4 Important Changes for 2017 that Could Affect Your Social Security Disability and/or Supplemental Security Income benefits

Every year the Social Security Administration (“SSA”) makes several changes to the monetary thresholds associated with Social Security Disability Insurance (“SSDI”) and Supplemental Security Income (“SSI”) benefits. It is important to know about these changes, so you are in compliance with SSA’s requirements. 

1.      SSA beneficiaries will receive a 0.3 Cost-Of-Living-Adjustment (“COLA”).

All people receiving any type of Social Security benefit will see a 0.3 increase to their monthly deposits in 2017. It may not seem like much, but there have been recent years in which SSA provided no COLA at all because the Consumer Price index didn’t justify it.  At least 2017 beneficiaries will see a slight increase.

2.      SSA has increased the threshold value for full-time work.

In order to be found disabled under SSA’s definition of disability, you must be able to prove that you are unable to earn a certain monetary value due to the limitations from your disability.  This value is referred to as “Substantial Gainful Activity (“SGA”). If you are able to work at SGA levels, SSA will not consider you to be disabled. For 2017, that monthly rate is $1,170.00 for a non-blind individual and $1,950.00 for a blind individual. Thus, if you are able to earn such monthly earnings, in spite of any impairment that you have, then you are not disabled under SSA’s definition of disability.

3.      SSA has increased the amount that a person can earn during a Trial Work Period.

SSA allows SSDI recipients to test their ability to work in a program called a Trial Work Period (“TWP”). During a TWP, a SSDI recipient is able to work for 9 month period without being at risk for losing his/her benefits. These months do not have to be consecutive. Specifically, SSA looks to see whether an individual can earn at certain levels over a rolling 60 month period. If a person exceeds certain monetary levels for 9 months (even if not consecutive) over a 5 year period, then the TWP has been exhausted. SSA will then look to see if a person has exceeded SGA values (see above) to determine whether or not, the person is still under a disability. For 2017, SSA will consider any month in which a SSDI recipient earns more than $840.00 to be a month in which goods and services have been performed at a TWP level.

4.      SSA has increased the value of a quarter of coverage.

In order to receive SSDI benefits, you must be insured for benefits. This means you must have paid into the Social Security system through the Federal Insurance Contributions Act (“FICA”). An individual must have worked a sufficient amount of quarters to be entitled to these benefits. Every year a person can earn up to 4 quarters. For 2017, one quarter of coverage is $1,300.00. This means you must earn at least $5,200.00 for 2017 in order to obtain all 4 quarters for the year. 

For more information, please see:

https://www.ssa.gov/news/press/factsheets/colafacts2017.pdf

Got a question about SSDI or SSI that you need us to answer? Please check out our website at www.westcoastdisability.com . We try to provide you with helpful information on our website that will allow you to successfully navigate the Social Security Disability process. Also, feel free to email me your questions at megan@westcoastdisability.com or call me at (800) 459-3017 x 103.

Medicare: A Worthy System with Some Wrinkles

Medicare is frequently in the news these days. It is a political hot button, as it is a health insurance program that is both respected and controversial at the same time. Medicare is not just a program for retirees. If you become disabled before retirement age and are awarded Social Security Disability benefits, you will be entitled to Medicare benefits after a 24 month waiting period.

Some disability recipients do not even have to wait for 24 months to start Medicare. The standard 24 month waiting period for Medicare has been eliminated for SSDI recipients diagnosed with Amyotrophic Lateral Sclerosis (“ALS”), sometimes referred to as Lou Gehrig's disease, and for individuals diagnosed with end-stage renal disease or kidney failure. These two exceptions are due to the poor prognosis of these diseases and the result of extensive lobbying efforts by support groups and advocates who work with individuals from these populations.

Regardless of when you may be entitled to Medicare, you need to understand some limitations of the program. Generally speaking, I think it is a valuable and effective program. Both of my parents are at retirement age and they both are Medicare recipients. It has been especially helpful for my mother who was diagnosed with both breast and colon cancer five years ago, which has metastasized. Her treatments are costly and Medicare has helped to defray the costs.

However, you must be aware that Medicare does have certain limitations, especially if you require some medications that are costly and often considered blockbusters drugs for the pharmaceutical companies that produce them.

 As you are probably aware, drug companies are constantly developing break-through medications that treat a variety of conditions, ranging from autoimmune disorders to end stage cancers. The companies have high research costs which are often reflected in the price of the new medication. Typically, it would be impossible for a consumer to pay for these cutting edge medications without insurance. However, even with exceptional insurance, the cost of certain medication co-pays can be cost-prohibitive for a consumer. Due to this conundrum, many pharmaceutical companies have issued “coupons,” so patients can still access these medications in spite of the high market price. Typically, these coupons are available to consumers who have a standard insurance program.

 The problem is that once you are on a government-sponsored insurance program like Medicare, you can lose your eligibility for these valuable coupons. Thus, you may be able to access certain medications while you have private insurance, but as soon as you switch to Medicare, you may lose your eligibility for certain life-saving medications.

 For example, a client of mine needed to take a Neulasta injection in order to boost certain blood cells to continue chemotherapy. She is a Medicare recipient and did not qualify for a “coupon” to help with costs for the medications. I called Amgen, the pharmaceutical company that makes Neulasta, to see what her options were. Normally, there are foundations that help with costs of such medications for Medicare recipients. However, when I placed this call about three months ago, I was told that the foundations that help Medicare recipients were out of funding at that time. Thus, her only choices were to pay the high cost for the medication or forego the treatment. Clearly, this is not a choice that anyone wants to make.

Medicare is an excellent government health plan, but it is not without its problems. It is always important to know what your health insurance plan covers and what it does not, especially if you are switching to a government-run program. This way, you can look into supplemental policies which may help you to defray your treatment costs.

Got a question about SSDI or SSI that you need us to answer? Please check out our website at www.westcoastdisability.com . We try to provide you with helpful information on our website that will allow you to successfully navigate the Social Security Disability process. Also, feel free to email me your questions at megan@westcoastdisability.com or call me at (800) 459-3017 x 103.

The Social Security Administration Adds Three Impairments To Their Compassionate Allowance List

The Social Security Administration (“SSA”) announced this week the addition of three new Compassionate Allowances conditions to their Compassionate Allowances program. This brings the total number of conditions on the list to 228 impairments. Disabilities included on the Compassionate Allowance list represent the most serious disabilities that affect individuals. The purpose of the program is to expedite disability decisions, so individuals suffering from these severe diseases receive their benefit decisions more timely than other SSA applicants. The conditions added this week include:

CACH – Vanishing White Matter Disease – Infantile and Childhood Onset Forms

Congenital Myotonic Dystrophy

Kleefstra Syndrome

The Compassionate Allowance program identifies claims that should easily meet SSA’s standard for disability. Several impairments will be found disabling based on diagnosis alone. Others must still meet certain criteria of severity. It is important to always check this list to see if your disability is listed before applying for benefits. If your condition is listed as a Compassionate Allowance Impairment, make sure you notify SSA and ask for a Quick Disability Determination (“QDD”).

Got a question about SSDI or SSI that you need us to answer? Please check out our website at www.westcoastdisability.com . We try to provide you with helpful information on our website that will allow you to successfully navigate the Social Security Disability process. Also, feel free to email me your questions at megan@westcoastdisability.com or call me at (800) 459-3017 x 103.

 

Why Haven’t I Received My Retroactive Benefits?

Have you been granted Social Security Disability benefits, but not received your retroactive benefits yet? You are not alone. We have been seeing significant delays when it comes to the release of retroactive benefits by the Social Security Administration.

Retroactive benefits are the benefits that accrue while a claimant waits for his/her Social Security Disability or Supplemental Security Income case to be granted.  On average, claimants would start their monthly benefits and then the retroactive benefits would be released within three months that the monthly benefit commenced. However, we have been seeing extreme delays in the release of these retroactive benefits over the last year or so.

Some local Social Security offices are estimating that it is taking certain branches of the payment center an additional eight to twelve months to release these retroactive benefits. The excuse that is being cited is that the payment centers are extremely backlogged and are understaffed. Thus, Social Security is concentrating on just meeting the demands of getting the monthly benefit started as the first priority. Processing the retroactive benefits is being pushed on to the back burner.

Social Security did tell me that if a claimant could prove a “dire need” situation, then the Administration would try to release the retroactive benefits sooner. For example, retroactive benefits may be released sooner if a claimant can show that he/she lacks food and is unable to obtain it, lacks critical medication or medical treatment, or lacks shelter. A claimant can submit eviction notices, foreclosure notices, shut-off notices, and other items to substantiate the claim that his/her case meets the “dire need” standard to expedite the retroactive benefit processing. Claimants who also suffer from terminal illnesses or are designated “wounded warriors” from active duty injuries may also see their retroactive benefits processed more quickly than other beneficiaries.  

We wish we could guarantee that your retroactive benefits will be released timely. However, that is not always the case. Attorneys are not even able to contact the payment centers directly. Like claimants, we must use the local Social Security offices as liaisons to the payment centers, as Social Security does not make their payment centers’ phone numbers public.

We have to put pressure on the local Social Security offices to encourage them to intervene with the payment center on our clients’ behalves. Managers at the local Social Security offices will send “manager to manager” status inquires to the various payment centers when retroactive benefits haven’t been released after an exorbitant amount of time. Therefore, we can make some leeway in retroactive benefits processing times if we have cooperative managers at the Social Security Administration’s local level. We do hope that timeframes will improve at all branches of Social Security over the next several years, but it would require that Social Security hire more employees to serve the large number of Social Security applicants and recipients.  That does not seem likely under the current Administration.

Got a question about SSDI or SSI that you need us to answer? Please check out our website at www.westcoastdisability.com . We try to provide you with helpful information on our website that will allow you to successfully navigate the Social Security Disability process. Also, feel free to email me your questions at megan@westcoastdisability.com or call me at (800) 459-3017 x 103.

 

Obtaining Social Security Disability Benefits Just Got a Lot Harder!

I hate to be the bearer of bad news, but the Social Security Administration (“SSA”) has implemented some changes that will make it much harder to meet their definition of disability. Not all changes are negative, but SSA has made some material revisions to long-standing provisions that I expect will make it much more difficult to meet SSA’s definition of disability.

For claims filed on or after March 27, 2017, SSA will no longer give special weight to the opinion of the treating source. Historically, an opinion issued by a claimant’s treating physician was given more weight than that of other providers, including the opinions of doctors hired by SSA for consultative examinations. SSA previously provided more weight to the treating doctor’s opinion because it was thought that a doctor with a personal and longitudinal relationship with a claimant would be the best source to issue an opinion as the claimant’s limitations. While it seems logical to presume a treating doctor would know more about his/her patient than a one-time evaluator, SSA will no longer give “special weight” to the opinion of a treating physician. The negative implications of this rule change are alarming, as doctors with limited to no knowledge of a claimant’s history, diagnosis and treatment could be afforded the same consideration as a provider who has first-hand and intimate knowledge of his/her patient.

In keeping with this theme, SSA will also no longer give special weight to the opinions of other governmental agencies. The United States Court of Appeals for the Ninth Circuit, which oversees appeals in California and other western states, had previously directed SSA to give “great weight” to the opinion of the Veteran Administration’s (“VA”) decisions when it came to service-connected benefits.  Other Circuits had different rules regarding this deference, but the 9^th Circuit had settled law on the matter. The new changes to the Federal Regulations, however, means that VA decisions, and other decisions from differing governmental bodies, will not influence SSA when it comes to determining disability.  You may have spent years trying to secure your VA benefits, but that struggle will not impact the outcome of your Social Security Disability, in spite of the fact that both SSA and the VA are Federal agencies.

Not all changes to the rules are detrimental to the claimant.  SSA will now consider physicians assistants, advanced practice registered nurses, audiologists, and optometrists as acceptable medical sources. Previously, medical evidence from these individuals was not considered to be probative in Social Security Disability cases.  SSA still does not consider chiropractors, social workers or registered nurses to be acceptable medical sources, however.

SSA also no longer allows individuals to submit evidence or statements more than five business days before a hearing, unless “good cause” exists. This new rule has been in effect since May 1, 2017. From what I have experienced, the Judges are being quite reasonable with this new standard. I always felt it was unprofessional to bombard a Judge with new materials a few days before a hearing, so I have always tried to cease submissions for a full week before the hearing. Now, SSA has finally made this the law. I personally have no problem with this.

Do not be alarmed. The Judges have been quite accommodating when important medical treatment or emergency medical treatment has occurred within this five day window.  The Judges are also still open to keeping the record open if a major medical procedure or diagnostic study is going to take place shortly after the hearing. The Judges are finding that good cause exists in appropriate circumstances and I do not expect that to change.

Do I expect these new regulations to be the last major changes that we see affecting Social Security Disability cases in the near future? No, I do not. In fact, President Trump’s proposal to cut almost 70 billion dollars to the Social Security Disability program in the next decade, just about guarantees it. Stay tuned!

Got a question about SSDI or SSI that you need us to answer? Please check out our website at www.westcoastdisability.com . We try to provide you with helpful information on our website that will allow you to successfully navigate the Social Security Disability process. Also, feel free to email me your questions at megan@westcoastdisability.com or call me at (800) 459-3017 x 103.

April is National Social Security Month

The Social Security Administration (“SSA”) launched its first ever National Social Security Month in April. The goal of the celebration isn’t just to make the public more aware of Social Security’s programs. Instead, National Social Security Month’s goal is to encourage people to take steps towards achieving financial security in general.

To help you in achieving your goals, SSA posted an online series of messages from personal finance expert, Suze Orman. These messages are designed to help you develop a financial plan that incorporates Social Security as a component of your overall financial strategies. SSA has also listed five steps to help you manage the SSA portion of your financial security. They include:

1.       Get to know your Social Security benefit (it is sometimes lower than you expect)

2.       Verify your lifetime earnings with a “my Social Security” account

3.       Estimate your future Social Security benefits at my Social Security

4.       Apply online for retirement, disability, or Medicare benefits

5.       Manage your Social Security benefits

Keep in mind that SSA’s retirement and disability programs were never designed to be total income replacement programs. Due to the rising costs of healthcare and housing, along with increased life expectancies, you need to recognize that you will have to develop a comprehensive financial plan that includes other types or savings or investments to supplement your Social Security benefit. You are never too young, or too old ,to start thinking about your financial health and April is a perfect time to start!

Got a question about SSDI or SSI that you need us to answer? Please check out our website at www.westcoastdisability.com . We try to provide you with helpful information on our website that will allow you to successfully navigate the Social Security Disability process. Also, feel free to email me your questions at megan@westcoastdisability.com or call me at (800) 459-3017 x 103.

The Social Security Administration Has A New Acting Commissioner

Nancy A. Berryhill, replaced Carolyn W. Colvin, as the Acting Commissioner of the Social Security Administration (“SSA”) on January 23, 2017. She will oversee close to 64,000 employees and a 12 billion dollar budget. Ms. Berryhill has worked at SSA for 40 years. She previously served as the as the Deputy Commissioner for Operations at the agency.

Clearly Ms. Berryhill has worked at the agency long enough to see the positive aspects of the agency as well as its flaws. Hopefully, Ms. Berryhill will be able to implement some processes that reduce the ever-growing backlog that exists at the Office of Disability Adjudication and Review.

 Got a question about SSDI or SSI that you need us to answer? Please check out our website at www.westcoastdisability.com . We try to provide you with helpful information on our website that will allow you to successfully navigate the Social Security Disability process. Also, feel free to email me your questions at megan@westcoastdisability.com or call me at (800) 459-3017 x 103.

What is The Difference Between Social Security Disability Insurance (“SSDI”) and State Disability Insurance (“SDI”)?

People often confuse the term Social Security Disability Insurance (“SSDI”) with State Disability Insurance (“SDI”), when in reality each program is quite distinct.

 SSDI is administered by the Federal government through the Social Security Administration (“SSA”). It provides a cash benefit to disabled workers who have paid into the Federal Insurance Compensation Act. A person’s monthly benefit for 2017 can be as low as a few dollars to as high as $2687.00 depending on one’s contributions to FICA. If you have minor children, the benefit may be increased. SSDI is not meant to be a full income replacement, however, which often surprises some people.

Recipients of SSDI also qualify for Medicare once they are on SSDI benefits for two years. Recipients can remain on SSDI until SSA has determined that a disability has improved or until the recipient is well enough to return to work. At retirement age, a disabled person can still receive his/her SSDI rate if this rate is higher than his/her retirement rate. However, SSA will start referring to these benefits as retirement benefits regardless of what rate you are being paid at.

SDI, on the other hand, is a State disability program unique to California. California has a State-run program due to our high cost of living. It is a temporary program and only lasts for a maximum of one year. You have to have paid enough into the State system to qualify. Benefits cannot be extended past one year even if you remain disabled after those 365 days. The program is administered by the Employment Development Department (“EDD”), a State agency that also administers unemployment. Recipients of SDI do not receive health insurance with this benefit, but recipients may be able to file for Medi-Cal separately if they meet the financial requirements.  SDI recipients receive weekly benefits (normally issued bimonthly) that range from $50.00 to $1173.00 per week, or $200.00 to $4692.00 per month. Thus, SDI may provide a higher monthly income than your SSDI for the first year.

You can apply for SSDI and SSI simultaneously, but please note that there can be an offset of these public benefits.   

Please check out our website at www.westcoastdisability.com  for more information about the SSDI program. For questions about SDI, please visit EDD’s website at: http://www.edd.ca.gov/Disability/Calculating_DI_Benefit_Payment_Amounts.htm .

Got a question about SSDI or SSI that you need us to answer? We try to provide you with helpful information on our website that will allow you to successfully navigate the Social Security Disability process. Also, feel free to email me your questions at megan@westcoastdisability.com or call me at (800) 459-3017 x 103.

4 New Rate Changes that May Affect Your Social Security Disability and Supplemental Security Income benefits for 2017

I previously wrote about the 0.3 percent cost-of-living adjustment (“COLA”) for both Social Security and Supplemental Security Income (“SSI”) recipients for 2017. However, there are some other important numerical changes that affect Social Security Disability and Supplement Security Income benefits. Below are 4 changes from the Social Security Administration (“SSA”) for 2017 to keep in mind.

1.       The Substantial Gainful Activity (“SGA”) rate has been raised to $1,170 for non-blind individuals and $1,950 for blind individuals. This means that if you can earn these amounts or more per month, you are not disabled under SSA’s laws. Keep in mind these thresholds reflect gross (not net) earnings.

2.       SSA raised the SSI Federal payment rate to $735 for an individual and $1,103 for a couple. California supplements this benefit due to our high cost-of-living, but most other states do not.  

3.       A quarter of coverage is now $1,300 for 2017. In order to receive SSDI benefits, you must be insured for benefits by securing quarters of coverage. This means you must have paid into the Social Security system through the Federal Insurance Contributions Act (“FICA”). An individual must have worked a sufficient amount of quarters to be entitled to these benefits. Every year a person can earn up to 4 quarters. This means you must earn at least $5,200 for 2017 in order to obtain all 4 quarters for the year. 

4.       The trial work period threshold for 2017 is $840. This number is important for those who are undergoing their trial work period with SSA. Any month in which a person earns $840 or more, counts as a month in which goods and services have been performed in keeping with the trial work period limitations.

Got a question about SSDI or SSI that you need us to answer? Please check out our website at www.westcoastdisability.com . We try to provide you with helpful information on our website that will allow you to successfully navigate the Social Security Disability process. Also, feel free to email me your questions at megan@westcoastdisability.com or call me at (800) 459-3017 x 103.