Can I get both SSDI and Social Security Retirement Benefits?

When making decisions about whether to continue working or take time off after a cancer diagnosis, it is important to understand your options so that you can make an educated decision. Disability insurance (e.g., SSDI) is a way to replace your wages if you need to take time off work because of a medical condition. Can I get SSDI and Social Security?

For an overview of disability insurance options, read our Quick Guide to Disability Insurance, or watch our recent webinar on Taking Time Off & Paying For It. One option is Social Security Disability Insurance (SSDI), which is one of the two federal long-term disability programs.

Depending on your age, you may also be considering retiring early or at your full retirement age and receive Social Security retirement benefits. We often get asked:

“Can you get both Social Security Disability Insurance (SSDI) and Social Security retirement benefits?”

For the most part, the answer is no. If you are receiving SSDI because you have a disability and are unable to work, you are effectively receiving your retirement benefits early. If your disability continues through to the time when you would normally retire, your SSDI benefit will just automatically convert to Social Security retirement benefits and the amount of money you receive each month will not change.

The Exception
There is one exception and that is early retirement. You can file for early retirement (which you are eligible for at 62), while you are waiting for your disability claim to be approved. You would receive a reduced retirement benefit (currently 25% less than your full retirement benefit amount) right away. If you are approved for SSDI, you will begin to receive your full retirement amount. You could also receive prorated retroactive payments for any time that you were determined to be disabled and were receiving reduced benefits.

The Risk/Reward of Early Retirement
If you take early retirement and then never apply for, or are never approved, for SSDI, you will receive a reduced monthly retirement benefit amount for the rest of your life.  That’s the risk.

But if you are approved for SSDI for a disability that began before your early retirement, your benefit payment will rise back up to the full amount. Furthermore, the Social Security Administration will enact a “disability freeze” on your earnings.  This is important because the amount of your retirement benefits and SSDI benefits are determined by your earnings record over your lifetime.  Zero earning or low earning years reduce the amount of benefits that you are eligible to receive.

If you are found to have a disability that began after you took early retirement, you would not get the benefit of a “disability freeze.” Furthermore, you would receive the higher SSDI payments only until the time that you turned your full retirement age, then your payments would return to the reduced early retirement amount for the remainder of your life.

Understanding the rules is the first step in getting the maximum benefits for which you are eligible.

Sexuality Concerns and Cancer

Sexuality and intimacy are important aspects of health for all people, including thoseSexuality Concerns diagnosed with cancer. For those patients currently in treatment or just recovering from surgery, there are some important considerations to be aware of before you engage in any sexual activity.

For Women:

  • When recovering from surgery, sex can cause bleeding or stress any incisions. Recovery times are different for each surgery, so check with your health care team about when is a safe time to resume sexual activity.
  • Cancer treatment often causes a weakened immune system. This makes it easier to catch all kinds of infections. Check with your health care team about the potential threat the sex poses to your immune system and ways to protect yourself.
  • Chemotherapy may thin the walls of the vagina, which can cause a small amount of bleeding. Using an unscented, uncolored, water-based lubricant can help.
  • Surgery and radiation to the vagina can cause vaginal dryness, which can cause pain and bleeding. Again, unscented, uncolored, water-based lubricant and using dilators can help.
  • Some chemotherapy can be present in some amounts of vaginal fluid. Protect your partner by using a condom throughout treatment and up to two weeks after treatment.

For Men:

  • Cancer treatment often causes a weakened immune system. This makes it easier to catch all kinds of infections. Check with your health care team about the potential threat the sex poses to your immune system and ways to protect yourself.
  • Radiation to the genital area can cause pain during ejaculation. This is not usually permanent.
  • Radiation can also cause skin irritation and a reduction in the amount of semen present in ejaculate.
  • For men being treated for prostate cancer, there may be small amount of blood in semen. This is not harmful, but notify your doctor.
  • Men treated for testicular cancer may have no semen at orgasm (dry ejaculation). This will not affect your pleasure or your partner’s.
  • Men who have been treated for testicular, prostate, bladder, colorectal, and even head and neck cancers often report having trouble getting erections after treatment. Speak to your health care team about hormone replacement (though men with some cancers can’t get have testosterone replacement).

The greatest thing you can do for you and your partner is to keep an open line of communication. Talk to your partner about how you are physically feeling, and about your emotional concerns.  Don’t push yourself.

For more information about sexuality during cancer check out: 

  1. Triage Cancer Webinar: You and Your Body: Cancer, Intimacy and Sexuality
  2. American Cancer Society: www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/fertility-and-sexual-side-effects/how-cancer-affects-sexuality.html

Clarifying Open Enrollment

There has been a lot of confusion about open enrollment for health insurance coverage in the news and on social media and we want to clarify some things and share some news:

  1. Open enrollment to buy coverage for 2018 through the State Health Insurance Marketplaces has been cut from 12 weeks to just 6 weeks, running from November 1 to December 31. However, there are some additional things you need to know:
    1. If you live in one of the states below, your state may have decided to keep open enrollment open longer:
      • California – November 1 to January 31
      • Colorado – November 1 to January 12
      • D.C. – November 1 to January 31
      • Massachusetts – November 1 to January 31
      • Minnesota – November 1 to January 14
      • Washington – November 1 to January 1
    2. If you were affected by Hurricanes Harvey, Irma, or Maria, you also have access special enrollment periods, which extends the time you have to get coverage in 2017 or enroll in coverage for 2018.
      • Group A:
        • Timing: The date of the SEP qualifying event through December 31, 2017.
        • Eligibility: Individuals who experienced an SEP qualifying event between 60 days prior to the start date of the incident period and December 31, 2017 and reside, or resided at the time of the hurricane, in any of the counties declared as meeting the level of “individual assistance” or “public assistance” by FEMA.
        • What to do: Contact the Marketplace Call Center at 1-800-318-2596.
      • Group B:
        • Timing: December 16, 2017 through December 31, 2017.
        • Eligibility: Individuals who reside in or move from areas affected by a hurricane in 2017, who are applying for 2018 coverage.
        • What to do: Contact the Marketplace Call Center at 1-800-318-2596 to request an enrollment after December 15, 2017.
  1. Medicare open enrollment occurs each year for people to enroll or switch Medicare plans and prescription drug plans. Medicare open enrollment runs from October 15 to December 7, but the Centers for Medicare & Medicaid Services have announced a special enrollment period to give people more time to enroll due to the recent hurricanes.
    1. Timing: From the start of the incident period through December 31, 2017.
    2. Eligibility: Individuals who reside, or resided at the start of the incident period, in an area for which the Federal Emergency Management Agency (FEMA) has declared an emergency or a major disaster; individuals who do not live in the affected areas but rely on friends or family members who live in the affected areas for help making health care decisions.
    3. What to do: Contact 1-800-MEDICARE to access the special enrollment period. Click here for more information.

Remember, with both Medicare and Marketplace plans, when you sign up for coverage in open enrollment, you coverage won’t actually start before January 1, 2018.

If you need coverage now, visit CancerFinances.org or watch our webinar recording on how to pick a health insurance plan, to see if you have other options.

How to Get a Better Night’s Sleep During and After Cancer Treatment

Sleeping well during and after cancer treatment can be a challenge. Cancer patientsSleep-Better often experience pain, fatigue, and discomfort that interferes with sleep.

While it’s not always easy, it’s important that you get the best sleep possible, as sleep deprivation can weaken your immune system and make symptoms or side effects, such as chemo brain, worse.

Improving sleep hygiene, treating sleep disorders, and participating in cognitive behavioral therapy can help cancer patients get better sleep.

How Cancer Affects Sleep

Sleep disturbances are not unusual among cancer patients. Between 30 to 75% of cancer patients experience sleep problems. Unfortunately, sleep problems can persist even after treatment has ended, with 25% of survivors reporting continued difficulty sleeping.

Cancer side effects and treatment can make it more difficult to sleep. Increased anxiety and depression can make way for insomnia. And with extensive treatment, you may be fatigued and experience cancer-related sleep disorders. It’s also common to experience hot flashes and night sweats. Sleep disorders can be serious and require treatment to improve your ability to sleep, as well as your quality of life.

How You Can Sleep Better During and After Cancer Treatment

Better sleep habits and treatment for sleep disorders associated with cancer can improve your sleep during and after cancer treatment. Try these tips and methods to improve your sleep:

  • Choose comfortable bedding materials: Cancer patients who experience night sweats or hot flashes may have difficulty sleeping due to heat. You should lower your bedroom temperature, and choose bedding and clothing that sleeps cooler and is more breathable. If you are experiencing discomfort and sensitivity to cold from chemotherapy, a memory foam mattress can offer softness and heat retaining properties.
  • Maintain a sleep routine: Go to bed at the same time every night, even on weekends, to help train your body to go to sleep at a regular time. You can support a regular sleep schedule with a sleep routine, going through the same actions before bed each night. Your routine can involve stretching, brushing your teeth, reading, and other nighttime tasks. The exact actions you do aren’t as important as doing them on a regular basis.
  • Try cognitive behavioral therapy: This therapy is helpful for insomnia, using techniques to reframe your emotions and thoughts around sleep. You will learn relaxation techniques and deep breathing exercises to help you fall asleep. You may also promote restfulness with progressive muscle relaxation and other therapeutic techniques.
  • Get treatment for sleep disorders: If you’re suffering from sleep disorders, it’s a good idea to talk to your doctor about treatment so you can get better rest. Good sleep is important. Sleep disorders may include those that are common among cancer patients, including insomnia, excessive daytime sleepiness, or restless legs syndrome, but other disorders, such as sleep apnea or narcolepsy, should be addressed as well to improve your sleep quality and quality of life.

Sara Westgreen is a researcher for the sleep science hub Tuck.com. She sleeps on a king size bed in Texas, where she defends her territory against cats all night. A mother of three, she enjoys beer, board games, and getting as much sleep as she can get her hands on.

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.

Early Withdrawal from Retirement Plans

Need Cash? Is early withdrawal from a retirement plan right for you?

Have you been financially impacted by a cancer diagnosis? Need access to money to Early-Withdrawlpay your medical bills or daily living expenses? Withdrawing money from your retirement plans may be an option for you.  However, it is important to understand the tax implications of doing that.

Fortunately, the IRS understands that you may need to dip into your retirement savings a little earlier than expected. And, unlike most of the tax code, this is pretty easy to understand.

Normally, if you withdraw money from a 401k or IRA plan before reaching age 59.5, you would be subject to an “early withdrawal tax” of 10%, above and beyond the normal income tax owed on the withdrawal. However, here are three exceptions to that rule, which can really make a difference:

  401K Plans IRA, SEP IRA, SIMPLE IRA, & SARSEP Plans
If the participant/IRA owner is totally and permanently disabled. No early withdrawal tax No early withdrawal tax
If your amount of unreimbursed medical expenses is greater than 10% of your Adjusted Gross Income. No early withdrawal tax No early withdrawal tax
If you are using your withdrawal to pay for health insurance premiums while unemployed. 10% early withdrawal tax applies No early withdrawal tax

There are close to 15 more exceptions to the Early Withdrawal Tax.  It is also important to know that with ROTH IRAs, you can always withdraw the money you’ve contributed (not the interest earned) tax free and penalty free.

When considering your financial situation as you face a cancer, remember to count every dollar. There could be money out there you thought you could not touch!

For more information on navigating finances after cancer, visit CancerFinances.org, read the financial topics on the Triage Cancer blog, or visit our other financial resources.

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.

Losing Your Health Insurance Coverage? Get the Details on Changes to Special Enrollment Periods.

You may qualify for a special enrollment period (SEP) to buy coverage through the Changes-to-Special-EnrollmentACA’s health insurance Marketplaces, if you experience a life-changing event that results in a loss of coverage, such as:

  • losing your employer based coverage,
  • aging out of your parent’s health insurance coverage, or
  • moving to a new state.

During a SEP you have 60 days to shop for, and buy, new health insurance coverage in the Marketplace. You may also add family members to your coverage during a SEP, if you get married, or give birth to or adopt a child.

Recently, the rules around special enrollment have changed by the Department of Health and Human Services (HHS) and there are a few extra steps that you now have to take.

On June 23, 2017, HealthCare.gov began requiring applicants to submit additional information to conduct a pre-enrollment verification of eligibility for a SEP. What this means, is that once you pick a plan the Marketplace will “pend” your enrollment and you will have 30 days to submit documents to confirm your SEP eligibility before you can begin using your coverage. When you submit an application on HealthCare.gov, you will get a notice with a list of documents you can send to provide this confirmation.

As soon as your SEP is verified, the Marketplace will send your information to the health insurance company you chose and your coverage will start based on when your SEP started and when you picked your plan. In some cases, this will be retroactive.

For more information and to see a copy of the various notices you may receive, visit the CMS Center for Consumer Information and Insurance Oversight website.

The Triage Cancer Conferences Are For You

Who should attend a Triage Cancer Conference?  In short, everyone in the cancer community.  We are coming to 3 different communities with a FREE program that has been designed for patients, survivors, caregivers, health care professionals, and advocates.  Whichever group you are part of, we will provide you with practical relevant information about navigating cancer survivorship, from the point of diagnosis, throughout life.

Where will we be in 2017?

What topics will we cover?

  • Cancer Survivorship: Advocacy & Being Empowered
  • Health Insurance: Understanding Your Options, Navigation, Prescription Drugs, and Appeals
  • Managing Finances & Accessing Financial Assistance Options
  • Taking Time Off Work & Disability Insurance
  • Returning to Work After a Cancer Diagnosis
  • Nutrition
  • Be Prepared: Estate Planning and Other Documents

The cost to register

$0.  Free.  Nothing.  And lunch will be provided free, too!

Are you traveling to the Conferences?

If you are a patient or survivor, we are pleased to offer travel assistance to those who would like to attend one of the 2017 Triage Cancer Conferences, but need help covering the cost of traveling to the Conferences. Travel assistance is limited and applications are reviewed as they are received or until funds run out, so we encourage you to apply as soon as possible.

Free Continuing Education Units

For oncology nurses and social workers, we are pleased to offer up to 6 contact hours absolutely free.  Our conferences have been approved though ONS and NASW, as well as the West Virginia Board of Social Work.  Again, the conferences cost nothing to attend, and offer you up to 6 contact hours free.

Still undecided?

Well, listen to what attendees of the 2016 Triage Cancer Conferences thought.

“I wish all patients could have this training.” – Attendee in Nashville

“Very good seminar! Enjoyed attending and hope that I can share these resources with other cancer patients!” – Attendee in Salt Lake City

“I would like to thank you so much for the very pleasant and informative conference. I am a 6 year cancer free survivor and I so wish that I had this information available to me when I was going through my cancer treatment. I came here today to try to get any resources I could pass on to others in order to help them through their cancer in any way I can. Please don’t stop doing what you are doing. You are so appreciated.” – Attendee in Philadelphia

Triage Cancer Conferences

We hope that we’ve made the case that attending a Triage Cancer Conference will be informative, valuable, and worthwhile.  And, we really hope to see you there!

For more information, please send an email to info@TriageCancer.org or visit the Triage Cancer Conference page on our website

Comfort Kits from GivingComfort.org

The cancer community is full of supportive resources.  Today we’d like to shine a light triage-cancer-blog-comfort-kitson a resource from the McKesson Foundation: Giving Comfort.  Giving Comfort is a program that puts together and delivers comfort kits to patients suffering from cancer.  Working with hospitals, care facilities and service organizations that support cancer patients, Giving Comfort gets these kits to someone who needs it, right when they need it the most.

The kits are customized by age group and gender and are full of things that are both helpful and comforting.  For example, a young girl would receive a kit with fuzzy socks, a soft blanket, a hope chest full of affirmation cards, a stuffed animal, a soft pillow case, a sleep cap and games.  A teen girl would get most of the same things, but with different games.  Giving Comfort came up with the packing lists after surveying over 1,000 patients, nurses and other oncology professionals.

Kits are assembled by a group of volunteers and they are distributed by a network of community partners.  Community Partners include the American Cancer Society Hope Lodges and the Ronald McDonald House.   Kits are provided to the community partners at no cost and are then given to patients at no cost.

To find out more about this thoughtful and generous program, visit http://www.givingcomfort.org.