Author: Prairie State Legal Services
Last updated: December 2009

(Chapter 1 Section 2 of the Senior Citizens Handbook)

What It Is: An insurance program that provides income to retired or disabled workers, their dependents and survivors.

Where to Apply: Social Security Administration (SSA)

Who May Be Eligible: Retired workers who are 62 years old or older, disabled workers, and spouses and dependents of retired, disabled or deceased workers.

How Social Security Works

Most workers pay into Social Security while they are working. Your pay stub will show deductions for the Federal Insurance Contribution Act (FICA). These deductions are the money or "premiums" which you pay into the Social Security system. For every contribution you make to Social Security, the employer makes an equal contribution. The SSA then uses that money to pay people who are eligible to receive benefits.

To become eligible, you must have worked for a minimum length of time before claiming benefits. The length of time varies depending on whether you are asserting eligibility for benefits based on disability, your age at the time of disability and whether you are seeking retirement benefits.

The amount of money you receive from Social Security depends upon the amount of money you made while you contributed to Social Security and whether you choose to begin receiving retirement benefits at 62 or to wait until you reach full retirement age. Every so often, the SSA adjusts the amounts of monthly benefits to keep pace with the cost of living.

If you are found eligible for Social Security based on disability, you may be entitled to a retroactive benefit. In general, you are entitled to receive benefits going back to the first month following the end of a waiting period. The "waiting period" is the five month period starting with the first month in which you were both insured for disability and "disabled." The waiting period can start no earlier than the 17th month before the month you apply.

Who is Eligible?

In General

You may be eligible for Social Security benefits if you are:

• A retired or a disabled worker who paid into Social Security
• The current or divorced spouse of a worker receiving benefits if you meet certain other requirements
• A deceased worker's widow or widower who is 60 years old or older or, if disabled, 50 years old or older
• The surviving divorced spouse of a deceased worker who meets certain other requirements
• The dependent child of someone who is receiving disability or retirement benefits, or the child of a deceased worker
• The surviving dependent parent of someone who was entitled to Social Security benefits

ADVOCACY TIP
In addition to income benefits, a surviving spouse or dependent child entitled to dependent's benefits is also entitled to a lump sum payment to help pay burial costs. The surviving spouse or dependent child must have been living with the deceased at the time of his or her death to obtain this benefit.

Qualifying for Benefits

Your eligibility for Social Security benefits is based on your work record. When you work and pay into Social Security, you earn credits toward Social Security benefits. The number of credits you need to get retirement benefits depends on when you were born. If you were born in 1929 or later, you need 40 credits (10 years of work) to qualify.

In order to qualify for disability benefits, generally you need 40 quarters of work, and 20 of them must be within the past 10 years before the onset of your disability.

Retirement Benefits

You are entitled 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 you were born in 1938, "full" retirement begins when you reach 65 years and 2 months old. If you were 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 will be 66 years. For persons born between 1943 through 1954, full retirement age will remain at 66 years. For persons born in 1955 and afterwards, full retirement age will increase in 2 month increments each year from 1955 until it reaches 67 years. For persons born in 1960 or later, full retirement age is now 67 years.

ADVOCACY TIP
If you receive "early" retirement benefits, you may not be entitled to Medicare until you are 65.

Disability Benefits

To qualify for Social Security benefits on the basis of disability, the disabled person must be disabled, as defined by Social Security. For a person to be "disabled," he or she 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.

In deciding whether you have a disability, SSA uses a five step analysis:

• Step One: If you are working and performing substantial gainful activity, then you are considered able to work and therefore not "disabled." In 2010, if your average monthly earnings are over $1000 per month, you are probably not eligible. If you are not earning significant income, proceed to step two.
• Step Two: You must have a severe impairment. This means that you must have a medical problem which significantly limits your physical or mental ability to perform basic work activities. If you have a severe impairment, proceed to step three.
• Step Three: Social Security has determined that certain medical conditions are automatically disabling. Social Security describes these conditions in a part of their regulations called the "Listing of Impairments." To be considered "disabled" under the Listings, you need to have the required type of medical proof and the indicated level of severity for your particular illness.

If you have impairments that are similar but not identical to those included in the Listings, or if you have a combination of illnesses, SSA will consider you "disabled" if your condition is considered to be "comparable" to those included in the listings, and is of equal severity. 

If your condition does not meet or equal one of the conditions in the Listings, proceed to step four.
• Step Four: If you are physically and mentally able to return to a job that you have held within the last fifteen years, then SSA considers you "not disabled." In general, SSA considers only those jobs which you held for more than a few months and in which you earned over $670 per month. If you cannot perform any of your past jobs, proceed to step five.
• Step Five: If you cannot perform your past work, then Social Security decides whether you are able to perform other types of work.

At step five, SSA will consider your physical limitations, your age, education, the type of work skills you have acquired and any mental limitations on work activities.

Working After You Start to Receive Benefits

Working After Retirement

When you choose to work after you retire, your earnings up to a certain level will have no effect on your Social Security benefit check. After earnings exceed the limit, however, your earnings will reduce your Social Security Check, as shown on this chart.

Your Age	Earning Limit (Does Not Affect Benefits)	After Limit is Reached
Under full retirement age	Up to $14,160*	For every $2.00 over the limit, $1.00 is withheld from benefits.
At full retirement age or older and retired	No limit on earnings	--------------------------------------
Year you reach full retirement age and actually retired	Up to $37,680*	For every $3.00 over the limit, $1.00 is withheld from benefits until the month you reach full retirement age.

*This chart is for the year 2009. These limits change each year. For subsequent years, check with your local Social Security office.

How Working Effects Social Security Disability Insurance (SSDI)

Under SSDI rules, you can have a trial work period. This means you can test yourself to see if you can work without having to worry right away that you will lose your disability benefits. The trial work period can be no longer than nine months, during which time your benefits will not be affected no matter how much you earn.

The nine months do not need to be consecutive. In 2010, a trial work month includes any month in which you earn more than $720 (with automatic yearly increases), or in which you work more than 40 hours on the job if you are self-employed.

Once you have completed nine trial work months in any 60 month period, SSA will review your earnings to determine if you remain eligible for SSDI.

Working After the End of the Trial Work Period

If you work on a sustained basis after the end of the nine month trial work period, it can affect whether or not SSA still considers you to be "disabled." In 2010, if you have average monthly earnings over $1000 after the trial work period, then the SSA may decide that you are no longer disabled and may terminate your eligibility for benefits.

If you receive SSDI, it is wise to contact your local Social Security office before you start working so that you can find out how it will affect your case.

How to Apply

You can apply at your local Social Security office or by calling Social Security at 800-772-1213 (toll-free).

Overpayments

Sometimes SSA tells people they have received more Social Security benefits than they were entitled to receive. This is called an overpayment. Usually, SSA will require you to pay back any overpaid benefits, and they will reduce your current benefits until the money is paid back.

If you receive a notice of overpayment, you have the right to appeal, if you think the decision is wrong, or if you believe that the amount of the overpayment is less than what SSA alleges.

Also, you can ask at any time that you not be required to pay back an overpayment. This is commonly called a request for a waiver. You may request a waiver by completing a written form available at the SSA office.

In order to qualify for the waiver, you must prove that:

• You received the overpayment through no fault of your own; and
• You cannot afford to pay it back.

ADVOCACY TIP
Keep a record of dates you call and the names of the representatives to whom you speak.

If you are not eligible for a waiver, you may be able to pay back the money you owe Social Security a little at a time. You can ask Social Security to take back some money each month from your Social Security check.

Decisions You Can Appeal

If SSA denies your application for Social Security benefits or reduces or terminates your benefits, you may want to appeal the decision. You also can appeal if you believe that SSA takes other wrongful actions against you, such as finding that you owe an overpayment or requiring a representative payee.

If SSA Denies Social Security Benefits or Reduces or Terminates Benefits

The Appeal Process

If you decide to appeal, here is how you do it:

• You will receive a notice of the SSA decision. You have 65 days from the date on the notice to request that Social Security reconsider this decision. The SSA will then review your claim again. If you request, you may receive a personal conference with the SSA staff to try to resolve the matter.

ADVOCACY TIP
If you appeal a termination or reduction of Social Security benefits within 10 days, you may be able to keep your benefits during the appeal. If you miss the 10 day deadline, your benefits will stop or be reduced while your appeal is pending. 

• If you are denied after reconsideration, you have 65 days from the date on the reconsideration decision to make a written request for a hearing. An Administrative Law Judge (ALJ) will run the hearing.
• If you lose the hearing, you can appeal again to the Social Security Appeals Council. You have 65 days from the date on the ALJ decision to make a written request for review by the Council.
• If the Council refuses to review your case or decides against you, you have 60 days from the date of the Council's decision to appeal the case to the United States District Court.

Missing an Appeal Deadline

At each stage of the appeal process described above, there is a time limit within which you must file an appeal. If you miss that deadline, the SSA will consider your appeal only if you show that you had good cause for the delay. "Good cause" includes such things as serious illness which prevents you from attending to your business, a death in the family, a fire or other emergency which disrupts your home. It also includes situations where you do not understand or know about the need to file an appeal because of your physical or mental condition, or because of your inability to read or communicate.

If you realize you have missed an appeal deadline, you should file your appeal in writing as soon as possible. You should include with your appeal a written explanation of why the appeal was not filed in time and a request for an extension of time in which to file the appeal.

Representation in the Appeal Process

You may be represented by a lawyer, a paralegal, a friend or a relative in the appeal proceedings. Only a lawyer can represent you in federal court.

Reduction of Benefits if You Owe Other Federal Non-Tax Debts

As of May 2001, the Debt Collection Improvement Act (DCIA) of 1996 allows the Treasury Department and Social Security to reduce Social Security benefits of individuals who owe non-tax federal debts. Notices will be sent by the federal agency to whom money is owed, not by Social Security. It is important that beneficiaries contact the agency involved to try to make payment arrangements. You will have no right to appeal the reduction of your benefits with the Social Security Administration. The first $750 of benefits will not be reduced.
Examples of federal non-tax debts: student loans and food stamp overpayments.

Where to Go for More Information

Statutes and Regulations

• The federal statute relating to Social Security retirement benefits can be found at 42 U.S.C. § 402(a).
• The federal regulations for that program are at 20 CFR 404.310 - 404.313.
• The federal statute relating to the Social Security Disability Insurance (SSDI) program can be found at 42 U.S.C. §§405, 423.
• The federal regulations for that program can be found at 20 CFR 404.

Agencies and Organizations

Social Security Administration
To apply for benefits or to file an appeal, contact your local Social Security office, or call 800-772-1213 (toll free) or 800-325-0778 (TTY) nationwide for information and assistance.

Additional information on Social Security can be found on the SSA website. At this website, you can also find a Benefit Eligibility Screening Tool (BEST). You can use this tool to find out if you could be eligible for benefits from any of the programs Social Security administers. 

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