About: Beth Laurence
Beth Laurence is a long-time Nolo editor and author. Beth is editor of Nolo's Guide to Social Security Disability and Social Security, Medicare & Goverment Pensions and the website popular website disabilitysecrets.com. Beth holds a law degree from University of California, Hastings College of the Law, a B.A. degree from Boston University (Phi Beta Kappa, magna cum laude), and is a member of the California State Bar. While at Hastings, she helped persons with disabilities in the Tenderloin district of San Francisco apply for and win Social Security and SSI disability benefits from the SSA. Over the last decade, she has been active on the board of directors of several local environmental and educational nonprofit organizations.
Recent Posts by Beth Laurence
Written on December 6, 2013 at 7:30 pm
Posted in Social Security Disability
Question: Social Security approved me for disability benefits due to arthritis and spinal stenosis. I receive a meager amount per month, but I have been able to work a few hours a month to supplement the SSDI. Now my back has gotten worse and I can’t work at all. Can I get my monthly benefit amount increased?
Answer: Unlike other benefits programs like veterans disability compensation and workers’ compensation, the amount of Social Security disability you’re paid doesn’t depend on how disabled you are, or how much your illness or injury limits you. Your monthly Social Security disability benefit is based on your earnings record (or your spouse’s earnings record, if you qualify for disability based on your spouse’s work). Your disability amount is the same amount of what your retirement benefit would be if you retire at full retirement age. Nor is your SSDI amount dependent on your income or your assets. You can be wealthy and still receive your full Social Security disability benefit.
If you receive SSI, it’s also not tied to the extent of your disability, but it is affected by the amount of your income. SSI is based on a set federal amount, but it’s reduced by the part of your income that’s countable. (Social Security doesn’t count the first $85 of your wages or one-half of the remaining income that you earn every month.) So if you stop working the few hours you’ve been working, your monthly SSI payment should go up.
Written on November 27, 2013 at 11:48 pm
Posted in Social Security Disability
Question: I was approved for SSDI because of multiple sclerosis almost two years ago. I should become eligible for Medicare in early 2014. Is Medicare free for disability recipients, or will I have to pay premiums? If so, how much?
Answer: You are eligible for Medicare two years after your entitlement date for Social Security Disability Insurance (this is the date your backpay was paid from). Medicare isn’t free for most disability recipients though. There are premiums, deductibles, and copays for most parts of Medicare, and the costs go up every year. Here are the new figures for 2014, and how you can get help paying the costs.
Part A Costs
You will have to pay a premium for Medicare Part A (hospital insurance) if you aren’t fully insured under Social Security. Generally being fully insured means having worked 40 quarters (the equivalent of 10 years) in a job paying FICA taxes. Many disability recipients aren’t fully insured because they became unable to work before getting enough work credits. If you (or your spouse) don’t have enough work credits, you’ll pay a premium of $426 per month, or if you (or your spouse) has between 30 and 39 credits, you’ll pay a premium of $215. (The premiums actually went down in 2014.)
If you need hospital or skilled nursing care, you’ll have to pay the first $1,216 in costs (your deductible) before Medicare will start paying anything. Once you’ve satisfied the deductible, the first 60 days in the hospital (or 20 days in skilled nursing care) are free. If you still need inpatient care after that, you will be responsible for the following copays.
- Hospital days 61-90: $304 per day
- Hospital days 91 and beyond: $608 per day, and
- Skilled nursing days 21-100: $152 per day.
Medicare can be quite expensive for those on disability who aren’t fully insured, but if you are eligible to be a Qualified Medicare Beneficiary (QMB) because of low-income, a Medicare Savings Program will pay your Part A premium, and possibly other costs as well.
Part B Costs
Most people pay a Part B premium of $104.90 each month. However, if your adjusted gross income is over $85,000 (or $170,000 for a couple), the monthly premium can be over $200. The Part B deductible for 2014 is $147 per year.
Again, if you have low income, there are various programs that can pay your Part B premium and deductible, called Medicare Savings Programs.
Part D Costs
Part D premiums vary depending on the plan you choose. The Part D deductible for 2014 is $310 per year (though some plans waive the deductible).
There are subsidies available to pay for Part D for those with low income (called Extra Help). See Nolo’s article on Extra Help for Part D for when you are eligible.
As for the “donut hole,” when Part D helps you less, in 2014 the donut hole begins after you’ve spent $2,850 on prescription drugs and ends when you’ve spent $4,550. However, in 2014, while you are in the donut hole, brand-name drugs must be sold to you at a 52.5% discount and generic drugs at a 28% discount.
For more details on the 2014 costs of Medicare and Medigap plans, see Nolo’s article on Medicare premiums, deductibles, and copays in 2014.
Written on November 13, 2013 at 5:47 pm
Posted in Medicare
Yesterday Social Security announced that there would be a 1.5% increase in Social Security and SSI benefits for 2014. This is smaller than most retirees and disabled recipients would have liked, but remember that in 2010 and 2011, there was no increase.
Along with this increase in benefits, many important Social Security limits and Medicare fees will change on January 1, 2014.
The average Social Security retirement and disability benefit is expected to increase to $1,294, the average disability benefit to $1,148, and the average surviving spouse benefit to $1,243. The most Social Security benefits a retiree can collect in 2014 will be $2,642 per month.
If you continue to work while collecting early Social Security retirement benefits, your benefits will be reduced by $1 for every $2 you make over $1,290 per month. But if you will turn 66 during 2014, you can make up to $3,450 per month before your benefits are reduced (there is no limit once you turn 66).
The maximum amount of your income that is subject to the Social Security tax to fund Social Security retirement, survivors, and dependents benefits, as well as Social Security disability insurance, is $117,000 in 2014. There is no limit to the amount of income subject to the Medicare tax.
As to SSI, the new federal SSI benefit rate is $721 per month for an individual and $1,082 per month for a couple. The SSI payment amounts are higher in states that pay a supplementary SSI payment. Although some states have higher limits, in states with=out a supplementary payment, if you have income between $721 and $1,527, your SSI payment will be reduced, and over $1,527, your SSI will be terminated.
As far as determining your initial eligibility for disability purposes, in 2014 you must be making less than $1,070 per month to qualify for benefits, or $1,800 if you are blind. If you receive SSDI and are trying to go back to work, if you make more than $770 per month, it will count as one of your nine trial work months.
Question: My employer’s insurance company approved me for short-term disability benefits and I was hoping to get long-term disability benefits when the short-term benefits ran out. But in the mean time my employer laid me off and terminated my disability insurance. Is this legal? Does this mean the insurance company can deny me LTD benefits?
Answer: As long as you were covered by long-term disability (LTD) insurance at the time you became unable to work, you may file for short- or long-term disability benefits, regardless of whether you’re still on your employer’s payroll. The decisive question is whether you were insured on your disability onset date, not whether you’re insured on the date you file your claim.
Think of it this way: If John has a car insurance policy that expires on August 31, he will be covered for damage to his car from a hailstorm that occurred on August 30, even if he’s been on vacation and doesn’t file his claim until September 3, after his policy has expired. Disability insurance works the same way.
Ask your employer for a copy of your LTD plan, which will state the eligibility requirements for both short-term disability and long-term disability coverage. Generally the requirements are the same for both policies. For instance, if the short-term disability plan requires you to work full-time (at least 35 hours per week) to be eligible for benefits, the long-term plan should as well. Make sure that you were working the required number of hours as of the date you filed your short-term disability claim. If you were, you should be eligible for long-term disability benefits as well.
Whether your employer can legally discharge you while you’re on short-term disability is a separate question. It’s important to remember that disability insurance is meant to provide income protection if you become unable to work. It does not offer any measure of job security. Your employer is under no obligation to continue employing you simply because you’re receiving disability benefits. However, there are federal laws that may impact whether your employer can legally fire you, particularly the Family and Medical Leave Act (FMLA) and the Americans with Disabilities Act (ADA).
Job Protection Under the Family and Medical Leave Act
The Family and Medical Leave Act (FMLA) allows certain workers to take up to 12 weeks of unpaid, job-protected leave per year to deal with personal or family medical issues. FMLA leave, which often runs concurrently with the receipt of short-term disability benefits, can be used to recuperate from your own illness or injury. While you can’t legally be discharged for as long as you’re on FMLA leave, exceeding twelve weeks of leave, even by a day, leaves you open to termination.
For FMLA to apply, the following two conditions must be met:
- The business must employ at least 50 individuals working within 75 miles of each other, and
- The employee must have worked for the employer for at least twelve months, and for 1,250 hours or more over the previous year.
If you wish to take FMLA leave, you should inform your employer as soon as possible that your requested time off is related to a family or personal medical situation. When you return from unpaid leave, your employer must give you back your old position or one that is substantially similar, assuming you can still perform the essential duties of the job.
Even if you’re not entitled to unpaid leave under the FMLA, you may be protected by state laws that extend FMLA-like benefits to employees of small and medium-sized companies. Check with your human resources department, your state’s department of labor, or an employment law attorney to learn more about the job protection laws in your state.
Employment Protection Under the Americans with Disabilities Act
The Americans with Disabilities Act (ADA) requires employers with 15 or more workers to make reasonable accommodations for employees with disabilities. The ADA defines a disability as a physical or mental impairment that “substantially limits a major life activity.”
Under the ADA, an employer must interact with the employee to design accommodations that might allow the disabled employee to continue working. For example, the employer could offer a more flexible schedule, additional unpaid leave, wheelchair ramps, ergonomic furniture, or some other accommodation that might allow the disabled employee to continue to perform the essential duties of the position. The employer need not offer accommodations that would cause the business “undue hardship.” Generally, courts have found that larger companies are better able to absorb the costs of accommodations than small businesses.
If an employer has attempted to make various reasonable accommodations and the individual is still not able to perform the essential duties of the job (or if no reasonable accommodations exist that would allow the individual to work), the ADA does not prevent the employer from firing the disabled employee.
For more information on how the FMLA and ADA interact to provide you with job protection, see Nolo’s article on whether you can get fired while on disability leave.
Wrongful Termination and Denial of Benefits
If you’ve been discharged from a job while on disability leave and you think you should have been protected under the FMLA or ADA, you may want to contact an employment or disability law attorney to discuss your options. You may be entitled to money damages or reinstatement if your employer hasn’t complied with the FMLA, the ADA, or applicable state laws.
Regardless of whether you were wrongfully terminated, however, you should be eligible for long-term disability benefits even though you were let go before your short-term disability benefits ran out. If your employer or its insurance company tries to deny you these benefits, contact an LTD lawyer.
By: Aaron Hotfelder, guest blogger and disability lawyer
Written on October 24, 2013 at 6:51 pm
Posted in Long-Term Disability Benefits
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About Beth Laurence
This blog is written by Beth Laurence, a long-time Nolo editor and author. Beth is editor of Nolo's Guide to Social Security Disability and Social Security, Medicare & Goverment Pensions and the popular website Disability Secrets. Beth holds a law degree from University of California, Hastings College of the Law, a B.A. degree from Boston University (Phi Beta Kappa, magna cum laude), and is a member of the California State Bar. Her first experience with Social Security disability was at General Assistance Advocacy Project, helping clients apply for SSI in San Francisco's Tenderloin district.Send Beth a question about disability, and if it hasn’t already been answered on our site, she may answer it. Please don’t send questions that you don’t want published, and know that we can’t guarantee an answer to all questions. Ask a question.
- Did my state labor department stop my unemployment checks because I filed for disability?
- My medical condition has gotten worse. Can my monthly disability benefit be increased?
- Does someone on Social Security disability get free Medicare?
- New Social Security Figures Released for 2014
- Can I get long-term disability insurance benefits if my employer fired me and ended my policy?