Congressman Rogers Urges The Ssa To Reinstate Benefits For All Victims Of The Eric Conn Fiasco
WASHINGTON, DC — U.S. Rep. Harold “Hal” Rogers demands answers from the Social Security Administration as hundreds of individuals continue to wait for benefits in the wake of the historic Eric C. Conn disability fraud scheme in Eastern Kentucky. Rogers issued a letter to SSA Commissioner Andrew Saul on October 17, 2019 urging the administration to immediately reinstate benefits to former Conn clients.
“While I am grateful that the SSA, by virtue of court order, has recently reinstated benefits to some 200 former Conn clients, many individuals remain without benefits. The uncertainty and delay surrounding reinstatement continue to add to the injustice experienced by the former clients,” wrote Rogers. “I urge the SSA to immediately reinstate all benefits to all former clients, especially those whose redetermination hearing have been ruled unconstitutional.”
In 2015, Congressman Rogers successfully requested SSA reinstate benefit payments for 900 former Conn clients while awaiting hearings to redetermine their eligibility to receive disability benefits. Last November, the 6th Circuit Court of Appeals ruled the hearings and processes used for many of these clients were unconstitutional. However, benefits have not been released for these individuals and those who could not keep their appeals active.
Rogers questioned the status of medical benefits for Conn clients, as well as why some beneficiaries are not receiving the full disability amount they are entitled to.
Extended Period Of Eligibility
Once youve used up all 9 Trial Work months, your Trial Work Period is over and your 3-year Extended Period of Eligibility begins.
When your gross monthly earnings are less than or equal to the Substantial Gainful Activity limit , you will keep getting SSDI benefits.
During your Extended Period of Eligibility and period of Expedited Reinstatement , Social Security allows for certain deductions when they calculate your earnings. These deductions are things that can help keep your countable earnings below the SGA level and let you keep getting SSDI benefits, even though you have a job. The most common deductions are called Impairment Related Work Expenses and subsidies. For a more detailed description of deductions, .
During your EPE, the first time you earn over the SGA limit in a month, your 3-month Grace Period begins. During the Grace Period, you will keep getting SSDI cash benefits no matter how much you earn. After your Grace Period ends, your SSDI benefits will be $0 in any month that you earn above the SGA limit.
If you are not earning above the SGA limit when your 3-year Extended Period of Eligibility ends, you will continue to get SSDI benefits. If you are earning more than the SGA limit, you will no longer get SSDI benefits, but you will be able to get back on SSDI if your income drops below the SGA limit and you are still disabled. More about what happens after the EPE ends is discussed later in this article under Expedited Reinstatement.
How Do You Get Benefits Reinstated
If youre receiving SSI, your payments are suspended while youre in prison. Your payments can be reinstated in the month youre released. However, if your confinement lasts for 12 consecutive months or longer, your eligibility for SSI benefits will terminate and you must file a new application for benefits.
If Social Security suspends your disability or SSI benefits because you were in prison, you can request for Social Security to reinstate your benefits. Youll need to contact Social Security and provide a copy of your official release documents before they can act on your request.
For SSI beneficiaries, benefits are terminated when the person is incarcerated for a year or more.
See our separate website on Criminal Law
Forms to Get one released from Prison
Is he on SSI or SSDI?
Were benefits suspended or terminated?
Was he getting benefits before?
Does the prison have a pre-release agreement with Social Security?
Please read this pamphlet from Social Security
A prerelease agreement is a written or verbal agreement between an institution and SSA to cooperate in the processing of Supplemental Security Income applications under the prerelease procedure. For a complete description of prerelease agreements see SI 00520.910 Prerelease Agreements Institutionalization.
Social Security and Health Care Benefits for the Incarcerated
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Can A Suspension Be Based On Substantive Reasons
Suspensions must therefore be based on substantive reasons and fair procedures must be followed before employees are suspended. Unless the circumstances dictate otherwise, employees must be offered the opportunity to be heard before being placed on suspension. There are currently two different approaches to the actual suspension discussion.
The employer determines how many days the employee will be on unpaid suspension and informs him or her. Both the employer and the employee know exactly how long the person will be out and unpaid, and when that employee will return to work.
Reinstatement Of Voluntary Suspension Versus Retroactive Benefits
As the MailBag emails noted earlier, several planners have attempted to engage in this strategy with their clients by going into the Social Security Administration offices, only to be rebuffed by Social Security employees who state that it is not possible to file for retroactive benefits more than 6 months, regardless of the file-and-suspend strategy and that as a result, theres really no reason for an individual to file and suspend at all.
Under the standard rules for Social Security, it is true that those who are full retirement age can file for retroactive benefits, but only as far back as 6 months of prior benefits. However, when someone chooses to file and then suspends benefits, and later chooses to undo the suspension, technically the decision is not an application for retroactive benefits. Instead, it is a request for reinstatement of benefits that were voluntarily suspending, which is an entirely different set of rules. And as the Social Security Administrations own Program Operations Manual System guidance explains, an individual who requested suspension may request at any time to have benefits reinstated effective for any month of the suspension period.
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What Are The Abbreviations For Suspended Or Terminated Disability Benefits
Selected Abbreviations DI Disability Insurance SSA Social Security Administration SSI Supplemental Security Income SVRA state vocational rehabilitation agency STW suspension or termination for work
Because of the widespread adoption of the doctrine of employment at will, it is usually difficult, if not impossible, to challenge an unpaid suspension. This doctrine refers to the arrangement between employers and employees, wherein the employment relationship may be terminated by either party at any time, for unspecified reasons.
Waiting For A Decision On Expedited Reinstatement
When you apply for expedited reinstatement of your benefits, your application has to go to Disability Determination Services , which can take a while. Fortunately, Social Security will pay you benefits for up to six months while you are waiting for an answer on your EXR. Even if your application for expedited reinstatement is denied, you get to keep the benefits Social Security paid you while your application was pending. In addition, while you wait for a decision, you’ll be covered by Medicare or Medicaid . If your request is denied, your Medicare or Medicaid will stop.
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What Do I Need To Do
It is likely you qualify for EXR if you meet the following conditions.
- Your Social Security payments stopped because you were making too much money after you returned to work
- You submitted your EXR application no later than five years after your benefits stopped
- You stopped working because of a condition that is the same as or closely related to the one you were receiving benefits for
- Your condition has not seen a medical improvement
If you meet these requirements, apply for EXR right away. The SSA is likely to give you provisional benefits for up to 6 months while they review your case. Provisional benefits are usually approximately the same amount as your previous SSDI or SSI benefits, and they usually dont need to be paid back, even if your EXR claim is denied. Provisional benefits may stop if 1) You receive a decision regarding your EXR, 2) You engage in SGA, or you 3) Reach the full retirement age .
How Can My Wife Get The Biggest Spousal Benefit
Ramon, Philippines: I retired last February at the age of 63 and two months and currently receive $659 a month in Social Security benefits. My wife will turn 62 in February of 2020 but never worked during her eight years in the U.S. How much will she get in spousal benefits if she files at 62?
I know that $659 doesnt sound much, but I understand that my wife is entitled to approximately 32.5% of my $659. If so, we can live comfortably in the Philippines.
Phil Moeller: Your wife is entitled to a spousal benefit, but Im not sure youre aware how much more money both of you could receive if you had waited to file until you were older.
Your wifes spousal benefit will reach its maximum if she waits to file until she reaches her full retirement age. Also, her benefit will be larger than you think, because it will be based on your FRA benefit, not the smaller benefit you actually receive.
While you have already filed for your benefit, you may still have a way to increase it. Social Security rules allow you to repay your benefits within a year of filing. If you can do this, Social Security would erase your application, and you could wait up until age 70 to file. If you did so, your benefit would be much higher than it is now.
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Please Answer A Few Questions To Help Us Determine Your Eligibility
If you stopped receiving Social Security disability benefits because you were earning more than the substantial gainful activity limit, but then your earnings drop below the SGA level again, Social Security has a faster application process for you to get your benefits reinstated. You can ask for “expedited reinstatement” of your disability benefits and avoid the long application process for new disability applications.
Subsidies And Special Conditions
Subsidies and special conditions are supports you get on the job that result in you getting more pay than the actual value of the services you perform. A subsidy is support that you get from your employer special conditions are generally supplied by someone other than your employer, for example, a Vocational Rehabilitation agency.
Social Security considers subsidies and special conditions when they make an SGA decision. They only use earnings that represent the real value of the work you do to decide if your work is at the SGA limit. This is good for you because if Social Security decides that you have a subsidy or special conditions, you can earn more while still getting benefits.
Subsidies or special conditions may exist if:
- You get more supervision than other workers doing the same or a similar job for the same pay
- You have fewer or simpler tasks to complete than other workers doing the same job for the same pay, or
- You have a job coach or mentor who helps you perform some of your work.
If you think you get a subsidy, talk to Social Security about it. They may ask you to get a letter from your employer, so they can document that you get a subsidy. If you think special conditions may apply to you, talk about it with Social Security. Also talk to your mentor or job coach they may need to supply documentation so that you can be recognized as having a special condition.
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What Is The Provisional Benefit Period
While waiting for an EXR to be approved, the SSA will pay temporary benefits for up to six months. However, provisional SSDI benefits will stop when you receive a decision about an EXR request or if you earn income above the substantial gainful activity amount. Provisional benefits will also be discontinued if you turn 65 years old before a decision is reached. If your expedited reinstatement request is denied, you do not have to repay provisional benefits as long as no overpayments were involved.
Monthly provisional benefits are generally equal to what you were receiving while on SSDI. Occasionally, this amount is adjusted if underpayments, overpayments or cost of living increases enacted by Congress have been established since your last benefit payment. Additionally, you are also entitled to health insurance while receiving provisional benefits. SSDI recipients are usually covered by Medicare.If your EXR is denied, Medicare will stop paying for your health costs.
How Long Does It Take To Reinstate Ssi Benefits & Get Paid
Once you start receiving Supplemental Security Income benefits, they last for as long as you continue to be eligible to receive them. If your eligibility ends, you also lose your benefits. However, because you were once approved to receive such benefits, the Social Security Administration allows you to reinstate your benefits as soon as you find yourself once again eligible to receive these benefits.
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When Does Deeming Not Apply
Deeming from the parent stops when a child attains age 18, marries, or no longer lives with a parent. Deeming does not apply, and we may pay up to $30 plus the applicable State supplement when:
a disabled child receives a reduced SSI benefit while in a medical treatment facility and
the child is eligible for Medicaid under a State home care plan and
deeming would otherwise cause ineligibility for SSI benefits.
Also, we do not consider the income of a parent for deeming purposes if the parent receives a Public Income Maintenance payment such as Temporary Assistance for Needy Families and his or her other income was used to compute the PIM payment.
|See SSI AND ELIGIBILITY FOR OTHER GOVERNMENT AND STATE PROGRAMS for information on TANF.|
If either child or parent is temporarily absent from the household , the rules about deemed income still apply. ssa.gov/ssi child-ussi
InKind Income is food or shelter that you get for free or less than its fair market value.
My Ssdi Stopped While I Was Incarcerated How Do I Restart It
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Who Is Eligible For Expedited Reinstatement
There are some basic requirements that you must meet to take advantage of expedited reinstatement. You must have:
- stopped getting payments because you made too much money when you returned to work
- requested the EXR within five years of when your benefits were stopped
- stopped working because of a medical condition that is the same as, or related to, the condition for which you were originally receiving benefits, and
- not experienced a “medical improvement” in your condition since your initial application.
Medical improvement has a certain meaning here. When you apply for expedited reinstatement, your application will be sent to your local disability determination services agency. DDS is the state agency that reviews Social Security claims to see if the applicant meets Social Security’s definition of disabled. This time, DDS will look at your medical records to see if you have experienced medical improvement since your initial application.
Medical improvement means that the condition on which your approval was originally based is no longer severe as it was, as it relates to your ability to work, and that you can now perform SGA. This standard is often difficult for Social Security to prove. This is good news for you because it may make it easier for you to get your EXR granted. For more information, see our article that explains the medical improvement standard.
How Do You Appeal An Exr At The Federal Level
You will need to file a civil complaint at a U.S. District Court nearest your location. Civil complaints are simply concise statements describing your disability and other aspects of your case. When you file an appeal at the federal level you are essentially not suing the SSA. Instead, the defendant named in your appeals complaint is the current commissioner of the Social Security Administration.
The SSA cannot assist you in completing a civil complaint since the case involves the SSA Commissioner. If you do not have a disability attorney at this point in the appeals process, it is likely your civil complaint will be rejected due to legal omissions and errors. The SSA and other disability experts strongly advise anyone to hire an experienced disability lawyer who give your case the legal expertise it needs to stand a chance at being approved in a Federal District Court.
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Tag: Reinstate Social Security Benefits
Social Security can be confusing, especially when you lose and regain your benefits. Not to worry, though! The process to reinstate SSDI or other Social Security benefits is much easier than you think. The process is not as difficult as your initial application for Social Security. Let our attorneys from SSDA explain to you how it works.