The Buzzz June 2009

By Penny Reeder

What if you find yourself with a disability. Because of accident or illness or other unforeseen circumstances, what if you find that you can't walk, or hear, or see, or think clearly, or read, or write, or speak, or cope, and your doctor, counselor or social worker tells you that this unplanned-for state of being will be with you for the predictable future, perhaps forever? What now? What happens when the doctor says, "Nothing more can be done," or an employer says there's just no way you can continue to do the job for which you were hired, "due to your disability?" Now what? What can you do for an income? Where can you turn for help?

One of your most immediate and pressing concerns is likely to be about money. If you can't work in the job that has provided crucial income for you and your family, because of a newly acquired disability, where can you turn for help?

There are several programs that can help with a reliable monthly income while you begin to deal with the emotional, physical, and practical aspects of getting on with your life as a person with a disability. Two of these programs are under the direction of the Social Security Administration (SSA).

The Social Security disability insurance (SSDI) program pays benefits to you and certain family members if you have worked long enough and paid Social Security taxes. The Supplemental Security Income (SSI) program pays benefits to disabled adults and Children who have limited income and resources. Both programs also permit beneficiaries to enroll in state and federally funded medical coverage programs (Medicare in the case of SSDI and Medicaid for SSI recipients).

Eligibility for SSDI and SSI depends upon the medical information that describes your disability. You can apply for both programs by completing the Adult Disability and Work History Report, online at http://www.ssa.gov.

Or, call the Social Security Administration, toll-free at 800.772.1213 or via TTY, at 800.325.0778) or contact your local Social Security Office to set up an appointment to complete the SSDI and/or the SSI application forms in person or over the phone.

You can get help and advice about applying for SSDI and/or SSI from the Center for Independent Living, CIL, that serves your community; find a Center for Independent Living in your area here, http://www.ncil.org/directory.html. And, state vocational rehabilitation offices, http://www.ed.gov/about/offices/list/osers/rsa/index.html,also make available benefits specialists to assist their consumers with Social Security-related matters. In addition, there are thousands of private attorneys who specialize in Social Security-related issues and cases, and many of these publish web sites where you can find answers to frequently asked questions about SSDI and SSI. If you use an online search engine to find answers to the questions you have about Social Security benefits for people with disabilities, you are likely to find many thousands of links to for-profit businesses who are eager to provide help for a fee.

Social Security Disability Insurance is paid to people who have earned enough Social Security credits, i.e., they have been paying into the Social Security system for enough quarters to qualify, and who are unable to work because of a disability that has lasted or will last for at least 12 months or end in death, and, generally, who have worked for five out of the last ten years. There is no minimum age as long as you meet the social security definition of disability. To qualify for disability benefits you must have worked long and recently enough under Social Security to earn the required number of work credits.

You can earn up to a maximum of four work credits each year. The amount of earnings required for a credit increases each year as general wage levels rise.

The number of work credits you need for disability benefits depends on your age when you become disabled. To request a copy of your Social Security Statement that will let you know your current tally of quarters (The minimum is six) and include an estimate of your disability benefit, visit: http://www.ssa.gov/mystatement.

For most people, the medical requirements that make them eligible for Social Security disability-related benefits are the same for both SSDI and SSI, and disability is determined by the same process. Expect to be asked for information about your medical condition, work and education history. SSA suggests that you apply as soon as you become disabled. The Social Security Administration will determine if you are eligible for benefits by determining if you are able to engage in substantial gainful activity (SGA). Substantial gainful activity for individuals who are blind is currently $1,640 (this amount does not apply to Supplemental Security Income benefits). For individuals who are not blind, the monthly substantial gainful activity amount for 2009, is $980 before taxes. If you are making more than the allocated SGA limits the Social Security Administration will automatically deny your benefits and consider you not disabled. Even if your reported income falls below the SGA limits, your case examiner could deny you benefits based on what he or she believes about the severity of your disability or its probable impact on your ability to work.

Because applications for SSDI and SSI tend to increase during periods of economic downturn, it is quite likely that your wait for SSA's response to your application could be somewhat lengthy. During an average week when I scan various newspapers for articles and columns related to disability, I find the issue of lengthy waits for Social Security Disability decisions to be one of the most frequently covered topics in all media. There have been frequent Congressional hearings on this issue as well. The consensus among benefits specialists seems to be that, On average, a decision for an Initial Claim takes three-to-four months, and a Reconsideration about as long, though it is not unheard of for a case to be decided much sooner or much later.

If your application for SSI or SSDI benefits is denied, you can appeal, and if your claim is denied again, you can appeal once again, at a higher administrative level. Claimants whose SSI or SSDI cases are denied at the Reconsideration level (the first appeal after the denial of the initial claim) will have to wait for a hearing to be scheduled before an Administrative Law Judge.

This routinely takes 6 months or longer (and in some parts of the country, the wait, can be as long as 18 months. I share this information with you, not to discourage you, but because I believe that "forewarned is forearmed." Advice from your local Center for independent living, as well as from the benefits specialists that work under contract to the vocational rehabilitation agencies is obtainable free of charge, so my advice is to take advantage of the availability of Social Security benefits experts who can provide advice and guidance. And, educate yourself by visiting the Social Security web site and downloading the many informative publications that are available there http://www.ssa.gov/pgm/formspubs.htm.

Finally, to maximize your household income, apply for any other benefits for which you may be eligible, including the benefits available under the Temporary Assistance for Needy Families (TANIF), including food stamps, heating and energy assistance, housing assistance; workmen's compensation if your disability resulted from a job-related injury, any pre-existing long-term or short-term private disability insurance benefits, and Veterans' benefits if you qualify.

I have read that as many as 45 percent of SSDI claims are denied initially. Some of the attorneys who assist claimants through the application and appeals processes claim that number to be as high as 60 percent. I cannot find statistics concerning how many of those initial denials are reversed on appeal. But, one piece of good news I found is that, if your denial of benefits decision is reversed, Social Security will pay your benefits as far back as the date of your initial application.

There is currently a two-year waiting period for Medicare eligibility, computed from the date you originally applied for SSDI if SSA's final decision is in your favor. Note that (People with ALS or end-stage renal disease receive Medicare immediately.)However, for people whose disabilities do not fall under these exceptions, the two years can be an excruciatingly long wait. Sometimes, Medicaid can provide medical coverage during this waiting period. Again, contacting your local social services agency and any benefits specialists through a Center for independent living or vocational rehabilitation agency may be a worthwhile avenue for advice and assistance. "Ending the Medicare Disability Waiting Act of 2009" was recently introduced by Sen. Jeff Bingaman (D-NM) and Rep. Gene Green (D-TX). The bill proposes to gradually phase out the two-year waiting period over the next ten years, so that in 2019 all SSDI recipients will receive Medicare benefits immediately. Language in other health care reform proposals in both the House and the Senate also proposes to eliminate the Medicare waiting period. Meanwhile, if you apply and are approved for SSDI today, you can count on waiting two years before your Medicare health coverage begins.

While you come to emotional, psychological, physical, and practical terms with your status as a person with a disability, the programs discussed above can help by providing income and hopefully some amount of medical insurance to tide you over and keep you and your family going. But, we at Gettinghired.com are all about helping people with disabilities to rise above all the negative impacts of disability and get to a point of wanting, once again, to go to work. That's why you came to Gettinghired.com, and that's what we and our employer partners are aiming for as well. So, not too surprisingly, are the federal government and the Social Security Administration. That's why, in addition to the SSI and the SSDI programs for people with disabilities, there are the vocational rehabilitation agencies, the Centers for independent living, and the SSA's Ticket to Work program, which is designed to help people get off SSI and SSDI and go to work. Among other things, the SSA Ticket to Work program allows people who are SSDI and SSI beneficiaries to choose an agency registered with the SSA's Employment Network (EN) to assist them in looking for, training for, and finding work. The "ticket" allows SSDI beneficiaries to go to work for an extended period of time without losing their Medicare benefits. Another SSA program initiated to help people with disabilities go to work is the Plan for Self Sufficiency (PASS) program, which assists people who receive SSI to return to work. Here is a brief explanation: Eligibility for SSI and the amount of payments are based on income, resources, and ownership of certain properties. PASS lets a person with a disability set aside money and/or things he or she owns to pay for items or services needed to achieve a specific work goal. For example, the PASS lets an SSI recipient set aside money for installment payments or a down payment for items like an accessible vehicle, wheelchair, or a computer if it is needed to reach a work-related goal.

If you are a person who has recently acquired a disability, we at Gettinghired.com urge you to look for help and support in the many places where it is available. Join the Gettinghired community, network with other people who have disabilities, look for mentors, investigate advocacy organizations and service providers, and take advantage of our job development tools and training videos. Find a support group in your area, and network with other people who may have had similar life experiences. Look for a Center for Independent Living, and a vocational rehabilitation state agency, and sign up for the vocational rehabilitation services that will help you focus on all of the things you can still do, and all of the ways you can still make your community a better place, for everyone, to live. And, check out the programs that are available from the Social Security Administration. SSDI and SSI can help to tide you over and keep you and your family safe and nurtured while you learn about your rights under the Americans with Disabilities Act and the assistive technologies and accommodations that will allow you to be just as productive and efficient on the job as you were before the advent of disability.