BASIC FACTS ABOUT SOCIAL SECURITY

posted on 12/11/95


INTRODUCTION
The Social Security Administration administers two programs of importance to many adults with disabilities: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). The first is a social insurance program, wherein an individual with a disability receives a cash payment based on their own earnings or those of a parent who has retired or died. The latter is an income maintenance program for aged, blind, or disabled individuals or couples with low income and few resources. Cash payments are not predicated on prior contributions to the Social Security Fund.

Both programs use the same definition of disability _ namely, that the person is unable to engage in substantial gainful activity (SGA) because of a medically determinable physical or mental disability which is expected to last 12 months or more. Activity is substantial if it is productive mental or physical work. It is gainful if done for pay or profit. If self-employed, SGA means 40 or more hours of work per month. If an employee, $500 per month (after certain work-related costs) is the SGA criterion.

SOCIAL SECURITY DISABILITY INSURANCE (SSDI)
SSDI benefits, typically based on the earnings record of a retired or deceased parent, are available to 'disabled children.' There is no resource (or asset) test for receipt of SSDI, unlike SSI, which has such a test. SSDI benefit levels depend on the earnings of the person on whose social security account the benefit is based, and on the number of persons drawing benefits on the same account.

SUPPLEMENTAL SECURITY INCOME (SSI)
This federal cash benefit program, with a California State Supplement Payment (SSP), provides for individuals who are aged, blind, or disabled and who have little (or no) other income and few resources. This program is needs based. There are both income and asset tests (or requirements) for receipt of SSI benefits, and it is not based on anyone's prior contributions to Social Security.

The Maximum Cash Benefit depends on age, disability, whether an individual or a couple, and living arrangement. Minors receive somewhat less; individuals who are blind receive a little more. Couples receive more than individuals, but not twice as much. The monthly cash maximums, shown on the next page, are for individual adults with disabilities. Since they typically change in January each year, you should check the date on this information sheet. (You can also check with Social Security for other rates.)

$603.40 independent living arrangement, with cooking facilities
$671.40 independent living arrangement without cooking facilities
(Note: The $68 extra is for eating out.)
$476.77 living in household of another; reduced needs
$736.00 non-medical board and care

In California, under work incentive provisions signed into law in 1987, an SSI recipient can earn in excess of $1,000 per month and still maintain eligibility for SSI. Countable assets cannot exceed $2,000 ($3,000 for a couple). If countable assets exceed this figure, SSI benefits may be terminated until those assets are spent down _ that is, until any excess above the asset limit has been eliminated. Countable assets include cash, bank accounts or other resources which can readily be converted to cash (e.g., securities), except for a car (of limited value, unless used for work or medical appointments), a home in which the recipient is living, furnishings and clothing to a certain dollar amount, a small insurance policy, and selected other assets (e.g., engagement ring and wedding band). An SSI recipient may receive $20 per month from any source without experiencing a reduction in SSI benefits. Most income, other than earnings, above this amount, results in a dollar-for-dollar reduction in SSI. The first $65 per month in earnings does not affect the benefit amount. If there are no sources of income other than earnings, an SSI recipient may earn $85 per month (i.e., $65 plus $20) without prejudice. For every two dollars above that figure, SSI is reduced by one dollar. To illustrate, a person earning $185 per month, with no other income except SSI, will have the first $85 of earnings ignored. $100 remains, and reduces the SSI benefit by $50. Net of the SSI reduction, the individual is better off from working by $135 per month (i.e., $185 less $50, the reduction in SSI).

1619(a)&(b)
Section 1619(a) of Social Security Act, as amended, makes it possible to earn more than the substantial gainful activity level, without being removed from the SSI rolls. The disability status remains, unless the person medically improves or is terminated for a non-disability reason. Section 1619(b) provides that should a disabled person's earnings reduce SSI benefits to zero, one may, for some time, continue to receive Medi-Cal benefits.

Medi-Cal coverage is categorically attached to SSI, and is also available to some individuals not receiving SSI under medically needy or medically indigent criteria. For example, some low-income individuals with disabilities who reside in health service facilities do not receive SSI, but remain eligible for Medi-Cal. By health care financing rules, if a disabled person receives SSDI (typically on a retired parent's account), he or she will be taken off the SSI roles while living in certain health service facilities (e.g., ICF/DD-H). To cover the cost of medical services, this person remains eligible for Medi-Cal through the local welfare department (Social Services).

FOR MORE INFORMATION
Call your local Social Security office and request a copy of "The Red Book." The full title of the publication is A Summary Guide to Social Security and Supplemental Security Income Work Incentives for the Disabled and Blind. There are many other publications which may be helpful as well. To find your local Social Security office, in the phone book find-

United States Government
Offices
U.S. Government
Health and Human Services
Department Of
Social Security Administration

Overview written by John Shea for Allen, Shea & Associates


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