Representative Payees

A representative payee is an individual or organization that receives Social Security and/or SSI payments for someone who cannot manage or direct the management of his/her money. The recipient can request a payee be appointed, or other concerned parties can make the request. Payees should use the funds for the current and foreseeable needs of the beneficiary and save any remaining funds for the beneficiary's future use.

• FAQs
• Rep Payee Fact Sheet from Justice in Aging (3/16)
  • Issue Brief: How SSA Can Improve the Representative Payee Program to Protect Vulnerable Seniors - Justice in Aging, 6/16
• Rep Payee Video Training Series (SSA)
• Social Security Handbook -Rep Payees
  • Regulations: 20 CFR 404.2001 (Note this section specifically addresses addictions issues)
• Rep Payee Portal (more information from MGH Community News, November 2019)

To apply to become a rep-payee or to request to have one appointed- If you are concerned that someone you know is incapable of managing or directing the management of his or her benefits, please call SSA at 1-800-772-1213 (TTY 1-800-325-0778) to request an appointment to discuss your concerns. Generally, we look for family or friends to serve as representative payees.

To become a Rep Payee you must submit an application, form SSA-11 (Request to be selected as payee - not available online) SSA requires a payee candidate to complete the payee application in a face-to-face interview (with certain exceptions). You will need documents to prove your identity; you will need to provide your social security number or if you represent an organization, the organization’s employer identification number.

If you do not have a friend or family member who is willing to be your representative payee, social service agencies, nursing homes, or other organizations may offer to serve as payees. If you are not connected with a specific organization that is willing to be your payee, there are a number of organizations that offer these services for a small fee. You can perform an online search to find representative organizations that serve Massachusetts.

If you believe you no longer need a representative payee, you must show SSA that you are now mentally and physically able to handle your money yourself. You could prove this by providing a doctor's statement that there has been a change in your condition and the doctor now believes that you are able to care for yourself; or you can provide an official copy of a court order saying that the court believes that you can take care of yourself. Please note: If SSA believes your condition has improved to the point that you no longer need a payee, they may reevaluate your eligibility for disability payments.

If you need to change or appoint a new representative payee, you must give adequate reason for changing. Go to your SSA field office and request a change of payee. If possible, take the person you want to be your new payee with you so their identity and willingness to be your payee may be verified.

For Rep Payees- The Representative Payee Portal provides a convenient way for individual representative payees with a my Social Security account to manage direct deposit, wage reporting, and annual reporting for their beneficiaries. (More information from MGH Community News, November 2019)

My Social Security (Online Services)

My Social Security is a personalized online account that people can use beginning in their working years and continuing throughout the time they receive Social Security benefits.

Social Security beneficiaries and Supplemental Security Income (SSI) recipients can access their benefit verification letter, payment history, and earnings record instantly using their online account. Social Security beneficiaries also can change their address and start or change direct deposit information online.

Social Security beneficiaries and SSI recipients with a My Social Security account can go online and get an official benefit verification letter instantly. This serves as proof of income to secure loans, mortgages and other housing, and state or local benefits. Additionally, people use the letter to prove current Medicare health insurance coverage, retirement or disability status, and age.

In addition, the portal also includes links to information about other online services, such as applications for retirement, disability and Medicare.

For more information or to sign up for a secure account go to: www.socialsecurity.gov/myaccount.

Same-Sex Married Couples

Under the Obergefell decision of June 26, 2015, all states are now required to issue marriage licenses to same-sex couples and to recognize same-sex marriages validly performed in other jurisdictions.

Previously, the U.S. Supreme Court struck down certain provisions of the Defense of Marriage Act (DOMA) in June 2013 (the Windsor decision). Under the federal DOMA same-sex married couples were not eligible for any federal benefits based on their marriage. An individual may have been eligible for SSDI or SSI based on his own record, but his husband would not be entitled to dependent's or survivor's benefits, for example. The June 2013 Supreme Court decision changed this.

On March 1, 2017 the Social Security Administration (SSA) announced that it would reopen its decisions to deny SPOUSAL or SURVIVOR'S BENEFITS to individuals who had been married to someone of the same sex, and whose marriage wasn’t recognized because of a discriminatory state or federal ban on marriage. This policy applies not only to individuals who were denied benefits after the Supreme Court struck down federal discrimination against same-sex spouses (in United States v. Windsor in 2013) and state discrimination (in Obergefell v. Hodges in 2015), but also to individuals who applied for and did not receive benefits BEFORE these Supreme Court decisions because of the discriminatory laws in effect at the time they applied.

A new Fact Sheet on this guidance from Justice in Aging includes more detailed information about who is affected by the new guidance, who isn’t, and what advocates and their clients should do to get their cases reopened. See the full MGH Community News article (5/17)

Many OASDI & SSI applications involving same sex relationships were on hold for a period of time between the above decision until June of 2014. SSA with the Department of Justice during the interim developed policy for adjudicating most claims involving same sex relationships. The policy is contained in POMS GN 00210.

SSI- If a marriage is recognized, the income and resources of both spouses will be counted for eligibility purposes and amount of benefits. As a means-tested program, SSI relationship recognition is far more likely to cause LOSS of benefits rather than an increase. Post-Windsor, SSI marriage recognition is determined by state of residence and then only if living together. Post-Obergfell this will change so that (barring any additional action) those living in a state that did not previously recognize their marriage or who aren't living together will be newly considered married and their SSI benefits will be at risk.

Soc Security halts seeking repayment of SSI "overpayments"- Long after the Defense of Marriage Act (DOMA) statute was struck down SSA continued to calculate eligibility and benefit amounts for married same-sex couples as if they were single, which resulted in overpayments. When SSA finally recognized these marriages, the agency asked recipients to pay back thousands of dollars in overpayments. In the spring of 2016 SSA announced a new policy that provides instructions to the field offices to presume that a waiver of the overpayment has been requested and that they should grant the waiver on the grounds that the individual is without fault for the overpayment and that collection would be against equity and good conscience. More information.

More information on our LGBT page.

Transgender Barriers Removed

The Social Security Administration (SSA) has updated its policies and procedures regarding the ability of transgender individuals to receive benefits through their spouses. A Lambda Legal Senior Attorney and Seniors Program Strategist explains it this way: "The old policy subjected every claim for spousal benefits by a transgender claimant to lengthy and excessive scrutiny, presuming that a spouse's gender transition was a barrier to receiving benefits. This new policy does a 180 degree turn - it presumes the validity of most marriages regardless of whether a spouse is transgender and ends the discriminatory special treatment experienced only by transgender spouses." the SSA clarified that although its "past policy was to refer all marriage-based claims involving transgender individuals for a legal opinion from the Regional Chief Counsel[,] [o]ur new policy allows us to process most claims...without the need for a legal opinion." (For More Information see the April 2014 MGH Community News article)

Re-Entry After Incarceration - Benefits after Incarceration: What You Need To Know, Social Security website

Supplemental Security Income (SSI)

Supplemental Security Income (SSI) is a needs based program. One does NOT have to have paid into the social security system to qualify for benefits (with the exception of certain immigrants). It is funded through general tax revenues.

Eligibility

• Categorical: One must be disabled, blind, or at least 65 years old.
  • More detail (on categorical eligibility)
    
  • Determining Disability- see above (in Both SSI & SSDI section)
    • For children under age 18: some medical conditions qualify as a disability for immediate SSI payments (if otherwise eligible) for up to six months while the state agency decides if the child is disabled. Some conditions that may qualify: HIV infection, Total blindness, Total deafness, Cerebral palsy, Down syndrome, Muscular dystrophy, Severe intellectual disorder (child age 7 or older) and, Birth weight below 2 pounds, 10 ounces. If ultimately the child is found not to be severely enough disabled to qualify for benefits, the family will not have to pay back the SSI payments. (From: http://www.socialsecurity.gov/pubs/EN-05-10026.pdf, p 8)

 

• Non-citizen eligibility - special rules apply.

• Residency - Note that despite being citizens, residents of Puerto Rico are NOT eligible for SSI (more information.)
  • SSA’s regulations include the Northern Mariana Islands in the definition of United States for SSI purposes. Individuals who are not residing in one of the 50 states, the District of Columbia, or the Northern Mariana Islands are ineligible for SSI (limited exceptions apply).
  • SSI is not available to residents of American Samoa, Guam, Puerto Rico, or the U.S. Virgin Islands, regardless of their citizenship or immigration status. These territories are not included in the definition of United States for purposes of SSI’s residency requirement.
  • Source (Proposed Extension of Supplemental Security Income (SSI) to American Samoa, Guam, Puerto Rico, and the U.S. Virgin Islands, Congressional Research Service, November 4, 2021.)

• Financial:
  • Income overview: The program is needs based, but relatively generous. A single parent with two children might be eligible with income up to the low $40K/year range. Basically if one earns less than the monthly benefit and are otherwise eligible, one can receive benefits.
    • Living arrangements are part of the equation. Whether one is living alone or sharing lodging and expenses affects income eligibility (and benefit levels).
    • Details- what income is counted.
  • Adult Asset/resource limits: $2,000 for an individual and $3,000 for a couple. (Unchanged since 1989.)
    • Details on countable assets/resources
    • Exceptions: additional assets may be retained under certain programs such as the PASS program (work incentive program) and for children and certain adults disabled before age 26, under the new ABLE Act. Also see Able Act- additional information.

  • Adult Income Limits
    • Step 1:  Determine countable income:  Total Gross Income - Non-counted Income  = Countable Income
      • For those applying as disabled, if they earn more than $1,310 per month in 2021 before qualifying ($1,350 in 2022) they would be earning more than Substantial Gainful Activity levels, and would be ineligible as not disabled (Note different SGA limits for those who are blind: 2021=$2,190, 2022=$2,260). (See: SSI and SSDI Basics- Disability Law Center, slide24.) Once someone has been on SSI for at least a month they may be able to earn more than SGA and still retain benefits as a work incentive- roughly 1/2 of earned income would not be counted, but one cannot earn more than the SSI benefit level. (More under Work Incentives).
    • Step 2:  Determine Individual Federal Benefit:  Maximum federal SSI benefit* - Countable Income =  Individual Federal Benefit.
      • If countable income is greater than the maximum benefit one is ineligible.

    *The Maximum federal SSI benefit is officially called the SSI Federal Benefit Rate. The 2021 Federal Benefit Rate, to use in the calculation above, for those living in their own household is $794 ($841 in 2022) for an individual and $1,191 where both members of a couple are eligible ($1,261 for a couple in 2022). NOTE: in states like MA that supplement SSI payments the income limit is actually higher- the MA limit. (See note about wages above.)

    Note- Deeming: if both members of a married couple who live together are not SSI eligible, spouse-to-spouse deeming applies. See Deeming on our SSI Details page for more information.

    For actual benefit that recipients receive, see note below for Massachusetts residents (Massachusetts supplements the federal benefit).

  • Financial Eligibility for Children

    Asset/Resource limits (for children):

    • Disabled child living with 1 parent $4,000 ($2,000 each)
    • Disabled child living with both parents $5,000 ($2,000 child, $3,000 parents)

    (No additional allowances for other non-SSI children in family.) 

    Exception: additional assets may be retained for children and certain adults disabled before age 26, under the new ABLE Act. Also see Able Act- additional information.

    More Detail- Resources

    Income Limits (for children):

    This is a complicated calculation with multiple factors. Not all of a parent's income is counted in determining a child's eligibility. What is counted is called "deemed"- available to the child. The result is that many families of moderate means are eligible.

    Since it is so complex, we encourage families to contact SSA directly and when in doubt to apply. We do not want to inadvertently discourage eligible families from applying.

    For more detail see our SSI Financial Eligibility for Children page.

• Turning 18- Ongoing Eligibility:  What Happens to My SSI When I Turn 18? (Tip Sheet)

Appeals

• Only about one-third of Social Security disability claims are approved at the initial level.
• Applicants will need to decide whether to appeal: learn more at Social Security Disability: What a Denial Means and Social Security Disability: Deciding Whether to Appeal a Denied Claim- both from NOLO.com
• SSI Court Settlement Extends Time Limit to Continue Receiving Benefits While Pending Appeal (MGH Community News, April 2023)
  • Extends the period from 10 to 60 days during which Supplemental Security Income (SSI) recipients can file a request for reconsideration and continue receiving benefits while their non-disability appeal is pending. 
• Appeals- SSA Fails to Properly Process SSI Appeals (MGH Community News, January 2014)

Benefit Amount

• If you are eligible for a particular month, the Social Security Administration (SSA) usually computes your SSI benefit amount for the month using your countable income from two months before the current month. This is called retrospective monthly accounting (More detail: § 2183).
• Massachusetts supplements SSI benefits (32 states do not).
  • See the Maximum Massachusetts benefit levels (remember certain income is subtracted from these amounts to determine an individual's SSI benefit. More about income limits.)

For those already on SSI (link to SSI/SSDI details page)

 

Keeping Full Benefits While Institutionalized (90 days maximum)

Generally SSI benefits are greatly reduced when one is institutionalized. Full benefits may be maintained for up to 90 days if the placement will be for 90 days or less (with written physician documentation) and if maintaining full benefits is necessary to maintain the home or living arrangement while in the facility.

To retain full benefits, one must notify SSA and submit relevant documentation before discharge or by the 90th day, whichever is earlier. Required documentation includes a doctor’s note that the expected stay is 90 days or less and a statement from the patient (or someone knowledgeable about the circumstances) to the effect that full SSI benefits are needed to maintain the living situation.

See the SSI Spotlight on Continued SSI Benefits for Persons Who Are Temporarily Institutionalized.

See SSI Details page for rules for those who

• are institutionalized (temporarily or permanently),
• receive lump-sums or wind-falls (court settlements, lottery winnings, inheritances, holocaust Survivor Supplemental Hardship Fund Payments, etc.)

When Benefits Start

SSI benefits are normally due on the first day of the month after the month of application. So if one applies on March 31, benefits would be due on April 1, but if one applies on April 1, benefits would be due May 1.

Timely application: Unlike SSDI which can provide back-benefits for up to 12 months prior to application (if one was disabled prior to application), SSI benefits are only due starting with the month after application, even if one is subsequently determined to have been disabled prior to application. Encourage patients to apply in the month they become disabled.

Note that it typically takes SSA at least several months to process an application. One generally receives a retroactive payment for the number of months due (starting with the month after application).

For children under age 18: some medical conditions qualify as a disability for immediate payments (if otherwise eligible) for up to six months while the state agency decides if the child is disabled. Some conditions that may qualify: HIV infection, Total blindness, Total deafness, Cerebral palsy, Down syndrome, Muscular dystrophy, Severe intellectual disorder (child age 7 or older) and, Birth weight below 2 pounds, 10 ounces. If ultimately the child is found not to be severely enough disabled to qualify for benefits, the family will not have to pay back the SSI payments. (From: http://www.socialsecurity.gov/pubs/EN-05-10026.pdf, p 8)

For those already on SSI

COVID Specific Content Stimulus Payments- while stimulus payments are not counted as income or as resources/assets for SSI continued eligibility for 12 months, many SSI recipients received their first stimulus payment in May 2020. SSI recipients and their payees must take care to be sure they have spent down their CARES Act EIP funds before 12 months have passed since they received the payment. Since EIP funds are not the same as SSI benefits, individuals are not limited in what they can spend these funds on and can spend down on whatever they wish, including on gifts and charitable contributions. For more information see SSA EM-20014 SEN, Effect of Coronavirus Aid, Relief, and Economic Security (CARES) Recovery Rebates on SSI Income and Resources, issued April 17, 2020. End of COVID-specific content

Keeping Full Benefits While Institutionalized (90 days maximum)

Generally SSI benefits are greatly reduced when one is institutionalized. Full benefits may be maintained for up to 90 days if the placement will be for 90 days or less and if maintaining full benefits is necessary to maintain the home or living arrangement while in the facility.

To retain full benefits, one must notify SSA and submit relevant documentation before discharge or by the 90th day, whichever is earlier. Required documentation includes a doctor’s note that the expected stay is 90 days or less and a statement from the patient (or someone knowledgeable about the circumstances) to the effect that full SSI benefits are needed to maintain the living situation.

See the SSI Spotlight on Continued SSI Benefits for Persons Who Are Temporarily Institutionalized.

Disability Reviews- SSA periodically reviews recipient's medical condition to see if they are still disabled. See - What You Need to Know: Reviewing Your Disability

Reporting Requirements - SSI recipients need to report any changes that may affect your SSI as soon as possible and no later than 10 days after the end of the month in which the change occurred.

Examples that must be reported (NOT a complete list): change in living arrangement or address, change in earned or unearned income, changes in resources* (assets), death of household member, change in marital status, change in citizenship or immigration status, changes in disability status including medical improvement and starting or stopping work. (See the full list.) *A note on resources- "Any payments that you get from SSI or Social Security for past months won’t be counted as a resource for nine months after the month you get them. If there are any past payments left over after the nine-month period, they’ll count as resources." (Source: What You Need to Know When You Get Supplemental Security Income (SSI), p 13)

Advocates recommend recipients ensure there is a record of any reports they make. The best way to do this is to make each report in writing and mail it certified mail, return receipt requested. Recipients should always keep copies of anything submitted to the SSA and file the copies in a place where they can be retrieved. If information is received over the telephone, the recipient should keep a written record of the date and time of the conversation, the name of the SSA employee, the phone number used, and what was said. Reports of earnings should result in a computer generated receipt, whether the report is made in person or otherwise.

Failure to report changes timely and accurately may lead to an overpayment that must be repaid, penalties and sanctions.

More information: What You Need to Know When You Get Supplemental Security Income (SSI) - see pages 6 for index of details on different types of changes as in examples above, and the "how and when to report changes" section

See SSI Details page for more on other rules including those related to

• Lump-sums or wind-falls (court settlements, lottery winnings, inheritances, holocaust Survivor Supplemental Hardship Fund Payments, etc.)
• Those who are turning 18 (ongoing eligibility)
• Understanding the State Supplement
• Rep Payees

 

References/For More Information (SSI)

• Supplemental Security Income 101: A Guide for Advocates (3/18; 15 pages) - Justice in Aging
• SSI and SSDI Advocates Guide (11/17; 124 pages) - Disability Law Center
• Social Security Handbook: Supplemental Security Income (SSI)
• Staff Training/Quick Reference guide to SSI/SSDI (compares the two programs) - NOT a patient handout
• SSI Basics - Part Two of a Two-Part Series - MGH Community News, August 2004
• SSDI & SSI - The Basics - MGH Community News, February 2007
• Disability Planning: SSI - Elderlaw Answers
• See our SSI Details page for more information including
  • Lump-sums or wind-falls (court settlements, lottery winnings, inheritances, etc.)
  • Those who are turning 18 (ongoing eligibility)
  • Understanding the State Supplement
  • Rep Payees

Newsletter Articles/Archive

• SSA Agrees to Stop Suspending Benefits On Existence of Arrest Warrant - MGH Community News, September 2009
• $250 Stimulus payment to Social Security recipients(5/09) - MGH Community News, March 2009
• Social Security Debuts Debit Cards for those without bank accounts - MGH Community News, July 2008
• Food Stamps and Cash Assistance For Iraqi and Afghan Military Interpreters - MGH Community News, January 2008
• Supplemental Security Income (SSI) Presentation- May 1999
• New SSI Transfer Restrictions - April 2000
• SSI Time Limit Reached For First Group of Refugees and Asylees - MGH Community News, January 2004.

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Social Security Disability Insurance (SSDI)

Program Description

SSDI benefits are not need-based and have no income or asset test. The monthly benefits paid by SSDI are essentially based on the amount of time worked and the amount of earnings.

To be eligible for SSDI a person must have "insured status", gained by working in FICA-covered work and paying FICA taxes for the required number of quarter. (Municipal or state employees for example may not be eligible if they have a separate retirement/disability system.) (See also Dependent's benefits)

Ineligibility/Waiting Period

There is a five month period of ineligibility, often called the "waiting period", after the date the disability began (as determined by Social Security) and before SSDI benefits are due to begin - with NEW exception of patients with Amyotrophic Lateral Sclerosis (ALS)*. The first SSDI benefit will be due for the sixth full month after the date of disability. For example, if the disability onset date is determined to be January 15, the first benefit would be due for the month of July, the sixth full month of disability. (Note: Social Security benefits are paid in the month after the month they're due. So, absent any processing delays, benefits would be paid in August.)

*ALS exception- in the final days of 2020 the ALS Disability Insurance Access Act was signed into law. This new law eliminates the five-month waiting period for individuals with Amyotrophic Lateral Sclerosis. The provision applies to applications for disability insurance benefits filed after the date of the enactment of the Act- December 22, 2020. Prior to the new law, SSA had an expedited approval process, but it meant only that an individual could receive SSI and Medicaid. They still had to wait five months to receive their Social Security disability benefits, which are based on their work history and generally substantially higher than the SSI amount. In addition, an individual approved for SSDI benefits for ALS becomes eligible for Medicare at the same time. (Most other individuals must wait two years for Medicare eligibility.) Source: The National Law Review, February 2, 2021 and on the SSA website.

Timely application and Back-Payments

SSDI can pay up to a maximum of 12 months of back-payments if one is determined to have been disabled before the date of application. Back-payments would be due for any months of disability before the application date that are beyond the five-month waiting period, with a maximum of 12 months due. So, if the disability onset date was 11 months before the date of application, one would be due roughly 6 months of back-payments (11 months disabled - 5 month waiting period = 6 months back-payments). Keep in mind that the five-month waiting period may actually be closer to six months- benefits are due starting the 6th full month after the disability onset date. See above. Encourage patients to apply in a timely manner to avoid forfeiting back-payments! (SSI does not offer back-payments.)

NOTE: Applicants may also receive retroactive payments because of lengthy application processing time. Learn more about SSDI Retroactive Benefits.

Determining Disability- see above (in Both SSI & SSDI section)

Qualified Work

Duration of Work Test

To qualify for Social Security disability benefits, you must first have worked in jobs covered by Social Security. SSA uses work "credits" to determine if you have enough work in such jobs to be eligible for benefits. To earn a credit in 2019 you must earn $1,360 (Historical list). You can earn a maximum of 4 credits a year. You might work all year to earn 4 credits, or you might earn enough for all 4 in a much shorter length of time. (Source)  For more information see: How You Earn Credits- SSA Publication No. 05-10072.

The number of work credits needed for disability benefits depends on your age when you become disabled.

• Before age 24--You may qualify if you have 6 credits earned in the 3-year period ending when your disability starts. (If disabled before age 22 see advocacy tip)

• Age 24 to 31--You may qualify if you have credit for working half the time between age 21 and the time you become disabled. For example, if you become disabled at age 27, you would need credit for 3 years of work (12 credits) out of the past 6 years (between ages 21 and 27).

• Age 31 or older--In general, you need to have the number of work credits shown in the chart below.

  Unless you are blind, you must have earned at least 20 of the credits in the 10 years immediately before you became disabled (this is also known as the Recent Work Test- more below).

  Become Disabled At Age	Number of Credits You Need
  31 through 42	20
  44	22
  46	24
  48	26
  50	28
  52	30
  54	32
  56	34
  58	36
  60	38
  62 or older	40

Recent Work Test

As noted above, in addition to the DURATION of work test above, one must also meet a RECENT work test to qualify.

Rules for work needed for the “recent work test”
If you become disabled...	Then you generally need:
In or before the quarter you turn age 24	1.5 years of work during the three-year period ending with the quarter your disability began.
In the quarter after you turn age 24 but before the quarter you turn age 31	Work during half the time for the period beginning with the quarter after you turned 21 and ending with the quarter you became disabled. Example: If you become disabled in the quarter you turned age 27, then you would need three years of work out of the six-year period ending with the quarter you became disabled.
In the quarter you turn age 31 or later	Work during five years out of the 10-year period ending with the quarter your disability began.

 

Note: See our SSDI Work History page for additional information.

*Advocacy tip: adults age 18 and over who were disabled before age 22 may qualify for SSDI on the basis of a parent's work IF a parent is receiving SSDI benefits, social security retirement benefits, or is deceased and worked long enough under Social Security.

The Adult disabled as a child must meet Social Security's definition of disability for an adult and not be earning more than Substantial Gainful Activity acceptable level of earnings. (see SSA publication: Benefits For Children With Disabilities and http://www.nolo.com/legal-encyclopedia/social-security-benefits-adult-children-with-severe-disabilities.html) See also: Dependents' Benefits.

 

Immigration Status

Non-citizens must be "lawfully present". The overall definition of "lawfully present" is an alien who has been inspected and admitted to the United States and who has not violated that status. Includes:  legal permanent resident aliens ("LPR" or "green card" holders), refugees, asylees, certain immigration parolees, certain conditional entrants, those with temporary protected status, certain Cuban/Haitian entrants, Family Unity beneficiaries, deferred enforced departure status, and applicants for asylum.

Note: as an earned benefit, receipt of SSDI should NOT pose a "public charge" risk. More on Public Charge.

Appeals

• Only about one-third of Social Security disability claims are approved at the initial level.
• Applicants will need to decide whether to appeal: learn more at Social Security Disability: What a Denial Means and Social Security Disability: Deciding Whether to Appeal a Denied Claim- both from NOLO.com

Benefits

The Social Security Statement - Individuals can get an individualized estimate of their disability benefits, along with a statement of lifetime earnings, estimates of retirement and survivors benefits. (SSA no longer mails the Social Security Statement yearly.) Request a Social Security Statement at www.socialsecurity.gov (requires setting up an account) or call toll-free 1-800-772-1213. Or use one of the online benefit calculators.

According to DisabilitySecrets.com (a site we've found to be generally reliable), most SSDI recipients receive between $700 and $1,700 per month (the AVERAGE for 2019 is $1,234). The MAXIMUM benefit in 2019 is $2,861 per month (a bit over $34,000 for the year). 

Combined Benefits:

• You may get both SSI and SSDI at the same time.
• You may also get disability payments from a private insurer or the Veterans Administration at the same time that you are receiving Social Security disability benefits, and it will not decrease your benefit.
• You can receive Workers' Compensation benefits as well in addition to Social Security disability, but the SSDI benefits will be reduced if the total of your workers' compensation and disability benefits exceeds 80 percent of your average wages before you became disabled.

See also: Dependent's Benefits.

Retroactive Benefits

It usually takes at least 3 to 5 months to process an application. Applicants will be due retroactive benefits for any months of disability after the application date that are beyond the 5 month "waiting period".

Example: SSA determines that Ms. X's date of onset of disability is the same as the date of application. It takes 9 months to process the application. She would be due retroactive benefits for roughly four months (9 months disabled – 5 month waiting period = 4 months benefits due). Keep in mind, however, that this is a rough estimate- the five-month waiting period may actually be closer to six months- benefits are due starting the 6th full month after the disability onset date. See Ineligibility/Waiting Period.

SSDI retroactive benefits may include back-payments. Back-payments are for months disabled beyond the 5 month waiting period, but before the application date (may pay a maximum of 12 months back-benefits).

Retirement

The full retirement age is slowly being raised to age 67.
The Social Security full retirement age had been 65 for many years. However, beginning with people born in 1938 or later, that age gradually increases until it reaches 67 for people born after 1959. See the Social Security Retirement Age Calculator to determine one's full retirement age. (Note: waiting to receive benefits until after normal retirement age may result in larger benefits. With delayed retirement credits, a person can receive his or her largest benefit by waiting to retire until age 70. There is no additional benefit to delaying retirement beyond age 70.)

(Can I get payment if I'm a resident or citizen of another country? See the Payments Abroad Screening Tool for personalized information about payments for retirement, disability, or survivor’s benefits.)

Should I Take Early Retirement or Apply for SSDI?

Patient Handouts from the CRC Should I Apply for Disability or Take Early Retirement?

 

Early retirement provides a reduced monthly benefit. A worker can choose to retire as early as age 62, but doing so may result in a reduction of as much as 30 percent in monthly benefits. (Note: waiting to receive benefits until after normal retirement age may result in larger benefits. With delayed retirement credits, a person can receive his or her largest benefit by retiring at age 70. There is no additional benefit to delaying retirement beyond age 70.) More information and a retirement age calculator at: www.ssa.gov/oact/quickcalc/early_late.html

Sometimes health problems force people to retire early. If you cannot work because of health problems, you should consider applying for Social Security disability benefits. The amount of the disability benefit is the same as a full, unreduced retirement benefit. If you are receiving Social Security disability benefits when you reach full retirement age, those benefits will be converted to retirement benefits. (From https://www.ssa.gov/pubs/EN-05-10035.pdf - also in Spanish)

Since there may be long delays in approving disability, those who have a serious impairment and/or are sure they qualify for disability may choose to apply for disability and elect early retirement to tide them over until disability begins. But there are risks to this approach. See next sections for more detail.

Can I get both SSDI and Retirement benefits?
Social Security Disability is a form of early retirement benefits that provides an unreduced retirement benefit. You cannot receive Social Security retirement benefits and disability benefits at the same time- EXCEPT if you took early retirement AND are subsequently determined to have been disabled prior to early retirement. In that case you would not receive a full combined benefit, but would receive a supplement to make up the difference between the early retirement amount and the full disability amount for those months you were considered disabled but receiving early retirement benefits (retroactively).

For example, say you quit work because of health problems, started to collect early retirement benefits for a time, and then applied for and got approved for disability benefits. If Social Security agrees that your disability started BEFORE you started to collect early retirement, Social Security would pay you the difference between your disability payment (which is equal to your full retirement payment) and your early retirement payment for those months that you received early retirement payments. (The difference between your early retirement payment at age 62 and your disability payment may be as much as 30%.) In addition, when you reach full retirement age, you would get your full retirement benefit, as if you had never opted to collect early retirement payments. In addition, you would get the benefit of the disability freeze, which means that your lack of income due to disability is not counted when calculating your Social Security retirement payment from your earnings record.

However, if Social Security determines that you are either not disabled, or the onset of the disability was AFTER you began collecting early retirement benefits, Social Security will not pay you the difference between your disability payment and the early retirement payment, and you would be paid at a less-than-full retirement rate for the rest of your life.  

How do I decide whether to elect to take early retirement while also applying for disability?
While some people who quit work at age 62 purposefully apply for disability and elect early retirement at the same time, so that the early retirement payments fill the gap until the disability payments start, remember that there is no guarantee you'll be granted disability benefits, and you could be stuck collecting less than your full retirement rate for the rest of your life. Still, this can work for those people who are severely impaired and are sure that they will get disability benefits. Getting disability benefits for those over 60 is easier than for younger folks, and Social Security gives special consideration to those over 65. If you are considering this course of action, talk to a disability lawyer, who can help you assess your financial options and your chances of winning disability benefits.

-Adapted from: http://www.disabilitysecrets.com/retired-draw-disability.html

See also: Unemployment vs. Early Retirement vs. Disability- Social Service Staff Mtg 11/16 and Questions and Answers Also see: Can I Collect Unemployment While Waiting for Social Security Disability?, Disability Secrets

Early Retirement "Do-Over" Can Provide Short-Term No-Interest Loan for Those Who Can Pay it Back

Under the so-called "Do-Over" rule, an individual 62 years or older can start collecting early retirement benefits but stop the benefits within 12 months of the start, repay the benefits collected, and then still be eligible for their higher benefit amount when they collect at full retirement age or older. This is a one-time option.

What’s the advantage if the benefits must all be immediately repaid? The strategy can work as a short-term interest fee loan. It makes sense, for example, in cases where an individual has a need for income in the immediate short term, due to an emergency such as a sudden loss of employment, but they anticipate income (i.e., finding a new job or collecting a pension), within the year which would allow for full repayment. Read the full article: How You Can Use Your Social Security Benefits as an Interest-Free Loan, MGH Community News, April 2014.

 

Dependent's Benefits

Certain family members may be eligible for dependent's benefits on the wage record of an insured worker. The wage earner must be eligible for SSDI benefits. Eligible dependents include:

• A spouse caring for the dependent child (under age 16 or disabled) of the wage earner. (More information)
• Unmarried dependent minor children up until the age of eighteen or, if enrolled in a full time secondary education program, until graduation or age nineteen, whichever comes first.
• Adults (18 and older) disabled as children (who have met the adult disability standard since prior to age twenty-two) whose parent is receiving disability or retirement benefits or is deceased and worked long enough to become insured. (More information: see SSA publication: Benefits For Children With Disabilities and http://www.nolo.com/legal-encyclopedia/social-security-benefits-adult-children-with-severe-disabilities.html)
• In some situations, a divorced spouse may qualify for benefits based on your earnings if he or she was married to you for at least 10 years, is not currently married and is at least age 62.

Same-Sex Married Couples- On March 1, 2017 the Social Security Administration (SSA) announced that it would reopen its decisions to deny SPOUSAL or SURVIVOR'S BENEFITS to individuals who had been married to someone of the same sex, and whose marriage wasn’t recognized because of a discriminatory state or federal ban on marriage. This policy applies not only to individuals who were denied benefits after the Supreme Court struck down federal discrimination against same-sex spouses (in United States v. Windsor in 2013) and state discrimination (in Obergefell v. Hodges in 2015), but also to individuals who applied for and did not receive benefits BEFORE these Supreme Court decisions because of the discriminatory laws in effect at the time they applied.

A new Fact Sheet on this guidance from Justice in Aging includes more detailed information about who is affected by the new guidance, who isn’t, and what advocates and their clients should do to get their cases reopened. See the full MGH Community News article (5/17)

More Information: see Same-Sex Married Couples on our LGBT page.

The maximum total family benefit is either 85 percent of the disabled worker's salary before disability or 150 percent of disabled person's disability benefit, whichever is less.

NOTE:
In some situations, a divorced spouse may qualify for benefits based on your earnings if he or she was married to you for at least 10 years, is not currently married and is at least age 62. The money paid to a divorced spouse does not reduce your benefit or any benefits due to your current spouse or children.

Incarceration - includes information on dependents' benefits when a recipient is incarcerated: Benefits after Incarceration: What You Need To Know, Social Security website

 

Survivors Benefits - see our survivors benefits page.

International Payments

Can I get payment if I'm a resident or citizen of another country? See the Payments Abroad Screening Tool for personalized information about payments for retirement, disability, or survivor’s benefits.

See also:  Rep Payees

Overpayments

SSA Overpayments Fact Sheet

Also see: Social Security Overpayments- MGH Community News, May 2018.

 

 

References/For More Information

• SSI and SSDI Advocates Guide
• Disability Benefits (SSDI)- SSA Publication no. 05-10029, August 2018
• What You Need to Know When You Get Social Security Disability Benefits (SSDI)- SSA Publication no. 05-10153, December 2018
• Staff Training/Quick Reference guide to SSI/SSDI (compares the two programs) - NOT a patient handout
• Services for people currently receiving benefits
• "SSDI Basics - Part One of a Two-Part Series" - MGH Community News, July 2004
• "SSDI & SSI - The Basics" - MGH Community News, February 2007

  Newsletter Articles

  • Geographic Disparities in SSI/SSDI Due to Prevalence of Disability and Socioeconomic Factors Not Inconsistent Administration- MGH Community News, June 2018
  • Elders' Social Security Checks Garnished by Student Loan Debt Leaves Many Below Poverty Level- MGH Community News, January 2017
  • Some SSDI Recipients Cut from MassHealth Due to Cost of Living Increase - MGH Community News, May 2015
  • Have private disability?  Why you should still apply for SSDI - MGH Community News, July/August 2010
  • Social Security Examines Massive, Years-Old Backlog - MGH Community News, October 2008
  • Social Security Debuts Debit Cards for those without bank accounts- MGH Community News, July 2008