HARRELL LAW OFFICE
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View the Video Discussion: "Learn the Facts Behind Social Security Disability Benefits with Chris Harrell"
If you missed out on Chris's conversation earlier this week, you can access the recording here: https://www.youtube.com/watch?v=ufaZwbh5IiQ&ab_channel=GatheringStrength%2CInc.
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"The U.S. Bureau of the Fiscal Service explains: 'Federal benefit payments, such as Social Security, Supplemental Security Income (SSI) and Veterans, are required to receive your payment electronically. You must either have the money deposited directly to a bank or credit union account or get your money each month on a Direct Express prepaid debit card.'"
"The pandemic threatens to strike Social Security’s disability program and its beneficiaries in multiple ways that play into the system’s weaknesses and its target population’s vulnerabilities."
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One of the most common questions I am asked is “What is the difference between SSI and Disability?” This is an important question that can have a significant impact on the amount of benefits awarded, or even whether there is an award at all.
I like to explain “disability” benefits (also called SSDIB or OASDI) as an insurance program. When you have money withheld from your paycheck for Social Security, these payments act like insurance premiums. The amount that you pay into the program throughout your working life determines the amount of benefits that you may receive.
The important thing to remember about these payments is that for disability purposes, your insurance coverage can expire. From the date that you become disabled under the medical rules, SSA will look backward ten years (which is equal to forty “quarters of coverage”). Within that ten year period, you have to have twenty quarters (five years) of coverage. To oversimplify, if you haven’t worked within the five years before you became disabled, you are not covered for disability benefits. It doesn’t matter that you worked for many, many years prior to the end of your working days; you still have to be covered during that period to receive benefits.
These rules result in seemingly harsh results for stay at home parents or someone caring for sick relatives, who often lose their coverage. It also makes life more difficult for folks who file their claim for disability several years after the onset of health problems.
Supplemental Security Insurance (“SSI”) does not require quarters of coverage. The financial eligibility for SSI is based on poverty. If you have very little income and very few assets, you may be eligible. The maximum amount of assets that you can own and be eligible is $2,000 for an individual and $3,000 for a couple. Fortunately, the home in which you live and your vehicle do not count toward that asset cap. There are more exemptions listed here: https://www.ssa.gov/ssi/text-resources-ussi.htm. Unfortunately, any pension or retirement assets do count toward the asset cap.
Income eligibility for SSI is more complicated. There is a list of exempt income at https://www.ssa.gov/ssi/text-income-ussi.htm, along with some other information about the program. To oversimplify, most non-work income acts as a dollar for dollar offset from SSI benefits. So, if you have a small retirement benefit of $200 per month each and every month, your SSI would be reduced by $200. If you are able to work for limited hours, then your work income acts as a fifty percent reduction in SSI. So, if you earn $300 per month, your SSI would be reduced $150. (There is also a $65 monthly waiver from work income, not included in this explanation, just to make things more complicated).
In 2021 the base SSI amount is $794. Check here for the amounts for other years https://www.ssa.gov/OACT/COLA/SSI.html.
The distinction between these programs is sometimes difficult to identify because most folks apply for both benefit programs at the same time. The Social Security Administration is pretty good about inquiring if you want to apply for both of them. Many folks with whom I speak don’t remember applying for both programs.
The other thing that may be confusing is that medical eligibility for both programs is the same. If you are sick or disabled enough for one program, then you are sick or disabled enough for the other. The difference is in the financial eligibility. You must meet the financial eligibility for one or the other, regardless of how sick or disabled you are. In other words, if you do not have the quarters of coverage to be eligible for disability insurance, and you have too many non-exempt assets to be eligible for SSI, then you will not be eligible for either program despite the severity of your health problem.
You have probably been asked by a doctor to “rate your pain on a scale of 0-10” before. The Visual Analog Scale (VAS) is a tool to track trends in your pain level. It can be difficult to know how to put your pain into a number, but doing so can show a clearer picture of what you’re dealing with and how to treat it. It can also show how your pain may change throughout the day, months, or year. Because of that, it is very important for you to be as accurate as possible in converting your pain into a number on the pain scale.
Try to think of the numbers on pain scale as the only numbers that possibly exist to quantify your pain. If your pain is at a 1 or 2 out of 10, it would mean that you have some pain that is noticeable, but you can generally function somewhat normally and "push through" the pain. Since "10" is the highest number that exists on this scale, your pain level being at a 10 out of 10 would mean you are so incapacitated from your pain that you need to have someone call an ambulance, or that you cannot walk or sit up due to the pain, or that the pain is making you vomit.
It is not helpful to rate your pain outside of the 0-10 pain scale, such as saying your pain is “15 out of 10.” While it may seem obvious that you are making the point that your pain is worse than it has ever been, rating your pain above the 0-10 scale will make people think that you are not accurately reporting your pain, or worse -- that you are exaggerating or drug-seeking. This can make you appear not to be believable witness to Social Security.
One thing to keep in mind in reporting your pain levels is not to avoid using absolutes like “never” or “always” when talking about your symptoms. Telling a doctor that your pain “never” goes away, for example, may not be accurate. While it may be true that you do always experience some degree of pain, if you are able to explain to the doctor that certain activities can make your pain better or worse it does give the doctor a great deal more information and it also helps you to be more credible.
It can be very helpful to describe the pain that you feel in different parts of your body separately and in terms of both what your “average daily” pain is and also what your “worst pain” is. For example, you have lower back pain that you would generally rate as 3 out of 10 on an average day. Sometimes it will go as high as 8 out of 10 on days when you’ve had to be on your feet longer than normal or when you’ve been engaging in a lot of activity. Keep track of anything that will help to reduce your pain, even if it does not make the pain go away entirely. If things like taking a hot bath, sitting in a recliner with your legs elevated, or taking pain medication does help your pain level to subside somewhat, try to think about how you would rate your pain after doing these things and to put that into a number that might be different from your worst pain.