Social Security Fraud Reporting

Social Security Fraud Reporting

Provider: UNITED STATES SOCIAL SECURITY ADMINISTRATION

This program provides monthly income benefits to low-income people who are age 65 or older and for people of any age who are blind or disabled. Children may be eligible for SSI if they meet both the income and disability requirements.

CITIZENSHIP/ELIGIBILITY REQUIREMENTS SSI is available to U.S. citizens and to Legal Permanent Residents (LPRs) who were in the United States as of August 22, 1996. There are additional exemptions for LPR's.

INCOME & RESOURCE LIMITS SSI applicants must meet certain income and resource limits. Some disabled people may work and still receive benefits. "Countable income" may not exceed the maximum benefit level.

Social Security may not count the following as resources:

The home one lives in;

One car if it is used for work or medical treatment at least four times a year, or if it is specially equipped for a person with disabilities;

Wedding and engagement rings;

Burial plots.

Resource limits for SSI applicants are as follows:

$2,000 equity value of household goods and personal belongings

$4,500 for a car that is not used for work or medical appointments or that is not specially-equipped to transport a person with a disability;

$1,500 per person for the face value of life insurance plus any money specifically reserved for burial expenses ($1,800 if the money is held in an irrevocable trust);

an additional $2,000 in "other resources" for one person and $3,000 for a couple (this could include money in savings accounts or the values of household goods and personal belongings, a car, life insurance and burial expenses that are over the limits).

CITIZENSHIP/RESIDENCY REQUIREMENTS A person must reside in the U.S. and be a U.S. citizen, or, an immigrant lawfully admitted for permanent residence, or meets the criteria of "qualified alien".

SSI eligibility for a sponsored immigrant depends on the resources and income of the sponsor, sponsor's spouse, and on the immigrant's own resources and income. During the first five years after an immigrant's admission for permanent residence in the U.S., part of the sponsor's resources and income are considered to be the immigrant's and count in determining the immigrant's eligibility and payment amount. After this five year period the sponsor's resources and income do not count. This provision does not apply to immigrants who entered as refugees, who became blind or disabled after admission for permanent residence in the U.S., or who have been granted asylum.

DISABILITY REQUIREMENTS To qualify as disabled by SSI standards, a doctor chosen by the state must confirm that an applicant's physical or mental impairment can be expected to keep, or have kept, him or her from working for 12 continuous months or longer, or be expected to result in death.

People who are disabled must agree to participate in vocational rehabilitation if it is offered. People who are dependent on alcohol or drugs must agree to take part in a treatment program.

EMERGENCY ADVANCE An SSI recipient who does not receive his or her check and who, as a result, is in clear danger of starving, being evicted, or facing an equally serious emergency may be eligible for an advance of up to $400 from Social Security. To be eligible, people must have exhausted other available community resources that might be potential sources of temporary assistance.

In this type of true emergency situation, a person can go directly to any SSA office and apply for an emergency advance; going through the teleservice number may delay the loan. Applicants need to substantiate the urgent need for the money and the efforts they have made to locate other assistance. If they are granted an advance, the amount of the loan is deducted from a subsequent check.

SSI PAYMENT STANDARDS Effective July 1, 2012 Individual Couple Aged or Disabled 854 1,444 Blind 909 1,591 Disabled Minor 761 If a beneficiary is unable to handle his or her own financial affairs, SSA may appoint a relative, friend, or other interested party as a "representative payee." Representative Payees must file periodic accounting reports with SSA to show how the beneficiary's funds were spent or saved.

Recipients must report to SSA the following changes in circumstance which may affect their continued receipt of benefits:

changes of residence or mailing address

change in marital status

change of name

change in income or earnings

if a child is born or adopted

if a beneficiary is imprisoned

if they leave the United States

if a beneficiary dies

WORK INCENTIVES SSI/SSP and SSD Recipients Work Rules

The administration has created a set of rules which act as INCENTIVES for disabled people to go to work. The new rules are designed to (1) provide cash benefits while you work; (2) help with work expenses; (3) help with training, education and rehabilitation; and (4) help with medical bills.

Trial Work Period

HOW DOES WORK EFFECT SSD If you are receiving Social Security Disability (SSD) benefits and attempt to work, you are generally entitled to 12 months of work during which your earnings will not effect you benefits. This includes a trial work period of 9-months and a 3-month grace period before benefits stop.

At the end of the 9-month period (these months need not be in a row), the Social Security Office will review your earnings from work to see if they are substantial. Generally, if the average monthly earnings are $620 or more, the work is considered "substantial gainful activity" and your SSD benefits stop.

However, after the trial work period, there is a 36-month period of entitlement to benefits. For any month you cannot work, or if your earnings drop below $620, your benefits can be started up again without a new application, disability application or waiting period.

HOW DOES WORK EFFECT SSI/SSP SSI/SSP benefits will not be stopped, but will be reduced in proportion to the recipients earnings. NOTE: the formula to determine how much of reduction there will be in SSI/SSP payments is an INCENTIVE as working will result in a significantly higher income for the recipient. Here is the formula: (Gross Work Earnings - $85 Deductible)/ 2

SSI FOR CHILDREN To be eligible for SSI, a child must be both financially needy and blind or disabled. Special rules apply for low birth-weight infants who require hospitalization. For a child to qualify as disabled, his or her physical or mental impairment must:

limit the child's ability to function independently, appropriately, and effectively in an age-appropriate manner, and

if the condition is expected to last at least 12 months or to result in the child's death.

The resulting limitations must be comparable to those that would limit an adult. A medical diagnosis is required which must be supplemented with evidence from other sources, including teachers, day care workers, family members, or neighbors.

Financial need is determined by considering family income, both earned and unearned. In the case of low birth-weight infants, family income is not counted until the calendar month following the month that the infant goes home to live. In general terms, SSI is available to children whose families are low-income. The following chart shows the income guidelines used to determine financial eligibility:

Number of Maximum Earned Maximum Unearned Children with Monthly Income Monthly Income No Disability 1 parent/2 parent 1 parent/2 parent in Household households households 0 $1,326 $1,732 $ 854 $1,057 1 1,529 1,935 1,057 1,259 2 1,732 2,138 1,260 1,463 3 1,935 2,342 1,463 1,666 The limit increases by $203 for each additional child with no disability in the household.

In addition to income, Social Security considers a family's property when determining financial need. Social Security cannot count the family's house, cars used for commuting to work or to take a child with a disability to the doctor, personal and household belongings, equipment needed for work, pension funds, and life insurance policies worth up to $1,500. If a 2-parent family's additional resources, such as cash, add up to less than $5,000, or $4,000 for a 1-parent family, and falls within the above income guidelines, the family can qualify in terms of financial need.

APPEALS People have the right to appeal a decision that affects their eligibility for Social Security benefits. There are three steps in the appeals process available with SSA. Beyond that, people may take their case to a Federal court.

People who receive a notice that they have been overpaid should request to file a "waiver of overpayment" questionnaire. Overpayments of up to $500 may be waived if a request for waiver or reconsideration is made. If they believe that their check or any notice they receive is wrong, they should ask for a reconsideration.

DIRECT DEPOSIT Go Direct is a national campaign designed to motivate more Americans to select direct deposit for their Social Security, Supplemental Security Income (SSI) and other federal benefit payments. The U.S. Department of the Treasury and the Federal Reserve Banks are sponsoring this campaign. LANGUAGES OTHER THAN ENGLISH Spanish; other languages are available depending on the office. A translation service is available for all languages. APPLICATION PROCEDURE To file a claim for SSI, people walk in to any SSA office. People may call the teleservice center to make an appointment. Applicants should file a claim as soon as they become eligible. Applicants who are blind or who have a very obvious disability are presumptively eligible and approved more quickly than those who must have their disabilities verified. Contact the local office where the claim was filed with questions about the application process, including disability evaluation.

Applicants may need to present the following documents when they file a claim:

Social Security card (or a record of their social security number)

birth certificate

children's birth certificates (if they are applying)

marriage certificate (if signing up on a spouse's record)

most recent W-2 or, if self-employed, tax return, or other proof of income

check or other papers with bank account number if direct deposit is requested

names, addresses, and phone numbers of providers that have provided treatment

Applicants for direct deposit can refer to www.godirect.org or call the contact numbers listed. FEES/PAYMENT SOURCE There are no fees for service.
Application Procedure
Languages
Spanish
Service Condition Fee

Free

Free

Service/Intake

(800) 269-0271 (Fraud Hotline - Inspector General) (800) 772-1213 (National, Toll Free Number) (866) 968-7842 (Ticket to Work - Maximus) (888) 741-1115 (Direct Express Card Customer Service)

TDD

(800) 325-0778 (866) 833-2967 (Ticket to Work - Maximus)

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