Questions I am Asked

 

The purpose of this section of the newsletter is to continue expanding your knowledge of Social Security benefit programs and other benefits received by individuals with disabilities.  Send me your question(s).

 

Question

Can you please ‘school’ me on what is likely to happen to an Asperger’s Syndrome child still in high school, who currently receives a small SSI check and a larger Survivor benefits check and turns 19 in May? Because he is disabled, I am assuming that the Survivor benefits will continue, as before, even though he has reached age 19?

 

Answer

You must determine if Social Security is conducting or has completed an “age 18 redetermination.”  A child would have to be found disabled by SSA to draw SSI.  At 18 years of age, the children’s medical criteria ends and the (now) young adult must qualify under the adult medical standards to continue receiving Childhood Disability Benefits (CDB) (you use the term Survivor benefits) and, possibly, an adjusted SSI benefit depending on the amount of CDB and her/his state of residence.

Question

I attended your training over a year ago, and use the information from it all the time. Lately, I have been dealing with questions regarding 5-week work months. Would you remind me exactly how those are determine when most months have a similar amount of days? I am assuming March is a 5-week work month, but what makes it so?

 

Answer

SSI counts wage when it is received or available to the recipient.  If the person is paid on a weekly basis it is possible to receive five pays in one month.  This would not be the case if the person is receiving Title II (SSDI or CDB).  Title II counts the total wage for the month, not the amount received during the month.

 

Question

My husband and I are Legal Guardian to my 14 year old niece. Her parents are both bipolar and on SSI disability benefits. Is my niece eligible for a benefit as well seeing that her parents do not support or take care of her???

 

Answer

A child is not eligible for any benefit because one or both parents is/are drawing SSI.  If she is found disabled and financially needy by Social Security, she may qualify for SSI.

 

Question

Have a client who stopped earning SGA in March 2011. She had been hired 20 years ago to work 40 hours per week and continued to do so the last year, by using FMLA whenever symptoms flared up and she could not go to work. She ran out of FMLA. She submitted a letter to her employer from her mental health doctor stating that she could work no more than 15 hours a week. The employer said they have no part time positions, and put her on short-term disability until April 24^th. She will receive full pay while on short-term disability.

 

On April 24^th, her doctor submitted a letter stating she needed to extend her short-term disability and consider long-term disability through her employer, which can be a maximum of one year. Her pay will be above SGA. During short-term disability, the company pays her health insurance premiums. Also, for the one year of long-term disability, the company pays her health insurance premiums. After one year of long-term disability receiving 60% of gross wages, she will be terminated from the company if she is unable to return to work.

 

She has been approved by the DDS (Disability Determination Service), based on medical disability only, without regard to income, and is receiving Kansas Medicaid. She has been denied by Social Security for SSDI, because she earned above SGA the previous 12 months. Two attorneys declined to file an appeal because of the SGA issue.

 

(Sender's) Questions:

1. For purposes of determining SSDI eligibility, will short term and long term disability through work be considered earned income? If so, she will still be over SGA.

 

2. When should she apply again for SSDI given the scenario? Her employer’s long term disability carrier will require her to file for SSDI.

 

Answer

Since the Disability Determination Service found her disabled to qualify for Medicaid it would be a fair assumption they would also find she meets Social Security’s medical criteria. 

 

Short-term disability insurance paid under an employer’s plan are considered wages for the first six months and after that the insurance payment is no longer considered wages.  In addition, any portion of the payment attributable to the employee's own contributions to the plan are not wages.  Since a portion of the payments are a return on the employee's premium rather than pay for service.  

 

To qualify for disability benefits she must demonstrate she will be unable to perform Substantial Gainful Activity (SGA), due to her disability, for twelve months, prior, or after she applies.  Six months of the short -term disability are considered wages, but she has no countable earned income.  When Social Security is considering her application they are required to only looking at the amount she earned not what she was paid.  Obviously, if she is not working, none of this income would not be considered countable earned income.

 

Another issue that must be considered is, does she have the ability to perform SGA?   Her doctor has stated she is able to work 15 hours per week.  (The person sending these questions did not state her occupation or hourly wage.)  If she held a position that paid $20.00 per hour, she has the ability to perform SGA ($20.00/hr x 60 hours = $1,200).  Thus she would not qualify for benefits since there are no work incentives that could used to reduce the potential income.  If she held a position that only paid $10.00 per hour, then she has a better chance of demonstrating she is not able to perform SGA.  The problem here is the doctor’s statement of how many hours she could work depending on her age, level of education, and previous work history might be used to deny her benefits.

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Thank You

 

Idaho

I would like to thank ACCSES - Idaho for the opportunity to present a three-day workshop to their members and invited Division of Vocational Rehabilitation.  ACCSES - Idaho is a statewide group of community rehabilitation providers.  Many of its members are employment networks under the Ticket to Work Program.  During this workshop, we covered three areas of information:

1) We explored models of Partnership Plus that would be most applicable to Idaho and financially beneficial to partners in a collaborative arrangement (DVR and an community rehabilitation providers);

2) I presented how income affects both benefits and the work incentives that can reduce how much income Social Security counts; and

3) The audience presented cases for discussion and the application of appropriate work incentives to enable each beneficiary to achieve a specific occupational goal.

 

To Gary Chiaravalli, TESH, Inc., a special thank you, for organizing the sessions (again).

 

Maine

Thanks, also, Ham Robbins of Goodwill Industries of Northern New England for sponsoring a one day workshop to enable new staff have learn how Social Security programs are affected by wages.

 

Delaware

For the past ten years (or so - I losing track), Delaware Division of Vocational Rehabilitation has sponsored a two-day training for staff and community rehabilitation providers. I would like to thank Carolanne O’Brien and her staff for organizing a well-attended workshop.

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Overpayments

Part 1 of a Series

 

I receive many calls and emails regarding overpayments.  Obviously, receiving a notice from Social Security that you have been overpaid is upsetting to most people.  So after the tears and anguish have subsided, we need to figure out how to address the issue.  And not all situations can be resolved in the person’s favor.   When this happens, I advise the person to work with Social Security to develop an installment payment plan.

 

I will be providing information about overpayments and how to handle them in a series, beginning with this newsletter.

 

Let’s begin by defining “overpayment.” 

Social Security’s definition - “An overpayment is the total amount an individual received for any period which exceeds the total amount which should have been paid for that period. Once a determination of overpayment is made, the overpaid amount is a debt owed to the United States Government.”

 

Did you notice the clause … “for any period”...  This means Social Security can go back an unspecified number of years a re-compute a person’s benefit.

 

People could avoid many overpayment situations if they would simply report their income to Social Security.  While Social Security encourages people to communicate the information by phone, I still prefer income reporting be done in writing and request a receipt.  Federal law requires Social Security to issue receipts when people report their income.  I have always encouraged people to keep all of the communication they receive from Social Security and likewise, keep a copy of what they send to Social Security.

 

Beneficiaries have the responsibility of reporting when they go to work and reporting when employment ends.  (Again, notify SS in writing).  I realize many Social Security offices advise people differently, but my goal is protect the person from overpayments, so report the income routinely.

 

Each program has different expectations on reporting of income.

If the person is receiving a title II benefit (SSDI, CDB or DWB), they should report when employment begins.  They should report monthly wages of more than $719 if they are still in their Trial Work Period.  When the Trial Work Period ends, they should report any monthly wage of $1,000 or more.

 

If the person is receiving SSI, they must adhere to one of three rules. Rule 1: If the SSI recipient works for someone else as an employee, s/he must report all there income for the month by the tenth of the following month.  Rule 2: If the recipient is in a sheltered workshop, they must report all of their income quarterly.  This rule should be modified of the monthly wage is $65 or more by following Rule 1.  Rule 3: If the recipient is self-employed, s/he must report their income annually.

 

By reporting income routinely people are protecting them self .  In the event, SS does determine the person was overpaid, we can request a waiver of overpayment by demonstrating two points 1. It is not the person’s fault there is an overpayment. 2. It would be a financial hardship to pay the amount back to Social Security.

 

The odd thing about overpayments, while a Social Security staff member may know the overpayment is their fault, they will still try to collect the overpayment.  They can not offer a person a waiver of overpayment, the beneficiary must request the waiver.

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The SSI Savers Act of 2011 (H.R. 2103)

 

Members of the House of Representatives have introduced legislation to increase the SSI resource limit.  The significant changes proposed:

1.  Increase the present resource limit of $2,000 (for an individual) and $3,000 (for a couple) to $5,000 for an individual and $7,500 for a couple.

2.  The increases would then be indexed to annual inflation.

3.  For SSI recipients under 65 years of age, the bill proposes to exclude as a resource:

            a. Retirement accounts up to $50,000 for an individual and $75,000 for a couple;

            b. Education accounts applicable to qualified tuition program (section 529 of the Internal Revenue

                Code of 1986) or in a Coverdell education savings account; and

            c. Individual development accounts established pursuant to the Assets for Independence Act or

                section 333B of the Consolidated Farm and Rural Development Act.

 

The bill has been referred to the House Committee on Ways and Means.  This bill does not address an adjustment to Medicaid resource limits.