Determining Social Security eligibility can involve wide-ranging and intricate assessment of an applicant’s social and financial situation in relation to their physical or mental disability. After an individual seeking Social Security Benefits receives approval, he or she may receive financial assistance for a varying length of time. But what kind of transition should a person expect when they are ready to return to work but still need help from the Social Security Administration?

The Work Incentives Planning and Assistance (WIPA) program operates under the Social Security Administration’s employment support program on a national and state-wide level to help SSA recipients with disabilities regarding job placement, career development and benefits planning.

The National Institute on Disability and Rehabilitation Research notes that since the WIPA program’s commencement in 2000, it has made several different kinds of helpful services available to more than 300,000 SSA beneficiaries who are currently employed or motivated to pursue employment. While some may simply believe that the WIPA program aims to help individuals remain on benefits, the program’s real mission is to help SSA recipients eventually work their way to not needing SSA funding. A National Beneficiary Survey (NBS) for 2006 demonstrated that 44 percent of SSA beneficiaries noted their personal goals to include either one or all of the following: obtaining employment, maintaining duties of a better job, advancing in a job as far as job title/position, and working for pay within the next five years.

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A Virginia man was recently sentenced to 18 months in federal prison for wire fraud and stealing $49,000 in Social Security payments. According to an Atlanta Journal-Constitution article, the 47-year-old man lived with a domestic partner who was given Social Security Disability Benefits between 1991 and 2001. After his partner left and went back to work, disability payments were still being sent to the 47-year-old man’s address. Instead of informing the Social Security Administration of the mistake, the man kept the payments, forged his former partner’s signature, and even went as far as asking that the checks be deposited automatically into his own checking account.

The Social Security Office of the Inspector General makes it known that concealing material facts or events that affect eligibility for benefits can be considered fraud. Far too many people make the big mistake of simply assuming that if they do not tell the SSA about changes that may affect their benefits, then the SSA won’t notice. Similar to how the man in the aforementioned case failed to report that Social Security checks of his former partner were still being delivered, a person can commit fraud by making false statements on an application or failing to inform the SSA about returning to work, getting a new job, being in jail, or failing to notify the SSA of the death of a beneficiary.

Calculating the amount of Social Security support a person receives is a complex process that examines an applicant’s social and financial circumstances. In many instances, an individual seeking Social Security Benefits finds it beneficial to have a Pennsylvania Social Security attorney on his or her side.

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A Washington Post article discusses some issues and prospective plans to help prevent the Social Security Trust Fund from ruin in years to come. A group of 15 military officers and government employees at the Industrial College of the Armed Forces estimated that in 2041, the Social Security Trust Fund will practically be nonexistent if nothing is done now. Based on the article, the meeting was initially organized as a way to establish a national security strategy for the U.S. in which the stability of our economy, social security included, has significant influence.

A few solutions presented by the group focus on decreasing the rate that benefits have been adding up. The group proposes connecting the growth of benefits to the price index instead of the wage index since wages often increase at greater rates than prices. Another point involves raising Social Security payroll tax based on the idea that gradually raising payroll tax coverage to 100% of earnings would help compensate for anticipated deficits. As of now, payroll tax applies to earnings of up to $106,800. One idea is to take away this limit so that those making more would pay 6.2% tax on what they earn.

While these prospective ideas involve several complexities, it will be interesting to see how the debate continues, especially as talk of raising the retirement age circulates. Considering that life expectancy has increased by 15 years (and gratefully so) within the 70 years that Social Security has been active, there is potential for the age to be set at 69 at a much faster pace than many people originally anticipated. In what is referred to as “means testing,” the group has recommended providing lower social security payments to those who earn higher amounts. The idea is that this would motivate such individuals to spend less and instead save more for retirement so they can retire at a later point.

While only time and more deliberating will tell whether some, if any, of these plans will go into effect, those reflecting on retirement would be well advised to do their research. It also can’t hurt to stay positive and take a glass-half-full attitude while considering potential options.

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However, you should not be discouraged! Many people give up after an initial denial, which is exactly what the Social Security Administration hopes you will do. In fact, only rarely should one drop their claim after an initial denial. Instead, this should be seen as nothing more than the first step in the long process that will eventually lead to the issuance of a Social Security Disability Award.

So what do you do if you are denied? According to the Social Security Administration website, the first step is to file for reconsideration no later than 60 days following the initial denial. This moves your claim to the next step: a hearing in front of an administrative law judge. In fact, benefits generally will not be awarded unless an administrative law judge hears the claim. An administrative hearing is not like a court trial. Usually, it takes place over the phone and is rather informal.

If you are not successful in front of an administrative judge, do not be surprised. Most cases on reconsideration are also denied. Therefore, reconsideration is not the final step. You next file an appeal for a Social Security hearing. The Appeals Council looks at your request for an appeals review and determines if the administrative law judge made a correct decision. If so, the Appeals Council will deny your appeal. If the Appeals Council decides to review your case, it has the option to review your case itself or return it to an administrative law judge for further review.

If the Appeals Council rejects your request for review or does review the case and makes a decision not in your favor, you can file a lawsuit with the federal district court. Again, this must be done in a timely manner or you lose your right to take your claim to the next level.

While the Social Security Administration provides guidelines for moving your claim through its system, consider retaining legal counsel with experience in social security law after the initial denial. This will help ensure that you do not miss any deadlines and that you are presenting the necessary documentation to eventually result in an affirmative decision on your behalf.

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You end up in jail! At least you do in Wisconsin.

Moreover, that is exactly what Lisa M. Miller, a 32-year-old Wisconsin woman found out last month when she was sentenced to federal prison for Social Security fraud. Although Social Security fraud is an all too common incident, according to a report on the case, the judge stated in sentencing that it was “time for a wake-up call” and therefore imposed two months in prison.

In fact, Social Security fraud is such a common occurrence that the Social Security Administration has set up an online and telephone hotline for reporting potential incidences. According to the Office of the Inspector General, Social Security fraud can include:

• Making false statements on claims
• Concealing material facts or events that affect eligibility for benefits
• Misusing benefits
• Buying or selling Social Security Cards or any other Social Security Administration information
• Impersonating a Social Security Administration employee
• Bribing a Social Security Administration employee

However, sometimes one may be committing fraud without even knowing it. For example, sometimes a person receiving Social Security Disability benefits is unaware of what they can and cannot do with the benefits. It is important to keep in mind that benefits are not “free money.” Instead, benefits come with limitations and restrictions. For instance, one cannot use benefits to pay for personal expenses that are not considered necessary. Similarly, a person cannot keep conserved funds once they are no longer qualified for benefits.

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According to a report on the hearing, schizophrenia is a “devastating disease that affects more than two million Americans—typically those in their teens and twenties.” Oftentimes schizophrenia has Social Security implications because it is a debilitating disease often resulting in unemployment and homelessness. The purpose of the testimony was to identify the severest of the cases and determine how to bring them under the agency’s Compassionate Allowances umbrella.

The Compassionate Allowances initiative began in 2008. Its purpose is to “expedite the processing of disability claims for applicants with medical conditions so severe that their conditions by definition meet Social Security’s standards.” Essentially, the program is a fast track method for getting Social Security Disability benefits to those with the utmost needs in an efficient manner.

According to Michael J. Astrue, Social Security Commissioner, “Our Compassionate Allowances and Quick Disability Determinations processes are making a real difference by ensuring that Americans with devastating disabilities quickly receive the benefits they need.” He went on to state that in 2009, the Social Security Agency fast tracked 150,000 cases through the initiative.

The Social Security Agency determines various conditions and diseases that, according to medical evidence, are so devastating that by their very definition, anyone who suffers from it will qualify for Social Security Benefits. Because of this determination, the individual is fast tracked through the traditional steps and instead is given a benefits award with little to no need for proof. It is likely that schizophrenia will be added to the list.

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Under this prong of social security, there are various requirements. For instance, in order to receive benefits, the individual must not be working and cannot be earning more than the set earnings limit for that given year. In the legal world, this means not participating in any “substantial gainful activity.” However, it is important to note that this does not include assets. In other words, when applying for benefits, the Social Security Administration does not take into consideration an individual’s assets.

The second form of disability, also administered by the Social Security Administration, is commonly referred to as SSI Disability. As the first form discussed above, SSI is a needs-based program. Likewise, the same limits to one’s earnings apply to SSI Disability. Unlike the first form, SSI does have a strict limitation to assets of $2,000. In other words, an individual seeking SSI Disability benefits cannot have in excess of $2,000 in countable assets or any assets “not essential for daily use and living” (i.e., home, primary vehicle, etc.)

So how does one decide under which program he or she should apply? Well, that depends. In some situations, an individual may choose to apply under both. Typically, however, the determination starts with a look at one’s countable assets. If they exceed the limit (which is often the case when a disability is the result of one’s work), then they opt for the first program.

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According to the Emergency Clearance request, the Social Security Administration states that the newly proposed 1699 form will allow, with respect to these representative individuals:

• The Social Security Administration to authenticate and authorize the representatives to do business with the Administration,
• The representatives to access the Administration’s records for the claimants they represent,
• The facilitation of direct payment of authorized fees to appointed representatives, and
• The collection of information that the Social Security Administration requires to meet the Internal Revenue Service’s requirements for mandated IRS forms whenever a representative receives payment in excess of $600.

The reasoning for this request is that under the older 1699 form, which was much lengthier than the new version of the form, bureaucratic hurdles held up payments for many people in need of Social Security Disability benefits. For example, under the old 1699 form a representative needing access to Social Security Administration information had to go through an extensive administrative process—and only then were they able to move forward with obtaining and administering the benefits. Under the proposed new 1699 form, the streamlined process benefits all parties by allowing completion of the entire process on a relatively short and user-friendly form.

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