Social Security Benefits

You have a right to disability benefits if you have a medical condition that is expected to last for more than one year or will result in death.

The Social Security Administration (SSA) determines whether you are disabled by asking the following questions:

• Are you currently working? If so, what are your monthly gross earnings?
• Do you have a medical condition that would qualify as “severe?”
• Is your condition severe enough that it is found on SSA’s Medical Listings (which you can read through HERE)?
• Can you go back to doing work you have done before?
• Can you work any other kind of work despite your medical conditions?

For a full explanation of this process visit: https://www.ssa.gov/planners/disability/qualify.html#anchor3

You have a right to SSDI benefits if you have a medical condition that keeps you from working and is expected to last for 12 months or more or will result in death. You must also have worked enough to qualify.

The government uses something called “quarters of coverage” (QCs) — also called “Social Security credits” — to figure out if you have paid enough Social Security taxes to qualify for SSDI benefits. You earn QCs based on how much money you earn while you are working. The amount of money you must earn to equal one QC changes each year. You can only earn up to 4 QCs in a year, no matter how much income you earn.

While this system may seem confusing, you can find more information on QCs and a list of what you need to have earned to get them here:https://www.ssa.gov/OACT/COLA/QC.html. 

In general, to qualify for SSDI you must have worked enough to equal 40 QCs in your lifetime, with 20 of those quarters being in the last 10 years.

The following people may qualify for SSI benefits:

People who are age 65 or older;

People who are blind, meaning they have:

• Central visual acuity of 20/200 in their better eye with corrective lenses, or
• Visual field limited to 20 degrees in their better eye

Disabled adults – People age 18 and older who have a medical condition that keeps them from working and is expected to last for 12 months or more or will result in death.

Disabled children:

• People under age 18 who have a medical condition that causes severe functional limitations and is expected to last for 12 months or more or will result in death.
• Some people under age 22 who are students regularly attending school may be considered children by the Social Security Administration. 

In addition to being in one of the categories above, you must also:

• Have limited income and resources,
• Reside in the U.S. for at least 30 days,
• Not be absent from the U.S. for 30 consecutive days or more,
• Be a U.S. citizen or have a qualifying immigrant status,
• Not be confined to an institution (hospital or prison) at the government’s expense,
• Not be a fleeing felon,
• Apply for other cash benefits you may be eligible for such as pension or retirement,
• Give the Social Security Administration permission to contact your financial institutions, and
• Most importantly, you must FILE YOUR APPLICATION!

To qualify for SSI you must have little or no income. Not all income is counted by the Social Security Administration (SSA), but what income is counted reduces the SSI benefit amount you may receive. The maximum SSI amount changes yearly and can be found here: https://www.ssa.gov/oact/cola/SSI.html.

Income SSA counts:

• Wages from work (including wages of a spouse living with you);
• Money from other sources, such as pensions, other Social Security benefits, VA benefits; and
• In-kind support in the form of food and shelter

Income not counted by SSA:

• The first $20 of most income;
• The first $65 of wages and ½ of wages over $65;
• Value of SNAP, energy assistance, or other assistance based on need;
• Grants and scholarships for school;
• Loans you have to repay;
• The cost of impairment-related work expenses; and
• Disaster assistance.

To qualify for SSI you must have little to no resources (assets). To get SSI you must not have countable resources worth more than $2,000 for an individual, or $3,000 for a couple.

What resources are counted?

• Cash, bank accounts;
• Stocks, savings bonds;
• Property that is not your home;
• Life insurance;
• Personal property;
• Vehicles;
• Anything else that can be turned into cash; and
• “Deemed resources” — A portion of the resources belonging to someone else (often a spouse or parent) that the Social Security Administration decides to count as your own resources when you apply for benefits.

What resources are not counted?

• The home you live in and the land it is on;
• Household goods and personal effects;
• Burial plots;
• Burial funds for you and your spouse up to $1,500;
• Life insurance with a combined face value of $1,500 or less;
• One vehicle, if used for transportation;
• Grants, scholarships, and gifts to pay educational expenses for up to nine (9) months after receiving them; and
• Up to $100,000 for funds in an Achieving a Better Life Experience (ABLE) account.

Anyone who has paid enough in Social Security taxes over the course of their working life is eligible for Social Security Retirement benefits at a certain age.

The government uses something called “quarters of coverage” (QCs) — also called “Social Security credits” — to figure out if you have paid enough Social Security taxes to qualify for retirement benefits. You earn credits based on how much money you earn while you are working. The amount of money you must earn to equal one credit changes each year. You can only earn up to 4 credits in a year, no matter how much income you earn.

Anyone born after 1928 needs 40 total credits (generally around 10 years of work) to get Social Security benefits. If you have stopped working before you reached 40, the credits you did make stay put, so you are able to add to them if you begin working again.

Social Security Retirement benefits are based both on the money you made while working and the age you choose to retire.

In addition to the Social Security credits you need, to apply for benefits you will also need to be at least 61 years and 8 months old. (The youngest you may start receiving benefits is 62 years old.)

Social Security payments are different for everyone because they are decided by a number of factors. What you get for your own retirement will depend on:

Your full retirement age: While you can start collecting as early as 62 years old, the amount of money you get from each payment will depend on if you retire before or after your “full retirement age.” This is based on the year you were born, and you can find your own full retirement age HERE.

When you start collecting: Collecting before your full retirement age could reduce your monthly payments, while delaying them past your retirement age could increase the amount you get.

If you continue to work: Continuing to work after you begin receiving Social Security payments could increase the amount of money you get in the future, because the SSA recalculates the payments for their recipients each year.

If your family qualifies for benefits: Some family members may qualify to get benefits from your Social Security account, as much as one half of your full retirement benefit amount. This will not lower the amount that you personally receive from your Social Security benefits.

The Social Security Administration has a Retirement Estimator to help give you a general idea of what you can expect to receive.

Your spouse is eligible to get Social Security retirement payment from your account — even if they haven’t paid Social Security taxes — if they are at least 62 years old. If they get their own Social Security benefits but yours are higher, SSA will pay them their regular amount and add an additional amount from your account to equal the bigger number.

If your spouse does collect benefits under your account:

• Their monthly retirement pay will be permanently lowered if they start collecting before full retirement age. A percentage is taken out which is decided by how many months they have left before they reach full retirement age. They may also be affected if they are working during this time period. The earliest they can collect is at age 62. 
• Your spouse can get payments earlier than 62 years old only if they are caring for your child who is also getting benefits. These payments end when the child turns 16, but they start back up when your spouse meets the age requirements.
• The maximum amount of money the spouse can receive at full retirement age is one half of your full retirement amount.

The money your spouse gets does not lower the amount you get. It just raises the overall total of what your family receives from your account.

Your children — including biological children, stepchildren, adopted children, and dependent grandchildren — can qualify for social security retirement benefits on your account if they:

• Are unmarried;
• Are under 18 years old;
• Are 18-19 years old a full time student (grade 12 and under); or
• Are 18 and older, and disabled from a disability that started before age 22.

The money your children get does not lower the amount you get. It just raises the overall total of what your family receives from your account.

Ex-spouses of the deceased person can qualify for benefits on your account if they:

• Were married to you at least 10 years;
• Have not remarried;
• Are 62 years old or more; and
• Are not entitled to their own retirement benefits which are greater than yours.

 If they get their own Social Security benefits but yours are higher, SSA will pay them their regular amount and add an additional amount from your account to equal the bigger number.

The money your former spouse gets does not lower the amount you get.

When anyone has money from their paycheck taken out for Social Security taxes, they are also contributing to survivors insurance. When they die, their family members may become eligible to collect Survivors Benefits.

The government uses something called “quarters of coverage” (QCs) — also called “Social Security credits” — to figure out if you have paid enough Social Security taxes for your family to qualify for Survivors Benefits. You earn credits based on how much money you earn while you are working. The amount of money you must earn to equal one credit changes each year. You can only earn up to 4 credits in a year, no matter how much income you earn.

Unlike other Social Security benefits, the amount of credits needed to qualify for Survivors Benefits depends on the age of the deceased worker (but will never be more than 40 credits). The SSA requires fewer credits be earned the younger someone is when they die, so someone who passes away at 25 years old would need to have worked less time than someone who dies at 45 years old. 

The amount of money actually paid out by Survivors Benefits is decided by how much money the deceased earned over the course of their working life.

Widows and widowers are eligible for benefits under their deceased spouse’s record, generally including:

• 100 percent of the worker’s benefit amount if they are at full retirement age; 
• 71-99 percent of the worker’s benefit amount if they are older than 60 but younger than full retirement age;
• Benefits beginning at age 50 if they are disabled and the disability started before or within 7 years of their spouse’s death;
• 75 percent of the worker’s benefit amount at any age if they are taking care of your child, who is under 16 years old or disabled, who received benefits on your record. They must also not have remarried.

Spouses of the deceased can still be eligible for the same Survivors Benefits stated above if the marriage lasted 10 years or more, but:

• If the divorced spouse is caring for the deceased’s child, who is under 16 or disabled, who receives benefits from their account, the divorced spouse does not have to meet the 10-year marriage requirement.
• Benefits to surviving divorced spouses won’t affect the amounts the other survivors receive, unless they are caring for the deceased’s child as a divorced mother or father.

Unmarried children can be eligible to receive Survivors Benefits — generally 75 percent of the worker’s benefit amount — as long as they are: 

• Under 18 years old;
• 19 or under and attending an elementary or secondary school full time; or
• Disabled before age 22 and remain disabled.

Stepchildren, grandchildren, step grandchildren or adopted children may also receive benefits under certain circumstances.

A surviving parent may receive benefits if:

• The deceased provided at least half of their support; and
• They are not already eligible to receive a retirement benefit that is higher than the survivors benefit they would get from the deceased’s account.

Adoptive parents and stepparents are also eligible if they became a parent of the deceased prior to age 16.

The total amount of Survivors Benefits paid out to a family cannot exceed a certain amount, usually between 150 and 180 percent of the basic benefit rate. If the payments for all of the surviving family are greater than this, the amount of money they receive will be lowered. 

Divorced spouses don’t count toward this amount, unless they are caring for the deceased person’s child as a divorced mother or father.

The Social Security Administration uses a number of factors to decide what your maximum family amount will be. To see these explained in detail, head to https://www.ssa.gov/policy/docs/ssb/v75n3/v75n3p1.html.

The Social Security Administration’s policy on same-sex couples’ benefits is stated below, as taken from their official website:

“We recognize same-sex couples’ marriages in all states, and some non-marital legal relationships (such as some civil unions and domestic partnerships), for purposes of determining entitlement to Social Security benefits, Medicare entitlement, and eligibility and payment amount for Supplemental Security Income (SSI). We also recognize same-sex marriages and some non-marital legal relationships established in foreign jurisdictions for purposes of determining entitlement to Social Security benefits, Medicare entitlement, and SSI.”

There are several ways to apply for Social Security benefits.

Call Social Security at 1-800-772-1213 (TTY 1-800-325-0778).

Visit your local Social Security office. An appointment is not required, but if you call ahead and schedule one, it may reduce the time you spend waiting to apply.

Some people may be able to apply online.

When you apply for benefits you will need the following information:

• Information about you, including your place and date of birth;
• Names and dates of birth for your spouse and children;
• Bank account information; and
• Proof of immigration status, if you were not born in the U.S.

If you want to apply for benefits based on disability, you will also need:

• Information about your medical condition, including names and contact information for all doctors and hospitals who have treated you, names of all medications you’re taking, and information about medical tests you’ve had;
• Information about your work for the last 15 years, including the name and address of employers, job duties, and any work-related benefits you filed or intend to file for; and
• Information about any military service.

To learn more about applying for benefits online visit:https://www.ssa.gov/benefits/forms/.

In order to receive Social Security benefits based on disability, you must prove to the Social Security Administration (SSA) that you meet their definition of disabled (see above).

Medical evidence is the most important evidence that you can use to show that you are disabled.

Seek medical attention for your disabilities. A lack of treatment allows Social Security to ignore your disabilities.

Try and access all available medical services, including clinics and emergency rooms.

When you can see a doctor, talk to them about all your medical problems. Be as detailed as possible when you tell them about your symptoms, your pain, and the limitations that your conditions cause.

If you are taking medications, keep track of the dosage and the side effects of each medication.

If you have a good relationship with your medical provider, ask them to provide detailed information to the SSA. It is not helpful for your doctor to tell the SSA that you “cannot work.” It is more helpful for them to include detailed information. For example, how have your conditions affected your ability to carry weight? Are you unable to stand, sit, or walk past a certain amount of time? Do you have to take a number of breaks when doing physical activities? Do you have to elevate your legs?

If your conditions are psychological, your treating doctor should provide information about your ability to focus and concentrate. Also, they should address whether you will have trouble working with coworkers or supervisors, following simple or detailed instructions, or dealing with changes in your work routine.

Evidence from treating providers can be in the form of progress notes, evaluations, physical therapy notes, lab results, and exam results.

Other records that can help to prove you are disabled include: vocational evaluations, school records, VA personnel records, case management notes, and letters or written attestations from third parties such as family members, friends, former employers, and teachers who are familiar with your medical conditions.

If the Social Security Administration (SSA) denies, reduces, or terminates (ends) your benefits you may appeal the decision. Generally, you have 60 days from the date of the notice to file an appeal. If you are already receiving benefits, you may request for your benefits to continue until you receive a hearing, if you ask for your appeal and request your benefits continue within 10 days of the decision made against you.

Request for Reconsideration — This is a review of your case, including any new evidence, by a new person at the Social Security Administration (SSA). If your case is based on disability and you have new diagnoses or medical results, or if you are seeing a new health care provider, you should inform the SSAso they can help you request those records. You can usually file a Request for Reconsideration online. To file an appeal based on disability online go to: https://secure.ssa.gov/iApplsRe/start. For non-medical appeals head to: https://secure.ssa.gov/iApplNMD/start.

Request for Hearing with the Administrative Law Judge (ALJ) — This allows you the opportunity to meet with an ALJ (either in person or using video conferencing on a computer – depending upon current COVID-19 safety measures) to tell them why you think the decision made in your case is wrong. You are allowed to bring witnesses to the hearing and can submit new evidence up to 5 business days before the hearing. It is your responsibility to provide new evidence. To help you prepare for the hearing, you can get a CD from SSA that will show you what evidence, including what medical records, the ALJ has. You may have to wait for up to a year or more to get the hearing after you request it. A Request for Hearing can usually be filed online. To request a hearing based on disability online go to: https://secure.ssa.gov/iApplsRe/start. To request a non-medical based hearing head to: https://secure.ssa.gov/iApplNMD/start.

Request Appeals Council Review — If your hearing with the Administrative Law Judge is not successful, you can request that the Appeals Council review your case. In this process, you must show that the ALJ acted in a way not allowed by law, that the ALJ made an error in the way they applied the law, that the conclusions of the ALJ are not supported by the facts, or that there is an issue with the procedures in the way your case was handled. The Appeals Council can refuse to review your case. If they choose to review your case appeal, they can make their own decision immediately or they may send it back to the ALJ for a new decision. You will be allowed to submit new evidence to the Appeals Council, but only evidence that relates to the time period before the ALJ decision. The Appeal Council will look at any new evidence along with whatever issues the ALJ considered when making their decision. To download a Request for Review of Hearing/Decision form (Form HA-520) head here: https://www.ssa.gov/forms/ha-520.html

File a Complaint in Federal Court — If you disagree with the decision of the Appeals Council, you can appeal to the U.S. District Court that covers your geographic area. It is extremely difficult to win at the Federal Court level and it is recommended that you work with an attorney to do so. Contact CLSMF for additional help if you are in this situation.

You can find more information about the appeals process on Social Security’s website: https://www.ssa.gov/benefits/disability/appeal.html

You should always keep copies of any documents you file with SSA and get the names of any Social Security representatives you speak with concerning your case.

If the Social Security Administration (SSA) says that you have been overpaid, you are entitled to written notice explaining why the overpayment occurred and how much you have been overpaid. If you are still receiving benefits, SSA can withhold some or all of your benefits to repay the overpayment. 

Some reasons for overpayments include:

• Your income is more than what you reported to SSA;
• Your living situation changed;
• Your marital status changed;
• You have or received more resources than allowed; or
• You are no longer disabled but continued to receive benefits — this includes receiving benefits while an appeal of a reduction or termination is pending.

If you disagree with the amount of the overpayment or believe that you were not overpaid, you have 60 days to file an appeal. If you are still receiving benefits, you may request for your benefits to continue at the same amount until you receive a hearing, if you ask for your appeal and request your benefits continue within 10 days of the notice of overpayment. The steps of the appeal process are the same as those listed above for appealing a denial, reduction, or termination of benefits.

If the overpayment was not your fault and repaying it would mean that you could not pay you other necessary living expenses or repaying it would be unfair, you can request a waiver. There is no deadline to request a waiver of the overpayment. Social Security can decide to waive all or some of the overpayment. If SSA determines you are not eligible for a waiver, you may still be able to arrange an affordable payment plan. You can download the necessary overpayment waiver forms at https://www.ssa.gov/forms/ssa-632.html

If you agree that you have been overpaid but are unable to repay the overpayment at the SSA has asked you to, you can work out a payment plan. You can download the Request for Change in Overpayment Recovery Rate form (SSA-632) at https://www.ssa.gov/forms/ssa-632.html.

Keep a copy of any documents you file with the Social Security Administration and get the names of any Social Security representatives you speak with concerning your case.

For more information about overpayments visit: https://www.ssa.gov/ssi/text-overpay-ussi.htm.

The amount of money you get monthly from SSI is based on the maximum federal benefit amount, but is reduced depending on how much income and support you have.

Your entitlement to benefits starts as early as the next month after you applied for SSI if the Social Security Administration says that your disability started in that month or earlier. For example, if you apply for SSI in January 2020, the earliest you would be entitled to SSI benefits is February 2020. This means you may be entitled to “retroactive benefits,” which are benefits you get for the time period before you began receiving payments.

With SSI you also become eligible for Medicaid.

If you receive SSI, there are no payments that go to your children or spouse based on your disability.

There is no prior earnings requirement to receive SSI, so unlike other Social Security benefits, you do not need “Quarters of Coverage” or “credits” to qualify for SSI.

You should always apply for both SSI and SSDI if you think you qualify as disabled and let the Social Security Administration figure out if you are eligible for one or both benefits.

The amount of monthly SSDI benefits you will get is based on how much you paid in Social Security taxes while you were able to work.

Benefits can also be paid to your spouse, ex-spouse, children under 18 years old, and adult children who become disabled before the age of 22.

Your entitlement to benefits starts 6 months after the month that the Social Security Administration (SSA) says you became disabled. For example, if SSA says you became disabled in June of 2019, you would be entitled to benefits starting in December 2019.

You can receive up to 1 year of “retroactive benefits” prior to your application date, so make sure you tell SSA the earliest date you believe you became disabled. Retroactive benefits are benefits you receive for the time period before you start receiving regular benefits.

You become eligible for Medicare 2 years after the date your SSDI entitlement begins. For example, if SSA says you became disabled in June of 2019, you would be entitled to SSDI benefits starting in December 2019, and Medicare would start in December 2021.

SSDI converts to Social Security Retirement benefits when you reach full retirement age. This is done automatically. The total amount of your monthly benefit will remain the same.

You should always apply for both SSI and SSDI if you think you qualify as disabled and let SSA figure out if you are eligible for one or both benefits.

The amount of money you get on a monthly basis from Social Security Retirement is decided using your highest 35 years of earnings. If you haven’t worked a full 35 years your benefits will be lowered, because years not worked count as zeroes.

If you wait to start collecting retirement benefits, the overall amount you get monthly will increase. Waiting may also increase the amount your survivors get when you die. Consider the benefits your family may be entitled to on your account to help decide if you want to begin getting retirement payments sooner or later.

Look up your “full retirement age,” which is different depending on when you were born. Retiring before or after this age has a large impact on the amount of money you will receive. You can find your full retirement age here https://www.ssa.gov/planners/retire/ageincrease.html.

If you start getting benefits before full retirement age and keep working, your monthly amount will be temporarily reduced. You’ll still get paid the money SSA withheld — it will be added to your monthly benefits after you reach full retirement age, whether you keep working or not.

Not everyone has to pay income tax on their Social Security retirement benefits. To see if you will need to, check the SSA page on taxes HERE: https://www.ssa.gov/planners/taxes.html

You can get benefits if you are a U.S. citizen and you may be entitled to benefits if you are a legal immigrant who is lawfully present in the country (as long as you and your employers have paid Social Security taxes).

Jobs you have worked that did not pay Social Security taxes may lower the monthly amount you get.

You will continue to get your retirement benefits for the rest of your life, so consider your health and life expectancy when deciding when to start collecting. Delaying payments will increase the overall amount you receive monthly when you finally begin collecting.

If you have already started getting retirement payments, you will automatically be enrolled in Medicare when you turn 65.

The amount paid out to survivors is based on how much money the worker paid into Social Security throughout their working lifetime.

Working while collecting Survivors Benefits, if younger than full retirement age, will reduce the monthly amount that you get.

Remarriage may affect whether you can claim Survivors Benefits from your former spouse’s account. If you remarry before the age of 60 (50 for the disabled), you cannot collect Survivors benefits.

Deaths must be reported to Social Security as soon as possible.

Reporting a death or filing an application for Survivors Benefits cannot be done online. You may call the Social Security Administration at 1-800-772-1213 (TTY 1-800-325-0778) Monday through Friday, from 7am to 7pm, or stop by your local Social Security Office. They will instruct you on what documentation you need for your specific claim.

The Social Security Administration has a free-to-join personal online account system where you can:

• View the status of applications or appeals;
• View your Social Security statements and history;
• View benefit estimates;
• Request a replacement Social Security Card;
• Request benefit verification letters;
• Report wages for SSI or SSDI;
• Update your direct deposit information;
• Get replacement forms for tax purposes;
• Get online notifications about your account; and
• Access multiple planning tools, such as the Retirement Calculator.

You can create your own account here: https://www.ssa.gov/myaccount/

Depending on the type of Social Security benefit you receive, you may be eligible for health care benefits too. 

• If you receive SSI, you will be eligible for Medicaid starting in the month your benefit payments start. You only need to be receiving $1 of SSI in order for Medicaid coverage to kick in. 
• If you receive SSDI, you become eligible for Medicare 2 years after the date your SSDI entitlement begins.

If you are receiving Social Security Retirement benefits, you should automatically be enrolled in Medicare.

The Social Security Administration (SSA) reviews disability cases for medical improvement about every 3 years. This process is called a Continuing Disability Review (CDR). If SSA determines you are no longer disabled, your benefits will stop.

You will know when your case is being reviewed because SSA will send you a written notice by mail that they are reviewing your case. As part of the CDR, SSA may ask for you to complete forms and for you to be evaluated by their doctors. 

Social Security also reviews children’s cases 2 months before they turn 18. During this review, SSA determines if the child’s disability meets the requirements for adults. 

See above for information about appealing a denial, reduction, or termination of benefits.

General information and guides from the Social Security Administration online, updated regularly with emerging information: https://www.ssa.gov/pubs/

To file an appeal online: https://www.ssa.gov/benefits/disability/appeal.html

Reconsideration Form: https://www.ssa.gov/forms/ssa-561-u2.pdf

Request for ALJ Hearing: https://www.ssa.gov/forms/ha-501.pdf

Request for Waiver of Overpayment: https://www.ssa.gov/forms/ssa-632-bk.pdf