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Chapter 1
How To Qualify
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Two disability programs have been established by the federal government. The first is based on an individual's work; the second, called Supplemental Security Income, went into effect in 1974 and is welfare.
Adults
The program based on an individual's work record goes by a number of names. Often, it is referred to simply as" regular disability." Sometimes it is called "DIB," which stands for Disability Insurance Benefits. But, when one wants to be perfectly clear, it is referred to as Title II, taken from the law itself. Supplemental Security Income is covered in the law under Title XVI.
SSA disability benefits are taken from the same pool of funds that are used for retirement benefits. Both are forced savings taken from you through the FICA taxes from your paycheck. At age 65, you receive each month the full benefit amount you are entitled to under the program. The exact amount is determined by taking an average of your earnings through your working years. In 2004, the most an individual could receive per month is $1870. Benefits payable to your spouse and children would add another $930.
With the money you pay into the program, you earn "quarter credits." One credit is earned for every calendar quarter you work. In order to be fully insured, you are required to have a certain total number of credits, as well as a portion of that total having been earned just prior to your becoming disabled.
See the table on the next page to determine if you qualify. The chart assumes that you became disabled in 2004.
On several occasions I have been asked by those who have discovered that they do not have enough quarter credits to qualify and are short by only a few, if they can buy the credits. In other words, simply pay the federal government the amount of money equal to what they would have paid if they were working for the quarters they lacked. While they get an "A" for creativity, this is not acceptable to SSA.
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Quarter
Credits Required to
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Year
of
Qualify for
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Birth
Disability Benefits
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1939-42
40
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1943
39
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1944
38
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1945 37
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1946
36
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1947
35
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1948
34
With
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1949
33 20 of the
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1950
32
Total Credits
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1951
31
Earned
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1952
30
in the Last
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1953
29 10 Years
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1954
28
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1955
27
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1956
26
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1957
25
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1958 24
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1959
23
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1960*
22
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1961* 21
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1962-73*
20 Earned in last 10 yrs
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1974*
19 Earned after age 21
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1975*
17 Earned after age 21
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1976*
15 Earned after age 21
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1977*
13 Earned after age 21
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1978*
11 Earned after age 21
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1979*
9 Earned after age 21
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1980*
7 Earned after
age 21
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After
1980
6 Earned in last 3 yrs.
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*The figure shown is the maximum number of
credits required.. Depending on month of birth and month of disability, the number
can be up to 3 fewer, with a minimum of 6 credits.
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In general, to be fully insured, an individual who was born after 1980 must have earned at least 6 quarter credits (1-1/2 years) for the previous 3 years after s/he became 21 and up to the year before s/he became disabled. Anyone who has had a steady work record will easily meet these requirements. They would continue to meet them for between 3 and 5 years after they stopped working due to illness or injury. Tragically, too many times people fail to apply as soon after they believe they will not be able to return to work. Consequently, after 2 or 3 years, they lose their insured status. At this point, the task becomes more difficult simply because doctors move, retire, and die. Without treating doctor records, the case becomes more and more difficult to win because one must prove that s/he was disabled on or before the onset date. The loss of benefits is often in the tens of thousands of dollars.
However, if you're able to get your records, you can win even though your insured status has expired by showing through medical records dated on or before the last date you were insured that you met the standards for disability.
It is impossible to determine exactly how many have fallen into this category, but there can be no doubt that it is quite large. The magnitude of human suffering as a result is larger still. It's ironic, but not surprising, that In less than 50 years, government is causing the destitution and misery it was designed to prevent.
There can be no justification in a country which stands for individual rights, for legislators to regard any part of an individual's earned income as theirs. They have not only violated property rights through legalized expropriation, but also squandered everyone's money on thousands of pork barrel projects. The obscenity is that your legislators are forcing you to put your money in a fraudulent Ponzi scheme which -if any one of us set up -- would be shut down in a heart beat when discovered by law enforcement.
Social Security should be completely voluntary - letting you decide for yourself the amount of money you want to put into retirement and medical savings accounts.
The “Waiting Period”
Because SSA disability is long term disability,there is what is referred to as a “waiting period” after one becomes disabled, during which you cannot be paid. This period is 5 months and should be called a “delayed benefit period” because there is nothing to prevent anyone from applying as soon as s/he believes that the medical problem will last at least 12 months. If disability is established prior to the date of the application, benefits are permitted to be paid a maximum of one year prior to the date of an application. So, given the 5-month “no pay” rule, you should try to take your onset date back to 17 months before your date of application. In no case will it be possible to take your case back to a point when you were working full time.
Adult Children
Adult children who are disabled can receive benefits on the work record of a parent who is retired, disabled or deceased. However, the child must not have married and must have become disabled before s/he became 22.
Widow(er)s
Widow(er)s and surviving divorced spouses are also eligible under the regular disability program (Title II). The requirements are that the deceased spouse was fully insured at the time of death, and that the marriage was for at least 10 years for a surviving divorced spouse. For a widow(er) the marriage need only have been for 9 months, with only a few exceptions. In both cases, the disabled parties must be at least 50 years of age and their disabilities must have started within 7 years of the spouse's death or within 7 years of when the widow(er) was last entitled to disability benefits.
Supplemental Security Income
Supplemental Security Income is for those who are disabled, do not have enough credits to be fully insured and have very few assets. Ironically, because of SSA's failure to inform people about the regular disability program plus the insured status rules, and the agency's high denial rate, the federal government actually contributes to this group. Moreover, since Medicaid, which pays 100% of all medical expenses and which automatically goes with SSI, the program ends up costing the government many times more than the Title II program. Had Anna, the woman I told you about in the beginning, not applied for benefits for 3 or 4 years after she became disabled, she would have run out of credits and then lost not only her assets, but also her ability to easily qualify under Title II. (If she could show that she was disabled on or before the date when she was last insured, then she would qualify and receive benefits on her work record.) Instead of being entitled to $600 or $700 per month on the basis of her work record, plus Medicare which goes along with this program, she would have received nothing because her husband was working at the time and earning too high an income.
With Supplemental Security Income, an individual is not permitted to have assets totaling more than $2,000. A couple is not permitted more than $3,000 in assets in order to qualify. A vehicle is allowed in addition to other assets as long as it is required for getting to and from medical treatment. For SSI, there is no waiting period. Benefits are paid from the month after the date of application. For 2005 the monthly SSI benefit is $579 for an individual and $869 for a couple. State monthly benefit amounts vary from state to state because some - but not all - supplement the federal contribution. Those which supplement the federal benefit are California, Hawaii, Massachusetts, Nevada, New Jersey, New York, Pennsylvania, Rhode Island, Vermont, and the District of Columbia.
Closed Period
If you think you are going to be unable to work for 12 months or more and qualify for SSD, but improve at some point after that, you can apply for benefits and request that you be awarded benefits for whatever period of time it was that you were disabled. (Minus the 5-month time period during which SSA will not pay.) Because benefits are paid for an expressed period of time, and not after, this is called a closed period.
For SSI claimants, you'll be paid from the month after you apply, but not before -unless you can reopen an earlier application. You cannot be paid before the date of your application, unless you reopen a previous application. (See Chapter 2.)
The Benefit Amount
The monthly amount you would receive under insured Social Security (Title II) is based on your earnings. The precise formula is somewhat complex.
In general, however, if you became disabled in 2004, were between the ages of 30 and 60, and your annual earnings were $20,000, your monthly benefit would be
about $848. If your annual earnings were $30,000, your monthly benefit would be $1,218; if your annual earnings were $45,000, your monthly benefit would be in the area of $1560; for $60,000, your monthly benefit would be in the area of $1,850; for those earning $87,900 and up, your monthly benefit would be in the area of $1,937.
Benefit figures are increased every year for cost of living increases. A spouse and each of his or her children under the age of 18 are also entitled to an amount roughly half of the disabled individual's amount up to 150% of the disabled individual's monthly payment.
To find out exactly what you are entitled to, call 1-800-772-1213 and ask for an "Earnings and Benefit Estimate Summary". SSA will send you a short, easy form to complete. You should receive an answer within 60 days. You can also get information online at www.ssa.gov./OACT/ANYPIA.
Workers' Compensation
If you are receiving workers' compensation, there is usually a reduction of Social Security benefits to the extent required to reduce your total benefit amount from all sources (state, federal, and local) to 80% of what you were earning when you became disabled.
Veterans Administration Benefits
If you are receiving Veterans Administration disability benefits, there is no reduction of SSA benefits. And, veterans receive more credits for their time in service than an equal time civilians spend working.
Unsuccessful Work Attempts
If you feel as though you might be able to return to work and do try, then later discover that it is just too much for you, you will not be penalized in any way for that period as long as it does not last more than 6 months. However, you must tell the Administrative Law Judge, either at the hearing or in writing, that you want this period characterized as an unsuccessful work attempt.
Drug Addicts and Alcoholics
As of March 29, 1996, benefits are no longer paid if drug addiction and/or alcoholism (DA&A) is material to the finding of disability. "Material" means that if the individual were to stop abusing alcohol and drugs, his or her physical and/or psychological symptoms would abate. If, however, the patient's medical problems would continue when the substance abuse stopped, then benefits will be awarded as long as the standards of judgment for disability are met for the other impairments. This applies to both Title II and SSI beneficiaries.
Substance abuse is considered material if: (1) the only impairment is substance abuse; (2) the individual's other impairments are not deemed disabling; or (3) other impairments are disabling only because they are exacerbated by the drug and alcohol abuse.
However, if the individual has an impairment which was caused by substance abuse and that impairment is disabling in and of itself, then that individual will be found disabled. The cause is irrelevant.
Those who are close to early retirement age of 62 may avoid this entire issue by requesting early retirement benefits.
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What is needed to qualify for Social Security disability;
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How To Win Social Security Disability Benefits"
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How To Qualify
The Application Process
The Appeal Process
Disability According To Social Security
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The Hearing
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