Can I receive Social Security and Medicare benefits simultaneously?

The Social Security Administration recently celebrated "National my Social Security Week" which was aimed at raising awareness for individuals to set up online accounts with the SSA. By so doing, they can be provided with access to their annual statements and information about their projected retirement savings, as well as their eligibility for disability benefits. By having a "my Social Security" online account, these and other questions can be readily answered.

For many retirees and disabled individuals, a common question is whether or not they can claim Social Security and Medicare at the same time. The programs combine to provide a significant amount of the financial support to retired and disabled individuals.

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How does one apply for the government benefits of Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI)?

If you are disabled and unable to work you may feel hopeless, but there are a number of government-administered benefits offered to help those in your situation. Two of these, the SSI and SSDI programs, provide cash benefits to those in need. SSI is a program for those who are low income and disabled, while SSDI provides benefits to those who are disabled with a relevant work history. If your situation fits into either of the above categories, you may be entitled to monthly benefits. In this article, we will cover the basics of the Read more . . .

At Seelig Law Offices, we fight tirelessly to ensure equal access and opportunities for all New Yorkers, regardless of physical limitation. Along the same lines, New York City’s Mayor De Blasio recently enacted several mandates ensuring the same equalities for residents across all five boroughs -- specifically with regard to access to services and events within New York City.

Interestingly, the first set of laws pertains to equal access to websites run by the city and state governments. The directives essentially mimic federal standards, and require municipalities to contract with web development experts to ensure everyone can access the important information found on government web pages. According to the Web Content Accessibility Guidelines followed by the federal government, city and municipal sites must be accessible to those with visual and hearing impairment, as well as those with limited cognitive ability.
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What groups benefit the most from Social Security Disability Insurance?

Social Security Disability Insurance (SSDI) is a government run program that helps millions of people across the country. If you are disabled, according to the Social Security Administration’s definition, and you cannot work, you are likely entitled to a monthly cash benefit. The program covers a multitude of physical and mental disabilities.
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Being injured on the job may not guarantee a full disability pension without a fight.

Newspapers often seize upon scandalous stories of policemen or firefighters who, while receiving a full disability pension, perform feats of physical strength, such as running a marathon. Less often do they focus on the struggles of those who, while injured on the job, must fight for years to get a disability pension approved.

An exception is a recent account of how retired NYPD Detective Sara Salerno of the Bronx has waged an eight-year battle against the Police Pension Fund and the City of New York, which have opposed her request at every turn.

Salerno had a 12-year career with the NYPD, making more than100 arrests while working in patrol, anti-crime and internal affairs. She tore her meniscus during training for a bicycle patrol at the 40th precinct in the Bronx.

In addition, according to court filings, she served at Ground Zero, responding to the attacks and working there for many days.Technically she was on restricted duty, so her name was not recorded in the roll call. The city's Law Department contests her claim that she was there and says she cannot show that her disabling respiratory ailments and immune system problems are connected to working at the WTC site. Her supervisors and fellow officers, however, have confirmed in writing that she was there.

The case is on appeal. Meanwhile Salerno receives a regular disability pension, which is 50 percent of her salary and is taxable. A full disability pension would mean 75 percent of her last salary, tax-free.

The case is a reminder that recovering one's rightful pension can be an obstacle course. Even with a strong claim, retirees with job-related injuries need a vigorous legal advocate in their corner to receive appropriate disability payments.

What changes were made by Congress to Social Security "files and suspend" claims?

In 2015, Congress voted to make some sweeping changes to Social Security laws – primarily those impacting retiring Baby Boomers and their portfolios. The following answers some general questions about the changes.

What are the two major areas impacted by the new legislation?

Under the new Social Security laws, two concepts known as “file and suspend” and “restricted application” will be eliminated as of May 1, 2016. These are known as “claiming strategies,” and are alternatives for retirees who do not wish to fully engage their benefits immediately upon reaching the age of eligibility.

What is “file and suspend?”

File and suspend is a claiming strategy in which one claimant files for full benefits at age 66, but opts to suspend the receipt of the first payment until some point thereafter – accruing retirement credits in the meantime. The option was popular with married couples, as it allowed one spouse to receive heightened monthly benefits while the other’s benefits lingered in suspension. Once the suspended benefits entered distribution, the second spouse would be eligible for a higher monthly payment.

What is a restricted application?

A restricted application is one in which a spouse files for full benefits at age 66, but opts only to receive spousal benefits only – thereby allowing the filer’s personal benefits to grow until age 70.

Are these options totally eliminated?

Anyone having already elected the “file and suspend” claiming strategy is safe, as the rules do not go into effect until May 1, 2016. At that time, file and suspend claims will no longer be an allowed; however, anyone who has reached full retirement age (66) by May 1 may still elect this option, provided the application is submitted by April 29, 2016.

With regard to restricted applications, claimants born on or before January 1, 1954 will still be eligible to elect this option, whereas all others will be prohibited as of May 1, 2016.

If you have questions or need assistance with filing for social security benefits, you should consult with a qualified attorney.

Is the Social Security Administration giving inaccurate projections?

Now that Congress has punted on any serious measures to reform the Social Security System, critics continue to question the accuracy of the Social Security Administration's funding projections. The concern is that the SSA's figures make the retirement and disability trust funds appear to be healthier than they actually are. One would think that because Social Security is the government's largest program that extra care would be taken by the agency to ensure that their figures are realistic.

The program is funded by payroll taxes and income taxes on benefits and these proceeds pay benefits and administrative costs. Further complicating the issue is the fact that more and more members of the Baby Boomer generation are retiring and this is putting a strain on the system. The result is a widening gap between revenue going into the funds and the amount of money being paid out.

In 2015, about 60 million people received benefits totaling $877 billion. Of those recipients, 40 million were retirees who received an average of $1,335 per month. The programs' Board of Trustees has released reports of different projections, but the long and short of it is that the asset reserves of the retirement and disability funds will be depleted by 2034.

As for the accuracy of the projections, a recent independent study outlined a number of problems with the Agency's methods. One is that The SSA does not meet the same standards in scientific evaluation procedures that other government agencies and private sector businesses employ. The errors in forecasting most likely occurred because the agency lacks formal statistical methods used to create forecasts.

There are also other problems plaguing the Social Security Disability Insurance Program, and long-term funding has still not been resolved. Currently, more than 10 million Americans are now on SSDI, at an annual cost of more than $140 billion. Some contend that the SSDI eligibility standards need to be updated as they currently rely on data that is 30 years old. In any event, the budget compromise struck between the White House and Congress last December, was only a short-term fix.

Given the fact that Congressional lawmakers have oversight over the Social Security Administration, these elected officials need to insist on greater transparency and accuracy, since their policy decisions are based on the administration's forecasts. In the meantime, if you have become disabled and are unable to work, a qualified attorney can help you secure disability benefits.

What does the Social Security Disability Insurance program cover?

Since the 1950s, the federal government has provided a safety net to people who are considered disabled, and are unable to work and support themselves and their dependents. The Social Security Disability Insurance and Supplemental Security Income system provides care for people who are terminally ill or disabled to the point that it is unlikely that they will ever be able to work again.  

Nearly since its inception, the government has worried about how much money this program will cost. Providing financial support to someone for the rest of their life could get quite expensive, especially considering people are living longer today than ever before. In order to control costs, the Social Security Administration (SSA) has put a rather strict definition of “disabled” in place to limit the number of people who can enroll in the program.

The SSA definition of disability is a complex one. In order to be considered disabled by the Administration:

“you must not be able to engage in any substantial gainful activity (SGA) because of a medically-determinable physical or mental impairment(s):

• That is expected to result in death, or
• That has lasted or is expected to last for a continuous period of at least 12 months.”

The key to determining if you are eligible for disability usually rests not on the disability part of this definition, but on the substantial gainful activity part.

According to the SSA, “Work is ‘substantial’ if it involves doing significant physical or mental activities or a combination of both.” This definition means even part-time, very low wage/low skill work counts.

“’Gainful’ work activity is:

• Work performed for pay or profit; or
• Work of a nature generally performed for pay or profit; or
• Work intended for profit, whether or not a profit is realized.”

The government looks at what you could expect to earn from the amount of “substantial,” “gainful” work you can do, and compares that to earnings guidelines it has developed. If you fall below a certain amount, presumably an amount necessary to support yourself, you qualify.

The earnings guidelines change each year, and it seems like the SAA’s ideas about what “substantial” and “gainful” do as well (even though the letter of the law does not change). So working with an attorney who has experience dealing with the SSA is advised.

Is the number of social security disability fraud claims overestimated?

Rumors of Social Security Disability fraud have been greatly exaggerated. While there are cases of people scamming the system, fraud is not nearly as widespread as some would suggest.

There is a growing narrative that the solution to fraud is to make it more difficult for people to qualify for disability. Currently, however, it is not that easy to go on disability. In fact, about 60 percent of disability applicants are denied, primarily because they have not worked long enough. A person must have worked at least one quarter of his or her adult life and also have worked 5 of the last 10 years to qualify. There must also be bona fide medical reasons: a physical or mental illness severe enough that it will either last for 12 months or end in death.

And it's not as easy to fake a disability as some contend. While some physical disabilities like back problems and mental illness are not easy to see, this is not to say they are being faked. The main causes of disability are chronic physical disorders, and many psychiatric disorders are also debilitating.

Contrary to what some believe, disability claims are not skyrocketing. While the age group of those likely to go on disability is growing (50 to 64 years old), the actual percentage of workers on disability has only slightly increased since the year 2000. Moreover, older women are more likely to qualify for disability than in years past.

Despite the calls for more stringent requirements to qualify for disability, the U.S. already has more stringent requirements than most advanced economies. The real solution to disability fraud is to detect and prevent fraudulent claims. That being said, Congress has not adequately funded the Social Security Administration's fraud prevention unit.

The fact that a person entering the work force today has a one in three chance of dying or qualifying for disability before retirement age is reason enough to ensure that disability funds continue to be available to those who qualify. If you are suffering from a debilitating physical or mental illness, a qualified attorney can help you secure disability insurance.

What can I do if I was denied a job I was otherwise qualified for on the basis of my disability?

The New York Times ran an article this week about a study recently presented by Syracuse and Rutgers Universities demonstrating that there is significant discrimination taking place when it comes to disabled job seekers. It is important to be aware that there is legal recourse available for disabled applicants who experience discrimination during their job hunting.

The study mentioned was organized in the following way:

Cover letter and resumes were sent in response to job opening ads. The applications were for fictitious candidates. There were two different resumes sent for each position, one for an experienced candidate, and one for a qualified candidate with little experience. Three different cover letters -- one purporting to be from a non-disabled applicant, one from an applicant with a spinal cord injury, and one from an applicant with Asperger’s syndrome were sent with each resume.

The researchers found that for the experienced candidates, responses from employers were significantly more likely when the employer was responding to the application of the non-disabled person. Employers were 34 percent less likely to show an interest in the disabled applicants. Researchers commented that they hypothesized this result, but that they did not foresee such a drastic outcome. The researchers also found that responses were 15 percent less likely for disabled applicants among the applicants that were not experienced, but nonetheless qualified.

Researchers were hoping to explain the steep drop off in employment rate for disabled workers. Statistics show that 34 percent of people with disabilities are employed as of 2013, whereas 74 percent of those without a disability are employed. It seems very likely that bias is a contributing factor in these hiring statistics. Particularly disturbing is that the gap is greater for people with disabilities who have more education, experience, and qualification.

For those who are disabled and experience discrimination relative to hiring or in the workplace, there are law firms that specialize both in disability and discrimination cases. If you are disabled and feel you have been discriminated against because of your disability, you should contact an attorney who specializes in disability to investigate the legal options available to you.

I have chronic asthma and suffer from frequent attacks. Could I be eligible for Social Security disability benefits?

With any evaluation of Social Security disability benefits, the SSA will review the applicant’s occupational information as well as the medical condition from which he or she is suffering. Generally speaking, benefits may be awarded to one who – due to both the nature of the job and the severity of the illness – is unable to continue working at their current place of employment without enduring a substantial health risk. Accordingly, the results of an application for benefits may vary – even within a group of applicants suffering from the same condition. However, when reviewing a claim involving a condition like a chronic respiratory issue, the SSA will take a look at certain factors across the board.

Respiratory disorders

Asthma, COPD, emphysema, and chronic bronchitis (bronchial inflammation) fall under the umbrella of chronic respiratory disorders. When reviewing claims involving these conditions, the SSA will refer to the list of qualifying symptoms as found in its Blue Book, which details the symptoms and effects of nearly all qualifying conditions recognized by the SSA. If a condition meets the symptoms listed in the Blue Book, the SSA will approve the application for benefits automatically. Nonetheless, proving that the symptoms interfere with patient functioning is not always easy.

• Chronic Pulmonary Insufficiency

  Meeting this test requires a spirometry test showing that the volume of air exhaled in one second is equal to or less than a certain amount given the applicant’s height. An alternative test may be necessary for applicants suffering from a condition impacting the oxygenation levels in the blood.

• Asthma

  To automatically qualify as an asthmatic, an applicant must show evidence of an asthma attack at least once every two months or six times per year, lasting longer than 24 hours, and requiring hospitalization.

• Cystic Fibrosis

When evaluating applicants with cystic fibrosis, the SSA will review the frequency of respiratory infections, lung capacity, and/or the number of annual episodes requiring medical intervention.

Though a patient may be troubled by respiratory difficulties, unless the patient meets the above conditions, he or she will not qualify as disabled under government guidelines.