[0:01] If you're applying for disability benefits or help people that are, the path to success has never been more complicated.
[0:06] Welcome to the Disability Expert Podcast, where we tackle the difficult issues and interview the country's top experts to help you better navigate the disability process.
[0:15] Winning a disability case is hard and keeps getting tougher every day.
[0:19] We can't promise you'll win your case by listening, but we sure think it's going to help.
[0:24] This really isn't that complicated. I mean, you want to win your case, don't you?
[0:29] Well, then listen to what I say.
[0:31] Hey, it's Chad Brown. Welcome to another episode of the Disability Expert Podcast, where we go through all things, social disability, with my trusted associate and sidekick here in Dalton.
[0:41] Hey, good to be that.
[0:42] Yeah, we are back again with another tentillating topic.
[0:48] The one the listeners have been begging for us to talk about.
[0:52] The always simple to explain, never misunderstood topic of SSI
[1:00] or supplemental security income.
[1:03] So, you know, we've been going through and looking at, we looked at a bunch of big topics.
[1:09] We talked about some medical conditions.
[1:11] I know in the past couple of weeks, we went through children's benefits,
[1:14] which are a program within the SSI, and we talked about disabled adult child benefits, which was also confusing.
[1:23] So we just said, hey, in that episode, we realized, hey, we've never actually talked about SSI.
[1:28] It is really a big part of the disability process, and so I thought what I'd do today is we would stop and do a, oh, let's say 50,000 foot overview of SSI.
[1:43] It's going to be an overview.
[1:45] The SSI gets really technical very quickly.
[1:49] There's a number of issues, because it's an entitlement program or a welfare based program.
[1:56] There's very stringent requirements for resources and income.
[2:01] They get complex really quickly.
[2:03] I don't think it's, I don't think it really helps anyone to try to go through really specific examples for SSI eligibility, looking at the income and resources components, just because everybody's case is different.
[2:17] And honestly, there's just so many factors that go into eligibility.
[2:24] So what I'm really hoping to do is say, can we give a broad introduction to SSI?
[2:29] What is SSI?
[2:30] How did the programs work?
[2:32] What are sort of the roadblocks or thresholds that you have to get across to get inside the program?
[2:39] And that way, at least someone who's saying, hey, I'm trying to get on disability, but I've heard about SSI or looking at child benefits, how do they work?
[2:49] At least they have a framework of saying, okay, this is a different program.
[2:52] It has similarities, but it has differences.
[2:55] So let's hopefully be able to go through and sort of explain what those are, so at least someone saying, hey, okay, at least I know what SSI is.
[3:02] I see how it might possibly impact me.
[3:05] And at the end of the day, candidly eligibility is going to be very, very fact specific.
[3:10] And so, you know, either working with the Social Security Administration specifically when you're trying to determine eligibility working with an attorney, someone who has a good understanding of the rules.
[3:21] So with that being said, I think the first thing people need to understand is SSI in the disability context is not about work.
[3:30] It's not a system where you pay in, it's truly needs based.
[3:36] Actually, there's sort of three different gateways you can come into the SSI program.
[3:41] There is SSI supplemental security income for the elderly.
[3:46] So when you reach 65, you can be eligible for SSI.
[3:50] There's program for persons that are blind, which starts to mirror.
[3:54] There's a blind disability program.
[3:56] Well, there's a blind SSI program as well.
[3:58] And then the third gateway would be establishing disability.
[4:03] And the standard that they're going to use though for establishing disability with SSI is going to be the same as someone who's trying to get a disability insurance benefits, who's actually worked and paid in the system.
[4:14] So I think the first sort of takeaway is understand this is a needs based program.
[4:19] It is an entitlement program.
[4:21] Basically, the government is stepped in and said we believe certain people in certain categories need money.
[4:28] They need resources. They need insurance.
[4:32] So most people on SSI are going to get Medicaid rather than get Medicare.
[4:36] So I think that's sort of the first big distinction people need to understand is this is not a program.
[4:43] This based on your work history is based almost purely on financial need and coming into the system through one of the three ways.
[4:51] With that being said, because it's a need based system immediately, we're into the fact that there are financial barriers or parameters.
[5:00] So generally they're going to fall into categories.
[5:03] We're going to have resources issues and we're going to have income issues.
[5:07] So let's just start with the resources because I believe of the two sort of barriers to getting into SSI,
[5:14] it's maybe the easiest to understand.
[5:16] So talk a little bit about what are resource limits?
[5:19] How do they impact SSI eligibility?
[5:22] What kind of things do people need to be aware of?
[5:24] Just sort of walk through.
[5:25] What's the big picture that the Social Security Administration is looking for in making decisions about resources?
[5:32] So with resources, they're essentially looking at things you already have.
[5:36] They're not looking at the income which we'll talk about in a minute.
[5:40] For individuals, the sort of the big picture is do you have two thousand dollars or more in resources for couples?
[5:49] That's three thousand dollars or more.
[5:51] Now, our listeners are probably thinking that's not a lot of money and you're absolutely correct.
[5:56] It is not a lot of money.
[5:57] I mean, a two thousand dollar resource cap or a three thousand dollar couple resource cap.
[6:02] We're going to talk about the exceptions and exclusions here in a second.
[6:05] But understand at the very beginning, this is for people who literally are in some respects destitute.
[6:13] They don't have financial means income.
[6:17] They don't have substantial resources.
[6:19] That's why they're eligible for need-based assistance.
[6:23] So talk about though the resources though.
[6:27] So it's a two thousand for individuals, three thousand for couples.
[6:30] But what are the exclusions? Because there are some exclusions.
[6:33] So for exclusions, the house that you live in is not counted as a resource.
[6:41] One vehicle is not counted as a resource.
[6:45] Personal property, you know, your furniture, your clothes, your dog or your cat, those are not counted as resources.
[6:53] However, money in the bank, money in retirement accounts, some life insurance policies with a cash value.
[7:03] Things like that are all going to be counted as resources.
[7:06] Let's get back to the, it's so funny.
[7:08] We used to, I used to, you get into this issue of residents.
[7:11] Let's just start with that.
[7:12] So it's your principal residence that is you can own a residence that you that you actually live at.
[7:18] So what happens if someone say owns a property but they rent another house so they don't actually live in their residence?
[7:26] How does that work?
[7:27] That's going to be a resource. You don't live there.
[7:30] So you get one car.
[7:33] Yes.
[7:34] What about boats?
[7:35] It's a great question.
[7:37] Yeah, the resources.
[7:38] So the boats, what people run into this issue where if it's not personal items, you know, they have mobile homes.
[7:49] Or they have a Winnebago.
[7:51] Even though it's broken down in the back and has it run in 12 years, right?
[7:55] They get into vehicles where you have, I call it the banger vehicle that's in their yard, right?
[8:03] We see that scenario all the time.
[8:05] So talk through that.
[8:07] So you get one car that's excluded.
[8:10] What about your second and third car that are in the, you know, one of them doesn't run and one of them's in the,
[8:18] one of them's in the yard up on block.
[8:20] So we make these sort of caricatures.
[8:22] But really this is what happens a lot here where they call us.
[8:25] So they're going to count as resources.
[8:27] So what's sort of the strategy for saying, hey, how do we value these correctly so that maybe someone's not excluded because they've got this junk or car with a, you know, with a salvage title that they can't sell.
[8:40] Right. So ultimately, the question is, are all of the resources worth more than $2,000?
[8:45] So one of the things we're going to be looking at is, you know, is the fair market value of these cars actually, you know, $400 for scrap metal or at a pull apart junk yard.
[8:56] And so proving that and so maybe you have two junk cars sitting in the front yard and together, they're worth $800.
[9:03] Well, assuming your other resources don't put you over the limit, that won't necessarily disqualify you.
[9:10] But if Social Security is looking and they can't tell that those are only worth $400 each, then that's going to be a problem.
[9:17] Yeah, I mean, I think in some scenarios, in the past, even we, you know, we will go to, like, we'll go to car dealers and say, hey, can you give us what a fair market value of this vehicle actually is.
[9:26] You know, and they'll look at it and say, well, it's on the tax books at this amount, but I mean, this car is basically not drivable like there's no market for this.
[9:34] It's worth whatever the scrap value is, which is maybe $100.
[9:37] You know, it's funny, I used to tell people, look, you can, you can live in a multi-million dollar mansion and have one vehicle that's a Ferrari and get SSI.
[9:45] But if you, but if you, you know, you can, you can live in a sort of a rundown shack and have two vehicles and one of them be worth $4,000 in your disqualified.
[9:57] So it's just understanding that there are exclusions, there are resources there.
[10:03] But you can't just assume that the valuations that the, that so screen administration is going to place on your resources that are counting or correct.
[10:12] So one of the big takeaways we have for people with resources is understand if you have excess resources, you need to make sure they're valued properly.
[10:22] Which leads to a second question in a related issue, which is disposal of resources.
[10:27] So sometimes people come to us and they say, well, I'm just going to give that car away.
[10:32] Yeah, please don't.
[10:33] Yeah, so what's what's the proper way to dispose of additional resources so that you can gain eligibility in the future?
[10:40] What should people be doing in that scenario?
[10:43] Best case scenario, you need to be getting fair market value for that resource.
[10:49] And really, you should be tracking how you're spending down the money you got from that transaction.
[10:54] So what we like to be able to do is go into social security and say, okay, you know, there's this car that was worth $4,000.
[11:02] We sold the car for $4,000.
[11:04] We spent that $4,000 in such and such a way.
[11:07] And now we're below the $2,000 amount.
[11:12] I think generally people need to understand that there's sort of a phrase, it's an arm's length transaction.
[11:17] So there needs to be, this needs to be legitimate transfers of the resources, which happens.
[11:22] A lot of times people come to us and we're like, look, you need to, you need to sell the old one a bago that doesn't run.
[11:27] You need to get rid of the car.
[11:29] You need to make these transactions because in, you know, literally in 30 to 60 days, you're probably going to be eligible.
[11:36] But right now you're not going to be.
[11:38] So when it comes to resources, I think you need to know the number, you need to understand the exclusions.
[11:43] And if you have resources that are disqualifying you, you need to give a lot of thought to whether it makes sense to dispose of those, dispose of those resources.
[11:53] And if you do, make sure you do it correctly under the law.
[11:55] So that's just resources though.
[11:58] The other gateway to SSI is looking at income.
[12:02] So walk through, so what are the types of income that they look at?
[12:06] How do they sort of evaluate?
[12:08] Do they count all the money? Do they only count some of it?
[12:11] What if you're married?
[12:12] Can you just sort of walk through how the income component works to see if you're qualifying for SSI benefits?
[12:18] So starting off with income, that's your income.
[12:21] They're looking at earned versus unearned.
[12:24] So earned would be wages.
[12:26] Unearned might be money from investments or something like that.
[12:32] They also, however, look at income.
[12:35] If you're married, they look at your spouse's income.
[12:39] When they're looking at earned income for yourself, so you have a part-time job, for example.
[12:46] They might not count the full amount of the money that you make from your part-time job.
[12:51] So let's just stop right there and sort of break it down a little bit.
[12:53] Because you really, what you run into are you have earned income, which is just money that you earn.
[13:00] Typically, it's a W2 type income.
[13:02] It could be self-employment income, which is another great different topic for today that can get complicated.
[13:10] But the reality is that you have earned income.
[13:14] Then you have unearned income, which we typically would call passive income.
[13:17] It could be a pension plan that you had where you get a couple hundred dollars a month from where you worked at a company 20 years ago.
[13:24] It could be money off of investments.
[13:27] I'll say you own some sort of real estate.
[13:31] But then again, you start to realize, okay, now we're back into resources.
[13:35] So usually what we're looking at for people in this scenario is going to be sort of passive retirement and those type of income.
[13:45] But then you have what I think is more properly called deemed income.
[13:49] You talked about this with the fact that when people are married.
[13:52] So when you look at spousal, when you look at SSI benefits for someone who is trying to get those benefits, but their spouse is not,
[14:03] it's treated differently than if both people, both people, both people, both partners in the couple.
[14:12] Callie, that's just not very clean.
[14:14] All right, whatever.
[14:15] They're married people, right?
[14:17] Okay.
[14:18] Where they're holding themselves out.
[14:20] Don't even get into holding out.
[14:22] So there's lots of people you can be treated as if you're married as if you're holding yourself out to be married.
[14:27] Regardless, we have a couple.
[14:29] All right.
[14:30] Maybe they're married.
[14:31] Maybe they're not married.
[14:32] Maybe they're treating them as they're married.
[14:33] But if both of them are eligible, how their income is treated is different.
[14:38] Just talk just briefly about the person who is married to a simple example.
[14:44] They're married to someone who is not eligible for SSI.
[14:48] Talk about what they're going to do to that spouse's income and how they're going to count it towards the person who's trying to get benefits.
[14:55] There's a chart that Social Security has where they look at, okay, we have this married couple.
[15:00] Are there minor children in the house, how many minor children, and they're working through that chart to figure out how much
[15:07] of the non SSI eligible spouses income is going to be attributed to or deemed to the person who's trying to get SSI.
[15:16] And what we see from the chart is it's very easy for your spouses income to disqualify you from SSI.
[15:23] And generally, this is just generally, they're going to, they're going to deem about half of their income to you.
[15:30] So, if your spouse makes $4,000 a month, they're going to deem $2,000 of that to you, which is almost immediately going to disqualify you.
[15:39] But then you have people who have smaller amounts and sometimes it doesn't disqualify you.
[15:43] So, I think with, if both people are trying to get SSI benefits, then they use a completely different calculation, which I'm not going to get into just because of time constraints.
[15:55] But understand, when you're trying to come into the SSI program, and let's just say they're trying to come in for disability purposes, they're disabled, they don't have a work history, they don't have insurance status with Social Security Administration.
[16:09] But they have a real need, they have a need for income, they have a need for insurance, they're going to, they're going to do an assessment of your resources, they're going to do an assessment of your income.
[16:20] And generally, what they're going to do is, in some respects, they work, how it impacts you is, it sort of works backwards.
[16:31] So, if you have an individual SSI for 2026, it's 990 something, I think is what the number is, I don't, I don't exactly have it on top of my head.
[16:40] But what they're going to do is they're going to look at your income and they're going to, they're generally for your earned income, they're going to reduce it by half.
[16:49] Now, there's a couple of other exceptions, but just hang with me here. So, so if you're making a thousand dollars working part time, generally, let's just say they're going to count 500 of that against you.
[16:59] And what they're going to do is reduce that from the 994 or 96, I can't, I don't know why, I think I would have got the number before we shot the FSA, but I don't remember.
[17:08] So, they're going to take that away, and that means the only eligibility you're going to have would be for that 400 plus or minus dollars later.
[17:15] If you have a spouse who's working, and let's say they're making 300 dollars a month, now they're going to deem another 150 of that income to you.
[17:24] So, now you've got 500 for you and 150 for your spouse, so you're at 650. So, what they're doing though, is looking at how much they're of the SSI you're actually eligible to receive.
[17:36] So, what practically happens is you go into the program, and they run this calculation on the back end, for disability purposes, I think the more prudent thing to do is to try to run the calculation on the front end so that you don't end up going through the whole process and then learn when the local office does your SSI assessment that you're not eligible.
[18:00] And so, when we're talking about this specifically in the disability context, one of the sort of entry level screenings that we're going to do is we're going to do a resources and assets assessment, and we're going to look at the resources you have, we're going to ask you these questions, do you have a house, do you have a car, do you have multiple cars, do you have a boat, do you have a win a bago, do you own any land.
[18:23] We're going to go through those with you, and the reason is we're trying to assess, are you going to get disqualified for resources. Second thing you're going to do is you're going to go through and look at income, do you have earned income, do you have passive income, do you have spousal income that's going to be attributed to you, do you have VA benefits, do you have some sort of pension.
[18:41] And so, the reason that you're trying to do that is because the disability process takes a long time, it's very frustrating for people. And you really need to sort of do a baseline assessment at the beginning.
[18:54] Now, the reality though is that with a lot of cases, it's hard to tell exactly. And sometimes it's hard to get a perfectly clear answer about whether you're going to be eligible or whether you're going to be eligible every month, because it is a month to month.
[19:08] It is a sort of a month of assessment that they're going to do. I think the big takeaway for people though is understand if you're disabled and you haven't worked or you haven't worked in a long time, and you don't have insured status for purposes of disability benefits, SSI is available to you.
[19:26] If you can sort of go through the right doorways, you're over 65 or blind, that's typically not what we're dealing with, right. We're dealing people with people who are disabled or dealing with disabilities that keep them from working.
[19:40] And just understand you're going to have to meet the resources, we're going to meet the income. And then when we get to the disability components, you've got all the same issues that you have before, right.
[19:50] We've got to go through the five-step sequential evaluation process, we get an episode on that, so watch that if you don't know what that is.
[19:56] You have to prove you're disabled under basically the same standard as you do for someone who works, but there's this additional set of requirements that are there.
[20:07] Finally though, one of the things I want to talk about is the fact that there is dual eligibility. Some clients that we work with get both disability benefits and SSI benefits.
[20:19] So can you talk a little bit just about how that works, and then maybe just a little bit about applications and how applications work because some preserve all, some don't preserve all, and we run into these situations where sometimes people have filed the right application.
[20:33] Let's just talk a little bit about how dual eligibility works.
[20:36] So there's two ways that dual eligibility can apply with SSDI, which is based on the work record. There is a five-month waiting period where the claimant does not get paid anything for the first five months of disability.
[20:49] If they're otherwise eligible for SSI under all the things that we've talked about today, they can actually get SSI payments for that five months that they're waiting.
[21:00] Assuming with the filing date and everything that that lines up.
[21:04] For a lot of our clients, they get paid during that first five month waiting period, and then once their SSDI kicks in, that is unearned income, that is greater than the SSI amount, so just the SSDI makes them ineligible for the SSI.
[21:22] However, some of our clients who maybe have had very limited work enough to receive SSDI, but maybe the SSDI amount is pretty low, two or three hundred dollars a month.
[21:36] Then the SSI can come in on top of that and sort of make up the difference.
[21:42] However, I always try to make sure that clients understand it's not SSI plus your SSDI amount.
[21:49] So what actually ends up happening is say you're getting 300 based on your work record a month, they subtract that from the 994 SSI.
[21:58] You can get both at the same time, which is important because people who get at least $1 of SSI get Medicaid, which in some respects is not as good as Medicare, but in other respects potentially is better depending on what your medical conditions are and how that's treated.
[22:16] But it's important because the dual eligible person who is eligible for ongoing dual benefits, not just in that five month weight window, but they're getting an SSI check and a DiB check every month.
[22:27] They're going to be eligible for Medicare and Medicaid, which is important because the Medicaid is typically also going to allow them access to Medicaid subsidies, which is going to pay for their Medicare premium, can pay for their copays, makes them eligible for what are called D-snips or dual special needs plans, Medicare Advantage plans,
[22:45] or they can not only get all of their medical care paid for, they can get substantial additional benefit, like money for groceries and things of that nature.
[22:53] So it's important that people understand there are both programs and they can work together. However, the applications are actually different with the applications, what happens is because SSI is a need based program, it actually preserves an application for a disability claim.
[23:11] But with a disability application, it does not preserve a claim for SSI benefits.
[23:17] So sometimes we have people come in and they've only applied for title two or disability benefits and we realize, oh, you're probably eligible for some SSI as well.
[23:28] And you have to go back and actually file a separate application for the SSI, then you have to try to get them to escalate it and combine the claims and that's another whole mess.
[23:38] But just understand there are two separate programs. They have a lot of similarities in how they establish disability.
[23:45] Obviously the gateway to getting into the disability program is you have to have insurance status, you have to work and pay into the system and have sufficient quarters of coverage and all those requirements.
[23:55] The gateway into the SSI program is that you have true financial need as demonstrated by limited resources and limited income.
[24:03] But for a lot of people, they need to be pursuing both avenues at the same time, but the application process for both is different.
[24:12] Now with that being said, it's a security of do both applications at the same time.
[24:17] And a lot of times that's what we do for clients when we file their initials.
[24:20] So hey, we'll work the security administration, get the SSI application completed, we'll do the disability application and they run through the system together simultaneously.
[24:29] But just be aware that if you just have a disability application, but you have SSI eligibility, it's not going to allow you access into that program, which also matters because SSI has no retroactive coverage.
[24:46] Because it's a need based program, your only eligible to get benefits for SSI from the month, typically the month following your application.
[24:53] And where a disability application has, you can get benefits for a year prior to your application.
[24:59] So all that being said, there are two different programs.
[25:02] A lot of times people have access to both, but understand you're going to need to file applications for both.
[25:07] For people who are on SSI, I think they need to understand with a disability claim, you are going to have continuing disability reviews that look at your medical.
[25:17] But with SSI, they're going to do a re-determination of your eligibility based on resources and income.
[25:23] And you just need to be aware that not only is that going to happen to you probably every year, you also have an ongoing obligation to disclose to them if your resource or income change, which is a problem because it can produce overpayments, it can disqualify you for benefits, which means now you're having benefits you're not supposed to.
[25:41] And all they do, they take them, then they try to collect the overpayment from you, so a lot of issues there.
[25:48] Well, that's all we got. There's more to it.
[25:52] But at the end of the day, I think the big takeaway is SSI is a need based program.
[25:58] And if you're disabled, it very likely could help you.
[26:01] But no, there are going to be resources and income factors that go into whether you're eligible.
[26:07] You're still going to have to meet the disability, eligibility requirements.
[26:11] But at the end of the day, SSI is literally a lifesaver for a large part of our elderly population, for those who have not been able to sustain work in a way they can get D.I.B benefits.
[26:24] And honestly, a lot of times just to Medicaid alone is the thing that actually helps them have a quality of life that's meaningful.
[26:32] So that's it. That's all we got for today. That's SSI.
[26:36] And hope you enjoy the show. Subscribe till next time. Take care.
[0:06] Welcome to the Disability Expert Podcast, where we tackle the difficult issues and interview the country's top experts to help you better navigate the disability process.
[0:15] Winning a disability case is hard and keeps getting tougher every day.
[0:19] We can't promise you'll win your case by listening, but we sure think it's going to help.
[0:24] This really isn't that complicated. I mean, you want to win your case, don't you?
[0:29] Well, then listen to what I say.
[0:31] Hey, it's Chad Brown. Welcome to another episode of the Disability Expert Podcast, where we go through all things, social disability, with my trusted associate and sidekick here in Dalton.
[0:41] Hey, good to be that.
[0:42] Yeah, we are back again with another tentillating topic.
[0:48] The one the listeners have been begging for us to talk about.
[0:52] The always simple to explain, never misunderstood topic of SSI
[1:00] or supplemental security income.
[1:03] So, you know, we've been going through and looking at, we looked at a bunch of big topics.
[1:09] We talked about some medical conditions.
[1:11] I know in the past couple of weeks, we went through children's benefits,
[1:14] which are a program within the SSI, and we talked about disabled adult child benefits, which was also confusing.
[1:23] So we just said, hey, in that episode, we realized, hey, we've never actually talked about SSI.
[1:28] It is really a big part of the disability process, and so I thought what I'd do today is we would stop and do a, oh, let's say 50,000 foot overview of SSI.
[1:43] It's going to be an overview.
[1:45] The SSI gets really technical very quickly.
[1:49] There's a number of issues, because it's an entitlement program or a welfare based program.
[1:56] There's very stringent requirements for resources and income.
[2:01] They get complex really quickly.
[2:03] I don't think it's, I don't think it really helps anyone to try to go through really specific examples for SSI eligibility, looking at the income and resources components, just because everybody's case is different.
[2:17] And honestly, there's just so many factors that go into eligibility.
[2:24] So what I'm really hoping to do is say, can we give a broad introduction to SSI?
[2:29] What is SSI?
[2:30] How did the programs work?
[2:32] What are sort of the roadblocks or thresholds that you have to get across to get inside the program?
[2:39] And that way, at least someone who's saying, hey, I'm trying to get on disability, but I've heard about SSI or looking at child benefits, how do they work?
[2:49] At least they have a framework of saying, okay, this is a different program.
[2:52] It has similarities, but it has differences.
[2:55] So let's hopefully be able to go through and sort of explain what those are, so at least someone saying, hey, okay, at least I know what SSI is.
[3:02] I see how it might possibly impact me.
[3:05] And at the end of the day, candidly eligibility is going to be very, very fact specific.
[3:10] And so, you know, either working with the Social Security Administration specifically when you're trying to determine eligibility working with an attorney, someone who has a good understanding of the rules.
[3:21] So with that being said, I think the first thing people need to understand is SSI in the disability context is not about work.
[3:30] It's not a system where you pay in, it's truly needs based.
[3:36] Actually, there's sort of three different gateways you can come into the SSI program.
[3:41] There is SSI supplemental security income for the elderly.
[3:46] So when you reach 65, you can be eligible for SSI.
[3:50] There's program for persons that are blind, which starts to mirror.
[3:54] There's a blind disability program.
[3:56] Well, there's a blind SSI program as well.
[3:58] And then the third gateway would be establishing disability.
[4:03] And the standard that they're going to use though for establishing disability with SSI is going to be the same as someone who's trying to get a disability insurance benefits, who's actually worked and paid in the system.
[4:14] So I think the first sort of takeaway is understand this is a needs based program.
[4:19] It is an entitlement program.
[4:21] Basically, the government is stepped in and said we believe certain people in certain categories need money.
[4:28] They need resources. They need insurance.
[4:32] So most people on SSI are going to get Medicaid rather than get Medicare.
[4:36] So I think that's sort of the first big distinction people need to understand is this is not a program.
[4:43] This based on your work history is based almost purely on financial need and coming into the system through one of the three ways.
[4:51] With that being said, because it's a need based system immediately, we're into the fact that there are financial barriers or parameters.
[5:00] So generally they're going to fall into categories.
[5:03] We're going to have resources issues and we're going to have income issues.
[5:07] So let's just start with the resources because I believe of the two sort of barriers to getting into SSI,
[5:14] it's maybe the easiest to understand.
[5:16] So talk a little bit about what are resource limits?
[5:19] How do they impact SSI eligibility?
[5:22] What kind of things do people need to be aware of?
[5:24] Just sort of walk through.
[5:25] What's the big picture that the Social Security Administration is looking for in making decisions about resources?
[5:32] So with resources, they're essentially looking at things you already have.
[5:36] They're not looking at the income which we'll talk about in a minute.
[5:40] For individuals, the sort of the big picture is do you have two thousand dollars or more in resources for couples?
[5:49] That's three thousand dollars or more.
[5:51] Now, our listeners are probably thinking that's not a lot of money and you're absolutely correct.
[5:56] It is not a lot of money.
[5:57] I mean, a two thousand dollar resource cap or a three thousand dollar couple resource cap.
[6:02] We're going to talk about the exceptions and exclusions here in a second.
[6:05] But understand at the very beginning, this is for people who literally are in some respects destitute.
[6:13] They don't have financial means income.
[6:17] They don't have substantial resources.
[6:19] That's why they're eligible for need-based assistance.
[6:23] So talk about though the resources though.
[6:27] So it's a two thousand for individuals, three thousand for couples.
[6:30] But what are the exclusions? Because there are some exclusions.
[6:33] So for exclusions, the house that you live in is not counted as a resource.
[6:41] One vehicle is not counted as a resource.
[6:45] Personal property, you know, your furniture, your clothes, your dog or your cat, those are not counted as resources.
[6:53] However, money in the bank, money in retirement accounts, some life insurance policies with a cash value.
[7:03] Things like that are all going to be counted as resources.
[7:06] Let's get back to the, it's so funny.
[7:08] We used to, I used to, you get into this issue of residents.
[7:11] Let's just start with that.
[7:12] So it's your principal residence that is you can own a residence that you that you actually live at.
[7:18] So what happens if someone say owns a property but they rent another house so they don't actually live in their residence?
[7:26] How does that work?
[7:27] That's going to be a resource. You don't live there.
[7:30] So you get one car.
[7:33] Yes.
[7:34] What about boats?
[7:35] It's a great question.
[7:37] Yeah, the resources.
[7:38] So the boats, what people run into this issue where if it's not personal items, you know, they have mobile homes.
[7:49] Or they have a Winnebago.
[7:51] Even though it's broken down in the back and has it run in 12 years, right?
[7:55] They get into vehicles where you have, I call it the banger vehicle that's in their yard, right?
[8:03] We see that scenario all the time.
[8:05] So talk through that.
[8:07] So you get one car that's excluded.
[8:10] What about your second and third car that are in the, you know, one of them doesn't run and one of them's in the,
[8:18] one of them's in the yard up on block.
[8:20] So we make these sort of caricatures.
[8:22] But really this is what happens a lot here where they call us.
[8:25] So they're going to count as resources.
[8:27] So what's sort of the strategy for saying, hey, how do we value these correctly so that maybe someone's not excluded because they've got this junk or car with a, you know, with a salvage title that they can't sell.
[8:40] Right. So ultimately, the question is, are all of the resources worth more than $2,000?
[8:45] So one of the things we're going to be looking at is, you know, is the fair market value of these cars actually, you know, $400 for scrap metal or at a pull apart junk yard.
[8:56] And so proving that and so maybe you have two junk cars sitting in the front yard and together, they're worth $800.
[9:03] Well, assuming your other resources don't put you over the limit, that won't necessarily disqualify you.
[9:10] But if Social Security is looking and they can't tell that those are only worth $400 each, then that's going to be a problem.
[9:17] Yeah, I mean, I think in some scenarios, in the past, even we, you know, we will go to, like, we'll go to car dealers and say, hey, can you give us what a fair market value of this vehicle actually is.
[9:26] You know, and they'll look at it and say, well, it's on the tax books at this amount, but I mean, this car is basically not drivable like there's no market for this.
[9:34] It's worth whatever the scrap value is, which is maybe $100.
[9:37] You know, it's funny, I used to tell people, look, you can, you can live in a multi-million dollar mansion and have one vehicle that's a Ferrari and get SSI.
[9:45] But if you, but if you, you know, you can, you can live in a sort of a rundown shack and have two vehicles and one of them be worth $4,000 in your disqualified.
[9:57] So it's just understanding that there are exclusions, there are resources there.
[10:03] But you can't just assume that the valuations that the, that so screen administration is going to place on your resources that are counting or correct.
[10:12] So one of the big takeaways we have for people with resources is understand if you have excess resources, you need to make sure they're valued properly.
[10:22] Which leads to a second question in a related issue, which is disposal of resources.
[10:27] So sometimes people come to us and they say, well, I'm just going to give that car away.
[10:32] Yeah, please don't.
[10:33] Yeah, so what's what's the proper way to dispose of additional resources so that you can gain eligibility in the future?
[10:40] What should people be doing in that scenario?
[10:43] Best case scenario, you need to be getting fair market value for that resource.
[10:49] And really, you should be tracking how you're spending down the money you got from that transaction.
[10:54] So what we like to be able to do is go into social security and say, okay, you know, there's this car that was worth $4,000.
[11:02] We sold the car for $4,000.
[11:04] We spent that $4,000 in such and such a way.
[11:07] And now we're below the $2,000 amount.
[11:12] I think generally people need to understand that there's sort of a phrase, it's an arm's length transaction.
[11:17] So there needs to be, this needs to be legitimate transfers of the resources, which happens.
[11:22] A lot of times people come to us and we're like, look, you need to, you need to sell the old one a bago that doesn't run.
[11:27] You need to get rid of the car.
[11:29] You need to make these transactions because in, you know, literally in 30 to 60 days, you're probably going to be eligible.
[11:36] But right now you're not going to be.
[11:38] So when it comes to resources, I think you need to know the number, you need to understand the exclusions.
[11:43] And if you have resources that are disqualifying you, you need to give a lot of thought to whether it makes sense to dispose of those, dispose of those resources.
[11:53] And if you do, make sure you do it correctly under the law.
[11:55] So that's just resources though.
[11:58] The other gateway to SSI is looking at income.
[12:02] So walk through, so what are the types of income that they look at?
[12:06] How do they sort of evaluate?
[12:08] Do they count all the money? Do they only count some of it?
[12:11] What if you're married?
[12:12] Can you just sort of walk through how the income component works to see if you're qualifying for SSI benefits?
[12:18] So starting off with income, that's your income.
[12:21] They're looking at earned versus unearned.
[12:24] So earned would be wages.
[12:26] Unearned might be money from investments or something like that.
[12:32] They also, however, look at income.
[12:35] If you're married, they look at your spouse's income.
[12:39] When they're looking at earned income for yourself, so you have a part-time job, for example.
[12:46] They might not count the full amount of the money that you make from your part-time job.
[12:51] So let's just stop right there and sort of break it down a little bit.
[12:53] Because you really, what you run into are you have earned income, which is just money that you earn.
[13:00] Typically, it's a W2 type income.
[13:02] It could be self-employment income, which is another great different topic for today that can get complicated.
[13:10] But the reality is that you have earned income.
[13:14] Then you have unearned income, which we typically would call passive income.
[13:17] It could be a pension plan that you had where you get a couple hundred dollars a month from where you worked at a company 20 years ago.
[13:24] It could be money off of investments.
[13:27] I'll say you own some sort of real estate.
[13:31] But then again, you start to realize, okay, now we're back into resources.
[13:35] So usually what we're looking at for people in this scenario is going to be sort of passive retirement and those type of income.
[13:45] But then you have what I think is more properly called deemed income.
[13:49] You talked about this with the fact that when people are married.
[13:52] So when you look at spousal, when you look at SSI benefits for someone who is trying to get those benefits, but their spouse is not,
[14:03] it's treated differently than if both people, both people, both people, both partners in the couple.
[14:12] Callie, that's just not very clean.
[14:14] All right, whatever.
[14:15] They're married people, right?
[14:17] Okay.
[14:18] Where they're holding themselves out.
[14:20] Don't even get into holding out.
[14:22] So there's lots of people you can be treated as if you're married as if you're holding yourself out to be married.
[14:27] Regardless, we have a couple.
[14:29] All right.
[14:30] Maybe they're married.
[14:31] Maybe they're not married.
[14:32] Maybe they're treating them as they're married.
[14:33] But if both of them are eligible, how their income is treated is different.
[14:38] Just talk just briefly about the person who is married to a simple example.
[14:44] They're married to someone who is not eligible for SSI.
[14:48] Talk about what they're going to do to that spouse's income and how they're going to count it towards the person who's trying to get benefits.
[14:55] There's a chart that Social Security has where they look at, okay, we have this married couple.
[15:00] Are there minor children in the house, how many minor children, and they're working through that chart to figure out how much
[15:07] of the non SSI eligible spouses income is going to be attributed to or deemed to the person who's trying to get SSI.
[15:16] And what we see from the chart is it's very easy for your spouses income to disqualify you from SSI.
[15:23] And generally, this is just generally, they're going to, they're going to deem about half of their income to you.
[15:30] So, if your spouse makes $4,000 a month, they're going to deem $2,000 of that to you, which is almost immediately going to disqualify you.
[15:39] But then you have people who have smaller amounts and sometimes it doesn't disqualify you.
[15:43] So, I think with, if both people are trying to get SSI benefits, then they use a completely different calculation, which I'm not going to get into just because of time constraints.
[15:55] But understand, when you're trying to come into the SSI program, and let's just say they're trying to come in for disability purposes, they're disabled, they don't have a work history, they don't have insurance status with Social Security Administration.
[16:09] But they have a real need, they have a need for income, they have a need for insurance, they're going to, they're going to do an assessment of your resources, they're going to do an assessment of your income.
[16:20] And generally, what they're going to do is, in some respects, they work, how it impacts you is, it sort of works backwards.
[16:31] So, if you have an individual SSI for 2026, it's 990 something, I think is what the number is, I don't, I don't exactly have it on top of my head.
[16:40] But what they're going to do is they're going to look at your income and they're going to, they're generally for your earned income, they're going to reduce it by half.
[16:49] Now, there's a couple of other exceptions, but just hang with me here. So, so if you're making a thousand dollars working part time, generally, let's just say they're going to count 500 of that against you.
[16:59] And what they're going to do is reduce that from the 994 or 96, I can't, I don't know why, I think I would have got the number before we shot the FSA, but I don't remember.
[17:08] So, they're going to take that away, and that means the only eligibility you're going to have would be for that 400 plus or minus dollars later.
[17:15] If you have a spouse who's working, and let's say they're making 300 dollars a month, now they're going to deem another 150 of that income to you.
[17:24] So, now you've got 500 for you and 150 for your spouse, so you're at 650. So, what they're doing though, is looking at how much they're of the SSI you're actually eligible to receive.
[17:36] So, what practically happens is you go into the program, and they run this calculation on the back end, for disability purposes, I think the more prudent thing to do is to try to run the calculation on the front end so that you don't end up going through the whole process and then learn when the local office does your SSI assessment that you're not eligible.
[18:00] And so, when we're talking about this specifically in the disability context, one of the sort of entry level screenings that we're going to do is we're going to do a resources and assets assessment, and we're going to look at the resources you have, we're going to ask you these questions, do you have a house, do you have a car, do you have multiple cars, do you have a boat, do you have a win a bago, do you own any land.
[18:23] We're going to go through those with you, and the reason is we're trying to assess, are you going to get disqualified for resources. Second thing you're going to do is you're going to go through and look at income, do you have earned income, do you have passive income, do you have spousal income that's going to be attributed to you, do you have VA benefits, do you have some sort of pension.
[18:41] And so, the reason that you're trying to do that is because the disability process takes a long time, it's very frustrating for people. And you really need to sort of do a baseline assessment at the beginning.
[18:54] Now, the reality though is that with a lot of cases, it's hard to tell exactly. And sometimes it's hard to get a perfectly clear answer about whether you're going to be eligible or whether you're going to be eligible every month, because it is a month to month.
[19:08] It is a sort of a month of assessment that they're going to do. I think the big takeaway for people though is understand if you're disabled and you haven't worked or you haven't worked in a long time, and you don't have insured status for purposes of disability benefits, SSI is available to you.
[19:26] If you can sort of go through the right doorways, you're over 65 or blind, that's typically not what we're dealing with, right. We're dealing people with people who are disabled or dealing with disabilities that keep them from working.
[19:40] And just understand you're going to have to meet the resources, we're going to meet the income. And then when we get to the disability components, you've got all the same issues that you have before, right.
[19:50] We've got to go through the five-step sequential evaluation process, we get an episode on that, so watch that if you don't know what that is.
[19:56] You have to prove you're disabled under basically the same standard as you do for someone who works, but there's this additional set of requirements that are there.
[20:07] Finally though, one of the things I want to talk about is the fact that there is dual eligibility. Some clients that we work with get both disability benefits and SSI benefits.
[20:19] So can you talk a little bit just about how that works, and then maybe just a little bit about applications and how applications work because some preserve all, some don't preserve all, and we run into these situations where sometimes people have filed the right application.
[20:33] Let's just talk a little bit about how dual eligibility works.
[20:36] So there's two ways that dual eligibility can apply with SSDI, which is based on the work record. There is a five-month waiting period where the claimant does not get paid anything for the first five months of disability.
[20:49] If they're otherwise eligible for SSI under all the things that we've talked about today, they can actually get SSI payments for that five months that they're waiting.
[21:00] Assuming with the filing date and everything that that lines up.
[21:04] For a lot of our clients, they get paid during that first five month waiting period, and then once their SSDI kicks in, that is unearned income, that is greater than the SSI amount, so just the SSDI makes them ineligible for the SSI.
[21:22] However, some of our clients who maybe have had very limited work enough to receive SSDI, but maybe the SSDI amount is pretty low, two or three hundred dollars a month.
[21:36] Then the SSI can come in on top of that and sort of make up the difference.
[21:42] However, I always try to make sure that clients understand it's not SSI plus your SSDI amount.
[21:49] So what actually ends up happening is say you're getting 300 based on your work record a month, they subtract that from the 994 SSI.
[21:58] You can get both at the same time, which is important because people who get at least $1 of SSI get Medicaid, which in some respects is not as good as Medicare, but in other respects potentially is better depending on what your medical conditions are and how that's treated.
[22:16] But it's important because the dual eligible person who is eligible for ongoing dual benefits, not just in that five month weight window, but they're getting an SSI check and a DiB check every month.
[22:27] They're going to be eligible for Medicare and Medicaid, which is important because the Medicaid is typically also going to allow them access to Medicaid subsidies, which is going to pay for their Medicare premium, can pay for their copays, makes them eligible for what are called D-snips or dual special needs plans, Medicare Advantage plans,
[22:45] or they can not only get all of their medical care paid for, they can get substantial additional benefit, like money for groceries and things of that nature.
[22:53] So it's important that people understand there are both programs and they can work together. However, the applications are actually different with the applications, what happens is because SSI is a need based program, it actually preserves an application for a disability claim.
[23:11] But with a disability application, it does not preserve a claim for SSI benefits.
[23:17] So sometimes we have people come in and they've only applied for title two or disability benefits and we realize, oh, you're probably eligible for some SSI as well.
[23:28] And you have to go back and actually file a separate application for the SSI, then you have to try to get them to escalate it and combine the claims and that's another whole mess.
[23:38] But just understand there are two separate programs. They have a lot of similarities in how they establish disability.
[23:45] Obviously the gateway to getting into the disability program is you have to have insurance status, you have to work and pay into the system and have sufficient quarters of coverage and all those requirements.
[23:55] The gateway into the SSI program is that you have true financial need as demonstrated by limited resources and limited income.
[24:03] But for a lot of people, they need to be pursuing both avenues at the same time, but the application process for both is different.
[24:12] Now with that being said, it's a security of do both applications at the same time.
[24:17] And a lot of times that's what we do for clients when we file their initials.
[24:20] So hey, we'll work the security administration, get the SSI application completed, we'll do the disability application and they run through the system together simultaneously.
[24:29] But just be aware that if you just have a disability application, but you have SSI eligibility, it's not going to allow you access into that program, which also matters because SSI has no retroactive coverage.
[24:46] Because it's a need based program, your only eligible to get benefits for SSI from the month, typically the month following your application.
[24:53] And where a disability application has, you can get benefits for a year prior to your application.
[24:59] So all that being said, there are two different programs.
[25:02] A lot of times people have access to both, but understand you're going to need to file applications for both.
[25:07] For people who are on SSI, I think they need to understand with a disability claim, you are going to have continuing disability reviews that look at your medical.
[25:17] But with SSI, they're going to do a re-determination of your eligibility based on resources and income.
[25:23] And you just need to be aware that not only is that going to happen to you probably every year, you also have an ongoing obligation to disclose to them if your resource or income change, which is a problem because it can produce overpayments, it can disqualify you for benefits, which means now you're having benefits you're not supposed to.
[25:41] And all they do, they take them, then they try to collect the overpayment from you, so a lot of issues there.
[25:48] Well, that's all we got. There's more to it.
[25:52] But at the end of the day, I think the big takeaway is SSI is a need based program.
[25:58] And if you're disabled, it very likely could help you.
[26:01] But no, there are going to be resources and income factors that go into whether you're eligible.
[26:07] You're still going to have to meet the disability, eligibility requirements.
[26:11] But at the end of the day, SSI is literally a lifesaver for a large part of our elderly population, for those who have not been able to sustain work in a way they can get D.I.B benefits.
[26:24] And honestly, a lot of times just to Medicaid alone is the thing that actually helps them have a quality of life that's meaningful.
[26:32] So that's it. That's all we got for today. That's SSI.
[26:36] And hope you enjoy the show. Subscribe till next time. Take care.
