What is the Social Security Disability Redetermination review?

If you are on Social Security Disability you will eventually have to go through the Redetermination process.

Author: Attorney Lonnie Roach

The Social Security Administration will periodically examine aspects of your life to determine whether or not you still qualify to receive benefits and that the amount of those benefits is still correct.

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The Social Security Administration will periodically examine aspects of your life to determine whether or not you still qualify to receive benefits and that the amount of those benefits is still correct. If you are faced with a review or have been denied disability call 512-454-4000 for help today!

Just as the Social Security Administration conducts a continuing disability review to determine if you still qualify as disabled, it will also review your income, resources, and living arrangements periodically to confirm that you continue to meet non-medical eligibility requirements for benefits and to make sure that you are receiving the correct payment amount.

The SSA also reviews your income, resources and living arrangements when you report a life change, such as marriage, that may affect your payment or eligibility. If you are married, or a disabled child under the age of 18, the SSA will review the income, resources and living arrangements of your spouse or parent. This periodic review is referred to as a redetermination. The SSA redetermines eligibility and benefit amounts every 1 to 6 years.

A. Income

The SSA considers four different types of income in its review: Earned Income, Unearned Income, In-Kind Income and Deemed Income. “Earned Income” includes wages, earnings from self-employment, royalties and sheltered workshop payments.

A “sheltered workshop” or “work center” refers to organizations or entities that are authorized to employ workers with disabilities at sub-minimum wages. “Unearned Income” is income that is not earned; for example, pensions, interest income, unemployment benefits, cash from relatives and Social Security benefits. “In-Kind Income” is food or shelter received for free or under fair market value. “Deemed Income” is the portion of the income of your spouse, parent, or sponsor with whom you live, that is used to compute the amount of your SSI benefit.

The more countable income you have, the less your SSI benefit will be.

If your countable income is over the allowable limit, you will not receive SSI benefits. Not all income, however, may count as income for the SSI program. Some payments or services SSA does not count as income include:

•   The first $20 of most income received during a month;
•   The first $65 of earnings and one-half of earnings over $65 received during a month;
•   Income tax refunds;
•    The value of food stamps received;
•   Interest or dividends earned on countable resources or resources excluded under other Federal laws;
•   Grants, scholarships, fellowships or gifts used for educational expenses;
•   Loans you must repay;
•   Money someone else spends to pay your expenses such as a telephone or medical bill (but not food or shelter);
•   Home energy assistance;
•   Earnings up to $2,350 per month to a maximum of $9,460 per year for a student under age 22;
•   The cost of work expenses that a blind person incurs in order to be able to work; and
•   Assistance based on need funded by a State, local government, or Indian tribe.

The Social Security Administration subtracts any income they do not count from your total gross income.

This amount is your “countable income.” Then the SSA subtracts your “countable income” from the SSI Federal benefit rate. The result is your monthly SSI Federal benefit.

1)    Your Total Income
     – Your income that the SSA does not count
________________________________________
     = Your countable income

2)   SSI Federal benefit rate
    – Your countable income
________________________________________
      = Your SSI Federal benefit

Has your disability been denied? Don’t give up! Contact an experienced Disability lawyer at 512-454-4000 for a free consultation and get the benefits you deserve.

B. Resources

Resources are important in a redetermination because the value of your resources is one of the factors that determine if you are eligible for SSI benefits.

Resources are things you own such as cash, bank accounts, stocks, savings bonds, land, life insurance, personal property, vehicles, or anything that could be changed to cash and used for food or shelter. Deemed resources are the portion of resources owned by a spouse, parent, parent’s spouse, or sponsor that Social Security “deems” belongs to the person applying for SSI. For example, if a child under 18 lives with one parent, $2,000 of the parent’s countable resources does not count. If the child lives with 2 parents, $3,000 does not count. The limit for countable resources is $2,000 for an individual and $3,000 for a couple.

As with income, not all resources count for SSI. For example, the following are not counted for SSI:

•   The home you live in and the land it is on;
•   Household goods and personal effects;
•   Life insurance policies with a combined face value of $1,500;
•    One vehicle used for transportation for you or a member of your household;
•   Retroactive SSI or Social Security benefits for up to nine months after you receive them;
•   Grants, scholarships, fellowships, or gifts to pay educational expenses for 9 months after receipt; and
•   Up to $100,000 of funds in an ABLE (Achieving a Better Life Experience) account.

If the value of your resources is over the allowable countable limit at the beginning of the month, you will not receive SSI for that month.

If you sell excess resources, you may receive SSI beginning the month after you sell the excess resources and you may be able to receive benefits while you are in the process of selling excess resources, depending on the situation.

C. Living Arrangements

The Social Security Administration also considers your living arrangements to determine how much Social Security Income you should receive.

The amount of your benefit will depend on whether you live in your own house, apartment or mobile home, in someone else’s home, a group care facility, or an institution such as a nursing home.

Your SSI benefits may be reduced if:

•    You live in another person’s house or apartment and pay less than your share of housing costs,
•   You live in your own house or apartment and all or part of your housing expenses are paid by someone else, or
•   You live in a nursing home and Medicaid pays for over one-half of your care.

The Social Security Administration conducts redeterminations in three ways:

•   In person,
•   By telephone interview, or
•   By mail.

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When the SSA plans a telephone or in-person interview, it will send you or your representative payee a letter relating the date and time of the appointment, or request that you appear at the Social Security office for a redetermination.

Social Security Staff will fill out any required forms during the interview based on information you provide.

If you are unable to keep the appointment, it can be rescheduled by a simple phone call to Social Security. If the redetermination is done via mail, Social Security will mail a redetermination form to you to fill out, sign and return. If you have a representative payee, they must complete and sign the form.

You have 30 days to complete and return the form, reschedule your appointment if necessary, or request help completing the form.

It is in your best interest to respond as quickly as possible. Failure to respond may result in termination of your payments, overpayment or underpayment of your benefits. Losing SSI eligibility may also result in loss of Medicaid eligibility.

Social Security may ask you to provide certain documents for a redetermination and may even help you obtain them. Some documents usually requested are:

•   Savings accounts, checking account, or other bank statements;
•   Pay stubs and income tax returns;
•   Proof of income such as pensions or worker’s compensation;
•   Life insurance contracts; and
•    Household receipts and bills to illustrate monthly expenses.

Author: Attorney Lonnie Roach has been practicing law for over 29 years. He is Superlawyers rated by Thomson Reuters and is Top AV Preeminent® and Client Champion rated by Martindale Hubbell. Through his extensive litigation Mr. Roach obtained board certifications from the Texas Board of Legal Specialization. Lonnie is admitted to practice in the United States District Court - all Texas Districts and the U.S. Court of Appeals, Fifth Circuit. Highly experienced in Long Term Disability denials and appeals governed by the “ERISA” Mr. Roach is a member of the Texas Trial Lawyers Association, Austin Bar Association, and is a past the director of the Capital Area Trial Lawyers Association (Director 1999-2005) Mr. Roach and all the members of Bemis, Roach & Reed have been active participants in the Travis County Lawyer referral service.