What should I know about Supplemental Security Income (SSI)?

Contents

• What is Supplemental Security Income?
• What are my rights with SSI?
• What are my responsibilities with SSI?

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What is Supplemental Security Income?

Supplemental Security Income (SSI) is a benefits program for people who are:

• Disabled,

• Blind, or

• Age 65 or older, and

• Have limited income and resources.

 

How is SSI calculated?

Effective January 1, 2021, the maximum monthly SSI benefit is $794 for an individual and $1,191 for a couple. To decide how much you will get, the Social Security Administration will subtract your countable income from the maximum benefit. So if your countable income is $500, your SSI benefit would be $294 ($794-$500 = $294). Georgia adds a state supplement to your federal benefit. 

 

Not all income is countable. In general, countable income is anything you can use as, or use to get food or shelter. This includes money:

• You earn through work,

• You receive as a benefit (including Social Security),

• You are given.

 

Examples of income that do not count for SSI are:

• The first $20 of unearned income in a month. Unearned income includes Social Security benefits, pensions, disability or unemployment payments, interest income, dividends, and cash from friends and relatives,

• If you have a job, the first $65 of what you earn, and then half of anything over $65 is not counted for SSI. So if you earned $500 in a month, the countable income from your earnings would be $217.5 (calculated as $500-$65 = $435/2 = $217.5)

• Money someone else spends to pay expenses other than food or shelter (like medical or phone bills),

• The value of any food stamps,

• Income tax refunds,

• Grants, scholarships and fellowships for educational expenses

• Loans that you have to repay;

• Housing provided by a non-profit organization.

 

How is SSI different from Social Security benefits?

Supplemental Security Income (SSI) is often confused with Social Security benefits. Both programs are run through the Social Security Administration and many people are eligible for both. However, there are many differences between the two programs in who qualifies and how they are run, including:

• Eligibility. Anyone who pays into Social Security long enough is eligible for disability (SSDI) or retirement (RSDI) benefits. On the other hand, SSI benefits are not based on your work history, but your income and resources.

• Health Insurance. With Social Security benefits, you automatically qualify for Medicare after a 24-month waiting period. With SSI, you are automatically qualified for Medicaid through the Department of Children and Family Services (DFCS).

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What are my rights with SSI?

You have the right to:

• Apply for benefits. SSI applications are free;

• Get help from the Social Security Administration (SSA) to fill out the application and get documents;

• Get help from a third party to fill out your SSI claim. That person can be with you when you meet with the SSA;

• Have an attorney, or another qualified person, represent you;

• Get copies of the information in your record;

• Get a letter from SSA telling you if you qualify for benefits and how much money you will receive;

• Appeal SSA decisions about whether you qualify and the amount of SSI you are awarded;

• Get help from a free interpreter;

• Get help from SSA to get your medical records; and

• Get copies of any law, regulations or policy that SSA used to decide your claim.

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What are my responsibilities with SSI?

If you apply for SSI, the information you or your representative must be truthful. It is illegal to give SSA information you know is false.

• You are responsible for telling SSA all the sources of your medical treatment.

 

If you want to appeal a decision, you are responsible for notifying SSA within 60 days of the decision.

 

If you get SSI, you must tell SSA when your circumstances change. You must notify the SSA when:

• You move, or when anyone moves into or out of your home;

• There is a change in your income or resources (or the income of your spouse or parent);

• You go back to work;

• Your medical condition improves to the point where you are able to work;

• You get money from friends or family;

• Your marital status changes;

• Your spouse or anyone in your home dies;

• You become eligible for other benefits or payments;

• You enter or leave jail, a hospital or a nursing home;

• You have an arrest warrant for  escape from custody, fleeing to avoid prosecution or confinement;

• You start or leave school (if you are under 22);

• Your immigration status changes;

• You need to miss an appointment with SSA.

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Contents

• How can I qualify for SSI?
• How can I apply for SSI?
• What happens after I apply for SSI?
• How can I appeal an SSI decision?
• What can I do if I missed an appeal deadline or deadline to continue payments?
• What happens if I have an overpayment?

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How can I qualify for SSI?

You are eligible for SSI if you have limited income and resources and are:

• 65-years-old or older;

• Blind; or

• Disabled.

 

Blindness is defined as:

• Having vision of 20/200 or less in your better eye with corrective lenses; or

• Have a visual field limitation in your better eye.

 

For those under age 18, disabled is defined as a physical or mental impairment that:

• Results in marked and severe functional limitations; and

• Can be expected to result in death; or

• Has lasted or can be expected to last more than 12 months.

 

For those 18 years-old or older, disabled is defined as a physical or mental impairment which:

• Results in the inability to do any substantial gainful activity (generally earnings over $1,220/month); and

• Can be expected to result in death; or

• Has lasted or can be expected to last more than 12 months.

 

You also must:

• Be a citizen or legal immigrant,

• Not be out of the country for 30 consecutive days or more,

• Not be confined to an institution (a hospital or prison) that the government pays for,

• Apply for any cash benefits you are eligible for,

• Give SSA permission to contact any financial institution and request your financial records,

• File an application

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How can I apply for SSI?

You or your representative can apply for SSI: 

• Online, 

• Calling the Social Security Administration at 1-800-772-1213 (or TTY 1-800-325-0778) and making an appointment to apply, or

• VIsiting your local Social Security office to apply.

 

Once you have completed the application, SSA will decide whether you meet the income, resource and other eligibility requirements.

 

If you are disabled or blind and applying for SSI, you will need to provide:

• Your work history for the past 15 years,

• Information about your impairments,

• Information for doctors, hospitals, and any other medical sources you have seen,

• Dates and kinds of treatment you have received,

• Names of prescription and non-prescription medicine you take, 

• Any medical tests you’ve had done,

• For children, the child’s school and teacher, and a third party to assist with the claim.

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What happens after I apply for SSI?

If you are applying on the basis of disability or blindness, your local Social Security office will send your application to a State agency called the Disability Determination Services (DDS). The DDS will contact anyone who can provide information about your impairment, including doctors, hospitals, and therapists, to decide if you meet the definition of blindness or disability. The DDS will not examine you. If they cannot make a decision after looking at the information provided and talking to your doctors, the DDS will arrange for an examination and testing by a medical professional.

 

Decisions usually take about 3-4 months.

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How can I appeal an SSI decision?

SSI applications are often denied. You have the right to appeal if: 

• you are denied SSI, 

• you don’t agree with the amount you are offered, or 

• you have SSI and changes are made to your benefit amount.

 

There are four levels of appeal. If you do not get a favorable result at the first appeal, you can appeal to the next level. The levels are:

1. Reconsideration. You will get a letter after your application telling you what SSA decides in your case. After you get that letter, you must contact the SSA in writing within 60 days to request a reconsideration. You can make this request online or by mailing a Request for Reconsideration form to the SSA. If you are already receiving payments and you are appealing a termination decision, you only have 10 days to appeal if you want to continue receiving benefits.

 

A reconsideration is a review of the evidence by someone at SSA who did not take part in the original decision. 

 

2. Administrative Law Judge Hearing. If you disagree with the reconsideration decision, you can ask for a hearing. The administrative law judge will set the time and place of the hearing. Hearings might be conducted by video conference. Before the hearing SSA might ask you to submit more evidence to support your claim. At the hearing:

   1. The judge will question you and any witnesses you bring to support your application;

   2. The judge might also ask medical or vocational experts to give information;

   3. You or your representative may also question witnesses.

After the hearing you will get a letter telling you of the judge’s decision.

 

3. Appeals Council Review. If you disagree with the judge’s decision, you can appeal that decision to the Social Security Appeals Council. The council may:

   1. Review your case and issue a decision,

   2. Decline to review your case if they agree with the hearing decision,

   3. Send the case back to the hearing judge for another review.

You will receive a letter explaining whatever decision the Appeals Council makes.

 

4. Federal Court. You can appeal the Appeals Council’s decision or denial to a federal district court. The Appeals Council’s letter will tell you how to file a lawsuit to appeal your case.

 

Keeping record of your appeal

Missing your appeal deadline usually results in dismissal of your claim unless you can show good cause why you missed your deadline. For example, if you are hospitalized or incapacitated for some other reason, you may be able to show this as good cause for missing your deadline.

 

Missing your deadline could also result in losing continuing payments while your appeal is pending. 

 

Although you may appeal by phone or online, it is best to keep a copy of your appeal notice. If you are able to visit SSA in person and have a copy of your appeal notice stamped, this is the best way to prove you filed your appeal on time. 

 

Another method for documenting your appeal is to (1) make a copy of your appeal form; (2) write your Unites States Mail return receipt number on it; and (3) mail your appeal notice by United States Mail, Return Receipt requested. 

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What can I do if I missed an appeal deadline or deadline to continue payments?

You should immediately file a Request for Reconsideration (Form SSA-729) along with evidence of any good cause why you missed your deadline.

In some cases, you only have 10 days to continue receiving SSI after a decision has been made against you.  If you have missed the 10-day deadline to continue receiving payments, you should also file a Claimant’s Statement (Form SSA-795).

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What happens if I have an overpayment? 

An overpayment happens when  SSA gives you more money than what they believe you actually should have received. An overpayment might happen if:

• Your actual income is more than you estimated,

• Your marital status changes,

• You have more resources than the limit allows,

• You are no longer disabled but still continue to receive benefits,

• You do not report a change (on time or at all) as required, 

• The SSA incorrectly computes your benefit amount.

 

If SSA decides there was an overpayment, they will send you a notice asking for a full refund within 30 days. You can: 

• If you agree that there was an overpayment, you can enter a payment plan to repay the amount, 

• If you do not believe you were overpaid or if you think the amount is wrong, you can appeal.

  • You must appeal within 60 days of getting the overpayment letter.

• If you do not believe you should have to repay the amount, you can ask for a waiver. To get a waiver you must prove:

  • The overpayment was not your fault,

  • It would be a hardship for you to pay back the overpayment.

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