1. Understanding Social Security Disability (SSDI) and Supplemental Security Income (SSI) www.socialsecurity.gov/disabilityfacts Presenters: Marie Grove, Technical Expert Vonda VanTil, Public Affairs Specialist Social Security Administration

2. Disability Programs Title II SSDI Social Security Disability Insurance Medicare Title XVI SSI Supplemental Security Income Medicaid

3. Social Security’s Definition of Disability A medical condition or combination of impairments preventing substantial gainful activity for at least 12 months, or expected to result in death. The determination also considers age, education & work experience.

4. What is Substantial Gainful Activity? Work is “substantial” if it involves doing significant physical or mental activities or a combination of both. If your impairment is anything other than blindness, earnings averaging over $1,090 a month generally demonstrate SGA.

5. Eligibility Requirements SSDI Be Medically Disabled Have worked long enough in jobs covered by Social Security or be a widow or a disabled adult child. SSI Be Medically Disabled Needs based, i.e. limited income and resources

6. SSDI Funded by FICA Taxes Generally unaffected by other income, resources or living arrangements SSI Funded by General Tax Revenues Affected by changes in income, resources and living arrangements Distinctive Features

7. SSDI Benefit amount is based upon level of earnings over working years Medicare coverage starts after 24 months of entitlement SSI Amount of payment is based upon income and living arrangement Immediate Medicaid

8. Social Security Disability Insurance (SSDI)  To qualify, the disabled person must have a recent work history  Special rules apply to younger persons who need less work to qualify

9. Work Requirements The amount of work you need depends on your age at the time disability starts Before age 24 1-1/2 years of work in a three-year period before becoming disabled Age 24-31 work during half the time between age 21 and the time the disability began Age 31 or older work during five out of the 10 years before the disability began

10. Work Credits When you work and pay Social Security taxes, you earn up to a maximum of 4 work credits each year. The work credits are based on the total amount of your wages or self-employment income during the year. For each $ 1,220 in gross earnings you get one credit, max. of 4 credits per year Earn $4,880 to earn 4 credits in 2015

11. Amount of Benefit Benefits are calculated based on your entire work history If your Social Security benefit amount is lower than the full SSI payment, you may be eligible to receive both Social Security and SSI

12. Onset Date  The Onset Date is the first day the individual meets the definition of disability.  The Alleged Onset Date is always the date the applicant alleges they became unable to work because of their medical condition. This is a starting point for Social Security. The date could change due to other circumstances.  If there’s work activity after that date, the onset date may be different.  Sometimes, in that instance, a Work Activity Form may need to be completed to evaluate the work.

13. Onset Date questions on application If applicant stopped working. If applicant never worked.

14.  A five-month waiting period applies to all SSDI beneficiaries  Payment begins the sixth full month after the date we find your disability began  For example, if your disability began on June 15, 2014, your first benefit would be paid for the month of December 2014, the sixth full month of disability.  Benefits are paid a month behind. So, the December benefit would be paid in January 2015. Five Month Waiting Period

15. Social Security Benefits for Adults Disabled Since Childhood  A person may be eligible for up to 12 months of retroactive benefits  Example: Disability began on 09/10/2012. Five month waiting period makes the first month of eligibility 03/2013. However, beneficiary doesn’t file until 01/22/2015. If approved, we cannot pay all the way back to 03/2013, only back one year to 01/2014. Retroactivity

16. Medicare  Medicare coverage automatically begins after being entitled to disability benefits for 24 months.  Example: Month of eligibility is 09/2014 – Medicare A&B effective 09/2016  We will send you information about Medicare several months before your coverage starts. Note: People who have permanent kidney failure requiring dialysis or a transplant or have amyotrophic lateral sclerosis (Lou Gehrig’s disease) may qualify for Medicare almost immediately.

17. Benefits for the Family Spouse  At age 62  At any age if caring for child under 16 or disabled  Divorced spouses may qualify Child  Not married under age 18 (under 19 if still in high school)  Not married and disabled before age 22

18. What is Supplemental Security Income? Supplemental Security Income (SSI) pays disabled individuals who are unable to work and have limited income and resources  It is designed to help aged, blind, and disabled people, who have little or no income and  It provides cash to meet basic needs for food, clothing, and shelter

19. Who can get SSI?  Aged - 65 or older  Blind - any age  Disabled - any age  Payments begin with the month after the month of filing  Medicaid begins immediately  Must meet medical and non-medical requirements

20. Supplemental Security Income - SSI  Payment amount is based on income, living arrangements and the state in which he/she lives.  Unlike SSDI, SSI has “No Waiting” periods to initially receive benefits.  In Michigan, automatic entitlement to Medicaid  Benefits are not immediately subject to cessation if a claimant returns to work, but SSI will be reduced for each additional income.

21. SSI Eligibility Requirements  Have little or No Resources  Be Disabled  Have limited income  Be a U.S. Citizen or “Eligible alien”  Reside in the U.S.

22. What is Resources? Individual Limit $2,000 Included Resources   Bank Accounts (CDs, IRAs)   Stocks, Bonds, 401Ks (Liquid Assets)   Second Car   Life Insurance   Property other than where you live Excluded Resources  Home in which you live  First car  Burial plots for self & family  Some resources set aside for burial Couple’s Limit $3,000

23. What is Income? Earned  Wages  Self-employment  Payment for services in sheltered workshop Unearned  SSA benefits  Veterans benefits  Unemployment benefits  Interest  Pensions  Cash from family/friends

24. Living Arrangements Living arrangement is another factor used to determine how much Supplemental Security Income (SSI) a person can get. This means your SSI benefits may vary depending on where a recipient live:  In someone else’s household  In an institution generally $30/month maximum  In a group care or board and care facility

25. SSI Benefits for Children  Disabled children living in limited income and resources households may be eligible to receive (SSI) benefits.  For eligibility, we look at the income and assets of the disabled child and parent(s) living in the household and those of the child who is disabled.

26. Deemed Resources Sometimes we “deem” a portion of the resources of a spouse, parent, parent’s spouse, sponsor of an alien or sponsor’s spouse as belonging to the person who applies for SSI. We call this process the deeming of resources. Example: If a child under age 18 lives with one parent, $2,000 of the parent's total countable resources does not count. If the child lives with 2 parents, $3,000 does not count. We count amounts over the parents’ limits as part of the child's $2,000 resource limit.

27. SSI Benefits for Children Resource Limits $4,000 if living with 1 parent $5,000 if living with 2 parents $2,000 if living with other than parents We count Bank accounts (including CDs & IRAs) Second car Stocks and bonds, 401Ks Liquid assets Property other than where you live

28. Children’s Income Examples:  Child support  Social Security auxiliary benefits  Gifts

29. Disability Determination for Children under Age 18  Must have a physical or mental impairment (or combination) that results in marked and severe limitation in functioning  Condition must be expected to last at least 12 months or result in death

30. Disability Determination for Children under Age 18  We no longer count the income and resources of parent(s) for eligibility.  If the child continues to live with parent(s) but does not pay for food or shelter, a lower SSI payment may apply  We make a new disability determination using the adult rules.

31. How to Apply for Social Security Disability Benefits – Adults (Age 18 and older)  Online at www.socialsecurity.gov/applyfordisability www.socialsecurity.gov/applyfordisability  Appointment over phone or face to face Call -800-772-1213 (TTY 1-800-325-0778) from 7 a.m. to 7 p.m., Monday through Friday to make appointment

32. How to Apply for Supplemental Security Income (SSI) for Disability – Adults (Age 18 and older) We do not have an SSI application online. To apply for SSI benefits for an adult with a disability:  Schedule an appointment by calling 1-800-772-1213 (TTY 1-800-325-0778) from 7 a.m. to 7 p.m., Monday through Friday or contacting your local Social Security office; or  Fill out the online Disability Application at www.socialsecurity.gov/applyfordisability to get the process started. A Social Security representative will contact you for additional information. www.socialsecurity.gov/applyfordisability

33. How to Apply for Supplemental Security Income (SSI) for Disability – Children (Under Age 18) To apply for benefits for a child with a disability:  Schedule an appointment with Social Security. Call 1-800-722-1213 (TTY 1-800-325-0778) from 7 a.m. to 7 p.m., Monday through Friday or contact your local Social Security office; and  Complete the online Child Disability Report at www.socialsecurity.gov/childdisabilityreport. www.socialsecurity.gov/childdisabilityreport

34. Advantages of Applying Online for Disability You can:  Apply for someone else;  Provide all the information at once or over several sessions, in the setting of your choice;  Use the “more info” links if you need help answering a question;  Print or save a copy of what you submit;  Send the information electronically; and  Check the status of your application online after it’s submitted.

35. Applying for Disability Benefits Online You can apply online for Disability Benefits by visiting www.socialsecurity.gov and then clicking on the “Benefits” tab and the “Apply Online for Disability” drop down link.

37. Start with the application You have two Options when you are assisting someone with filing

38. What Happens Next  Social Security will forward the application to the state Disability Determination Services (DDS) agency  The DDS will contact the medical providers to obtain medical records  The DDS may ask for additional information about how the condition affects daily activities

39. If Claim is Allowed We send an award notice that explains:  When benefits start and monthly benefit amount  Reporting Responsibilities (Examples: work activity, medical improvement)  When the case will be reviewed  What to do if questions

40. If Your Claim is Denied  We send a letter explaining our decision  The decision can be appealed within 60 days after the notice is received  At the appeal, if anything has changed the application can be updated

41. Internet Appeals If an application is denied for medical reasons, the fastest way to file an appeal is online. http://www.socialsecurity.gov/disabilityssi/appeal.html

42. BEST Screening Tool http://www.benefits.gov/ssa This screening tool helps you find out what benefits an individual may be eligible form. It will screen for:  Medicare  Social Security Disability (SSDI)  Social Security Retirement  Social Security Survivors  Special Veterans  Supplemental Security Income (SSI)

43. www.socialsecurity.gov/myaccount my Social Security is an easy-to-access, easy-to-use portal to view and update some of your own Social Security information. mySocial Security my

44. www.socialsecurity.gov/myaccount If you don’t get benefits, you can—  View, save, and print your online Social Security Statement. If you do get benefits you can—  Get your benefit verification letter;  Check your benefit and payment information and your earnings record;  Change your address and phone number; and  Start or change your direct deposit. mySocial Security

45. Remember the fastest way to verify Social Security and SSI benefits Visit: www.socialsecurity.gov/myaccount my Social Security provides an online benefit verification letter immediately.

47. Disability Planner

48. The Faces and Facts of Disability

49. Ordering publications You can order any of the booklets and publications or download them for free at http://www.socialsecurity.gov/pubs/

50. Visit the website www.socialsecurity.gov Call the toll-free number 1-800-772-1213 Specific questions can be answered from 7 a.m. to 7 p.m., Monday through Friday. Information is provided by automated phone service 24 hours a day. If deaf or hard of hearing, call Social Security’s TTY number, 1-800-325-0778. Visit a local office Most offices are open to the public Monday, Tuesday, Thursday and Friday from 9 a.m. to 3:00 p.m. and Wednesdays from 9 a.m. to 12:00 p.m., except Federal holidays. Contacting Social Security

51. Are you interested in staying current on Social Security disability related issues? If yes, email vonda.vantil@ssa.gov and ask to be added to the Michigan Updates Disability advocates distribution list.vonda.vantil@ssa.gov It’s that easy! Michigan Updates Newsletter

52. Contact Information Vonda Van Til Social Security 3045 Knapp NE Grand Rapids MI 49525 vonda.vantil@ssa.gov (877)-322-5883 x18872 Next Webinar Series Social Security Disability Programs – The Medical Decision Process Tuesday, February 24 or Thursday, March 5 You will receive your invitation soon.