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Hackensack Disability Law Blog

What are work incentives under Social Security Disability?

For many New Jersey residents who are receiving Social Security Disability benefits, their first goal is to return to work. However, they are confronted with the very real concern that they will try to work and find they are unable to continue. It is a worry as to whether they can get their benefits again and the speed at which this can occur. Fortunately, there are work incentives for those getting SSD benefits. Knowing what the work incentives are as well as their requirements is important before making the attempt to get back to work.

The person has the right to a trial work period. This is a set amount of time at which the person can try to get back to work for at least nine months. While using the trial work period, the person will keep getting the SSD benefits in full no matter how much they are earning. This is contingent on reporting to work and still having the disability. Currently, the trial work month will be a month in which the total earnings go beyond $840. For the self-employed, it will be a trial work month if they earn more than $840 post-expenses or work more than 80 hours in their own business. The nine months will fall within a 60-month period.

What should I know about a redetermination of my SSI benefits?

Getting approved for Supplemental Security Income through the Social Security disability program might give New Jersey residents some piece of mind, but they must be aware of certain rules and requirements to continue receiving SSI. For example, the Social Security Administration will review various aspects of the recipient's life to make certain that the payment amount is accurate. These aspects include income, resources and living arrangements. For a person who is married or is a disabled child under age 18 who still resides with their parents, the spouse or parents will also have the above factors reviewed.

These reviews are conducted once in one to six years. Even if the recipient reports changes to the SSA - as they are obligated to do - the SSA might still conduct a review. Redeterminations are done over the phone, in person or via mail. When it is done over the telephone or in person, the recipient will be informed in a letter as to what date and time it is scheduled. When it is done by mail, there will be a form to fill out, sign and return. Some people have a representative payee and that person can fill the form out and sign it for the recipient.

What if I need a special examination for my SSD benefits?

For those in New Jersey who believe they have a medical issue that warrants Social Security disability benefits of any kind, the Disability Determination Services might request that there be a special examination to make certain of their decision. DDS makes the decision on behalf of the Social Security Administration. When they believe that more information is needed to make a fair decision, they will request that this special exam be taken and the SSA will pay for it. If there are travel expenses, the SSA will pay for that as well. The applicant can have their regular doctor get a copy of the test if it is not that doctor who conducts the exam.

When the applicant is informed that the special examination is needed, it must be taken and full cooperation must be provided. If an appointment is made and the person cannot keep it, the agency should be told immediately. Simply not going to the appointment will likely mean the decision will be made without the exam, which will probably result in a denial.

Can I continue to get health benefits under COBRA?

Health care coverage is a hot button issue for New Jersey residents and people across the nation. Protections that are given to workers via the Consolidated Omnibus Budget Reconciliation Act are vital for those who are at risk of losing their coverage. COBRA gives a temporary continuation of the plan the person was on if it would otherwise end. Understanding who is eligible for COBRA is essential when there is a chance that benefits will be lost.

For a person to use COBRA, the following must be in place: the group health plan must be covered by it; there must be a qualifying event; and the person must be a qualified beneficiary for the event. Those who are in a health plan that was sponsored by an employer - whether it was private or state or local government - that had a minimum of 20 employees during more than half of its typical business days in the prior calendar year can use COBRA. When the number of employees is calculated, full and part-time workers are part of the process. A part-time employee will be considered a fraction of a worker who is employed full-time. There is a formula that is used to come to a total number of workers.

How does age influence SSDI eligibility?

Each disability is its own case with its own distinctions. As applicants consider Social Security Disability Insurance, it’s important to remember there is flexibility to meet individual situations. Like most government entities, the rules are dense and precise. This doesn’t mean they follow a one-size-fits-all model.

One of the notable elements of SSDI is that age is a determining factor in the review and approval process. Generally, those under the age of 50 have the same considerations. There are more exceptions after the age of 50, and even more after retirement age (60 and above).

What if I need a consultative exam for my SSD benefits?

Some New Jersey applicants for Social Security disability benefits will not be approved right away. There are times when the Social Security Administration will need more information before deciding on a claim. This is when a consultative examination might be requested. People who are seeking SSD benefits should be cognizant of all the various medical requirements that are needed to be approved. It might be worrisome to have a consultative examination, but it does not automatically mean the application will be denied.

The SSA can ask for a consultative examination for many reasons. Included are the following: to accrue more evidence because what they have is not sufficient to make a decision on the application one way or the other; more medical findings in greater detail are needed regarding the person's impairment; specific medical or technical information is needed; there is a conflict in the medical findings that the SSA already has; there is an issue regarding the person's ability to perform substantial gainful activity for an adult; or there is an issue in determining a child's ability to function as other children of the same age do.

What is the prerelease procedure for SSI benefits?

For New Jersey residents who are seeking Supplemental Security Income, there are a seemingly endless number of rules and requirements for them to receive an approval. In truth, it is not that complex if the person has legal assistance and understands the rules. For those who meet the income and disability requirements to get SSI benefits, there are other factors that must be taken into consideration. One is if the person is in an institution and is anticipating a release. There are steps to take to get the SSI benefits quicker than they otherwise would. This is what is known as the prerelease procedure.

With a prerelease procedure, the person applying for SSI benefits can do so several months prior to their release from an institution. This is useful for a person who is hospitalized, in a nursing home, and even if they are incarcerated. The person should know the criteria for SSI and that they are likely to meet it before moving forward with the prerelease procedure. It is important that the person is scheduled to be released within several months of applying.

Points to remember when SSD benefits are stopped

For people in New Jersey who are approved for and are receiving Social Security disability benefits, it is vital to remember that in many cases, the benefits will not go on indefinitely. This is true whether the benefits are from Social Security Disability Insurance or Supplemental Security Income. The Social Security Administration can stop the benefits if the person no longer has a qualifying disability or if the circumstances change. However, a person whose SSD benefits are stopped still has recourse and can appeal the decision. There are important points to remember regarding an appeal of stopped benefits.

There is only a certain amount of time to appeal. It must be filed within 60 days. The countdown will begin after the person receives the letter from the SSA saying the benefits will stop. The SSA will function under the belief that the person got the letter five days after the date it was mailed. Missing the time for which to appeal does not automatically mean that no appeal can be made. If there is a good reason for missing the deadline, it is still possible to appeal.

Can living arrangements have an influence on my SSI benefits?

Since Supplemental Security Income is a Social Security Disability program that is meant to benefit people who meet certain requirements based on income and other factors, there are numerous ancillary issues that can affect the benefits and how much is received. New Jersey residents who are seeking or already receiving SSI benefits should be aware of them. One issue is living arrangements.

The living situation can affect the amount of SSI a person receives. If a person is living in their own residence and paying for the costs - food, shelter and other expenses - independent of whether the residence is owned or rented, the maximum amount of SSI is available. A person can also receive the maximum SSI if they are living in the home of another person, provided food and shelter costs are paid by the SSI recipient. Living in someone else's residence and not paying for food and shelter costs or only part of those costs can lead to a reduction in SSI benefits by up to one-third of the federal benefit rate.

What if my SSD benefits are up for review?

New Jerseyans who are approved for Social Security disability benefits after suffering from an injury or being diagnosed with a condition or illness must be aware that the Social Security Administration will conduct periodic reviews of the circumstances to ensure that the SSD benefits are still warranted. The claimant will be informed in writing. In general, if the person's health has not improved or if they cannot work because of the disability, the benefits will continue.

Information will be accumulated about the person's condition. Medical professionals will be contacted, medical records will be examined and anyone involved in the treatment will be asked about the medical records and treatments. If there is a need for more information, there will be a special examination request, which the SSA will pay for. The facts of the case will be reviewed and compared to what the condition was the previous time the case was reviewed.