Author: Social Security Disability Advocates USA

The Basics of Social Security Disability

The Basics of Social Security Disability

SSDI basics
Want to Know More SSDI Basics? Contact SSDA USA today!

Social Security programs can be difficult to deal with. There are a multitude of programs that help a variety of different groups. So the question is, which groups do you fit into? Do you qualify for any social security programs? We know it’s confusing, so allow us from Social Security Disability Advocates USA break down the SSI and SSDI basics.

To begin, Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) are two entirely different programs. Qualifying for one program does not necessarily mean you will qualify for the other. There are different standards that you must meet for both programs. Let’s go over the differences.

Social Security Disability Insurance

Social Security Disability Insurance is a program that the Social Security Administration (SSA) oversees and funds. SSDI provides assistance to disabled individuals and their families. You pay into this program when you work via FICA taxes. There are a variety of requirements that you must meet before you qualify for SSDI.

SSDI Prerequisites

  •         Meet the Definition: You must meet the SSA’s definition of disabled. Partial or temporary disabilities do not qualify. You must have a disability that 1) prevents you from doing the work you did before, 2) has lasted or is expected to last for no less than one year, or is expected to result in death, and 3) prevents you from doing other types of work in addition to the work you did before you became disabled. This means that your disability must interfere with everyday activities, e.g. standing, walking, etc., to the point that you cannot make a living.
  •         Documents: When you apply for SSDI, you must submit 1) your social security number, 2) your birth/baptismal certificate, 3) names, addresses, and phone numbers of doctors who took care of you, 4) names and the dosages of all medicines you take, 5) medical records and test results, 6) a summary of your work duties, and 7) a copy of your most recent W-2 form.

SSDI Basics

Once the SSA determines you meet their definition of disabled, they forward your case to the Disability Determination Services (DDS) office in your state. There, you must submit all medical records for review if you want to qualify for SSDI. Disability specialists will ask your doctors about your condition, when your medical condition began, how your medical condition limited your activities, information regarding test results, and what treatment you received. They will also ask your doctors a multitude of other questions that we cannot list here.

  •         Work: One of the key requirements for SSDI is work. You must have worked enough and earned enough work credits to qualify for SSDI. Generally, 10 years is the minimum number of years you need to work. This is because you receive one work credit for every $1,320 in 2018, up to 4 a year. If you earn the maximum number of credits a year for ten years, you will have 40 work credits, which is generally the minimum amount. Younger people do not need as many work credits. The number of required work credits goes up with age. Working credits allow that you are “insured” under FICA regulations. In addition, your monthly SSDI benefits are based on how much you earned during your working years. Also, if you are working, you cannot earn above the Substantial Gains Activity (SGA) monthly limit. If you do earn above the SGA, you probably won’t qualify for SSDI.
  •         Age: You must be younger than your full retirement age. If you reach your full retirement age (generally around age 65-67), your benefits will automatically convert to retirement benefits.

The Social Security Administration will send a letter to you after a decision has been made regarding your case. If you disagree with the ruling, you can appeal it. Keep in mind, applications for SSDI take approximately five months to look over, and an application to appeal a decision can take another five months to review.

·       Supplemental Security Income

Supplemental Security Income is another program that the SSA oversees. However, SSI aids only individuals with low income who are blind, suffer from disabilities, or are age 65 or older. There are other important differences to take note of.

   SSI Requirements

  •         Meet the Definition: To qualify for SSI, you must have limited income resources and be blind, disabled, or age 65 or older. In addition, you must reside in the United States or the Northern Mariana Islands, not be absent from the country for a full calendar month or more or for 30 consecutive days or more, and be either a U.S. citizen or national or a qualifying non-citizen.
  •         Documents: You will still need to prove to the SSA and to your state’s DDS office that you are in fact disabled and qualify for benefits.
  •         Work: Unlike SSDI, SSI is need-based, so work credits are not required. Because of this, though, your monthly benefit is not calculated based on your earnings. You may therefore receive less than you would if you had qualified for SSDI. Some individuals may qualify for both SSDI and SSI.
  •         Age: The age range is more flexible, as you can receive SSI benefits even if you are 65 or older.

With the requirements out of the way, let’s go over some other basic characteristics.

Medicaid and Medicare

Generally, people who qualify for SSI immediately qualify for Medicaid, a joint federal-state healthcare program. Medicaid is a very comprehensive health care coverage program. People who qualify for SSDI, on the other hand, qualify for Medicare two years after they qualified for SSDI. Medicare is a health care insurance program that covers most hospital visits and most primary medical care. Medicare is generally not as comprehensive as Medicaid, as there are insurance “gaps” that can be filled by purchasing supplemental coverage plans. An individual may qualify for both Medicare and Medicaid, and they will both work to make doctor’s visits and hospital bills as little as possible.

Family Benefits

Individuals who qualify for SSI do not have their benefits extended to their family. However, people with SSDI may have family members who can qualify for benefits, too. If you have SSDI, your family may qualify for benefits if 1) Your spouse is age 62 or older, 2) Aforementioned spouse is caring for your child who is under age 16 or disabled, 3) Your unmarried child (or in some cases a grandchild or step-child) is under age 18, or under age 19 if still in school, 4) Your unmarried child who is 18 or older acquired a disability for age 22.

The total disability benefit for your family is approximately 150% – 180% of your monthly disability benefits. For example, if the monthly limit is 150% of your benefit and you have two children, each child would receive 25% of your monthly benefits. This is because you receive 100% of your monthly benefits, and each child receiving 25% makes up for the remaining 50% of the limit.

Have Questions About Social Security?

If you still have questions about the SSI or SSDI basics, contact Social Security Disability Advocates today! We are available 24/7, and we are happy to answer all your questions. Call us at (602) 952-3200, or contact us online and check out our LiveChat feature.

The information on this blog is for general information purposes only. Nothing herein should be taken as legal advice. This information is not intended to create, and receipt or viewing does not constitute, a representative-client relationship.

 

Commonly Approved Conditions for SSDI

Commonly Approved Conditions for SSDI

Commonly Approved SSDI Conditions
Do you have a question about a commonly approved SSDI condition?

Commonly Approved SSDI Conditions

Have you or a family member been struggling with a disability? Has this disability made it impossible to work as a result? Consequently, people who would most benefit from assistance don’t think they will be approved. Check out this comprehensive list of commonly approved SSDI conditions.

Cancer

If your cancer symptoms or treatment have made it impossible for you to work, you will probably qualify for social security. This is especially true if the cancer has metastasized (spread to other parts of the body) or is in its later stages. Recently diagnosed cancer patients do not normally receive coverage until they begin treatment.

Multiple Sclerosis

Multiple Sclerosis, or MS, is a disabling disease of the nervous system. The disease begins slowly. Most persons with MS will not know it for many months. However, MS can get worse fairly quickly. Full diagnosis effects the probability of approval. By the time a social security hearing is scheduled and completed, the disease will have progressed. This means that your chances of qualifying is much higher after some time has passed. So, people with MS will most likely find approval for SSDI.

Heart Problems

Heart problems occur commonly in older people. So often, heart problems come along with numerous additional disabilities. Full diagnosis with any other conditions you may be suffering from can make or break your case. These can include any circulatory system problems, such as high blood pressure or diabetes. Once fully diagnosed, include these details thoroughly in your case description. These more minor disabilities are not as commonly approved SSDI conditions.

Mental Disorders

There is a wide range of conditions under the “mental disorder” label. Conditions that may qualify are neurocogitive disorders, intellectual disabilities, schizophrenia, autism, and also learning disabilities.  Neurocognitive disorders can range from Alzheimer’s disease to the effects of a traumatic brain injury or stroke. Intellectual disabilities refer to a low IQ. Anxiety and other mood disorders are the most common mental disorder to be approved for social security. Many people who apply for this reason worked their whole lives, possibly with their condition.

Back Problems and Musculoskeletal Disorders

Musculoskeletal disorders, or those that affect your bones, joints, and muscles, are very commonly approved SSDI conditions. Degenerative disc disease, a spinal injury, or amputation may also qualify. Many of the musculoskeletal disorders can cause back problems. Older people tend to also suffer from back problems the most.

Conditions Not Approved

Social Security is a way to support those with disabilities and their families. Not disabled? No coverage. If you do suffer from a disability but still work, you will not find coverage. Many of the above listed conditions may be manageable to continue working. For instance, some sufferers of anxiety are able to use self-care methods or medicine to control their symptoms. Someone suffering from back problems may work in an environment where they are able to move about freely, and may remain at work. Certainly, the severity of the condition is a big factor in what is approved and what is not.

What’s Next if I have one of the Commonly Approved SSDI Conditions?

Do you suffer from one of these commonly approved SSDI conditions? Has this condition worsened? We are ready and willing to help. Be sure to fill out our Contact Form, to the left this page. This handy form will help us- and you!- understand what you may quality for. So, call (602) 952-3200 today!

The information on this blog is for general information purposes only. Nothing herein should be taken as legal advice. This information is not intended to create, and receipt or viewing does not constitute a representative-client relationship.

Has Your SSDI Stopped?

Has Your SSDI Stopped?

ssdi stopped
Has your SSDI stopped? Call SSDA USA today!

So, your Social Security Disability Insurance (SSDI) stopped. You’re probably wondering, “How could this happen?” Well, you’re not alone, and Social Security Disability Advocates USA is here to help.

There are a multitude of factors that influence your SSDI, everything from medical improvement to incarceration. It can be overwhelming to keep track of all the variables, so let us from Social Security Disability Advocates USA clarify some of the key issues surrounding your SSDI and explore some plausibilities for why your SSDI stopped.

You Went Back to Work

Going back to work is one of the most likely reasons for the reduction or cancellation of your SSDI benefits. SSDI requires that you not earn an amount equal to or above the Substantial Gainful Activity (SGA) limit, which in 2018 is $1,180 per month for non-blind people or $1,970 per month for blind people.

Earning the SGA or above will initiate a nine-month trial work period in which you will still receive SSDI benefits. If you continue to engage in SGA after the nine-month trial work period, you will no longer be considered disabled, and your benefits will stop.

If you are unable to work after your SSDI stopped, you don’t have to reapply for benefits all over again. You can apply for an Expedited Reinstatement (EXR) of benefits. This is so people who unsuccessfully tried to go back to work can more readily reinstate their benefits if they lost their job after their trial work period.

Be careful, though! If you are working but earning below the SGA, the Social Security Administration (SSA) may still determine that the fact you are working means you are no longer disabled. The SGA is just a definite no-go zone for people working; you can still see a reduction or a cancellation of your benefits even if you do not engage in SGA. Of course, individual cases vary, so contact SSDA USA if you have any questions about your SSDI.

You Reached Retirement Age

The SSA prevents you from receiving disability and retirement benefits concurrently. Therefore, once you reach retirement age, your SSDI benefits will stop and you will be eligible for retirement benefits. You do not have to apply for Social Security retirement benefits right away, however. Delaying your retirement benefits can be extremely beneficial for many people. Just keep in mind, though, that your SSDI will stop once you reach retirement age. You should plan ahead for this and save up as much as you can to prepare for a change in your Social Security Benefits.

You Were Incarcerated or Institutionalized

Incarceration or institutionalization can suspend your benefits until you are free again. You will see a suspension of your SSDI benefits after 30 days of incarceration unless you willingly participate in a rehabilitation program. You should see a reinstatement of your SSDI in the month following your release.

Sometimes, you will see a cancellation of your SSDI even without any incarceration. For example, a felony conviction will automatically cancel your SSDI benefits.

Your Dependent’s Benefits Stopped

If you are receiving SSDI based on someone else’s earning record, your benefits may stop if certain changes occur. For example, if you are a child receiving benefits from your parent’s SSDI, your benefits could stop when you turn 18 or get married. Dependent’s benefits are usually different from primary benefits, so different rules apply. If you are a dependent, you should always be aware of what will affect your benefits.

Your Condition Improved

So, your condition has seen a medical improvement. That’s great, right? Well, it’s tricky.

If your condition sees a “medical improvement,” as the SSA calls it, your Social Security benefits could stop. This is because if your condition sees a medical improvement, the SSA may no longer consider you disabled.

Now, what is a medical improvement? According to SSA, “Medical improvement is any decrease in the medical severity of your impairment(s) which was present at the time of the most recent favorable medical decision that you were disabled or continued to be disabled. A determination that there has been a decrease in medical severity must be based on improvement in the symptoms, signs, and/or laboratory findings associated with your impairment(s).”

Now this may sound all fancy, but it simply means this: if your condition has improved to the point that you can work or potentially earn SGA, you will no longer be considered disabled. This means that medical improvement does not necessarily mean you will no longer be considered disabled. If you can prove that you cannot work and cannot earn SGA despite your medical improvement, you will still likely receive your SSDI benefits.

Wondering Why Your SSDI Stopped?

Contact Social Security Disability Advocates today! We are professionals, and we work tirelessly to address all your concerns. Call us anytime at (602) 952-3200. Alternatively, you can contact us online or check out our LiveChat feature. Don’t let your questions bother you any longer. Contact SSDA USA today!

The information on this blog is for general information purposes only. Nothing herein should be taken as legal advice. This information is not intended to create, and receipt or viewing does not constitute a representative-client relationship.

Are You Getting Enough from your Social Security Disability Insurance?

Are You Getting Enough from your Social Security Disability Insurance?

how much ssdi
Wondering how much SSDI you should be receiving? Contact SSDA USA today!

Many people receiving Social Security Disability Insurance assume they are receiving the correct amount. Usually, they are. But there are a variety of factors that can influence how much SSDI you receive.

Here’s the gist:

It’s impossible to know right off the bat how much an individual will make from their SSDI. There are many factors to consider, everything from work history to disability status. Because of this, let us from Social Security Disability Advocates USA explain some common factors that affect how much SSDI you and your family can receive.

Employment Income

To qualify for SSDI, an individual must have a condition that 1) will result in death, or 2) has lasted or will last for no less than a year, and 3) prevents them from working above the Substantial Gainful Activity (SGA) limit (which, in 2018, is $1,180 or $1,970 for blind people).

You must consult your total work credits and work earnings to calculate your monthly SSDI payment. For most people, 40 work credits (approximately 10 years of work) is the prerequisite for collecting SSDI benefits. Younger people do not need as many credits, however. When calculating SSDI, SSA agents use a formula on your work earnings to figure out how much SSDI you will receive monthly. Check out this SSDI calculator for more info.

If you earn a monthly amount equal to or greater than the SGA, your benefits will likely stop. Working part-time and earning below the SGA will not necessarily stop your benefits, but you could see a significant reduction.

Medical Improvement

The entire point of SSDI is to aid disabled individuals. If you see any kind of medical improvement, you could see a reduction or even a halt of your benefits. A medical improvement is any kind of improvement that would allow you to go back to the work you were doing before, or even some new kind of work.

Incarceration

Crime charges and incarceration for more than 30 days will result in the reduction or cancellation of your benefits. You will be able to reinstate your benefits once you leave, but you will not receive any Social Security benefits while you are in jail/prison.

Family Changes

Sometimes, certain arrangements in the family can reduce or cancel benefits. For example, if you are a dependent receiving SSDI based on your parent’s record, your benefits will likely end if you turn 18 or get married. If you are receiving SSDI benefits based on your own record, however, getting married will not affect your SSDI benefits. Reaching retirement age also cancels your SSDI benefits, since you cannot receive Social Security disability benefits and Social Security retirement benefits in tandem.

Still Wondering How Much SSDI You Qualify For?

If you still have questions about Social Security, Social Security Disability Advocates USA is here to help! We work tirelessly to help you with any concerns you have, so call us anytime at (602) 952-3200. Additionally, you can contact us online and utilize our LiveChat feature. Don’t wonder anymore about Social Security. Contact us today!

The information on this blog is for general information purposes only. Nothing herein should be taken as legal advice. This information is not intended to create, and receipt or viewing does not constitute, a representative-client relationship.

How can Paid Family Leave Help you this Holiday Season?

How can Paid Family Leave Help you this Holiday Season?

How can Paid Family Leave Help you this Holiday Season?
Need Paid Family Leave Help?

PFL Can Help You This Holiday Season

As of January, 2018, most employees who work for private employers are eligible to take paid family leave. If you work for an public entity, your employer may choose to offer paid family leave.

Paid Family Leave (PFL) provides job-protected, paid off time so you can:

  • Bond with adopted/fostered child or a newly born
  • Care for a close relative with a serious health condition
  • Assist loved ones when a family member is deployed abroad on active military service

How long do I have to work for eligibility?

  • Full-time employees -who work 20 or more hours per week, are eligible for Paid Family Leave after 26 consecutive weeks of employment.
  • Part-time employees – who work less than 20 hours per week, are eligible after working 175 days, which do not need to be consecutive.

How do I apply?

Four basic steps for an employee to request Paid Family Leave:

  1. First, you must notify your employer at least 30 days before your leave will start. If this is not done, it’s foreseeable. Otherwise, notify your employer as soon as possible.
  2. Second, obtain the request form package for the specific type of leave you need to take (from your employer, your employer’s insurance carrier or directly from the website.) Complete the request form for Paid Family Leave (Form PFL-1), following the instructions on the cover sheet. Make a copy for your records, you submit it to your employer.
  3. Third, the employer must fill out their section of the form and return it to you within 3 business days.
  4. Fourth, you lastly then submit Form PFL-1, the other request forms specific to the leave you are taking, and supporting documentation directly to your employer’s Paid Family Leave insurance carrier. You can then submit your request before or within 30 days after the start of your leave process.

Required Supporting Documentation

When you put in a request for Paid Family Leave, you will need to file a Request for Paid Family Leave form. Documentation will be needed in support of your Paid Family Leave request. The specific documentation required varies based on the specific type of leave you are requesting.

For the Birth of a Child:

  • Birth certificate
  • Documentation of pregnancy or birth form from health care provider

A second parent will need:

  • Birth certificate/ voluntary acknowledgement of paternity
  • Copy of documentation of pregnancy or birth from a health care provider that includes mothers name and due/birth dates.

Foster Care:

  • Letter of placement issued by city department of social services, county, or local voluntary agency
  • If second parent is not named in documentation, a copy of that document verifying relationship to the parent named in the foster care placement will be needed.

Adoption:

  • Provide legal evidence of adoption process
  • If second parent is not named in legal documents, the second parent must provide a copy of the legal evidence of adoption process. As, well as another document verifying the relationship to the parent in the document.

Leave to Care for Serious Medical Condition:

  • Family member with serious health condition will need to have their health care provider complete the Health Care Provider Certification for Care of a Family Member with Serious Health Condition ( Form PFL-4)
  • This form is a required part of your Paid Family Leave request. It must be submitted to your employer’s Paid Family Leave insurance within 30 days of the first date you take Paid Family Leave.

Military-related Leave:

  • US Department Labor Military Family Leave Certification
  • Copy of Military Duty papers
  • Documentation supporting the reason for the leave

Questions during this process:

  • Can I take both short-term/ temporary disability and Paid Family Leave at the same exact time?

Answer: No, not at the exact same time. You can take the short-term disability and then Paid Family Leave or Paid Family Leave and then short-term disability. If you qualify for either. However, you cannot take more than 26 weeks of combined short-term disability and Paid Family Leave in a 52-week period.

  • If I participate in Paid Family Leave, when will I receive payment?  How many days will I have to wait?

Answer: The insurance carrier has 18 days after receipt of a completed request for Paid Family Leave. To either pay or deny the claim. After the initial payment, they’ll pay benefits bi-weekly.

  • Where and who do I send my completed request forms and documentation?

Answer: Your completed request should be sent to your employer’s Paid Family Leave insurance carrier at the address provided in the PFL-1 Form Part B, Question 13 (the section your employer completed), if they are self-insured send it directly. If all the information is not on the form, ask your employer for the carrier’s address. Or contact Paid Family Leave Helpline at 844-337-6303.

Complaints: Benefit/ Denial Disputes

If you happen to get denied or partially denied for Paid Family Leave, your insurance carrier (or employer, if self-insured) must provide you with specific reason for denial and information about requesting arbitration. This is one of the best times to enlist the Social Security Disability Advocates for your case.

The NAM (National Arbitration and Mediation) handles Arbitration. You may also request arbitration for any other PFL claim-related disputes, such as denial or timeliness of the carrier’s payment. Insurers must deny or pay your request within 18 days of receiving your completed request, or your first day of leave, whichever is later.

How to Protect Yourself from Discrimination and Retaliation When taking Paid Family Leave

Your employer cannot discriminate or retaliate against you for requesting or taking PFL. They must reinstate you to the a comparable position when you return from Paid Family Leave. If you make a request or take PFL and your employer:

  • Terminates your employment completely
  • Reduces your pay or benefits in anyway
  • Disciplines you in anyway or matter
  • Does not return you to your comparable job

Which States Enacted Paid Family Leave Programs?

Six current states and the District of Columbia have programs for Paid Family Leave in order to bond with a new child, care for oneself because of a serious health condition, or care for certain ill family members. Most states are considering enacting such policies.

Paid Family Leave benefits can also raise administrative concerns from the employer’s perspective. However, research in early-adopter states showed the value of paid family leave as a “caregiver-friendly” policy, for employers and the economy as a whole. Also, Paid Family Leave lessens the strain of care giving and actually provide family caregivers with greater financial security, help maintain a productive workforce, and lastly increase employee retention.

Majority of employers surveyed in states that have enacted these workplace leave benefits have not experienced any negative impacts on their business trends suggest increasing share of family caregivers will also be in future labor force.

PFL policies are an amazing investment, from both the perspective of America’s working families and employers. Workers should not have to choose between providing care to a seriously ill family member or keeping their jobs.

Questions about Social Security?

We know that Social Security can be confusing to deal with, so contact Social Security Disability Advocates USA for help. Reach us at 24/7 at (602) 952-3200 or you can also chat with us online. Consultations are free, too, so don’t hesitate to contact us.

The information on this blog is for general information purposes only. Nothing herein should be taken as legal advice. This information is not intended to create, and receipt or viewing does not constitute, a representative-client relationship.