Eligibility For Medicare Disability Benefits
If You Are Under Age 65 Social Security Disability Insurance
If you are age 18 to 64, your eligibility for Medicare is tied to your eligibility for Social Security Disability Income benefits. One exception is for people with end-stage renal disease , who are automatically eligible for Medicare solely on the basis of having ESRD.
You must qualify for and receive SSDI monthly income benefits to be eligible for Medicare. SSDI benefits are based on work credits earned through Social Security, Railroad Retirement or Medicare-covered government employment. Note: If you dont have work credits and dont qualify for SSDI, you may qualify for other income benefit programs such as Supplemental Security Income . For more information, see If You Dont Qualify for SSDI.
To qualify for SSDI, you must be unable to work for a least one year because of a qualifying physical or mental impairment, a combination of impairments or a terminal condition resulting from an impairment. You can apply for SSDI at your local Social Security Administration office. Once you are approved for SSDI, you must wait 5 months for your income benefits to begin, and an additional 24 months before Medicare benefits begin.
However, there are 2 exceptions:
Amyotrophic Lateral Sclerosis
If you have Amyotrophic Lateral Sclerosis , you can get Medicare the first month you get SSDI monthly income benefits.
Ongoing Eligibility for Medicare and SSDI
If You Dont Qualify for SSDI
How Much Does Permanent Disability Pay
There is a complex formula used to determine how much you draw from Social Security Disability Insurance . In general, most people get between $700 and $1,700 each month. According to the Social Security Administration , the average monthly payout for qualified individuals is $1,197 for 2018. Those who earned a high income during their years working could get as much as $2,788 per month in benefits.
At Berger and Green, our disability lawyers can help you understand how much permanent disability pays. We can discuss how to qualify for benefits during a free consultation. Call us at to get started.
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Your Health Care Rights
The Americans with Disabilities Act of 1990 , federal legislation and California state law all prohibit discrimination on the basis of a disability. However, these laws are limited in a number of ways, and they dont require insurance companies to sell you policies.
Medical providers cannot refuse to treat you because you have a disability. But they can refuse to accept you as a new patient if they are refusing other Medicare patients, or if they dont treat anyone with Medicare. Medical providers are also permitted to refer you to another provider if the care you need is not within the scope of their practice.
If you think a physician or health care plan is denying your disability rights, file a complaint with your medical group, your plan and the U.S. Department of Justice . If you need help, contact your local Health Insurance Counseling & Advocacy Program office for free counseling and information.
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Importance Of The Permanent Disability Rating
States use yourpermanent disability rating to determine the amount of monetarycompensation you will receive to compensate you for your permanentimpairment due to your industrial injury or occupational disease.
In some states,the permanent disability rating corresponds to a certain number of weeksof wages worth of income you will be paid. For example, in California, a10% permanent disability amounts to 30 weeks worth of wages.
Inother states, your permanent disability rating corresponds to an exactdollar figure. For instance, a 8% left knee impairment may equal $4,572.You would receive $4,572, either in installment payments or in a lumpsum.
It is important toremember that permanent disability awards are made near the end of yourworkers compensation claim, after you have reached maximum medicalimprovement and your permanent disability has been evaluated.
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Work Incentives Planning & Assistance
The Work Incentives Planning and Assistance program is a free service that helps Social Security beneficiaries who receive benefits based on a disability make informed choices about their employment goals. This program is for individuals currently employed, self-employed, or who are seeking employment or selfemployment.
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Independent Contractor Or Self
This pub tells you when you have to report your self-employment or independent contractor earnings to Social Security. It tells you about work incentives so you can work and not lose your benefits. It has forms you can use to report your earnings. It tells you how to get help if you have questions about reporting your work.
Where Am I The Benefits Planning Query
If you have any questions about your Social Security benefits, or if youre planning a life change that can affect your benefits, it helps to know exactly what your Social Security records look like.
You can get this information by ordering a free statement from Social Security called the Benefits Planning Query . You can request your BPQY at your local Social Security office or by calling 1-800-772-1213 or 1-800-325-0778 .
If the BPQY is incorrect in any way, or you dont understand what its saying, you should call Social Security and get it straightened out.
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California Social Security Disability
Each year the Social Security Administration receives millions of applications for Social Security Disability benefits. In California, the number of applications received has increased nearly three-hundred percent over the past three years. This has resulted in significant delays for many of the California Social Security Disability applicants who are in desperate need of disability benefits. While the initial application process for a California Social Security Disability claim only takes about three to four months to complete, the majority of applicants are denied at the initial stage of the application process. These applicants must then file for an appeal if they hope to receive the disability benefits they may be entitled to.
The hearing stage of the disability appeal process is the reason why it takes some California Social Security Disability applicants so long to receive disability benefits from the SSA. Depending on where in California you live, it can take anywhere from 327 days to 602 days to obtain your California Social Security Disability hearing. Then it takes another 45 to 90 days before you receive the decision from the administrative law judge who heard your disability case. This means that most California Social Security Disability applicants wait more than one to two years before they ever receive a single benefit payment from the SSA.
Question: If I Owe Back Child Support Can The Government Garnish My Disability Benefits
Answer: Yes. Whether its SSDI or SSI, the court can garnish your benefits for any back child support payments you owe. Supplemental Security Income is a government program that helps disabled people with the lowest income. While SSI isnt garnished for outstanding taxes and debts, the court can garnish it for child support non-payments. For this reason, its important not to fall behind on your child support payments.
However, its important to note they use your current income to calculate how much child support you owe. If that goes down , you may be able to modify your child support agreement. If so, it should lower your child support payments going forward.
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Reduction For Disability Payments From Other Sources
If you receive disability benefits from a private source, like a private pension or private insurance benefits, these benefits will not affect your SSDI benefits. If, however, you receive other public disability benefits, they may affect your SSDI benefits. For instance, if you were injured on the job and are receiving workers’ compensation benefits, the amount of SSDI benefits you receive might be reduced.
Other disability benefits that are not job-related and are paid for by the federal, state, or local government may also reduce your SSDI benefit amount. Examples of these include temporary disability benefits paid by the state, military disability benefits, and state or local government retirement benefits that are based on disability. Some public benefits are not counted toward the 80%, including SSI or VA benefits.
The combined total amounts you receive from SSDI and all other public disability benefits cannot be more than 80% of the average amount you earned before you became disabled. If the amount is more than 80% of what your average earnings were before you became disabled, in most states, the excess amount is deducted from your SSDI benefits.
The interaction between workers’ compensation and SSDI can be complicated and varies depending on what state you live in. If you qualify for more than one public disability benefit, you may want to speak with an attorney to make sure you do not miss out on any benefits you are entitled to.
How Much Does California State Disability Insurance Pay In Benefits
Your weekly benefit amount is calculated using a base period consisting of 12 months. SDI then takes that 12-month base period and divides it into four quarters. The quarter when you earned the most money is the quarter they use to decide your benefit amount.
You must have earned at least $300 in your base period, and you must have paid SDI taxes on those earnings . Your base period does not include wages paid at the time your disability begins.
Your weekly benefit amount is about 60 to 70 percent of wages earned, up to the maximum weekly benefit amount. The minimum benefit amount is $50 per week up to a maximum of $1,357 per week.
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How Does Social Security Define Disability
To be eligible for SSI, you must show that you have a disability that prevents you from working. Social Security requires that:
- You must be able to show medical reports that confirm that you have a severe physical or mental disability.
- The disability must be life-threatening or have lasted or be expected to last at least a year.
- The disability must prevent you from doing Substantial Gainful Activity for at least a year.
How Long For A Decision
It can take up to 4 months for a decision to be made. The date your application form is received may affect the date your benefit begins. Do not wait for your completed medical form before sending your completed application form.
However, a decision on your application can only be made when you have sent both of the following:
- a complete application form
- a signed medical report
For eligible disabilities, we aim to make a decision on your eligibility within 120 calendar days .
If we confirm your condition is grave, we aim to process your application within 30 calendar days.
If we confirm you have a terminal illness, we aim to process your application within 5 business days.
Who Qualifies For Disability In California
Am I Eligible for Disability Insurance Benefits? Be unable to do your regular or customary work for at least eight days. Be employed or actively looking for work at the time your disability begins. Have lost wages because of your disability . Have earned at least $300 from which State Disability Insurance deductions were withheld during your base period.
People Living In Medical Facilities
People who live in medical facilities like hospitals and nursing homes generally cant collect full SSI benefits.
- If you are living in a medical facility where Medi-Cal pays for more than half the cost of your care, your SSI benefits amount is at most $56 a month for an individual or $112 for a couple.
- If you live in a public facility and Medi-Cal is NOT paying for more than half of your care, you cannot get any SSI benefits.
- If your doctor says you will be in the facility for less than 90 days, and you can show that you need your SSI benefits to keep your home or living arrangement, you may continue to get your SSI benefits.
If youre expecting to stay for less than 90 days, you need to get the doctors note and documentation about your need to Social Security right away. The facilitys admissions office can help you. SSI also needs a statement from you or someone who knows your cicrumstances saying that you need to keep your SSI benefits to avoid losing your home or living arrangements.
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Expanded Unemployment Benefits Under The Cares Act
The Coronavirus Aid, Relief, and Economic Security Act included a section that expanded unemployment benefits by an additional $600 per week on top of the benefit offered by states. This provision is being rolled out on a state by state basis, however, the benefit is retroactive to April 5, 2020.
The additional $600 weekly benefit brings the state and federal unemployment benefits up to an average of the median weekly wage in the United States. However, because the expanded benefits are being offered to everyone on
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Your Disability Payment Is Based On Your Average Lifetime Earnings Before You Became Disabled The Severity Of Disability Does Not Factor In Although Payments From Other Sources Can
Unlike Supplemental Security Income , which also pays benefits to people who are disabled and unable to work but is based on limited income and resources, SSDI requires that you have worked and paid Social Security taxes for a certain length of time.
The average SSDI payment is currently $1,277. The highest monthly payment you can receive from SSDI in 2021, at full retirement age, is $3,148. This article covers how the monthly benefit is calculated.
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How Much Will I Receive From Sdi
Your benefit amount is calculated based on the amount of earnings you had in the highest-earning quarter of your base period, and is about 60-70 percent of your regular earnings. In 2018, the maximum amount of SDI you can receive is $1,216 per week. SDI payments are processed every two weeks.
The entire amount you receive in SDI benefits from a single claim may not exceed the total amount of wages you earned during your base period.
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Permanent Partial Or Total Disability
California workers compensation laws provide specific coverage for individuals who have been injured on the job, whether that injury results in a few lost days of work or permanent disability. Ideally, your medical care and needs will be covered after your injury, but some types of workplace injuries and illnesses result in long term issues. When you have a long-term injury, you may not be able to regain your original good health and condition. Once youve attained the maximum amount of medical improvement possible, you could be entitled to financial compensation for any remaining disability or impairment.
Eligibility for an Award of Permanent Disability
When an injured workers medical condition has reached Maximal Medical Improvement, or Permanent and Stationary status, a doctor may assess how much, if any, permanent impairment results from a work injury. If a disability is rated under the 2005 Schedule for Rating Permanent Disabilities, an injured worker may see the term Maximal Medical Improvement used in place of Permanent and Stationary.
Difference Between Permanent Partial and Total Disability Some Injuries cant be Fixed Workplace Injuries can Change Your Life A Santa Ana Workers Compensation Attorney can Help Inland Empire
NOTICE: Making a false or fraudulent workers compensation claim is a felony subject to up to 5 years in prison or a fine of up to $50,000 or double the value of the fraud, whichever is greater, or by both imprisonment and fine.
What If I Disagree With My Benefit Amount
The SSA does not always get your benefit amount correct when it approves you for SSD. The appeal process can be long and complicated, which is why it helps to have one of the experienced disability attorneys at the Disability Advantage Group working for you. Our lawyers know the law and, chances are, they have handled many situations similar to yours in the past.
We have years of experience with disability claims and will pursue your case aggressively. Call today at for a consultation.
Can I Use Only Part Of The Benefit Or Is It All Or Nothing
If you want to go back to work before the full leave is up, you can use part of the benefit. You might choose to do so if, for example, you cant afford to receive only 60 to 70 percent of your pay for the eight weeks covered by PFL. Note, though, that if you do decide to go back to work before youve used all of your leave time, you can still hold the rest in reserve as long as your benefits are taken within 12 months after your baby is born or your adoption/foster care placement takes place. That could come in handy for another purpose, such as if a close family member is seriously ill or you need to participate in a qualifying military event.
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How Income Affects Your Ssi Payment
If you have any income coming in other than SSI, some of it, but not all of it, will be subtracted from your SSI payment.
The SSA will first look to see what income you have is countable. Countable income includes:
- money you earn from work
- food or shelter you get for free, or for less than what itâs worth
- money you get from friends or family
- other benefits, such as workersâ compensation, unemployment, SSDI, or a pension.
But not all of your income is subtracted from your SSI payment. Each month, the SSA does not count:
- the first $20 of any kind of income you receive
- the first $65 of money you earn from work, plus half of the remainder
- food stamps
- food or shelter provided by a nonprofit agency.