How Does Using Paid Time Off Impact an SSDI Application?

If you are applying for Social Security Disability Insurance (SDDI), you may wonder if you have to stop working before you apply. You may also wonder if you are allowed to use your sick time, vacation time, or some other paid time off.

The first thing that the Social Security Administration (SSA) looks at when determining if you meet their definition of having a disability, is whether you are currently working. SSA believes that if you are working, then you are able to work and do not have a disability. But there is a big difference from working 40 hours a month as a receptionist and working 160 hours a month as an attorney. Each year, the SSA establishes a dollar threshold amount, and if you make under that amount, you are not considered to be working, according to SSA. This threshold is called Substantial Gainful Activity (SGA).

In 2017, the SGA is $1,170 per month for individuals with a disability other than blindness. If you make more than the SGA, you will not qualify for SSDI and your claim will be denied. The SGA for blind applicants is $1,950 per month. These amounts are your gross earnings.

When determining your income, the SSA will only look at earnings derived from actual work activity in the month under consideration.  That means that sick days, vacation days, or other paid time off will not be considered.

So, if you worked 5 days in a month, and then took 15 sick days, only the 5 days of work will count towards the SGA threshold. If you work 2 weeks in a month (10 days) and then take the next 10 days off using accumulated vacation time, only the 10 days you worked will counts towards the SGA.

This is important, because it means that you can apply for SSDI, without having to first use up all your paid time off.  And, since there is a five-month waiting period for SSDI benefits to begin, you paid time off can help bridge that gap.

For more information about SGA and applying for SSDI, visit: https://www.ssa.gov/pubs/EN-05-10029.pdf or https://secure.ssa.gov/poms.nsf/lnx/0410505010.

People with Cancer are Stuck in the Disability Backlog

Tai Prohaska, MPH
Manager of Strategic Alliances, Allsup

Most people don’t know much about the Social Security Disability Insurance (SSDI) Disability-Backlogprogram until they have to stop working because of an illness or injury. Then, one of their first questions is, “Am I eligible?” They may qualify for monthly income (based on what they have paid into the system) and other benefits if they:

  • Are unable to work for at least 12 months or more, or their condition is terminal
  • Have paid FICA taxes for at least five of the last 10 years
  • Are over 21 and under full retirement age (65-67)

For more information about disability insurance options, read Triage Cancer’s Quick Guide to Disability Insurance.

While SSDI benefits can be useful, there are some barriers to getting access to these benefits:

  • It’s not easy to obtain benefits. Two-thirds of people who apply are denied and must go through an appeals process that can sometimes take years.
  • People are waiting an average 596 days for a disability hearing. Almost half of U.S. hearing offices now report waits of 600-plus days, including 14 offices whose times exceed 700 days. Click here for the average wait in your state.
  • After the hearing, people could wait an estimated 78 to 120 days to find out the judge’s decision.

The disability backlog was also an issue in 2009, when Allsup surveyed individuals going through the SSDI appeals process. Of those surveyed, 90% said they faced negative repercussions while waiting for their SSDI award. These included:

  • Stress on family – 63%
  • Worsening illness – 53%
  • Draining of retirement/savings – 35%
  • Lost health insurance – 24%
  • Missed mortgage payments – 14%
  • Foreclosure – 6%
  • Bankruptcy – 5%

Cancer is one of the top five categories of conditions that qualify someone for disability insurance benefits, according to the Social Security Administration (SSA). A 2013 study estimated that cancer accounted for 9% of all SSDI awards. Based on those numbers, we can only guess how many individuals with cancer are stuck in the SSDI backlog.

Banish the Backlog

One way individuals with cancer can improve their likelihood of avoiding the SSDI backlog is to get help at the very beginning of the process, starting with an eligibility assessment before they ever go to the SSA. Most people who apply through the SSA’s website for SSDI are denied. They don’t have enough work credits, do not submit adequate medical records, do not fill out SSA’s forms properly, or do not respond to the SSA’s requests for additional information. The process can be overwhelming and confusing.

Many websites offer tips on how to apply for disability. Allsup has a free online screening tool, empower by Allsup®, which also incorporates return-to-work information. Getting help with the initial application can mean the difference between getting benefits in a matter of months instead of years.

If you are stuck in the disability backlog and want to post your experiences and suggestions for tackling this problem, visit the Banish the Backlog Facebook page at www.facebook.com/banishthebacklog.

Understanding SSDI vs. SSI Can Save You Time, Effort, & Maximize Benefits

Tai Prohaska, MPH
Manager of Strategic Alliances, Allsup

There are two main federal disability benefits that can be a lifeline for individuals diagnosed SSDI vs SSIwith cancer: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). Both programs are administered by the Social Security Administration (SSA), and people often get them confused.

Before applying for either program, it’s best to understand the difference between them, and their eligibility criteria, so you don’t waste your time, effort, and resources applying for benefits that will be denied. On the flip side, understanding these programs can help ensure you get the benefits you deserve. About 8% of all Social Security disability beneficiaries qualify for both programs.

Social Security Disability Insurance (SSDI)

SSDI is a payroll tax-funded, federal insurance program. A portion of the FICA taxes workers pay is set aside for SSDI (as well as Social Security retirement and Medicare). SSDI provides you with income if you are unable to work due to a disability or until your condition improves, and guarantees income if your condition does not improve. To qualify for SSDI, you must:

  • Be between 21 and full retirement age
  • Have worked five out of the last 10 years
  • Be unable to work and are expected to be unable to work for 12 months or longer, or have a terminal condition.

The average monthly SSDI benefit in 2017 is $1,171 for a disabled former worker and $1,996 for a disabled former worker with dependents.


Supplemental Security Income (SSI)

SSI is a means-based program for low-income individuals, so eligibility is based in part on your income and resources. To qualify for SSI, you must be:

  • Aged 65 or older;
  • Blind; or
  • Unable to work for 12 months or longer due to a medical or mental health condition that is expected to last at least one year or result in death; and
  • Have no more than $2,000 in resources (for an individual) or $3,000 (for a couple).

The SSA does not count the home you live in or your car as resources.

The maximum monthly SSI benefit in 2017 is $735 for an individual and $1,103 for a couple. Most states pay some persons who receive SSI an additional amount called a “state supplement.”

Concurrent Benefits

Some individuals are eligible for both SSI and SSDI. This happens when a person is approved for SSDI, but receives a monthly payment that is less than the SSI maximum payment ($735 in 2017). This can happen when a person has not worked much in recent years, or earned low wages. People who are eligible for both programs can file a concurrent claim for disability benefits with the SSA.

Resources

Triage Cancer has resources to help you find out more about disability insurance and how it can help you:

For more information about the Social Security Administration’s disability benefits, visit: www.ssa.gov/disabilityssi or read this guide: www.ssa.gov/pubs/EN-05-10029.pdf.

Important Social Security Information for People Affected by Hurricane Harvey

The following information is from the Social Security Administration’s press release, issued on Thursday August 31, 2017. Our hearts go out to all those impacted by Hurricane Harvey.

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Many Social Security and Supplemental Security Income (SSI) benefit payments are scheduled for Friday, September 1.  The following information covers the various delivery methods for these payments in the wake of Hurricane Harvey.

Payments by Paper Check Delivered by the US Postal Service

Hurricane Harvey’s impact on the Gulf Coast resulted in the temporary suspension of mail delivery service, as well as the closure of some postal facilities in the Houston area.  The U.S. Postal Service is providing additional information on how customers displaced by Hurricane Harvey can retrieve checks they receive via the mail.

Provided here about.usps.com/news/state-releases/tx/tx.htm is a list of Post Office locations, by ZIP Code, where checks will be made available for pick-up beginning Friday, September 1.  People must have proper identification to receive their check.

Payments by Direct Deposit

Nearly all payments issued by direct deposit will arrive as scheduled.  If a person’s payment is delayed, they should contact their financial institution.  If the financial institution is not operating, please see the “emergency payment” information below.

Payments by Direct Express Debit Card (a Treasury Department program)

For recipients in the affected areas who receive their payment through a Direct Express card, fees will be waived, even if they have evacuated out of the area. Payments will be posted to Direct Express cards on September 1.

People may contact Direct Express at 1-888-741-1115.

Emergency Payment Locations

Social Security has established three emergency payment locations in Texas where Social Security and SSI beneficiaries may request an immediate payment in person if they cannot receive their regular payment.  The locations and hours are:

Friday, September 1, and Saturday, September 2:

Houston: NRG Center
2 NRG Park, Houston, TX 77054
From 9:00 AM – 4:00 PM

Dallas: Kay Bailey Hutchison Dallas Convention Center
650 S. Griffin Street, Dallas, TX 75202
From 9:00 AM – 4:30 PM

Austin: Tony Burger Center
3200 Jones Road, Austin, TX 78745
From 9:30 AM – 3:00 PM

For people who cannot receive their regularly scheduled Social Security payment as a result of Hurricane Harvey, in most cases they can go to any open Social Security office and request an immediate payment.  A list of offices that are currently closed, as well as additional information for the public, is available at www.socialsecurity.gov/emergency.

To find the nearest open Social Security office outside of the affected areas, call 1-800-772-1213 (TTY 1-800-325-0778) or go to www.socialsecurity.gov/locator.

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To get more Social Security news, follow the Press Office on Twitter @SSAPress.

“Going Out on Disability”

When someone is faced with a cancer diagnosis and treatment, they often wonder “do I Going Out on Disabilityneed to go out on disability?”  Unfortunately, they aren’t always sure what that actually means, or that it could mean multiple things.

The main confusion comes from not understanding the difference between disability leave and disability insurance.

Generally, the term “disability leave” is used to refer to time off from work, taken by an employee due to a serious illness or injury. However, it is important for individuals to understand how they are taking that leave.  Employees may be able to take time off from work under the Family and Medical Leave Act (FMLA), which is a federal law that provides eligible employees with up to 12 weeks of unpaid, but job protected leave, per year.  (Triage Cancer’s Quick Guide to the FMLA).  Some employees may also be able to get some time off as a reasonable accommodation under the Americans with Disabilities Act (ADA), which is a federal law that provides protections for individuals with disabilities. (Triage Cancer’s Quick Guide to Reasonable Accommodations). Disability leave may also refer to time off from work because of an employee’s medical condition, which is allowed under a specific employer’s policy rather than required by law.

If an employee has to take some time off, or has determined they are unable to work at all, the next thing they have to understand, is how they might be able to replace their lost wages. That is where disability insurance comes into play. Disability insurance benefits can be purchased directly from a private insurance company, or can be offered by an employer, some state governments, or the federal government.

You may be able to purchase a private disability policy directly from an insurance company. Unfortunately, there are very few regulations around the sale of these policies, so companies are allowed to take into consideration pre-existing conditions and health status when determine whether to sell you a policy and what to charge. So, if you already have a pre-existing condition, it is difficult to get a private disability insurance plan. However, it doesn’t hurt to look into your options in your state.  You can visit http://triagecancer.org/stateresources to find your state’s insurance agency, which should share information about which companies sell policies in your state.

Many employers also offer disability insurance as a benefit of employment.  Employers may pay all or part of the premium. One example of an employer-sponsored disability insurance plan is Aflac, but there are many others. These group plans are guaranteed-issue, meaning that you cannot be denied, but you may face exclusions of coverage for pre-existing conditions. Contact your employer’s human resources representative or your employer’s insurance company for more information about your specific plan.

There are also a handful of states (CA, HI, NJ, NY, RI, and PR) that have state disability insurance programs. The details vary by state, but generally these programs are for short term disabilities (up to one year).

Finally, there are two federal disability insurance programs: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI).  Both programs are run by the Social Security Administration and are based on having a long term disability.

Get more, customized information about disability insurance at http://cancerfinances.org, or check out Triage Cancer’s Quick Guide to Disability Insurance

The bottom line, is instead of simply saying “I’m going out on disability,” it can help to be clear about if you mean disability leave or that you are receiving disability insurance benefits, or both!

An Update to Cancer Exposure at Camp Lejeune

Cancer Exposure at Camp LejuneIn February of 2016, we notified you that the Department of Veterans Affairs (VA) has acknowledged that exposure to Camp Lejeune’s contaminated drinking water increases your risk for cancer and other medical conditions. Now the rules that will allow potentially thousands of veterans stationed at the base — or surviving spouses — to receive automatic disability benefits if they have been diagnosed with one of eight diseases, have been finalized.

If you or your spouse were stationed at Camp Lejeune for at least 30 cumulative days, between August 1, 1953, and December 31, 1987, and you have been diagnosed with adult leukemia, aplastic anemia, bladder cancer, kidney cancer, liver cancer, multiple myeloma, non-Hodgkin’s lymphoma or Parkinson’s disease, you could be eligible for Disability Benefits from the VA. You will have to submit evidence of the diagnosis and service information.

Please be aware, according to the VA, it is currently taking about 133 days to process Disability Claims.

Getting Back to Work: SSI Employment Support Programs

money-ssiSupplemental Security Income (SSI) pays cash benefits to eligible, low-income individuals who are 65 or older, or have a disability, or who are blind.  SSI is run by the Social Security Administration. There is no requirement to pay into the Social Security retirement system before you can receive SSI benefits, which is different from Social Security Disability Insurance (SSDI).  View our Quick Guide on Disability Insurance for more information.

One thing that both SSI and SSDI have in common is a system of support programs to help you get back to a well-paying job when your medical condition no longer keeps you from working. Please see our blog on SSDI Employment Supports for information on the Ticket to Work Program, which is available to both SSDI and SSI recipients.

In this blog, we would like to share a brief overview of SSI specific employment supports that help determine how much your benefit will be when you try to return to work:

Earned Income Exclusion

The first $65 of the earnings you receive in a month, plus one-half of the remaining earnings will not be counted when determining your benefit amount. This means that they count less than one-half of your earned income when they figure your SSI benefit amount.

Section 1619 – Special SSI Payments for People Who Work

You can still be eligible for SSI and Medicaid while working (under section 1619(b) of the Social Security Act) as long as your earnings remain under your state’s threshold amount, you need the Medicaid coverage, and you continue to be eligible for SSI except for your earnings (meaning you still have a disability).  After you return to work, your Medicaid coverage can continue, even if your earnings (alone or in combination with your other income) become too high for a SSI cash payment.

Reinstating SSI Benefits without a New Application

If you lose your eligibility for SSI because of your work situation, you may be able to restart your SSI benefits again at any time within 5 years, without a new application.  Basically this means if you lose your job or take a pay cut, but are still disabled, your SSI payments will resume immediately.

If you have been ineligible for SSI and/or Medicaid for any reason other than work or medical recovery, you may be able to restart your SSI cash payment and/or Medicaid coverage within 12 months without a new application.

Student Earned Income Exclusion

If you are under the age of 22 and regularly attending school, they don’t count up to $1,780 of your earned income when figuring your SSI benefit.

Property Essential to Self-Support (PESS)

They do not count some resources that are essential to your means of self-support when they decide if you are still eligible for SSI.  For example, they don’t count up to $6,000 of the equity value of a non-business rental property, if that property has an annual rate of return of at least 6%.

For more information about the detailed rules surrounding working while receiving SSI benefits, please visit https://www.ssa.gov/redbook.

This can be very confusing information, so for a complete overview of the entire SSI program go to https://www.ssa.gov/ssi/text-understanding-ssi.htm. You can also call the Social Security Administration at 800-772-1213 or visit your local Social Security office for assistance.

Understanding your options can help you get back to work and get back to normal.

Getting Back to Work: SSDI Employment Supports

triage-cancer-blog-return-to-workReturning to work after being out because of a serious medical condition can be a scary prospect.  It usually takes a person quite a long time to get approved for SSDI benefits, so the thought of giving up those benefits is alarming if you are not 100% sure you’re ready to work.  The Social Security Administration understands that fear, and has you covered, with what they call “employment supports.”

This is a quick overview of SSDI employment supports and how they work together:

Step 1. The Trial Work Period (TWP)

This is an opportunity for you to test your ability to work, during which time you will continue to receive SSDI payments, no matter how much you earn as long as you still have a disability and are reporting your work to the SSA.  The details:

  • The TWP lasts for 9 months
  • The 9 months do not have to be in a row
  • The 9 months must take place within a 60 month timeframe

Step 2. The Extended Period of Eligibility (EPE)

This period begins the month after your TWP ends.  So, if you’ve worked and received benefits for 9 months, on your 10th month you would be in your EPE.  This means you might be eligible for another 36 months of benefits depending on how much you are earning. This one is a little trickier:

  • During your EPE, you will receive benefits for any month you work and your earnings are not considered a substantial gainful activity (SGA).
  • During your EPE there is a grace period. Meaning, if you suddenly get a raise or get more hours at work and your earnings are considered substantial, you will receive benefits for that month and the following 2 months.
  • Your benefits will end if your earnings are substantial in any month after the EPE ends.

Step 3. Expedited Reinstatement (EXR)

Step 3 only comes into play if you have returned to work and your SSDI benefits have ended because your earnings are considered substantial.  EXR is a safety net, meaning it’s there for you when everything is going great, you’re back to work, and then all of a sudden your medical condition flairs up.  The details:

  • If your benefits ended within the last 5 years due to an increase in your earnings, but you still have your original medical condition, you do not have to reapply for benefits.
  • Instead, you will receive 6 months of temporary benefits while your case goes under medical review. Also, if you are found not to be eligible for benefits after that review, you don’t have to pay back the temporary benefits you received.

Please visit www.ssa.gov/redbook/documents/TheRedBook2016.pdf to get a full understanding of the rules surrounding going back to work.

Getting Back to Work: Ticket to Work Program

triage-cancer-blog-return-to-workIf you are receiving disability benefits because of a cancer diagnosis, you may be considering going back to work. You may even be eager to get back to the normalcy of working.  As Americans, we get a great sense of worth and identity from our jobs.  Work is also a great social outlet for a lot of people.  After a cancer diagnosis, working can mean more than financial independence.  It can also mean moving beyond your diagnosis.

Well, when you’re ready to return to work, the Social Security Administration is ready to help.  They have a robust program designed to assist you to find work after a disability: the Ticket to Work Program.

Ticket to Work
If you are receiving SSI or SSDI, and are between the ages of 18 and 64, you qualify for a program called Ticket to Work.  This is a free and voluntary service that can help you go to work, get a good job that may lead to a career, and become financially independent.  Essentially, this program matches you with career planners and vocational rehabilitation services that will help you make a plan for getting back to work, and then help you execute that plan.  They will review your resume, set up interviews, conduct job training, and much more.  They will also provide information about your disability benefits and what they will look like when you go back to work.  Here are some things you should understand about the Ticket to Work program:

  • Opening a Ticket to Work does not mean you will automatically lose your SSDI or SSI benefit. If you open a Ticket to Work and make timely progress with either an employment network or a state vocational rehabilitation counselor, your medical condition will not be reviewed and you will continue to receive you normal benefit until you start actually working.
  • Opening a Ticket to Work will not cancel your Medicare benefit. Even if you go back to work and make enough to stop your SSDI benefit, you are still eligible to keep Medicare Part A (hospital insurance) for up to 93 months.
  • Opening a Ticket to Work will not necessarily cancel your Medicaid benefit. If you make enough to stop your SSI benefit, but are still under the earnings threshold set by your state, you could still be eligible for Medicaid.  Even if you make more than your state earnings threshold, you could be eligible for a Medicaid buy-in program.  You need to speak with your state Medicaid office to find out what that threshold is in your state. Click here to find your state Medicaid agency.

Another concern you may have about returning to work too early is sacrificing the SSDI or SSI benefit that took you so long to get in the first place.  Social Security has a work incentive program called Expedited Reinstatement.  Basically this means that if your benefits ended within the last 5 years due to an increase in your earnings, and you still have your original medical condition, you do not have to reapply for benefits.  Instead, you will receive 6 months of temporary benefits while your case goes under medical review.  If you are found not to be eligible for benefits after that review, you don’t have to pay back the temporary benefits you received.

Don’t be afraid to get back out into the workforce if you are able.  Cancer can be very isolating and working can be just the thing you need to feel better and move on from your diagnosis.

2017 Raise for Social Security & SSI

Triage Cancer Blog SSA Disability Insurance

The Social Security Administration (SSA) recently announced that the cost of living adjustment (COLA) for 2017 will be a 0.3 percent increase for Social Security and Supplemental Security Income (SSI) benefits.

That means that the SSI federal benefit rate in 2017 will increase by $2 to $735 per month for an individual, and by $3 to $1,103 per month for an eligible couple.

The estimated average monthly Social Security benefit payment will increase by $5 to $1,360 for retired workers, and by $4 to $1,300 for surviving spouses.

This marks the first COLA in two years, as there was no adjustment in 2016.

We will have to wait until next month to learn what the Medicare premiums for 2017 will be.

For more information on the other benefit changes for 2017, visit https://www.ssa.gov/news/press/factsheets/colafacts2017.pdf