supplemental security income & social security disability ... · starting the disability...

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Starting the disability process for the first time can be overwhelming and complicated, but understanding how Supplemental Security Income (SSI) & Social Security Disability Insurance (SSDI) work is important to winning your case. With endless amounts of information to sift through, we decided it necessary to create a one-stop-shop Disability Guide to walk you through the disability process as smoothly as possible. Whether you want to tackle disability on your own, or find it complicated and need an advocate to walk you through, you should at minimum read through these pages. You owe it to your financial future and well being to understand your disability case. We promise to try and make this as short and painless as possible. You’ve found your primary disability resource—let’s get started! Supplemental Security Income & Social Security Disability Insurance When people talk about disability benefits, they are usually referring to either SSI or SSDI. Supplemental Security Income, or Title XVI, was created to help individuals older than 65, blind or disabled, and is awarded to those with low-income and few assets. Benefits are intended to provide basic needs such as shelter, food and clothing. Social Security Disability Insurance, or Title II, is a monthly insurance benefit for disabled individuals who have earned sufficient Social Security credits by working long enough. Credits that you have accumulated are based on Social Security taxes you have paid in the past while working. Requirements state that you must have at least 20 Social Security credits out of the last 40 that were made available to you. This usually equates to having worked full-time five out of the past 10 years Even though SSI and SSDI differ in eligibility requirements, the

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Page 1: Supplemental Security Income & Social Security Disability ... · Starting the disability process for the first time can be overwhelming and complicated, but understanding how Supplemental

 Starting the disability process for the first time can be overwhelming and complicated, but understanding how Supplemental Security Income (SSI) & Social Security Disability Insurance (SSDI) work is important to winning your case.

With endless amounts of information to sift through, we decided it necessary to create a one-stop-shop Disability Guide to walk you through the disability process as smoothly as possible. Whether you want to tackle disability on your own, or find it complicated and need an advocate to walk you through, you should at minimum read through these pages. You owe it to your financial future and well being to understand your disability case. We promise to try and make this as short and painless as possible. You’ve found your primary disability resource—let’s get started!

Supplemental Security Income & Social Security Disability Insurance

When people talk about disability benefits, they are usually referring to either SSI or SSDI.

Supplemental Security Income, or Title XVI, was created to help individuals older than 65, blind or disabled, and is awarded to those with low-income and few assets. Benefits are intended to provide basic needs such as shelter, food and clothing.

Social Security Disability Insurance, or Title II, is a monthly insurance benefit for disabled individuals who have earned sufficient Social Security credits by working long enough. Credits that you have accumulated are based on Social Security taxes you have paid in the past while working. Requirements state that you must have at least 20 Social Security credits out of the last 40 that were made available to you. This usually equates to having worked full-time five out of the past 10 years

Even though SSI and SSDI differ in eligibility requirements, the

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 Social Security Administration’s process to determine whether you are truly “disabled” is the same for both programs.

What “Disabled” Means to the Social Security Administration

The Social Security Administration strictly defines “disability” as the following:

▪ The inability to perform substantial gainful activity, i.e. work, due to

▪ A medically determinable mental or physical condition; and

▪ Your disability has lasted or is expected to last for at least one year or to result in death.

The Social Security Administration determines if you are disabled by using the following five-step question process:

5 Step Process to Determine Disability

1. Are you working?

Although you aren’t prohibited from working while receiving disability, the Social Security Administration must determine if you are engaging in substantial gainful activity. A person with monthly earnings of $1,090 or greater will not be considered disabled in 2015. If you fit within the financial requirement, move to step two.

2. Is your condition too severe to work?

If your condition does not interfere with your basic work-related duties, you will not be found disabled. Again, your condition MUST prevent you from performing your basic work duties. If it does, move to step three.

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 3. Is your condition listed on the Compassionate Allowances or Quick Disability Determinations lists?

The Social Security Administration uses these two lists to expedite the disability process by automatically determining any conditions listed therein as a disability and in turn approving your claim. If your condition is not found on these lists, move to step four.

4. Can you do the work you did previously?

If you have a severe condition, but not more severe or equal to a condition on the list, the Social Security Administration must determine if you are able to perform your past job duties and whether or not your condition interferes with those duties. If it does, move to step five. If not, your claim will be denied.

5. Can you do any other type of work?

The Social Security Administration evaluates your job skills, age, education and past work experience to determine whether you can adjust to other types of work. If they find that your condition prevents you from doing other types of work, your claim will be approved. If they find that you are able to do other types of work in the current economy, your claim will be denied.

Disabilities That May Qualify

Cancer

Such as lung cancer, breast cancer or prostate cancer.

Cardiovascular Conditions

Conditions of the heart, such as heart failure, heart attack, or coronary artery disease.

Digestive Tract Disorders

Such as GERD, liver disease, or Crohn’s Disease.

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 Endocrine Disorders

Such as diabetes and obesity.

Genitourinary Impairments

Conditions affecting the urinary, renal and reproductive systems such as renal disease or kidney cancer.

Hematological Conditions

Blood disorders, such as sickle cell disease.

Immune System Disorders

Such as HIV/AIDS, rheumatoid arthritis and lupus.

Mental Disorders

Such as autism, schizophrenia and depression.

Musculoskeletal Problems

Such as Degenerative Disc Disease and amputation.

Neurological Disorders

Such as epilepsy, cerebral palsy and multiple sclerosis.

Respiratory Problems

Such as sleep apnea, COPD and asthma.

Skin Disorders

Such as dermatitis, shingles and cellulitis.

Senses and Speech Issues

Such as vision and hearing loss

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 Various Syndromes

Such as Marfan Syndrome and Sjogren’s Syndrome.

Addiction is not considered a disability by the Social Security Administration.

Title XVI - Supplemental Security Income (SSI)

The SSI program was developed in the early 1970s to give monthly financial assistance to low-income elderly and disabled individuals. It continues to provide much-needed income for millions of Americans unable to work today. In 2014, the Social Security Administration reported administering payments to 8.9 million disabled workers. They predict that in 2015 more than 59 million Americans will receive nearly $863 billion in Social Security benefits, and we hope you are included in that number.

In order to qualify for SSI, you must meet the following requirements set by the Social Security Administration:

▪ You must be 65 years old, OR

▪ Have a disability that will last or has lasted for at least one year or blind; AND

▪ Be a U.S. citizen or qualified alien;

▪ Have income and resources within certain limits;

▪ Cannot engage in any form of substantial gainful activity;

▪ Have medical evidence supporting your inability to work. To be considered financially eligible, one must be able to prove a lack of resources and income. For an individual, your liquid asset value cannot be greater than $2,000, or $3,000 for couples. Liquid assets are easily converted into cash and consequently are viewed as the same by the Social Security Administration.

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4 Types of Income Typically the more countable income you have, the less your monthly SSI benefit will be. Many may think their income is over the allowable limit not knowing that some of their income may not count in the SSI program. For this reason, it’s important to familiarize yourself with what the Social Security Administration recognizes as income.

• Earned Income is wages, net earnings from self–employment, certain royalties and honoraria and sheltered workshop payments.

• Unearned Income is all income that is not earned, such as Social Security benefits, pensions, state disability payments, unemployment benefits, interest income and cash from friends and relatives.

• In–Kind Income is food or shelter that you get for free or less than its fair market value.

• Deemed Income is the part of the income of your spouse with whom you live, your parent(s) with whom you live or your sponsor (if you are an alien), which will be used to compute your SSI benefit amount.

Payments and services that the Social Security Administration does not count as income for the SSI program include, but are not limited to:

▪ The first $20 of unearned income received in a month;

▪ The first $65 of earned income and one half of earnings over $65 received in a month;

▪ The value of Supplemental Nutrition Assistance Program (food stamps) received;

▪ Income tax refunds;

▪ Home energy assistance;

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 ▪ Assistance based on need funded by a state or local

government, or an Indian tribe;

▪ Small amounts of income received irregularly or infrequently;

▪ Interest or dividends earned on countable resources or resources excluded under other federal laws;

▪ Grants, scholarships, fellowships or gifts used for tuition and educational expenses;

▪ Food or shelter based on need provided by nonprofit agencies;

▪ Loans to you (cash or in kind) that you have to repay;

▪ Money someone else spends to pay your expenses for items other than food or shelter (for example: someone pays your telephone or medical bills);

▪ Income set aside under a Plan to Achieve Self–Support (PASS);

▪ Earnings up to $1,780 per month to a maximum of $7,180 per year (effective January 2015) for a student under age 22;

▪ The cost of impairment-related work expenses for items or services that a disabled person needs in order to work;

▪ The cost of work expenses that a blind person incurs in order to work;

▪ Disaster assistance;

▪ The first $2,000 of compensation received per calendar year for participating in certain clinical trials;

▪ Refundable federal and advanced tax credits received on or after January 1, 2010; and

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 ▪ Certain exclusions on Indian trust fund payments paid to

American Indians who are members of a federally recognized tribe.

How Income Affects Your SSI Benefit

Now that you know what the four types of income are and what types of income do and do not count towards your SSI income allowance, you can calculate your potential SSI benefit using the instructions below:

Step 1: The Social Security Administration subtracts any income that they do not count from your total gross income. The remaining amount is your "countable income".

Step 2: The Social Security Administration subtracts your "countable income" from the SSI federal benefit rate. The result is your monthly SSI federal benefit as follows:

1) Your total income - income the Social Security Administration does not count = countable income

2) SSI federal benefit rate - countable income = Your monthly SSI federal benefit

Title II - Social Security Disability Insurance (SSDI)

Social Security Disability Insurance is a federal, tax-funded insurance program that provides monthly income for those unable to continue working. In order to be eligible for SSDI, the Social Security Administration and the law strictly require that individuals:

§ Have a physical or mental condition that prevents any type of substantial gainful activity; AND

▪ Have a disability that will last for one year or result in death in one year; AND

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 ▪ Be under the age of 65.

▪ Must have worked five out of the last 10 years or earned 20 Social Security credits out of the last 40 available credits

▪ Medical evidence supporting your inability to work

Unlike SSI, SSDI relies on your work history, not your income.

As an employee, you paid Social Security taxes from your paychecks and in turn the Social Security Administration translates those taxes as “credits”. To qualify for SSDI, you must have accumulated at least 20 Social Security credits per the last 40 credits available, earning up to four credits per year. If you’ve worked five out of the last 10 years, you should meet the Social Security Administration’s work credit requirement and should be “insured” for up to five years after you stopped working.

The “Treating Physician” Rule The Social Security Administration gives “controlling weight” to your treating physician because they believe that with a patient-doctor relationship, the physician is more familiar with the claimant’s medical history and is in the best position to judge their patient’s ailments. For this reason, administrative law judges will give the personal physician’s opinions greater influence. Making sure all forms are filled out correctly and all evidence is documented properly will also strengthen your case.

Residual Functional Capacity Form (RFC) The Social Security Administration uses a residual functional capacity (RFC) form to determine whether or not a physical or mental disability is severe enough to limit the claimant from working. The RFC assessment helps determine what types of activities and duties the applicant can and cannot do and is performed by either a consultative examiner contracted by Disability Determination Services or your treating physician. The

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 physical RFC measures your exertion level based on whether you can perform sedentary, light, medium or heavy tasks such as pushing, pulling, how much you can carry/lift and how long you can sit/stand.

If the claimant is filing for disability for a mental condition, a mental RFC form will need to be filled out by a psychiatrist or psychologist. The mental RFC form will describe the claimant’s mental symptoms and how it affects their ability to work. A mental RFC will detail mental symptoms dealing with issues such as concentration, social situations, stress tolerance, and illogical thinking.

The RFC form has a big influence over your claim because, depending on what your RFC levels are, you may be automatically determined to be disabled if they meet certain GRID rules. GRID rules are a set of conditions individuals must meet in order to qualify for disability, and are based on your age, RFC level, education level, work history and skills. Having your personal physician fill out the RFC form (instead of the Disability Determination Services doctor) will be the most beneficial to your claim because they have first-hand knowledge of your condition and how it limits you.

Back Pay

Also called retro-benefits, the Social Security Administration issues back pay after your disability application is approved. Social Security disability applications can take anywhere from six months to two years to be approved, so back pay is almost always issued to claimants.

For SSI, the back pay can only go back to the date you first filed your initial application. For this reason, it’s very important that you file your initial application as soon as possible. If you waited to file an application long after you were disabled, you will not receive back pay any further back than the date you filed your initial application.

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 For SSDI, the back pay can only go back 12 months prior to the date you apply for benefits, if you were disabled before that point in time. With approved SSDI claims, benefits start five months after the beginning of your disability, or your alleged onset date. This means that if your alleged onset date is January 1, you will not be paid benefits prior to May 1. In order for you to receive a full year of back benefits, you would have to have applied 17 months earlier. If the Social Security Administration does not agree with the date you say your disability started, they will determine a new date, called the established onset date. For the Social Security Administration to change your alleged onset date, there needs to be conflicting medical evidence. You are able to appeal this decision, but without representation many find it difficult to take on this process alone.

Monthly Benefit Payments

The amount of your monthly supplement is dependent on whether you applied for SSI or SSDI.

Maximum Monthly Amounts for SSI:

▪ $721 for an eligible individual

▪ $1,082 for an eligible individual with a spouse

▪ $361 for an essential person.

You may receive more or less than these amounts depending on the state that you live in and your income.

There is no set amount for SSDI payments because the Social Security Administration uses a complex, weighted formula to calculate benefit amounts for each individual. However, in 2014 the average recipient received $1,148. Currently, the maximum amount allowed for SSDI payments is $2,642.

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Disability Checklist ❏ Birth and citizenship

❏ Social Security card or record of SSN ���

❏ Birth certificate (proof of age) ���

❏ Permanent Resident Card number (if not a U.S. citizen)

❏ Info about where you live

❏ Lease or mortgage

❏ Detailed info about your income and assets

❏ Bank account numbers and routing numbers

❏ Family member information

❏ Name of current/prior spouse ���

❏ Spouse(s) DOB and SSN (optional) ���

❏ Dates of marriage(s) ���

❏ City, state and country (if outside the U.S.) where married ���

❏ Children ���

❏ Names and birth dates of children that:

❏ Became disabled prior to age 22, or ���

❏ Are under age 18 and unmarried, or ���

❏ Are 18-19 years old and still going to secondary school ���

❏ Employment/job history

❏ Employer name ���

❏ Employment dates ���

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 ❏ Employment total earnings (W2) ���

❏ Medical Info

❏ Names, telephone numbers, addresses and patient ID numbers where you have received treatment. ���

❏ Names and dates of examinations, treatments, and tests/test results, along with the referring physician’s name. ���

❏ List of all medications (prescription and over-the-counter), dosages, reason for the medication and the prescribing physician. ���

❏ Medical records you are able to obtain. ���

❏ Education and Vocational Training

❏ Highest grade completed in school and date completed. ���

❏ Name of trade school or vocational school and date completed. ���

❏ Special education school name, city and state, and date completed. ���

❏ Residual functional capacity or ability-to-do-work related activity form. ���

Children’s Disability Benefits ��� Children of retired or disabled workers and disabled children are able to acquire monthly cash benefits through SSI and SSDI. This can be a confusing subject, but understanding how this process works will prove to be advantageous in your efforts to winning benefits for your child. ���

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SSI Benefits for Disabled Children ��� For SSI, the Social Security Administration defines a child to be a person that is neither married* nor the head of the household and is:

§ Under 18 years old; OR

§ Is under 22 years old and is regularly attending school*.

*As determined by the Social Security Administration – documentation needed.

Both children and adults are required to be blind, deaf or disabled in order to be eligible for SSI, and the Social Security Administration uses the same determination process to discern truly disabled individuals. Although the process is the same, the Social Security Administration recognizes the differences in limitations between children and adults and adjusts assessments accordingly.

For a child to be considered disabled, the medical requirements are:

▪ The child must have a medically determinable physical or mental impairment(s); which result in

▪ Marked and severe functional limitations; AND

▪ The impairment has lasted or is expected to last for a continuous period of at least 12 months or result in death.

The financial requirements for child and adult SSI claims are the same because the Social Security Administration assumes that part of the parents’ income is shared with the child. They take into account all available income sources to the child in a process called “deeming”. These sources are:

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 ▪ Parents’ earned income, unearned income, other resources

and assets, and

▪ Stepparents’ earned income, unearned income and resources if the child lives with the stepparent and natural or adoptive parent.

SSDI Benefits for Disabled Children There are two ways in which children can collect SSDI benefits.

The first scenario is for children who do not qualify for SSI based on their family’s income. The second scenario is for adults who have been disabled since childhood, or before the age of 22.

SSDI gives retired or disabled workers a monthly income supplement to those that have sufficient work credits, and may be transferrable to dependents. If a child has worked, they probably will not have enough Social Security credits or income to qualify for disability on their own, but the same earnings limits apply to them as you. This means that dependent individuals of SSDI recipients qualify for SSDI based on the qualifying parent’s earnings record, also called dependents benefits. Minor dependent children, stepchildren and grandchildren of an SSDI recipient may be eligible under certain circumstances. The child must meet the following requisites to qualify for dependent disability benefits:

▪ Be unmarried; AND

▪ Be under age 18; OR

▪ Be 18-19 years old and a full-time student (no higher than grade 12); OR

▪ Be 18 or older and disabled from a disability that started before age 22.

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 For children that are still full-time students at the age of 18 or 19, benefits will continue until the child graduates or is two months past their 19th birthday, whichever comes first. Otherwise, benefits will stop when the child turns 18 years old or the child gets married.

Adult children that were disabled before the age of 22 are eligible for SSDI as a “disabled adult child.” The Social Security Administration uses the same disability requirements for disabled adult children as they do for adults applying to collect SSDI:

▪ You are unable to perform any type of substantial gainful activity due to

▪ A medically determinable mental or physical condition; AND

▪ Your disability has lasted or is expected to last for at least one year or to result in death

Again, the Social Security Administration uses the same five-step process to determine disability for children and adults alike.

Spouse’s or Ex-Spouse’s Benefits If your spouse or ex-spouse is collecting Social Security disability or retirement benefits based on their earnings record, you may be eligible for a portion of that benefit depending on the length of your marriage, your age and whether or not children are involved. Mothers or fathers taking care of the spouse’s minor dependent (under 16) or their disabled dependent may also be able to receive a percentage of their SSDI benefits. Spouse’s benefits are only available under SSDI, not under SSI.

Spouses of a retired or disabled worker receiving SSDI can collect 50 percent of the benefits if he or she is 62 years or older and have been married for at least one year. However the spouse collecting benefits on the disabled worker’s earnings record will be hit with an early retirement penalty because they

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 did not wait until their full retirement age of 65 to collect benefits. Even though you can get up to 50 percent in spousal benefits, the amount of the benefit will be reduced if there are other dependents collecting on the SSDI recipient’s Social Security record.

Divorced Spouse’s Benefits

An ex-spouse of a disabled worker may be able to get benefits on their earning record if they meet the following requirements:

▪ The ex-spouse and disabled worker were married for at least 10 years;

▪ They are at least 62 years old;

▪ They are unmarried;

▪ They are not eligible for an equal or higher benefit amount on their own or someone else’s earning record.

Even if the disabled worker remarries, an ex-spouse may still be eligible for benefits.

Mother’s or Father’s Benefit

Surviving or ex-spouses of the disabled worker may be able to collect benefits if they are taking care of the disability recipient’s children. In order to receive benefits, as the mother or father you must be able to prove that you are providing a suitable living situation and be able to properly raise the child. To qualify, you must meet the following requirements:

▪ You are raising or have parental responsibility for a child under 16 years old; OR

▪ Providing physical care for a physically disabled child over 16; OR

▪ Providing care for a mentally disabled child over 16.

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Survivors’ Benefits Also called widow or widower’s benefits, this benefit is available to a surviving spouse of a disabled worker that was receiving SSDI before his/her death. In order to be eligible, the surviving spouse must meet the following requirements:

▪ The widow/widower is at least 60 years old; OR

▪ The widow/widower is eligible for mother/father’s benefits (at any age); OR

▪ The widow/widower is disabled and at least 50 years old; AND

▪ The widow/widower’s disability began before or within seven years of the worker’s death; AND

▪ The disabled worker and the surviving spouse must have been married for at least one year.

Divorced Spouse’s Survivors Benefits

The ex-spouse of a deceased, disabled worker is eligible for benefits if they meet certain criteria:

■ The ex-spouse is at least 60 years old; OR

■ The ex-spouse is at least 50 years old and disabled; AND

■ The marriage lasted at least 10 years; OR

■ The ex-spouse is eligible for mother’s/father’s benefits (10 year rule does not apply).

If the ex-spouse remarries after they are 60 years old (50 years old if disabled), they will still be able to receive benefits. If they remarry before the age requirements, they will be denied benefits.

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GRID Rules

GRID rules are in place to determine disability in applicants with a severe condition that does not meet a medical impairment listed in the “Blue Book”. Before applying the GRID rules, the Social Security Administration takes into account:

▪ Age

▪ Education level

▪ Residual functional capacity (RFC)

▪ Past employment experience

▪ Whether job skills can be transferred to another job.

Wounded Warrior’s Benefits Transitioning from active duty military life can be difficult for many. There are several health risks, physical and mental, that result from active duty service. Disabled active-duty military members and their families may be eligible for disability benefits, but regardless of the outcome, they are always entitled to an expedited decision if they were disabled after September 2001.

Although it is a common misconception, veterans and active-duty military members can apply for Social Security disability, even if they are already receiving VA disability benefits. Though Social Security and the VA have similar benefits, their application and disability determination process are completely separate. Having one benefit does not automatically grant you the other benefit and you need to apply for them separately.

Social Security pays disability benefits through SSI and SSDI. Veterans and active duty military members must qualify under the same criteria required for a disability under SSI and SSDI, which are:

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 ▪ You must be unable to work or perform substantial gainful

activity because of your medical conditions; and

▪ You medical condition must have lasted, or will last for at least one year or result in death. In order to qualify for each individual program, veterans and active duty members must fit the specifications under each program. For SSI, you must have income within certain limits. For SSDI, you must have worked long enough and earned at least 20 (out of the last 40) work credits.

If you apply for disability and are still active duty, you may still be eligible for benefits. This is because the military frequently pays full pay to individuals unable to work. Instead of the amount of pay, the Social Security Administration usually looks at the type of work you are doing and how your disability affects your work. If you are able to perform substantial gainful activity, your claim will be denied.

Family Benefits for Wounded Warriors

Family members of disabled veterans or active duty members can receive benefits based on your work. This includes:

▪ Your spouse, if he or she is age 62 or older;

▪ Your spouse, at any age, if he or she is caring for a child of yours who is younger than age 16 or disabled;

▪ Your unmarried child, including an adopted child, or, in some cases, a stepchild or grandchild. The child must be younger than age 18 or younger than age 19 if in elementary or secondary school full time; and

▪ Your unmarried child, age 18 or older, if he or she has a disability that started before age 22; and

▪ A divorced spouse, if he or she was married to you for at least 10 years, is not currently married, and is at least at the age

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 of 62. When applying for Wounded Warrior’s benefits, be sure to have the following documents:

▪ Original or certified copy of your birth certificate or proof of U.S. citizenship or legal residency if foreign born;

▪ Form DD-214, if discharged from military service;

▪ W-2 form or income tax return from last year;

▪ Proof of military pay or workers’ compensation;

▪ Social Security numbers of your spouse and minor children;

▪ Checking or savings account number, if you have one;

▪ Name, address and phone number of a contact person, in case you are unavailable; and

▪ Medical records that you have or that you can easily obtain from all military and civilian sources. Be sure to report the following changes:

▪ When you start or stop work;

▪ If there is a change in your job duties, hours or work, or rate of pay;

▪ If there is a change in your Military Occupational Specialty code (MOS);

▪ If there is a change in your Air Force Specialty Codes (AFSC);

▪ If there is a change in your Navy Enlisted Classification (NEC)

▪ If you have a permanent change of station (PCS)

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Reporting Changes SSI

You must report any income changes to the Social Security Administration while receiving SSI because it may affect your benefit amount and eligibility. The Social Security Administration requires you to report any of the following changes:

▪ Change of address;

▪ Change in living arrangements;

▪ Change in earned and unearned income, including a change in wages or net earnings from self-employment, your spouse’s income if you are married and living together and parents income if applying for a child;

▪ Change in resources including your spouse’s resources, if you are married and living together and parents’ resources if applying for a child;

▪ Death of a spouse or anyone in your household;

▪ Change in marital status (including same-sex relationships);

▪ Change in citizenship or immigration status;

▪ Change in help with living expenses from friends or relatives;

▪ Eligibility for other benefits or payments

▪ Admission to or discharge from an institution (such as a hospital, nursing home or correctional institution such as prison, jail, detention center, boot camp, etc.,);

▪ Change in school attendance, if you are under age 22;

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 ▪ Change in legal alien status;

▪ Sponsor (or sponsor’s spouse) changes of income, resources, or living arrangements for aliens;

▪ Leaving the U.S. for a full calendar month or for 30 consecutive days or more;

▪ An unsatisfied felony, arrest warrant for escape from custody, flight to avoid prosecution or confinement, or flight escape;

▪ Violate a condition of your probation or parole imposed under federal or state law.

▪ Improvement in your medical condition

▪ When you start or stop work, or have a change in pay or hours worked;

▪ Change in name;

▪ Any overpayments;

▪ Change in direct deposit information (if you receive payments through direct deposit);

▪ Any change in your ticket to work state; or

▪ Any change in your work or Plan to Achieve Self-Support (PASS) expenses.

SSDI needs to report the following changes to Social Security Administration:

▪ If you begin working;

▪ If you start collecting other disability benefits;

▪ If you start collecting a pension from a previous job; and

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 ▪ If your marital status changes

Report any changes as soon as possible and within 10 days after the end of the month in which the change occurred. If you do not report changes made, you may be subject to a penalty and discontinuation of benefits for a period of time.

Potential For Other Benefits

In many cases, those receiving SSI or SSDI have the potential to qualify for other benefits. For SSI recipients, there may be benefits available to you based on your income, like SNAP (food stamps) or Section 8 Housing. With the exception of some states, SSI recipients are automatically approved for Medicaid coverage because Medicaid and SSI are both based on income. Those getting SSI are not eligible for Medicare until the age of 65 when they are able to file an uninsured Medicare claim. SSDI recipients are eligible for Medicare two years after their date of entitlement.

Using Representation

Using an attorney or representative for your disability claim has many advantages. Not only are they more familiar with the disability process, they know tips and tricks to speed up the application process and avoid denials. Winning disability benefits can take up to two years and you may receive multiple denials before being approved. Having representation gives you a greater chance of being approved at an earlier stage in the application process, and possibly even the first time around.

Most people are unfamiliar with the disability application process, and an attorney or advocate will know how to prepare a disability case for you. Disability attorneys and advocates get paid on contingency (only if you win), and the payment is usually deducted from your back pay. There are no guarantees when it comes to Social Security disability, but using an expert will make the process much easier.

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Social Security Disability Application Process

Learning and understanding how the disability application process works will make applying for benefits easier and less stressful. Many people go through the first step of submitting their initial application, and when they receive a denial they don’t know there are other options, such as appealing that decision.

The starting point of this process is filing your initial application. Your initial application should include your medical evidence and other documentation required. Your application is first processed at the Social Security Administration’s district office, and then sent to Disability Determination Services. It can take anywhere from four to six months to receive your first decision. Less than 30 percent of these applications are approved at the initial application stage.

Once you’ve received the first decision, you’ve either been approved for benefits or you received a denial. If you received a denial, you need to file an appeal within 60 days of the denial date found in the denial letter. If you do not file an appeal within 60 days, you will have to start your application over. Filing an appeal at this stage is called a request for reconsideration, and only 10 percent of these claims are approved. Some states have removed this step from the process. After filing the first appeal, it can take up to six months to reach a second decision.

Again, your claim with either be approved or denied, and if denied, you will have 60 days to appeal the decision by requesting a hearing in front of an administrative law judge. It can take up to 12-24 months to get a hearing in front of a judge; however, it is usually worth the wait, as almost 50 percent of these claims are approved. If you weren’t approved, the judge will either send your case back for review or deny the claim.

If you were denied at the hearing level and you disagree with the

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 judge’s decision, you can file a third appeal, which is a review of the decision by the Appeals Council. This can take six months to one year to process, and not very many claims are approved at this level. Fewer than two percent are approved at the Appeals Council level.

If the Appeals Council also denies your claim, you can request your claim to be reviewed by the Federal District Court. They can approve, deny or send your claim back for review to the Social Security Administration. About 30 percent of cases sent in front of the Federal District Court are approved. This can take between six months to one year to complete. If you are denied, you will have to start the disability process over.

Forms

Work History Report SSA-3369-BK

Authorization to disclose information to the SSA - SSA-827-BK