Social Security Programs
Clients may receive income from the Social Security Administration (SSA) for a variety of reasons such as; retirement, disability, or due to a family relationship. Often, clients will refer to their benefit checks as "Social Security," regardless of which program they fall under. Therefore, it is important for an advocate to know the differences between each program, how a claimant qualifies for benefits, and where to find a particular program's rules.
Most workers pay into Social Security while they are working by deductions taken for the Federal Insurance Contribution Act (FICA). These deductions are the money or "premiums" which workers pay into the Social Security system. For every contribution a worker makes to Social Security, their employer makes an equal contribution. The Social Security Administration (SSA) then uses that money to pay people who are eligible to receive benefits.
To become eligible for benefits through the Old-Age, Survivor, and Disability Insurance (OASDI) program, an individual must have worked for a minimum length of time before claiming benefits. The length of time varies depending on whether the claimant is asserting eligibility for OASDI benefits based on disability, their age at the time of disability and whether they are seeking retirement benefits.
In general, an individual may be eligible for Social Security benefits through the Old-Age, Survivor, and Disability Insurance program (OASDI) based on being:
A retired or a disabled worker who paid into Social Security; or
The current or divorced spouse of a worker receiving benefits if you meet certain other requirements; or
A deceased worker's widow or widower who is 60 years old or older or, if disabled, 50 years old or older; or
The surviving divorced spouse of a deceased worker who meets certain other requirements; or
The dependent child of someone who is receiving disability or retirement benefits, or the child of a deceased worker; or
The surviving dependent parent of someone who was entitled to Social Security benefits.
Eligibility for Social Security benefits is based on a person's work record. When a person works and pays into Social Security, they earn credits toward OASDI benefits.
For a person to be entitled to receive retirement benefits, the claimant must earned enough work credits and be of a certain age.
The number of credits needed to get retirement benefits depends on when the claimant was born. For claimants born in 1929 or later, 40 credits is needed (10 years of work) to qualify.
A person is eligible to receive retirement benefits:
At age 62: Monthly benefits are reduced permanently by 5/9 of 1% for each month before the age of 65.
At age 65 or older: If a claimant was born in 1938, "full" retirement began when they reached 65 years and 2 months. For claimants born between 1939 and 1943, full retirement age goes up in 2-month increments each year, so that for persons born in 1943, the full retirement age is 66 years. For persons born between 1943 through 1954, full retirement age remains at 66 years. For persons born in 1955 and afterwards, full retirement age increases in 2-month increments each year from 1955 until it reaches 67 years. For persons born in 1960 or later, full retirement age is 67 years.
Social Security Disability Insurance Benefits (SSDI)
For a person to be entitled to Social Security Disability Insurance (SSDI) benefits, the claimant must have earned enough work credits and SSA must determine the person is "disabled" as defined by SSA's rules and regulations.
In order to qualify for disability benefits, generally a claimant needs 40 quarters of work, and 20 of them must be within the past 10 years before the onset of the claimant's disability.
For a person to be determined "disabled," the claimant must be unable to work due to a physical or mental impairment which has lasted or is expected to last for at least 12 months or to result in death. SSA uses a five step sequential evaluation for determining disability.
Benefits for Family Members
If a person is eligible for retirement or SSDI benefits, his or her other family members may also be eligible for benefits based on his or her earnings record. Other family member benefits include:
the person's spouse if s/he is at least 62 years old; or
the person's spouse if s/he is under 62 years old, but caring for a child under age 16; or
the person's spouse if s/he is under 62 years old, but caring for a child 16 and older who is disabled and entitled to benefits on the wage earner's record; or
his or her children if they are unmarried and are under age 18; or
his or her children age 18-19 and attending high school full-time; or
his or her children 18 or older, but disabled; or
his or her ex-spouse if other requirements are met.
Supplemental Security Income (SSI)
Supplemental Security Income (SSI) is a needs-based program run by the Social Security Administration (SSA) that provides a basic income for older people, people who have disabilities, and people who are blind. Often, a person can supplement this income with benefits from other programs including Medicaid, Food Stamps, and Aid to the Aged, Blind, and Disabled (AABD) which are available from the Illinois Department of Human Services (Public Aid).
SSI is totally different from Social Security benefits paid through the OASDI program. Old-Age, Survivors, and Disability Insurance (OASDI) is an insurance program that provides income to workers who retire or become disabled, and to their dependents and survivors. SSI is a financial aid program for needy people who are elderly or have disabilities, and who meet specific low-income and asset guidelines.
Qualifying for Benefits
Eligibility for SSI benefits is not based on a person's work record. A person may be eligible for SSI benefits even if they have never worked, or have not worked enough to qualify for Social Security through the OASDI program.
Individuals must meet the following general criteria for SSI eligibility:
Must be either age 65 or older, disabled, or blind
Must be a U.S. Citizen or in a group of immigrants eligible for SSI
Must have limited income. Income limits are based on the amounts of earned and unearned income, size of household, and number of persons who are SSI-eligible in a household
Must have limited resources. Resource limits allow no more than $2,000 in countable resources (bank accounts, personal belongings, and one motor vehicle exempt); and $3,000 in countable resources for a married couple
The maximum SSI monthly payment for individual in Illinois in 2015 is $733; married couples are paid $1,100 in 2015. For comparison, the federal poverty level for one person per month in the continental United States (excluding Alaska and Hawaii) is $980, and for a couple, the federal poverty level is $1,327. Thus, SSI payments are less than 100% of the federal poverty level.
Visit SSA's website for the table of monthly SSI benefit amounts.
SSI Based on Disability
For a person to qualify for SSI benefits based on disability, the claimant must have limited income, limited resources and SSA must determine the person is "disabled" as defined by SSA's rules and regulations. For purposes of SSI eligibility, a claimant is "disabled" if they are unable to work because of a physical or mental impairment which has lasted or is expected to last for at least 12 months or is expected to result in death. For both SSI and SSDI benefits, SSA uses the same five step sequential evaluation for determining disability.
The Social Security Administration has several legal sources that govern its programs. Visit SSA's website for a listing of all its program rules. Please note that SSDI may also be referred to as “Title II” benefits and SSI may also be referred to as “Title XIV” benefits in certain SSA resources.
Federal regulations that cover Social Security Disability Insurance (SSDI) are found at 20 C.F.R. Part 404. Federal regulations that cover Supplemental Security Income (SSI) are found at 20 C.F.R. Part 416. The federal regulations are binding on all components of Social Security.
Social Security Rulings (SSRs)
SSRs are a series of precedential decisions relating to the programs administrated by SSA and are published under the authority of the Commissioner of Social Security. SSRs are binding on all components of the Social Security Administration. 20 C.F.R. § 402.35(b)(1). Visit SSA's website for the Social Security Rulings.
Program Operations Manual Service (POMS)
The POMS is a primary source of information used by Social Security employees in Social Security District Offices to process claims for Social Security benefits. The public version of POMS is identical to the version used by Social Security employees except that it does not include internal data entry and sensitive content instructions. While not binding, the POMS is generally followed by Social Security District Office staff in evaluating requests for review of overpayments, requests for waiver, and requests to negotiate repayment amounts for overpayments. Visit SSA's website for the Program Operations Manual System.
SSA's website, www.ssa.gov, is a helpful resource for understanding and navigating its programs. The website includes information about SSA's programs, rules and regulations, forms, publications, and Social Security Office locations.