1. How is the cash amount of
a person's Title II (SSA) benefits calculated?
2. In determining SGA what time
period does SSA use to calculate income for a month (i.e. 1st
to the 30th, 15th to the 15th)?
3. If a person is self-employed
what money is counted toward SGA for a Title II beneficiary?
4. If a person who receives
Title II (SSA) benefits has earnings of $100.00 over SGA, can an IRWE
and a Subsidy be used for the same service (i.e., 10% follow-along service
from a job coach, $50.00 covered under the subsidy and $50.00 paid with
the IRWE)?
5. Do the Title II payments
to an eligible child of a qualified disabled worker count as income when
calculating SSI payments?
6. When a Title II beneficiary
is in their Extended Period of Eligibility (EPE) and earns over Substantial
Gainful Activity, does the beneficiary have to pay for the Medicare coverage?
7. How does in-kind support
affects Title II?
8. Do federally funded
"work study" program earnings effect the Trial Work Period (TWP) if the
student is a beneficiary of Title II (SSDAC or SSDI)?
9. If Title II or Title
XVI benefits are terminated or reduced, there normally is a 60 days to
appeal the decision. What is the 10-day rule about?
10. Will a Title II Beneficiary
who is on dialysis lose his/her Medicare when they return to work?
11. If a Title II beneficiary
has a disability that began two years before he applied for benefits,
how far back will SSA go when determining date cash benefits can begin?
12. If a beneficiary of
Title II who experiences blindness opens her own business, how is a TWP
month calculated or the SGA determined during the EPE?
13. Is there a maximum
cash amount of SSDI or SSDAC a person can draw?
14. Are SGA earnings counted
in the month earned or in the month paid?
15. How does Transitional Employment
(TA) affect the Trial Work Period?
16. When vacation pay or sick
leave is used, will the subsidy or IRWE still count, even though there
were no real hours used for additional supervision?
17. When both husband
and wife work, then the woman dies and the husband continues to work,
will the children be able to claim survivors' benefits?
18. Would a VR funded
assessment that includes payment to the vendor for the service and an
allowance to be paid to the client by the vendor for participation (a
stipend), be considered services when determining a TWP month?
19. If a qualified worker
with an adult child with a disability does not report the child as such
at the time of retirement, disability, or death of qualified worker, does
that exclude the adult child from ever receiving the disabled adult child
(SSDAC) benefits?
20. Can a trial work period (TWP)
be applied to child who will be eligible for SSDAC but are under the age
of 18, if they are in a school work program?
21. When does SSA count the
Cessation month and the two Grace months?
1. How is the cash
amount of a person’s Title II (SSA) benefits calculated?
In order to be insured for disability benefits, the worker
must have earned quarters of coverage under the Social Security system.
There must be one quarter of coverage for each year that elapses between
the worker's twenty-second birthday and the year the worker becomes
disabled.
There are special rules for workers who become disabled
at a very young age. People who become disabled before their twenty-second
birthdays must have six quarters of coverage. In 1999 one must earn $740.00
to earn a quarter of coverage. Only four quarters can be earned in any
year. In addition some of the quarters must be earned recently. This is
called the 20/40 rule. Basically one must have quarters of coverage in
twenty of the last forty quarters, five of the last ten years.
For example if a person becomes disabled at the age of 52,
SSA subtracts 22 from 52. The worker needs 30 quarters of coverage; of
this number at least 20 must have been earned in the past ten years. Next
the earnings are "indexed" or translated into modern money values, adjusting
for wage inflation. Social Security takes into account the average wage
in the year of the earnings and updates, translates or "indexes" it to
reflect the value those earnings would have had in the year in which the
person become disabled. In order to calculate the benefit amount SSA will
drop the lowest five years of indexed earnings.
Next SSA calculates the average indexed monthly earnings.
In the case above, the best 25 years of indexed earnings are averaged.
Keep in mind that if the worker does not have 25 years of earnings under
the Social Security system, that zeros will be averaged in for missing
years.
SSA next applies a rather complicated formula. Each year
"bendpoints" are announced for benefits to be calculated that year. SSA
takes 90% of the average indexed monthly earnings through the first bendpoint,
32% through the second bendpoint, and 15% of the average indexed monthly
earnings in excess of the second bendpoint. This means that if one's earnings
are quite small, it is likely that he will receive 90% of his average
indexed monthly earnings, but if his earnings are much larger, he will
receive a smaller percentage of his average indexed monthly earnings.
Thus the worker whose lifetime earnings have been small will receive a
disability benefit proportionally larger than the person who has been
more highly remunerated.
In 1999 the first bendpoint is $505.00. So if one's average
indexed monthly earnings were $505.00, he would receive 90% of this
amount or $454.50 as his disability benefit. The second bendpoint is
$3,043.00. So people who earn between $506.00 and $3,043.00 monthly
receive $454.50 plus 32% of the amount between $506.00 and $3,043.00.
Earnings over $3,043.00 increase the disability benefit at a rate of
only 15%. This computation is weighted to give a higher return to the
workers on the lower end of the wage scale, who have less opportunity
to save and invest during their working years.
The amount of the disability benefit may be reduced, if
the worker has received Workers Compensation or another public disability
benefit.
2. In determining
SGA what time period does SSA use to calculate income for a month (i.e.
1st to the 30th, 15th to the 15th)?
A full calendar month is used, not time by certain dates.
3. If a
person is self-employed what money is counted toward SGA for a Title II
beneficiary?
Earnings and participation in the business determine SGA
for people who are self-employed. The beneficiary is asked to describe
what activities he or she performs in the operation of the business, such
as, management, responsibilities, hours worked, etc. It is possible that
even though the earnings are not at the SGA rate, the person may be determined
to be working at the SGA rate, possibly adversely effecting his/her benefits.
4. If a person
who receives Title II (SSA) benefits has earnings of $100.00 over SGA,
can an IRWE and a Subsidy be used for the same service (i.e., 10% follow-along
service from a job coach, $50.00 covered under the subsidy and $50.00
paid with the IRWE)?
No. Not if it was for the exact same service. However, if
there is additional supervision involved by management, a coworker, or
job coach which is not part of the 10% time (perhaps funded by a secondary
source) then, yes, both a Subsidy and an IRWE could be used to reduce
income below SGA.
5. Do
Title II payments to an eligible child of a qualified disabled worker
count as income when calculating SSI payments for a parent?
No. The payments made to children of a disabled worker does
not count against the beneficiary.( If a PASS is written for an amount
that reduces the beneficiary's unearned income below the FBR, he/she could
be eligible for a cash payment from SSI.) Children's incomes are never
"deemed" toward the parents.
6. When
a Title II beneficiary is in their Extended Period of Eligibility (EPE)
and earns over Substantial Gainful Activity, does the beneficiary have
to pay for the Medicare coverage?
Yes, the beneficiary is responsible for the Part B premium.
SSA will bill the beneficiary for the coverage.
7. How
does in-kind support affect Title II?
It will only effect it if IRS counts it as earned income,
as in the case of an apartment manager who does not pay rent
8. Do
federally funded "work study" program earnings effect the Trial Work Period
(TWP) if the student is a beneficiary of Title II (SSDAC or SSDI)?
Yes, even though Work-Study earnings are not counted as
wages and the IRS deducts no taxes, earnings are counted as services
toward the TWP.
9. If
Title II or Title XVI benefits are terminated or reduced, there normally
is a 60 days to appeal the decision. What is the 10-day rule about?
If the beneficiary or recipient appeals within 10 days of
the notification benefits will continue and not be suspended during the
appeal process. However if the decision is in the favor of SSA the beneficiary
or recipient will have to reimburse SSA for the payments received during
the appeal.
10. Will
a Title II Beneficiary who is on dialysis lose his/her Medicare when they
return to work?
NO, there is a kidney disease exception for Medicare
coverage. It allows eligible beneficiaries access to premium free
Part A Medicare. Eligibility is not connected to earnings only to
the beneficiary's physical state.
11. If
a Title II beneficiary has a disability that began two years before he
applied for benefits, how far back will SSA go when determining date cash
benefits can begin?
The maximum SSA will go back is seventeen months.
This will include the claimants five-month waiting period and twelve months
of retroactive payments beyond date of applications.
12. If
a beneficiary of Title II who experiences blindness opens her own business,
how is a TWP month calculated or the SGA determined during the EPE?
There is no different test for the TWP it remains
the same for the beneficiaries who are not blind. However during the
EPE, A self-employed beneficiary of Title II who experience blindness
is evaluated for SGA solely on earnings. A separate evaluation
of the time spent in the business is not made as it is for beneficiaries
who are not blind.
13. Is there
a maximum cash amount of SSDI or SSDAC a person can draw?
Technically there is no limit. What you earn and what
you pay into the system determines your benefit amount. A worker who
always paid the most Social Security tax and retires at age 65 in the
year 2001 AD will receive $1,536 monthly.
14. Are SGA earnings
counted in the month earned or in the month paid?
For Title II, the earnings are for the month earned. For
example if a person was paid $600.00 a month for 12 months but only worked
9 months, earnings at $800.00 a month, putting him over SGA and affecting
his benefits and/or his eligibility status.
For Title XVI, income is counted as it is paid. SSA measures
earnings paid against the Federal Benefit Rate to determine the dollar
amount of SSI.
15. How
does Transitional Employment (TA) effect the Trial Work Period?
Generally, any income earned over $530.00 in one month
is considered "services" and will count as a trial work month. However,
there has been at least one case taken to the SSA Office of Hearings
and Appeals, Appeals Council. A determination was made that the work
the claimant performed during the time in TA employment does not constitute
services for the purpose of determining completion of a trial work period.
16. When
vacation pay or sick leave is used, will the subsidy or IRWE still count,
even though there were no real hours used for additional supervision?
For a subsidy vacation pay and sick leave are accumulated/earned
when the supervision was given. Vacation pay or sick leave would not have
an adverse effect on a person’s subsidy.
For an IRWE, if the individual does not pay for the service/products
needed for work and related to his disability then it will effect the
earnings SSA will count toward SGA and toward the countable income when
figuring the SSI cash payment.
17. When
both husband and wife work, then the woman dies and the husband continues
to work, will the children be able to claim survivors' benefits?
Yes, to the age of 18 unless the child was born with or
acquired a disability prior to the age of 22. However the surviving spouse
would not be eligible for survivors benefits if his income is high. The
child's survivor benefits are not reduced because of the living parent's
income.
18. Would
a VR funded assessment that includes payment to the vendor for the service
and an allowance to be paid to the client by the vendor for participation
(a stipend), be considered services when determining a TWP month?
No, a stipend is not related to earnings therefore would
not be counted toward the TWP.
19 If
a qualified worker with an adult child with a disability does not report
the child as such at the time of retirement, disability, or death of qualified
worker, does that exclude the adult child from ever receiving the disabled
adult child (SSDAC) benefits?
No, however there must be medical evidence that the disability
occurred prior to the age of 22 and the adult child is over the age of
18.
20. Can
a trial work period (TWP) be applied to a child who will be eligible for
SSDAC but is under the age of 18, if they are in a school work program?
No the TWP does not start until the child becomes eligible
for SSDAC benefits (age 18 is the earliest).
21. When
does SSA count the Cessation month and the two Grace months?
During the Extended Period of Eligibility (EPE) the first
month the beneficiary earns over SGA is the Cessation month (The beneficiary
will receive a check even though SGA had been earned.), and the next two
consecutive months are the Grace months (the beneficiary will also receive
a check even though SGA is earned.)
If the beneficiary never earns more than SGA during their
EPE then the Cessation and Grace months will be the first month of SGA
and the next two consecutive months. Even though the beneficiary will
receive a check from Title II for those three months they would have been
terminated from eligibility for Title II on the first month SGA is earned
after their 36 months of EPE.
