Demystifying

Social Security offers two separate programs for people who are medically disabled. These two programs are Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). With two different programs available a common question is: Can I receive both SSDI and SSI if I am found disabled. The quick answer is yes, but it will all depend on earned income. When a claimant meets the technical requirements of both the SSDI and SSI programs it is called a concurrent claim. To qualify for SSDI you have to have worked long enough and more recent enough, while paying Social Security taxes, to meet the technical requirements of this program. The SSI program does not consider work in determining eligibility, but there are income and asset limits for the program which is intended for lower income claimants. If your income and assets are low enough to qualify for SSI, and you qualify for SSDI, it’s not likely you will receive benefits from both programs because you are not allowed to earn a higher monthly combined benefit than you would be eligible under the maximum SSI monthly payment of $710. If your SSDI amount, which is based on the taxes you paid while working, is more than $710 there would be no SSI eligibility. If a claimant’s SSDI amount is less than $710 per month the claimant would be technically eligible for both SSDI and SSI. Keep in mind that these are only the technically requirements of the program. Once Social Security determines that a claimant meets the technical requirements of one of the two disability programs the next step is to make a medical disability determination. Meeting the medical requirements of Social Security disability is no small feat of its own as most applicants will be denied on initial application. For more information about the requirements for the SSDI and SSI programs visit: http://www.ssa.gov/disability/.  

Social Security Commission Michael J. Astrue announced in July of 2012 that Adult Onset Huntington’s disease will be added to the Compassionate Allowance List as of December, 2012. This news follows the addition of Juvenile Huntington’s disease to the Compassionate Allowance List effective in August, 2012. The expedited disability process will identify people with significant symptoms of this devastating neurological disease. The condition, also called Huntington’s Disease, is an inherited brain disorder that usually appears between the ages of 30 to 50 and worsens over a 10 to 25 year period. Compassionate Allowances are a way of quickly identifying diseases and other medical conditions that qualify under the statutory standard for disability.  The Compassionate Allowances program “fast-tracks” disability decisions to ensure that Americans with some of the most serious disabilities receive their benefit decisions within weeks instead of months or years. Huntington’s Disease results in progressively worse cognitive, behavioral and physical symptoms. In the early stages, a person with the disease may experience subtle changes in mood, thinking and the ability to move. During the second stage of the disease, a person may lose the ability to work and may need help performing general activities of daily living. Many people experience difficulties with balance, swallowing and motor tasks may worsen, and a person may have difficulties with organizing information. Irritability, aggression and apathy are among the other worsening symptoms. In the later stages of Huntington’s disease, people usually need assistance with all activities of daily living. A person with Huntington’s disease may be unable to speak or respond to people but still comprehend what is happening. Involuntary movements may occur. Often, people must receive 24-hour care during the late stages of the disease. The diagnosis of Huntington’s Disease by itself it not likely to be sufficient to receive Social Security benefits. The Social Security Administration will consider the severity of your Huntington’s Disease to establish how this degenerative disorder is affecting your work-related abilities and daily functioning. By adding this disorder to the Compassionate Allowance list, Commissioner Astrue is allowing people who are experiencing severe symptoms of this tragic disease to have their claims for benefits considered faster than other applicants. For more information on compassionate allowance conditions please visit: http://www.socialsecurity.gov/compassionateallowances/

A technical denial is issued to a claimant who does not meet the non-medical requirements for one or more of the disability benefit programs through the Social Security Administration (SSA). If you do not meet the non-medical requirements for any of the SSA benefits programs your claim will not be evaluated for a medical determination. If you have filed for the Supplemental Security Income (SSI) program and receive a technical denial this means the assets of you or someone in your household exceed the established limits. The SSI program is a needs-based disability program. For a single person, the asset limit is $2000. For a married couple, the asset limit is $3000. However, the SSA does have some exemptions. For example, the SSA will exempt the value of one home and one car. More information can be found on the SSI Eligibility Requirements page of the SSA’s website. If you receive a technical denial for the Disability Insurance Benefit (DIB) program this is because you have not worked long enough or recently enough under the SSA’s rules. In order to qualify for DIB benefits you need to have earned enough work credits. You earn work credits by paying FICA taxes.  More information regarding work credits can be found in the Disability Planner section How Much Work Do You Need? on the SSA website. In order to qualify for DIB benefits you need to be found disabled prior to your Date Last Insured (DLI). Earning work credits extends your DLI.  As a general rule of thumb, you must have worked at least five of the last ten years to qualify for DIB benefits. If you have previously filed for DIB benefits and were denied after your DLI you will receive what is called a Res Judicata technical denial. The SSA issues the denial because they will not reevaluate an issue they have already made a determination on. For either SSI or DIB, if you are currently working over what the SSA considers Substantial Gainful Activity (SGA) you will receive a technical denial. For 2013 the SSA states that any work activity over $1040 gross income per month constitutes SGA. If you file and your income is over SGA you will be mailed a technical denial and your claim will not be processed. This means, basically,  that the SSA is unable to determine the merits of your case because you do not meet the technical requirements of one or both disability programs. Typically technical denials cannot be appealed.  But if your circumstances change you can file a new application. If you think that there is an appealable issue, i.e. the SSA made a mistake determining your asset value or work history information, you will have 60 days from the date of the technical denial to file an appeal.

Due to the high volumes of Social Security Disability claims waiting for a hearing by an Administrative Law Judge, the average wait time is between 12-15 months. This can be financially straining for many people pursuing disability claims. Clients frequently ask me if there is any way to speed up this process. The Social Security Administration (SSA) Office of Disability Adjudication and Review (ODAR) will expedite a claim if the claimant is in “dire need.” SSA classifies this as the inability to obtain food, medicine or shelter. In order to request an expedited hearing, please provide a written letter explaining your current financial situation. It is also important to show documentation, such as an eviction or foreclosure notice, to verify your financial need. Utility disconnect or shut-off notice are other examples of helpful documentation. It is very important to show proof of your hardship or SSA may not grant this request. If your request is granted it does not mean that your hearing will take place immediately but rather when the ODAR office is able to fit your claim into their schedule. ODAR offices are typically scheduling hearings two to three months in advance. Successful requests for expedited hearings may speed up the process by several months, potentially alleviating the financial difficulties experienced while awaiting your hearing. For more detailed information regarding this process, click here. (Section B, number 4).

Most people who file for Social Security disability never dreamed they would be asking the government for assistance because they could not longer work, but eventually they realize they have no other choice. As Americans we are told at an early age the importance of a hard day’s work, but what happens when you are no longer able to work because you are disabled? Many people who end up filing for Social Security disability express a sense of shame or embarrassment because they have to seek Social Security disability benefits. The truth of the matter is if it wasn’t for many of these same people there would be no Social Security disability program to speak of. Social Security Disability Insurance provides benefits to those who have spent the better part of their lives working and paying Social Security taxes. The only way to meet the technical requirements for this program is to work long enough and recently enough to qualify if you are found disabled. In a sense, these people are asking to benefit from a program they helped create by paying their taxes. There is certainly no shame in that. Supplemental Security Income is a bit different as it is not based on work history. This program is for the people who fall through the cracks and don’t have enough work credits to qualify for Disability Insurance. As long as income and asset levels do not exceed Social Security’s limitations those who have never worked, or not worked long enough because of disabilities, have a safety net. The main message for anyone seeking the assistance of these programs because they can no longer work due to physical and or mental health disabilities is there is nothing to be embarrassed about in asking for help and accessing programs specifically designed to help you.