Dennis W. Fox & Associates

 " Representing individuals before the Social Security Administration." Call 314-241-9666

 BENEFIT ELIGIBILITY

About Receiving Benefits
Under Social Security, there are two general categories of benefits: retirement benefits and disability benefits. When you work and pay Social Security taxes, also called "FICA," you earn credits to get retirement benefits. The number of credits required to get the benefits depends on your date of birth, and you must have the required number before retirement benefits can be paid to you. If you stop working before you have enough credits to qualify, those credits will remain on your record, and you can add more credits by returning to work. Most people earn more than they need to qualify during their working lifetime. How much money you receive in benefits is based on your earnings averaged over your working career. The more you earned, and the older you are before you retire and start receiving benefits, the more you receive.

The earliest you can retire and receive benefits is age 62, with most people retiring at 65, which is called the "full retirement age." However, because people are living longer, starting in the year 2003, full retirement age will increase be increased in gradual steps until it reaches age 67, affecting people born in the year 1938 and after. Under Social Security, you're considered "disabled" if you're unable to do any kind of work for which you're suited, and your disability is expected to either last for a year or more, or result in death. You can receive disability benefits at any age, although at age 65, they become retirement benefits.

Certain members of your family, such as your children or spouse, may also qualify for benefits under your record. To qualify for Social Security disability benefits, you must have worked long enough and recently enough: generally 20 credits earned in the last ten years. You should apply at any Social Security office as soon as you become disabled.

Benefits don't begin until the sixth full month of disability, as determined by Social Security.

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Benefits Can Continue Beyond 18
In most cases, children's social security or S-S-I benefits are payable only until age 18. However, there are several situations where benefits may continue beyond 18. For example, suppose a child is the dependent of someone who's drawing retirement o disability pay, or of a parent who has died. If that child is a full-time elementary or high school student, they may continue to receive benefits until age 19.

Another case where benefits might continue, is when the child is disabled. These are known as benefits for adults disabled since childhood. To be eligible, you must have a parent who is receiving retirement or disability, or who has died. Also, your disability must have begun before you turned 22.

There are still other situations where a disabled child who could not receive S-S-I before 18, because their parents' income was too high, may be able to get benefits after age 18. That's because when a child turns 18, and lives on their own, the parent's assets no longer affect their ability to qualify for S-S-I. To find out more about benefits that may be paid past age 18, contact the social security office.

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Can I get my eligibility extended?
If you're currently receiving Social Security disability benefits, those benefits will continue as long as you're disabled. However, your case will be reviewed periodically. The frequency of the reviews depends on if, and when, you're expected to recover. If you're expected to improve, your case will normally be reviewed within six to 18 months, then again in no sooner than three years. If medical improvement is not expected, your case may be reviewed in no sooner than seven years. There are two things that can cause you to no longer be considered disabled and your benefits to be discontinued. If you work at a level that's "substantial"-- that is, if you make 500 dollars a month or more-- or if you're no longer disabled, your benefits will stop. You must promptly report any improvement in your condition, your return to work, and certain other events. There's a trial work period that allows you to earn as much as you can during nine months over a five-year period without affecting your benefits.

After your trial work period ends, your earnings are evaluated, and if they don't average more than 500 dollars a month, benefits will generally continue for a three-month grace period before they stop. For 36 months after a successful trial work period, if you're still disabled, you'll be eligible to receive benefits without a new application for any month your earnings drop below 500 dollars. Your Medicare coverage will continue for 39 months beyond the trial work period.
If your Medicare coverage stops because of your work, you may purchase it for a monthly premium. If you're receiving SSI benefits-- Supplemental Security Income-- different rules apply.

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Eligibility for Family Members
In many cases, family members may qualify for social security benefits on your work record.
If you become disabled, they may be eligible for dependents' benefits. This includes your unmarried son or daughter, adopted child, and in certain cases, your step child or grandchild. However, the child must be under 18, or under 19 if attending high school full-time. Your unmarried son or daughter who has a disability that began before age 22 may also qualify.
If your spouse is 62 or older when you become disabled, they may be eligible for dependents' benefits. Or, a spouse may get dependents' benefits at any age, if he or she is caring for your child who is disabled, or under 16, and also getting payments.

In addition, there are survivors' benefits for your family, should you die. For example, your disabled widow or widower who is at least 50 may qualify, as well as any dependent children.
To find out more about how family members may receive benefits, contact the social security office.

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Extended Period of Eligibility
Those with a disability who want to work can take advantage of the work incentive program.
This special group of rules is designed to help you ease back into the workforce. One such rule is the trial work period. It allows you to work for up to nine months, and still draw your full disability benefits, no matter how much you earn. When the trial period is over, if you are making substantial money,, your benefits will end in three more months. However, you are still protected for an additional three years, should your earnings fall below $700. This is called the extended period of eligibility. It means you are eligible to receive your full disability benefit, in any month where you make less than $500.

These benefits may continue as long as you remain disabled, and your wages average less than $500 per month. If you'd like to get back to work, contact the social security office. They can give you more information about extended eligibility, and other work incentives.

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Household Worker
The social security administration defines household workers as anyone who is employed to work in or around someone's home. Some common examples would be babysitters, maids, butlers, cooks, laundry workers, gardeners, and chauffeurs. If you're a household worker, it's important to understand that you, too, can earn credits under social security. But first, your employer must report your wages to the irs, and deduct the necessary taxes. Make sure your employer sees your social security card, and that he or she withholds social security taxes from your earnings. Your employer must also pay a matching tax amount, and send the total tax to the irs, along with a report of your wages.

Remember, if the wages aren't reported, you won't earn social security credit for your work. That means you may not get enough credits to qualify for monthly benefits when you retire, or if you become disabled or die. Even if you do get benefits, they may be lower than they should be, if all your lifetime earnings have not been reported. If you are being paid by an individual, and are not sure if they're paying your taxes, contact the social security office.

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Medicaid
Each state has some leeway in determining who is eligible for Medicaid; however, in order for the states to receive federal funds, there are certain groups that must be covered. For these people, Medicaid coverage is mandatory. They include recipients of aid to families with dependent children, or A-F-D-C; infants born to Medicaid-eligible pregnant women; and children under age 6 and pregnant women with limited income. Furthermore, states are required to provide Medicaid coverage until age 19, to all children born after September 30th, 1983 in families with income at or below the poverty level.

Most people who get S-S-I also qualify for Medicaid, though in some states, they must meet more restrictive conditions than required by S-S-I. There are other groups for whom the state has the option of providing Medicaid benefits. These include certain aged, blind or disabled adults with income below the poverty level, institutionalized persons with limited resources, and other groups, as determined by that state. Laws vary from one state to another. Recent reforms in welfare have also changed some of the rules regarding Medicaid. So you'll need to speak with a representative in your state Medicaid office, for more details.

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Low Income Medicare Beneficiaries
Medicare has two programs designed to assist those with low income and limited resources.
Both are run by the health care financing administration, along with your state agency that handles Medicaid. The first program is the qualified Medicare beneficiary, or Q-M-B. If you are eligible for Q-M-B, the state will pay your monthly Medicare premiums.

What's more, you will not have to pay any Medicare deductibles or co-payments. The other medical assistance program is the specified low-income Medicare beneficiary, called S-L-M-B for short. Under the S-L-M-B program, your state pays only the monthly premium of your part b Medicare.

The guidelines that determine who is eligible are different in each state. But generally, you may be able to receive Q-M-B or S-L-M-B if your income and the things you own fall below a certain limit. Not everything you own counts as a resource: your home and items like your car usually don't count. But only your state can decide if you qualify for assistance.
To find out if you're eligible for q-m-b, or s-l-m-b, contact your state or local Medicaid agency, social service office, or welfare office.

General information is also available from social security: just ask for the booklet titled "Medicare: savings for qualified beneficiaries.

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Opting for Reduced Benefits
Ordinarily, a person who has worked under social security is eligible for full retirement benefits starting at age 65. You may also have the option to draw retirement as early as age 62; however, if you do, your monthly payment will be permanently reduced. You'll need a certain number of work credits to qualify for retirement benefits; most people need at least 40 credits.

Assuming you qualify, you can opt for early benefits either on your work record, or your spouse's. But be aware, your benefit will stay reduced, even if you first take benefits on your record, and then take spouse's benefits when your husband or wife retires. The decision of whether to take early retirement benefits depends on your particular situation.

Here are some things to consider: do you expect to have, income from other sources? Will you draw retirement from your former employer? Do you have investments that may pay you interest? Most importantly, find out how much your benefit will be reduced, if taken early.

The social security office can help you get an estimate of your benefit both ways: reduced versus full.

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Women and Social Security
Today, almost 60 percent of the female population works outside the home. While social security has always paid benefits to women, more women than ever now qualify for the protection social security can provide. Working women earn protection for themselves and their families, should they die or become disabled. Through work, they also earn credits toward retirement benefits.

As long as you pay social security taxes, these benefits apply whether you are self-employed, or work for someone else. There is also coverage for women who have never worked; they may be eligible through their husband's work record, receiving benefits when he becomes disabled, retires, or dies. Special rules apply if you are disabled, or caring for children under age 18.

There are also special guidelines for widows. If your husband dies, you can receive widow's benefits if you are 60 years or older. If disabled, widow's benefits are payable to those 50 and older. As a widow, you may also be eligible for medicare at age 65, assuming your husband worked long enough before his death. There are many ways that women may qualify for social security benefits.

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