were 1.4 million disabled workers who received Social Security Disability Insurance (SSDI). That number nearly increased six fold by 2011 as 8.3 million people were collecting SSDI benefits according to the Congressional Budget Office, which recently released a report on SSDI policy options. The report indicated that there were three main reasons why SSDI claims have increased so much over the last 40 years. These reasons include the aging Baby Boom Generation, changes in federal policy and changes in opportunities for employment and compensation. To learn more about policy changes recommended by the Congressional Budget Office visit: http://www.cbo.gov/sites/default/files/cbofiles/attachments/43421-DisabilityInsurance_screen.pdf    

Obliterative Bronchiolitis is a very rare and non-reversible form of obstructive lung disease. When someone suffers from this condition a small airway in the lungs becomes compressed and narrowed by scar tissue or inflammation. In these types of cases, the disease is extremely serious and can be fatal.  Common symptoms of the condition include obstruction of the airway, scarring in the airway of the lungs, wheezing, shortness of breath, fatigue and dry cough. Some possible causes that lead to the development of Obliterative Bronchiolitis can be related to collagen vascular disease, rejection of a transplant organ, viral infections, drug reactions, aspirations, toxic fume exposure or rheumatoid arthritis. However, today it is unclear what exactly causes the condition itself. One of the causes of this rare lung disease is exposure to toxic fumes. According to the Veterans Administration, open-air burn pits were used to destroy waste products that included “chemicals, paint, medical and human waste, metal/aluminum cans, munitions and other unexploded ordnance, petroleum and lubricant products, plastics and Styrofoam, rubber, wood, and discarded food.” Yet, a report from the Institute of Medicine has not fully convinced the VA that there are long-term health concerns caused from toxic exposure to burn pits. This condition is rare, irreversible and can be life threatening.  Since August 2011 the Social Security Administration recognized this condition for compassionate allowance which helps many veterans and other people inflicted with the disease receive Social Security disability benefits more quickly. “This is a huge breakthrough for us,” Army Chief Warrant Officer 4 Neil Rogers said in an Army News Times article. The former helicopter pilot has the disease and can’t work because of his symptoms. “It practically guarantees us benefits.”  Early detection of this condition is very important. The condition is irreversible and can become actively progressive. Early diagnosis allows medical intervention to prevent additional medical problems down the line. In the event of the most serious case, lung transplant surgery can be the only means for effective treatment. Other types of treatment for less serious cases include types of breathing support and many medications to help open the airway. When filing for Social Security be sure to provide all test results, medical records, and professional medical statements to ensure accurate approval of benefits. The more detailed information you are able to provide the more likely Social Security will not make you go through a secondary review or appeal.

Supplemental Security Income (SSI) benefits are paid to disabled individuals who also have little or no financial resources. Since SSI benefits are paid based on financial need your living arrangement may impact the amount of benefits you are eligible for. The Social Security Administration (SSA) considers where you live and who pays for your food and shelter while defining your living arrangement. For 2013, the maximum monthly SSI benefit amount is $710. The SSA will assess the value of any shelter or food you are being given and make a deduction on based on that.  This typically occurs when you are living with another person and not paying any rent or not paying what the SSA considers to be market value for rent. A deduction is also made if you are living in an institution run by a federal, state, or local government or living in a hospital/nursing home and Medicare pays for over one-half of the cost of your care. If the SSA decides that a deduction to your SSI benefits is necessary based upon your living arrangement you will receive a letter detailing the deduction. If you believe there is an error in their deduction or living arrangement has changed you need to contact your local office right away. It is important to inform the SSA of any changes; failure to inform the SSA could result in an overpayment if it is later deemed your benefits should have been reduced. For more information on this topic please view the SSA’s article “Effect of living arrangement on my SSI benefits.”