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Free legal services in Washoe County, Nevada
Washoe Legal Services Information:
Social Security / SSI
- What is Social Security?
- Retirement Benefits
- Who is eligible to receive Social Security retirement benefits?
- At what age can I receive Social Security retirement benefits?
- How are monthly retirement benefits currently calculated?
- How can I obtain my Primary Insurance Amount?
- If I retire early, how will the amount of my benefits be affected?
- How much will my benefits increase if I take late retirement?
- Will my retirement benefits be reduced if I work while receiving them?
- Disability Benefits
- Family Benefits
- Lump Sum Death Benefits
- Supplemental Security Income (SSI)
- Direct Deposits
- Representative Payees
- Appeals
- If I disagree with a decision made by the Social Security Administration, may I appeal?
- Should I seek legal representation when appealing a Social Security Administration decision?
What is Social Security?
Social Security is a group of government programs administered by the Social Security Administration (SSA) which make payments to individuals. Eligibility for most SSA programs is based upon the work history of the recipient or a family member. They may be placed the following general categories:
- Retirement benefits;
- Disability benefits;
- Spousal benefits;
- Dependent benefits; and
- Lump sum death benefits.
Another SSA program is the SSI program. Eligibility for those payments is based upon financial need; not work history.
[Return to top] Retirement Benefits Who is eligible to receive Social Security retirement benefits?
Generally, to be eligible a retiring individual must have worked for ten years during the worker's lifetime in employment covered by Social Security. To reach 10 years of coverage, one must work 40 quarters (three-month periods), which for 1998 equaled $700 of earnings. Since 1970, quarters of work have been based upon annual earnings, not the actual number of months worked. Therefore, a worker earning $2,800 in 1998 would receive 4 quarters of credit, even if all of the money was earned within one calendar month. No more than 4 quarters may be earned in any calendar year, however.[Return to top] At what age can I receive Social Security retirement benefits?
Eligible individuals may take "early retirement" at a reduced monthly benefit level starting at age 62. If you wait until age 65 (the "expected" age of retirement), you will receive a normal benefit. Taking a "late retirement" after age 65 will give you a higher than normal monthly benefit.Due to increasing average life spans the "normal" or "expected" retirement age will be increased in the future. For persons born between 1943 and 1959, the "expected" retirement age is gradually increased to age 66 and for persons born after 1959 it is increased to 67.
[Return to top] How are monthly retirement benefits currently calculated?
First, SSA calculates your average monthly earnings during your work history. The 40 year period concluding with the year during which you turn 61 is utilized. Your 5 lowest earnings years are discarded. Earnings are adjusted for inflation.Second, SSA utilizes a complicated formula to determine your "Primary Insurance Amount". Third this "Primary Insurance Amount" is increased by cost of living increases beginning with the year you turn 62 (whether or not you retire at that age). For example, if Ms. X was born on 7-4-32, has a Primary Insurance Amount of $1,000, and retires on her 65th birthday which falls on 7-4-98, she would receive a first month's retirement check of $1,085. That check would include the cost-of-living increases for 1994 (when she turned age 62), 1995 and 1996.
[Return to top] How can I obtain my Primary Insurance Amount?
If you submit the form " Request for Earnings and Benefit Estimate Statement" to your local SSA office, SSA will provide you with a free estimate of your Primary Insurance Amount. Obtain a form at your local office or call SSA at (800) 772-1213.[Return to top] If I retire early, how will the amount of my benefits be affected?
Your retirement benefits are reduced by 5/9 of 1 percent for each month prior to age 65 for which you receive benefits. Individuals retiring at age 62 have their Primary Insurance Amount reduced by 20%, 13 1/3% at age 63 and 6 2/3% for retirement at 64. Again, in future years, the "expected" retirement age will be increased.[Return to top] How much will my benefits increase if I take late retirement?
The amount of increase depends on your age. If you were born before 1917 your increase will equal 1/ 12 of 1% per month. If born between 1917 and 1925 you will receive an increase of _ of 1 % per month. Those born after 1926 receive increases ranging from 3 1/2% to 8% per year. All persons born in 1943 or later will receive increases of 8% annually. At the present, these increases stop when you reach age 70.[Return to top] Will my retirement benefits be reduced if I work while receiving them?
Maybe. Persons under 65 currently may earn up to $8,280 annually with no reduction in benefits. Benefits will be reduced by $1.00 for every $2.00 earned in excess of that amount. Individuals age 65 through 69 may earn up to $12,500 with no reduction in benefits. Benefits will the reduced by $1.00 for every $3.00 earned in excess of that amount. Once you reach age 70 you may earn any amount without a reduction in retirement benefits.[Return to top] Disability Benefits Who is eligible to receive Social Security disability benefits?
If you are "disabled" and have worked a sufficient number of quarters during your work history, you may be eligible for Social Security disability benefits. You are considered "disabled" if you have physical or mental impairments which prevent you from engaging in "substantial gainful activity". Your "disability" must be expected to last for a minimum of 12 months or expected to result in death.If you become disabled before age 24, you must have worked at least six quarters in the three years before the disability began in order to qualify. If you become disabled at any time from 24 to age 30, you must have worked at least _ the quarters which passed between age 21 and the time your disability began. If you became disabled after age 31, you must have one quarter of work for each year after your 21st birthday and before the year in which the disability began. In addition, you must have worked at least 20 quarters in the ten years before the onset of your disability.
[Return to top] How are monthly disability benefits calculated?
The calculation of disability benefits is almost identical to the previously explained formula to calculate retirement benefits. Under both programs you would receive your Primary Insurance Amount, adjusted by annual cost of living increases. Your disability benefit calculation ends with the year you become disabled (the retirement benefit calculation, on the other hand, ends the year you become 61). You exclude your five lowest earnings years to calculate your retirement benefits, while you exclude 0 to 5 of your lowest years depending on the age at which you became disabled to calculate disability benefits.[Return to top] How can I prove that I am disabled?
It will be necessary to submit written medical evidence from your physicians to document your "disability". Under revisions to N.R.S. 629.061, which were passed by the 2001 Nevada Legislature, a health care provider shall furnish one free copy of any records that are necessary to support a claim or appeal under the Social Security Act, to a patient, (or a representative with written authorization from the patient), who requests it, within 30 days after the date of receipt of the request. The request must be accompanied by documentation of the claim or appeal,It may be necessary to take additional tests or be evaluated by Social Security physicians. You may also be required to document the limitations which your impairment places on your ability to perform basic work functions (sitting, standing, lifting, ability to understand and carry out routine instructions, etc.). If your application is initially denied, it is often wise to obtain the services of an attorney to help you gather and present your medical evidence. These rules are covered at 20 CFR 404, Subpart P.
[Return to top] When do disability benefits and Medicare began?
Payments for Social Security disability do not began until the sixth full month of disability. Individuals receiving Social Security disability benefits cannot qualify for Medicare coverage for two years after the onset of their disabilities.[Return to top] Family Benefits
If I retire or become disabled, can my family get benefits with me?Yes. As you work you are also building up protection for your family. Subject to the limitation explained below, qualified family members may receive a check of up to 50% of your retirement or disability benefit. Benefits may be payable to:
- your unmarried children under 18 (under 19 if in high school) or 18 and older if disabled before age 22.
- your spouse, if 62 or older (or any age if carrying for qualified child who is under 16 or disabled).
- your divorced spouse (who was married to you for at least 10 years) if 62 or older and unmarried.
[Return to top] Are my survivors covered when I die?
Your unmarried young or disabled children may qualify for monthly benefits. Moreover, your widow or widower, even if divorced (if you were married for least 10 years), may qualify for payments. Benefits can start at age 60 (or 50 if disabled) or at any age if caring for your qualified child who is under 16 or disabled.[Return to top] Is there a limit on the amount which my family and I may receive each month?
Yes. The total depends on the amount of your benefit and the number of family members who also qualify. The total varies, but generally is equal to about 150 to 180% of your retirement benefit (may be less for disability benefits). The family limit also applies to benefits for your survivors.[Return to top] What it my spouse worked enough to qualify for benefits?
Your spouse cannot receive benefits on his/her record plus a full benefit on yours. The most which your spouse can receive is the larger of the two benefits. To compare your spouse may request a Personal Earnings and Benefit Estimate Statement from SSA.[Return to top] Lump Sum Death Benefits Does Social Security make a death benefit payment when I die?
Yes. Social Security pays a $255 lump-sum death benefit if you worked either (a.) 40 total quarters, (b.) at least one quarter for each year after your 21st birthday [excluding the year of your death] or (c) at least 6 quarters in the 13 quarters preceding your death. The benefit is payable to your spouse, or if there is no eligible spouse, to a child.[Return to top] Supplemental Security Income (SSI) Does Social Security offer benefits to aged, blind and disabled individuals with little money and limited work histories?
Yes. The Supplemental Security Income (SSI) program pays benefits to individuals who are 65 and older, blind or disabled who are "needy". Persons are considered "needy" if they have limited income and resources. The limits on income vary from state to state. In Nevada an individual's monthly income may not exceed $494 if disabled, $534.40 if aged or $$603.30 if blind (assuming each is living independently). An individual's non-exempt resources may not exceed $2,000 in value.A husband and wife can receive SSI benefits as a couple if they are both either 65, blind and/or disabled. A couple may not have over $3,000 in non-exempt resources. The income limits for couples living independently in Nevada are:
- $815.46 Aged couple
- $965.53 Aged person and blind spouse
- $778.23 Aged person and disabled spouse
- $1,115.60 Blind couple
- $928.30 Blind person and disabled spouse
- $741.00 Disabled couple
The income limits for both couples and individuals are affected by living arrangements. Those in domiciliary care may qualified despite higher incomes (and receive a higher benefit). Those living in household of another have lower income limits and benefits (receiving free rent is considered "in-kind" income).
The purpose of the SSI payment is to ensure a minimum subsistence income for aged, blind and disabled individuals with limited work histories. In Nevada, a disabled individual is currently (1998) determined to need a minimum income of $494.00 per month. If, for example, such as individual's Social Security monthly check was only $200.00 (due to a limited work history), the SSI program would supplement the Social Security check by an additional benefit of $294.00. The two checks together would total the minimum subsistence income amount of $494.00.
[Return to top] What assets are exempt from the SSI resource limits?
Most importantly, your home does not count against the SS I resource limit. The rules allow several other types of resources to be exempt. Exemptions include a car (if necessary for employment or medical treatment), clothing, household goods, jewelry, life insurance with a cash surrender value under $1,500 and burial plots.[Return to top] How does the SSI program define "disabled"?
SSI uses the same definition used to determine eligibility for Social Security disability benefits. Essentially, you must show that you are physically or mentally unable to work for a period of at least 12 months.
[Return to top] If I receive SSI, will I be eligible for medical benefits?
Yes. SSI recipients are eligible for Medicaid. It is necessary, however, to file a separate application for Medicaid at your local Nevada State Welfare Division (NSWD) district office. To maximize coverage, file your application as near as possible to the date of your SSI application. Medicaid can pay for medical bills incurred up to 3 months prior to the date of your application.If you transfer resources to another person without receiving fair market value in return within 30 months prior to applying for Medicaid, NSWD will presume that you transferred the resource for the purpose of qualifying for Medicaid. You will have the burden of proof to demonstrate that you had a different purpose for transferring the resource. If you can not prove an innocent reason for the transfer, you will be disqualified from receiving Medicaid until you spend the uncompensated value of the resource on nursing home care or 30 months passes, whichever is sooner.
[Return to top] Direct Deposits May I have my Social Security or SSI check deposited directly to my bank account?
Yes. Request forms for direct deposit are available at any Social Security office.[Return to top] Representative Payees If I become the physically or mentally unable to handle my financial affairs, may a friend or family member receive my check?
Yes. The Social Security Administration may appoint a "representative payee" who may receive a check may payable to, for example, John Doe as representative payee for Sue Smith. The representative payee is accountable to the Social Security Administration for spending the check on the needs of the receiptient.[Return to top] Appeals If I disagree with a decision made by the Social Security Administration, may I appeal?
Yes. The appeals process contains four possible steps:
- econsideration by a second SSA eligibility worker,
- Hearing before an Administrative Law Judge (ALJ)
- Appeals Council review of the record, and
- Federal court judicial review.
The Social Security Administration must first give a written notice of its decision (for example, to deny benefits). The notice must state the reasons for the decision and explain how an individual can request a reconsideration. A reconsideration must be requested within sixty days of the date of the written notice.
When appealing from a decision to terminate SSI benefits once you qualify, you may continue to receive your check while the appeal is pending. To do so you must request a reconsideration within 15 days of the date of the written notice. You may call in to request that SSA calendar the request if you cannot file a written appeal on time (but must file it within 10 days of the call). If you wait longer than 15 days, you may still appeal within sixty days but your benefits will not be restored until after hearing if you win.
If reconsideration is unsuccessful, the Social Security Administration must send you another notice of decision. Within sixty days, you may request an administrative hearing before an ALJ. It is unnecessary, but usually helpful, to be represented by an attorney at this hearing. After hearing, the ALJ will send you a written notice of decision.
If administrative hearing is also unsuccessful in may request review by the Social Security Appeals Council within 60 days. This request is made in writing and the review is on the record. No hearing is held. If you receive an unfavorable decision, you may appeal to federal District Court within 60 days.
[Return to top] Should I seek legal representation when appealing a Social Security Administration decision?
Legal advice may be very helpful at any stage of the appeals process. If you are not represented prior to requesting an ALJ hearing, it is generally advisable to seek to services of an attorney at that point. You may agree to pay an attorney fee approved by the Social Security Administration from funds which you receive if you win your appeal.If you cannot afford an attorney, you may contact:
Washoe Legal Services, Inc.
650 Tahoe Street
Reno, Nevada 89509
(775) 329-2727
FAX: (775) 324-5509[Return to top] The following web sites may provide additional information or assistance:
Social Security Administration
http://www.ssa.govNat. Org. of Social Security Claimants' Representatives
http://www.NOSSCR.org[Return to top]
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