Thursday, September 22, 2011

Author: Brett E. Schmied

Disability is something most people do not like to think about.  But the chances that you will become disabled probably are greater than you realize.  Studies show that a 20-year-old worker has a 3 in 10 chance of becoming disabled before reaching full retirement age.  As a result, the Social Security Administration has instituted two programs in order compensate individuals who become disabled prior to reaching full retirement age.

Social Security Disability Insurance (SSDI), also known as Title II, is a disability benefit amount based on payments previously made into the Social Security system by a worker who has become disabled.  Therefore, the worker’s benefit amount is based on that worker’s earnings record.  In order qualify for SSDI, an individual must have earned enough “work credits.”  An individual worker must have 20 work credits within the past 10 years in order to be eligible for SSDI.  A worker can earn a maximum of four work credits in each calendar year.  Simply stated, if an individual has worked 5 of the last 10 years, they will likely be eligible for SSDI.

An individual will have to become disabled before their work credits drop below 20 within the past 10 years.  Individuals who receive SSDI are eligible for Medicare; however, Medicare eligibility does not begin until the individual has received SSDI benefits for 24 months.  No application is necessary for Medicare because eligibility occurs automatically in month 25 of receiving SSDI.  For more information on Medicare, please visit www.medicare.gov.

Supplemental Security Income (SSI), also known as Title XVI, is a federally financed, needs-based benefits program.  SSI guarantees an income for individuals with low income and resources on the basis of age, blindness, and disability.  The eligibility requirements are very different from SSDI.

First, there is no requirement that an individual earn any work credits.  SSI is a need-based program.  In order to qualify for SSI, a recipient must meet the following five criteria: (1) Categorical; (2) Residential; (3) Citizenship or Alien; (4) Resources; AND (5) Income.

(1) The individual needs to be at least 65 years old, blind, or disabled.

(2) The individual must have resided in the USA for at least 30 days.

(3) The individual must be a citizen of the USA or a qualified alien.

(4) The individual must have under a certain amount of resources.  A resource is defined as cash on hand, other than personal or real property, that an individual has some level of ownership and maintains some level of control. For an individual, the SSI resource limit is $2,000 in countable resources.  For a couple, the SSI resource limit is $3,000. Certain resources can be excluded including, but not limited to, the SSI recipient’s home, automobile, and personal/household goods.

(5) The individual must make under a certain income.  Income is anything an individual receives in cash or in kind that can be used to meet ones needs for food, clothing, and shelter.  Almost all income is countable, although there are some exclusions and deductions.  Income reduces the maximum monthly benefit to which a SSI recipient would otherwise be entitled.  Common sources of income include, but are not limited to, wages, tips, alimony, pensions, worker’s compensation benefits, unemployment benefits, among others.

Unlike SSDI, SSI recipients will likely not qualify for Medicare.  On the other hand, SSI recipients are likely immediately eligible for Medicaid but will need to apply for it.

Please contact us at (877) SSD-IWIN or email consult@ericjoneslaw.com for additional information.

Did you get a COBRA notice after the termination of employment?

If you have been terminated from employment and have not been offered the right to purchase continuing health care benefits through COBRA, you may have a claim against your previous employer regardless of whether you would have elected COBRA benefits.

Employers must provide notice of your right to continue your health care coverage. This notice has specific requirements and must be delivered within a specific time frame. If you received no notice or insufficient notice of your COBRA benefits, you may have a claim.

By failing to send proper NOTICE, your employer may be subject to:

1. a statutory penalty of up to $110 per day for each violation;

2. excise taxes;

3. liability for any beneficiary’s medical expense due to the gap in coverage;

4. attorney fees;

To establish a claim, you must have been covered under your company’s health insurance at the time your job ended. It does not matter whether you left voluntarily or were terminated. A few brief questions will help us determine whether the COBRA ‘notice’ requirements apply to your situation. Attorney’s fees would come directly out of any potential recovery. If you are interested in determining whether you may be eligible to recover against your former employer, please contact us at (614)545-9998.