If You Get Ssi Disability And Dont Have Medicaid
You can apply for Medicaid coverage. But whether you need to apply depends on your state
- In many states, SSI recipients automatically qualify for Medicaid and dont have to fill out a Medicaid application.
- In other states, your SSI guarantees you Medicaid eligibility, but you have to sign up for it.
- In a few states, SSI doesnt guarantee Medicaid eligibility. But most people who get SSI are still eligible.
If you have SSI Disability and dont have Medicaid, you can apply for Medicaid coverage 2 ways:
Who Pays For Disability Insurance Benefits
Workers and employers pay for the DI program with part of their Social Security taxes. Workers and employers each pay a Social Security tax that is 6.2 percent of workers’ earnings up to a cap of $127,200 in 2017. The cap is adjusted each year to keep pace with average wages. Of the 6.2 percent, 5.015 percent goes to pay for Social Security retirement and survivor benefits and 1.185 percent pays for disability insurance. The combined tax paid by workers and employers for disability insurance is 2.37 percent of wages, while the combined tax for retirement and survivor benefits is 10.03 percent, for a total of 12.4 percent.
Types Of Disability Policies
There are two types of disability policies.
Short-term policies may pay for up to two years. Most last for a few months to a year.
Long-term policies may pay benefits for a few years or until the disability ends.
Employers who offer coverage may provide short-term coverage, long-term coverage, or both.
If you plan to buy your own policy, shop around and ask:
How is disability defined?
How long do benefits last?
How much money will the policy pay?
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What Is The Standard For Disability
Who is considered “disabled” for SSI or SSDI benefits?
To receive benefits under either program, you must meet the SSA’s definition of disability. The term disability means that you are unable to engage in substantial gainful activity because of:
- A medically determinable physical or a mental impairment
- Which has lasted or is expected to last for at least 12 months or is expected to result in death.
This standard for disability is described in the below paragraphs.
Disability for adults
In deciding whether you meet the disability requirement, SSA uses a five-step analysis:
Step one: are you working?
If you are working and performing a substantial gainful activity, then you are considered able to work. You are therefore not disabled. The SGA limit is $1,310 per month. If you earn more than $1,310 per month, you are probably not eligible, unless there are special cases. For example, you have intensive job coaching to help you work or you work at a sheltered workshop. If you are not earning significant income, proceed to step two.
Step two: do you have a severe impairment?
You must have a problem which significantly limits your ability to perform basic work activities. The impairment must be expected to last for 12 months or end in death. If you have a severe impairment, proceed to step three.
Step three: does your medical condition match one of SSAs listed impairments?
- Medical findings,
- Signs, and
- Symptoms that must be found for your condition to meet the listing.
Which States Offer Supplementary Disability Payment Programs
The majority of all disability payment programs are administered on the federal level, but there are five states that offer state-funded disability programs in addition to SSDI and SSI. Currently, those five states are California, Hawaii, New Jersey, New York and Rhode Island. They are intended to supplement, but not replace, federal disability payment programs.
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Medical Evidence Required When Applying For Disability Based On Vision Loss
First, Social Security requires a physical examination by an ophthalmologist or optometrist to measure your central visual acuity . If you won’t qualify for disability under poor visual acuity alone, you’ll also need to get your visual field efficiency tested. All testing is done without your glassesyour doctor will use lenses that are part of the testing equipment. You will be asked to read letters from a chart at a certain distance away . If the SSA suspects your vision is better than you say , the SSA may require you to undergo visual evoked response testing .
If you’ve been diagnosed with an eye disease, your medical record should reflect it. Cataracts, macular degeneration, diabetic retinopathy, hypertensive retinopathy, cancer-related or melonoma-related retinopathy, retinal detachment, or other types of central retinal disease can be responsible for a loss in visual acuity.
How To Buy A Home Using Disability Income
Proof of income is one of the biggest factors in whether you qualify for a home loan.
Lenders need to know that you can afford the monthly mortgage payment, whether thats from wages earned at your job, disability income, or a combination of the two.
So if all, or part, of your income comes from disability benefits, your lender will want to know all the details. That includes the type of disability benefits you receive and how long youll be eligible to receive them.
Now, if you are a low-income borrower or youre on a fixed income, thats OK. The lender will just need to verify that you have enough income to afford payments on the home you want to buy, and that your debt-to-income ratio is in a qualifying range.
Your DTI represents how much of your monthly income goes toward debts including housing payments, credit cards, student loans, and other loans. The maximum DTI allowed depends on the type of loan program you want to use, though generally speaking youll want it to be 50% or less.
Some lenders and programs have more flexible criteria than others, though, which is why its always a good idea to request quotes from at least three mortgage lending companies.
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Disability Determinations For Child Ssi Claimants
As noted earlier, because children are generally not expected to work, the SSI program uses a special definition of disability for minors. Individuals under the age of 18 must have a medically determinable physical or mental impairment, which results in , and which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months. The first part of the disability determination process for child SSI claimants is similar to the one used for SSDI and adult SSI claimants .263
Figure 6. Initial Disability Determination Process for Child SSI Claimants
CRS, based on Subpart P of 20 C.F.R. Â§404, Subpart I of 20 C.F.R. Â§416, and Chart 2 in Bernard Wixon and Alexander Strand, Identifying SSA‘s Sequential Disability Determination Steps Using Administrative Data, Research and Statistics Note no. 2013-01, June 2013, .
Notes: In 2018, the SGA earnings limit is $1,180 per month and applies only at the time of application.
How To Qualify For Ssi Benefits
You can get Social Security Disability benefits even if you do not have enough work credits to qualify for SSDI. The SSA offers the SSI program to disabled adults and children who have limited financial resources. It is a safety net so that people who cannot work for a living but do not qualify to collect SSDI can pay for essential items, like food, clothing, and shelter.
To qualify, you have to meet the same medical disability standards as a person does for SSDI. In addition, your income must be low, and your countable assets cannot exceed certain limits. Specifically, you could qualify for SSI benefits if:
- You have a severe illness or injury that meets the benchmarks of the SSAs Listing of Impairments, also called the Blue Book.
- Your disability prevents you from supporting yourself through gainful employment.
- You have very little income. This income limit can change every year. In addition, the income limit tends to vary by location because SSI is a joint program of the federal and state governments.
- Your countable assets do not exceed the SSI limit. This number can also change every year. Your home and the land it is on do not count as assets. Most cars also do not count toward your resources.
You must satisfy all of these elements to be eligible for SSI benefits. If you are struggling to understand the qualifications for SSDI or SSI, our firm can help you navigate these matters and apply for the benefits you may be entitled to because of your medical condition.
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Appealing Denied Social Security Disability Application
Its common for applicants to be denied. In fact, only about 1 in 3 applicants are initially approved for SSDI benefits. The two main reasons for denial are usually a lack of work credits, or that applicants do not meet the criteria for disability.
If you have been turned down, you do have the right to go through a Social Security Disability appeal process. Either you or your designated representative can file a Request for Reconsideration. Your initial appeal will then be turned over to Disability Determination Services, who will thoroughly review your file.
If you are denied again, you can proceed to the next level of appeal which is to appear in front of an Administrative Law Judge. An Administrative Law Judge will conduct a hearing in which all of your medical records and testimony will be heard before the judge renders a decision in the form of a written notice.
If you are still denied benefits, then you have a final appeal step you can take: filing a lawsuit in U.S. district court. You will need an attorney for this step if you havent already retained one. This can be an expensive and time consuming option, and as a result, less than 1% of disability claimants take their cases to this level.
What Is Supplemental Security Income
Supplemental Security Income is a federal program that pays monthly benefits to low-income aged, blind and disabled individuals. The Social Security Administration runs the program, which is financed from general tax revenues, not from Social Security taxes. The SSI test of disability for adult applicants is the same as the test in the Social Security disability insurance program. Only people who have low incomes and limited financial assets are eligible for SSI. The federal SSI payment in 2017 for an individual with no other countable income is $735 a month. Payments are reduced as other income rises, and some states supplement the federal payment. Each month on average in 2016, 8.3 million low-income adults received SSI. These beneficiaries included 4.8 million adults under age 65 who were eligible based on disability or blindness and 2.2 million adults aged 65 and older. In addition, 1.3 million children under age 18 receive SSI based on disability or blindness.
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How The Eitc Affects Other Government Benefits
If you apply for or get benefits or assistance using a program that uses federal funds, the refund you get when you claim the EITC does not count as income. It cant be counted as income for at least 12 months after you get it.
To find out if this rule applies to your benefits, check with your benefit coordinator.
What Medical Conditions Qualify For Long
Most medical conditions can qualify for long-term disability. However, some long-term disability plans will exclude certain medical conditions.
Assuming you dont have an excluded condition, then you can qualify for long-term disability benefits if your medical conditions prevents you from doing your regular work. You wont qualify to apply right away. Most long-term disability plans require you to be continuously disabled for a number of weeks before you are eligible to apply. This called the waiting period or elimination period.
The most common length of the waiting period is 17 weeks, but this can be different for each disability plan.
Most long-term disability plans have a two tier requirement for disability. For the first 2 years you can qualify for benefits if your medical condition prevents you from doing your regular work.
However, after 2 years, you can only qualify for long-term disability benefits if your medical conditions prevents you from doing any gainful work .
Following is an example of a long-term disability requirement fround in a group long-term disablity plan. This is only an example and these requirements and wording vary from plan to plan.
An employee is entitled to payment of a long term disability benefit if the employee presents proof of claim acceptable that:
- the employee became disabled while covered
- total disability has continued beyond the elimination period
- the employee has been folloing appropriate treatment for the disability condition
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As Inflation Rises Rapidly The Senior Citizens League Is Calling On Congress To Send Those On Social Security A Fourth Stimulus Check Worth $1400
Earlier this fall, the Senior Citizens League , a non-partisan advocacy group, started a pressure campaign to push Congress to send those receiving Social Security additional stimulus money. In a letter to leaders of Congress, TSCL Chairman Rick Delaney called for a one-off $1,400 Social Security stimulus payment for seniors.
Delaney urged members to send a special $1,400 stimulus check to those receiving Social Security benefits. Such a measure could help defray the costs associated for some seniors from the 2022 cost-of-living adjustment, which was the highest in 40 years, pushing them into a higher tax bracket. The letter began by highlighting that the organization has heard from thousands of seniors who have exhausted their retirement savings and started eating just one meal a day or cutting their pills in half because they cant afford their prescription drugs.
NEW: Inflation is being blamed on workers and government spending. The real culprit? Corporate greed.In our new episode of The Class Room we dug into financial reports to investigate the REAL reason prices are going up.Hint: corporate profits have never been higher.
More Perfect Union
Social Security Administration announced a historic COLA increase
Starting A Disability Claim For Vision Loss
If you don’t know whether you are eligible for Social Security disability insurance or Supplemental Security Income , you can apply for both. You can file for disability online or call the SSA at 800-772-1213 to set up an appointment to fill out an application for disability. When you fill out your application, include both how your vision loss has been affecting your life outside of work, including driving and reading, and how it impairs your ability to work. If you have both a vision loss and another physical impairment, be sure to include symptoms of the other physical impairment as well. It can take several months for the SSA to determine whether you are eligible for disability benefits .
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Were There When You Get Married
Whether youre celebrating your anniversary or starting a new chapter alone or with a new spouse, a part of that new life may include a new name. If you legally change your name due to marriage, divorce, or any other reason, let us know so you can get an updated Social Security card and so we can accurately keep track of your earnings. Theres no charge for a.
Application And Initial Determination Process233
The process begins when a claimant files an initial application for SSDI or SSI using one of four methods: submitting an application in person at one of SSA’s more than 1,200 nationwide field offices contacting a SSA teleservice representative over the phone and relaying the necessary information sending a paper application by mail or filing an electronic application on ssa.gov . If the agency requires more information to process the application, it will contact the claimant by phone or arrange for an in-person interview at the local field office. Claimants must inform and submit all evidence to SSA related to their impairment as a condition of their application for benefits.234
Claims representatives at SSA’s field offices screen claimants to make sure they meet the applicable non-medical entitlement factors. For SSDI, non-medical factors include disability-insured status, the work activity test , and the claimant’s relationship to certain family members. For SSI, such factors include income, resources, living arrangements, the work activity test , citizenship, residency, and the requirement to apply for all other benefits. In general, claimants who do not meet the applicable non-medical entitlement factors are found to be ineligible for benefits and do not receive a disability determination. SSA field office personnel notify claimants whose applications are denied due to non-medical factors.
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Eligibility Requirements For Dependents And Survivors
In addition to the disabled worker’s own benefit, SSDI provides benefits to certain family members of the worker. Social Security pays benefits to family members because workers with one or more dependents are presumed to have greater financial need when they retire, become disabled, or die than similarly situated workers who are single. The OASI component also provides benefits to eligible disabled dependents of retired workers and to eligible survivors of deceased insured workers. The term includes deceased individuals who received Social Security retired or disabled-worker benefits and non-beneficiary workers who were insured for Social Security at the time of their deaths.
Validly married spouses of disabled workers qualify for benefits if they are aged 62 or older or are any age and have an eligible child in their care who is under the age of 16 or disabled, are not entitled to a retired or disabled-worker benefit equal to or larger than the spousal benefit, and have filed an application for benefits.15 Spouses also must have been married to the worker for at least one continuous year immediately before the day on which the claimant’s application is filed.16 This provision is known as a duration-of-marriage requirement.
SSDI Minor Children
SSDI Student Children
SSDI Disabled Adult Children
OASI Disabled Widows
OASI Disabled Adult Children