Elder Living

Take Advantage of Government Programs for Seniors

Due to current inflationary pressures, many US seniors are experiencing financial insecurity. In addition to cutting back on unnecessary expenses, retirees and those approaching retirement should apply for government assistance programs so they may qualify and alleviate the anxiety many Americans experience with a fixed income.

The National Council on Aging (NCOA) works with thousands of national and local partners to provide tools, resources, advocacy, and best practices for every aging American to have health and financial security. Checking out if you qualify for senior benefits through government programs is easy to do with NCOA’s online BenefitsCheckUp tool.

Wasted Benefits

Every year billions of available dollars in US benefits programs are not claimed because older adults (55 or more) are unsure if they are eligible and, if so, how to apply. No registration is necessary, and requests for information are minimal. Personal data entered into the website will remain confidential, and accessing the database costs nothing. If you hate filling out forms and get confused by all the questions, estate planning and elder law attorneys go through this process every day. Contact them for help. There is rarely an upfront cost for legal help, and you will be in a much better financial position once you begin receiving assistance.

The Online Benefits Check Up

If you complete the benefits check-up online, NCOA will send a confidential report to your mailing address listing the help available to you and how to apply for it. Since 2001 this NCOA program has helped millions of older adults receive help paying for medicine, food, utilities, and more. More than 2,000 benefits programs are in the check-up system, including categories such as:

  • Food and nutrition
  • Health care and medication
  • Housing and utilities
  • Income
  • In-home care and aging in place
  • Disability services
  • Skilled nursing facilities and other long-term care environments
  • Tax help
  • Legal, crisis, and general assistance
  • Veterans’ programs
  • Discounts and activities

The online BenefitsCheckUp site helps older individuals identify the federal and state assistance programs for which they can qualify. This NCOA website is newly revamped and permits error corrections and the addition of information if you feel the need to revise your answers. The resulting online individualized Eligibility Results report can be saved in a PDF format to email to yourself, your lawyer, or a trusted family member.

Providing this eligibility information to your elder law or estate planning attorney is a smart strategy. Suppose you already receive disability benefits through SSDI, SSI, or other programs. In that case, adding other government assistance programs may result in unintended and negative consequences that may render you ineligible for benefits you already receive. Your lawyer will know the strategies already in place and how additional programs may affect your current planning.

The chart above shows how many older adults struggled to manage basic expenses even before the inflationary circumstances of late 2021 – 2022 (and predicted beyond). Participation rates in government assistance programs are at a historic low, with a mere low to mid sixty percent of eligible individuals participating.

Benefit take-up rates are low due to program enrollment barriers. Many older adults lack awareness that these benefits exist, and when they do, the application process for many programs can be cumbersome and complex. Additionally, perceived stigma about receiving government assistance and other program misconceptions contribute to lower participation rates.

Ramsey Alwin, NCOA CEO and President, admits, “In today’s economy, inflation is taking a bigger and bigger bite out of people’s incomes.” He adds, “We completely redesigned BenefitsCheckUp to make it even easier … no one should have to choose between paying for medications or food.”

To worry less and age better with more resources at your disposal, explore the NCOA’s BenefitsCheckUp website and learn what is available to you. Before you use the contact information to take the next step to apply, be certain to consult with your elder law or estate planning attorney. All assistance you receive should not interfere with existing plans and help you age successfully. More than 2,000 government benefits programs are available to help you, and it can make the difference between thriving or just surviving.

We hope you found this article helpful. If you have questions or would like to discuss your personal situation, please don’t hesitate to contact our Reno office by calling us at (775) 853-5700.

Elder Law

Rejection Reasons for SSI and SSDI Claims

Before spending time and effort on the SSI or SSDI application process, you should consider some of the major disqualifiers. Eligible individuals can benefit from both programs though they have distinct differences. The major difference is SSI eligibility qualification relies on age, disability, and limited resources and income, while SSDI eligibility determination relies on disability and work credits. In most states, SSI recipients automatically qualify for Medicaid health care coverage, which could result in additional supplementary benefits through your state’s Medicaid program. However, both programs have some common reasons that can disqualify your claim. 

Typically most people think about the reasons they should receive benefits without ever considering why they may be denied. Some of the reasons are beyond your control, while other reasons are missteps you can avoid that result in denial. Things to consider include:

Your Income Earnings are Too High 

In the case of SSI, the disability benefit for low-income individuals, you cannot exceed the substantial gainful activity (SGA) threshold. However, it is permissible to earn more money after your approval. Still, there is a limit of about $1,600 a month on all earned and unearned income for SSI. This dollar amount applies to both application for and collection of benefits. Any time your monthly income exceeds $85, your SSI payment will receive a reduction based on a complex formula. Anything over $1650 per month, and you will no longer qualify.

When you apply for SSDI (the benefits program for workers who paid into the Social Security tax base over multiple years), your claim may be denied if you work above the threshold considered substantial gainful activity. Going over this amount means you earn too much money to be considered disabled. It is permissible to earn a small amount during your application and collecting of SSDI but not over the SGA limit. This limit (for non-blind individuals) was $1310 per month in 2021, and the figure is adjusted annually. It is worth noting income from investments does not count toward the SGA; only work income determines your ability to work.

Your Disability is Not Considered Severe or Won’t Last Long Enough 

Qualification for both SSI and SSDI benefits means the Social Security Administration (SSA) must believe your impairment is severe enough to continue for at least 12 months or result in your death. Blind SSI applicants are the only exception to the duration requirement.

Many claims based on bone fractures resulting from acute trauma from accidents are commonly denied since the disability is unlikely to last 12 months. Nearly all bone fractures heal in under a year. If your bone fractures are severe enough and have not healed after six months, you may resubmit your claim as the SSA will likely believe your impairment will last a year. Each case receives an individual evaluation.

If your medical condition is not trauma-related, it must still cause severe limitations of disability to qualify for SSI or SSDI. Most denied claims are due to the applicant’s impairment not being severe enough. You can learn about the disability determination for benefit claims here.

The Social Security Administration Can’t Reach You

Both the SSA and Disability Determination Services (DDS) agencies need to be able to communicate with you regarding your application. If they cannot reach you, schedule examinations, appointments, or communicate about critical matters, you will likely be denied benefits. Every day claimants are denied because the SSA cannot locate them. If you opt to name a representative (such as a disability lawyer) to handle your application, you may not have to contact the SSA. However, you most certainly must maintain contact with your disability attorney.

Your Refusal to Cooperate

The SSA requires medical information about your impairment, and if you refuse to release these records, your claim of disability will likely be denied. If you provide medical records, but the SSA deems them incomplete, or you lack a regular doctor for treatment, they will schedule a consultative examination (CE) with an SSA doctor. Refusal to accept this exam(s) and requesting a determination of eligibility be based on existing medical records may be cause for denial due to inadequate medical data or failure to comply with a CE. Your attorney also helps you gather the correct medical information according to the requirements.

Your Failure to Follow Prescribed Therapy

If you receive medical treatment, failure to adhere to the doctor’s prescribed therapy when you are able to may cause a denial of disability benefits. Some acceptable medical excuses include:

  • The severity of your mental illness precludes your ability to comply with the prescribed therapy.
  • You elicit intense fears regarding surgery, making the procedure inappropriate. Your treating doctor will confirm the severity of your fears to the consulting DDS doctor.
  • You are physically unable to follow the prescribed therapy without assistance due to paralysis, cataracts, or other physical limitation.

Some acceptable non-medical excuses include:

  • You lack the money to pay for the treatment.
  • You have religious beliefs that prohibit receiving the proposed medical therapy.
  • Your doctor prescribes a treatment with which a second opinion doctor disagrees.
  • The proposed therapy will not result in the restoration of your ability to do substantial gainful activity.

Your attorney can review the details of your situation to see if any exclusions apply and collect the necessary documentation.

Your Disability is a Result of a Drug Addiction or Alcoholism (DAA)

If a contributing factor to your disability is DAA, the SSA will deny your claim for benefits. The DDS medical consultant will determine whether you would still be disabled if you ceased using drugs or alcohol. You can read more about DAA determining factors here.

You have a Criminal Conviction

Certain conditions relating to criminal conviction or imprisonment will prevent approval of SSDI.

  • You are in prison after your felony conviction without a court-approved rehabilitation program likely to result in employment upon release. That release expectation is within a reasonable amount of time.
  • You received an injury while committing a felony and are convicted of the crime. The resulting impairment, or worsening of an existing one, suffered during a felony crime is ineligible to use as a basis for disability benefits.
  • You became injured while in prison. The resulting impairment, or worsening of an existing one, suffered while incarcerated can’t be used to get benefits. However, you can likely receive benefits after your prison release.

If these conditions apply to your situation, it is still worth the effort to apply for SSDI benefits. Although you will not receive cash benefits, you may still be granted a benefit-free disability period that freezes your earnings record, preventing the decrease of eventual disability, retirement, or dependents benefits. Talk to a disability attorney if your claim is complicated by these circumstances.

The above conditions do not prevent your receiving SSI disability benefits, although you will be unable to collect them while incarcerated.

You Commit Fraud

Always apply for disability benefits honestly. If you receive them by dishonest means, the SSA may terminate your benefits and choose to prosecute you for fraud. Benefits obtained through fraudulent methods by your representative or someone working for the SSA also may cause the termination of your benefits.

These common reasons stop you from legally obtaining SSI and SSDI benefits. Before you become too involved in applying, be certain you meet the minimum standards for approval. A disability lawyer can help you sort out any issues, avoid missteps, and properly present your case for disability approval.

We hope you found this article helpful. If you have questions or would like to discuss your personal situation, please don’t hesitate to contact our Reno office by calling us at (775) 853-5700.