Applying for SSI Benefits

1. Applying for SSI Benefits Presented by Scott Leonard and Joanne O’Neill Department of Community and Human Services Developmental Disabilities Division

2. Social Security • Began in 1935: Social Security Act • Response to Great Depression • Protect workers from living in poverty after retirement • FICA taxes • 1954: Disability Insurance (including for Disabled Adult Children) • 1974: Supplemental Security Income (SSI) • aged, blind, and disabled with economic need • managed by Social Security but not funded by FICA

3. What are you applying for? Title XVI • SSI: Supplemental Security Income • Cash benefit: $674 / month • Medicaid (managed in WA)

4. What are you applying for? Title II • SSDI: Social Security Disability • Cash benefit: depends on applicant’s work history • Medicare • CDB: Childhood Disability Benefits (also called Disabled Adult Child, or DAC) • Cash benefit: depends on parent’s work history • Medicare

5. Not sure for which benefit to apply? • Not absolutely necessary to specify benefit type • Social Security awards the largest benefit for which a person is eligible.

6. Applying for Benefits

7. 3 Ways to Apply • Website: www.ssa.gov • Phone: 1-800-772-1213 • Local offices

8. Application Age for SSI • If a person is under the age of 18, the parents’ income and resources will be considered. • If a person is over the age of 18, only the individual’s income and resources are considered.

9. SSI-eligible Turning Age 18 • Disability criteria is different between people under age 18 and over age 18. • People who are eligible for SSI prior to age 18 must undergo an “Age-18 Redetermination” • SSA initiates Redetermination after 18th birthday, usually within 12 month.

10. SSI for 18 and over: When should I apply? If a person intends to apply at age 18, she can apply as early as the 1st day of the month when she turns age 18.

11. Applying Online(SSI for Adults)www.ssa.gov

12. Online Steps to Apply for SSI - Adults • Review “How this Report Works” • Complete “Adult Disability Report” • Print and sign one release (to bring to appt. or mail to local office) • Contact Social Security (1-800-772-1213) and schedule an appt to finish the application, submit information, and submit release

18. Understanding the Questions: Work • Questions are designed for people who have been employed but are now unable to work due to a disability. • Many people with developmental disabilities require support in order to work. • Fill out the questions to the best of your ability!

19. Disability Report Topics Personal Identification • Personal Identification info • Reporter info • Contact info Medical • Medical Conditions • Doctors and Other Healthcare Professionals • Hospital Clinics • Tests • Medicines • Other Medical Records

20. Disability Report Topics Work/Education • Work Status • Work Activity • Job History • Education and Training Remarks Disability is often defined in terms of ability to work and earn a substantial wage

21. After Submitting Disability Report • Print out SSA Release and sign / date • Contact Social Security (1-800-772-1213) and schedule an appt to complete the application, submit information, and submit release

23. Information for Mtg. to Complete Application • Birth Certificate (original or certified copy) – disputed! • SSN • Bank Statements (2 months) • Documentation of any income (wage stubs for last 2 full months; tax returns; child support payment documentation; etc) • Rent / Mortgage payment information* • Resource information (stocks, bonds, burial funds, etc.) • Special Needs Trust documentation, if applicable • Guardianship documentation, if applicable • Spouse’s wage information if working

24. Information for Mtg. to Complete Application (*more later) • Any documentation regarding the disability; • Statements by relatives, friends, and other people who know the applicant and the obstacles he/she faces due to the disability • Third Party Function Report (optional)

25. Information for Application • Checking account information for Direct Deposit • Person designated to have Authority of Representative

26. Waiting for A Decision • The waiting period for eligibility determination is approximately 120 days.

27. SSDI Denial Letter • Letter stating applicant has been found ineligible for SSDI does not mean that SSI application has been denied. • Top of letter will reveal which benefit is being denied. • “Social Security Administration” at top of letter: SSDI • “Supplemental Security Income” at top of letter: SSI

28. Follow-up Requests May receive letters from SSA requesting information about disability or financial matters May be asked to meet with a doctor – Consultative Examination (CE)

29. Appeals • If denied eligibility, you have the right to appeal. • Find appeal process on www.ssa.gov - “Forms and Publications” • Online Forms: “Appeal a Recent Medical Decision” • Paper Forms: • “Request for Reconsideration” Form SSA 561; AND • “Disability Report Appeal” Form SSA-3441

30. Review: Online Steps to Apply for SSI - Adults • Review “How this Report Works” • Complete “Adult Disability Report” • Print and sign one release (to bring to appt. or mail to local office) • Contact Social Security (1-800-772-1213) and schedule an appt to finish the application, submit information, and submit release

31. Financial Eligibility:SSI – Adults (age 18 and older)

32. SSI – AdultFinancial Eligibility • Earning less than $1,000 gross per month at time of application* • Resources: Less than $2,000. Exclusions apply. • Income: Earned and Unearned income allows for at least $1.00 SSI at time of application *Earnings can be greater if there is indication of a Subsidy.

33. SSI and Living Arrangement • A person is expected to use his/her SSI to pay food and shelter costs. • If a person is receiving support and not paying a fair share of living expenses, SSA can reduce the person’s SSI benefit. • In-kind Support

34. Rental Arrangement • Date of rental arrangement • Monthly rental amount • Is cost for just rent or a flat-rate for room and board? • Is this the same amount you would charge another? • If the tenant does not have enough money to pay for rent or room and board, will he/she owe it to you? • Repayment schedule • Cannot be based eligibility for a full SSI benefit check. • Signed by both tenant and landlord • Investigate tax implications

35. Disability Eligibility

36. DDDS • Social Security forwards all disability information to Division of Disability Determination Services (DDDS) • Disability determinations made by DDDS • State program; federally funded. • Makes disability determinations for other State programs such as Medicaid.

37. DDDS • DDDS tries to obtain evidence from the claimant’s own medical sources. • If evidence is insufficient, DDDS will arrange for a consultative examination (CE) to obtain the information needed.

38. 5 Step Process • Is the applicant performing Substantial Gainful Activity (SGA)? • Is the medical condition “severe”? • Is the medical condition on the list of impairments? • Can the applicant do the work the applicant did before? • Can the applicant make an adjustment to any other type of work?

39. Step 1:Is the applicant performing SGA? • Decided usually by SSA, not DDDS. • SGA often measured as gross wages earned. In 2011, SGA is $1,000 gross per month. • If person has work history that demonstrates SGA, letters from employer and or job supports should be submitted that explain the true value of the work performed. • Does not apply with “Age 18 Redetermination”

40. Step 2:Is the Medical Condition Severe? • For adults, the medical condition must significantly limit the ability to do basic work activities. • For children, the condition must reflect marked and severe functional limitations. • For both, the condition must be expected to last at least one year.

41. Step 3: Is the Medical Condition on the List of Impairments? Refer to the SSA Blue Book for a list of impairments: http://www.socialsecurity.gov/disability/professionals/bluebook/

43. Step 4: Can the Applicant Do the Work the Applicant Did Before? Step 5: Can the Applicant Make an Adjustment to Any Other Type of Work?

44. Sequential Evaluation Process

45. Helpful Tips* • Think about which doctors or specialists will provide the best information about the disability. • Write a letter that further explains the disability. • Consider filling out the “Third Party Function Report” • Generally, the more information provided, the better.

46. Thank you! Department of Community and Human Services Developmental Disabilities Division