Houston SSI Disability Lawyer

Seeking a Free Consultation with one of Texas’ Houston Social Security Disability Lawyers? Call the Social Security Disability Lawyer Reshard Alexander today at 713.766.3322.

Social Security Disability Lawyer Reshard Alexander helps disabled persons receive the care and compensation they deserve.

Supplemental Security Income (SSI) is a United States means-tested federal welfare program that provides cash assistance to individuals residing in the United States who are either aged 65 or older, blind, or disabled. SSI was created by the Social Security Amendments of 1972 and is incorporated in Title 16 of the Social Security Act. The program began operations in 1974.

SSI was created to replace federal-state adult assistance programs that served the same purpose, but were administered by the state agencies and received criticism for lacking consistent eligibility criteria. The restructuring of these programs was intended to standardize the eligibility requirements and level of benefits.^[1] Although administered by the Social Security Administration,^[2] SSI is funded from the U.S. Treasury general funds,^[3] not the Social Security trust fund. Today, the program provides benefits to approximately eight million Americans.

Eligibility

In order to be eligible to receive SSI benefits, individuals must prove the following:^[4]

They are 65+ years of age or blind or disabled; and
They legally reside in one of the fifty states or the District of Columbia or Northern Mariana Islands, are the child of military parents assigned to permanent duty outside of the US, or are a student (certain restrictions apply) temporarily abroad; and
They have income and resources within certain limits (see subsections); and
They have applied for the benefits.

An individual may be ineligible if he or she is a resident of a public institution from the first day of a month through the last day of that month,^[5] fails to apply for all other benefits for which they may be eligible (including Social Security benefits), has an unsatisfied warrant or violates parole conditions, fails to give SSA permission to contact any financial institution for financial records, or is outside the US for thirty consecutive days (with some exclusions).^[4] Numerous restrictions have been placed on who is eligible for the benefit, which is considered a welfare benefit. However, unlike social security benefits (Title II), earned work credits are not a requirement for SSI.^[6]

If insured for disability and not currently receiving benefits, an applicant for SSI also applies for Social Security Disability Insurance Benefits (DIB), and the standard by which applicants are judged to be disabled is virtually the same for SSI and DIB.

The decision as to whether an individual is disabled is made by the various state Disability Determination Services (DDS), which contract with the federal government. Although the DDS’s are state agencies, they follow federal rules. This arrangement arose from the inception of OASDI, when some key members of Congress considered the Social Security Disability program should be administered employing federalism, fearing expansion of the federal government.

Aged, disabled, or blind

In order to be eligible for SSI, a person must meet the definition of being aged, disabled, or blind.

Aged – Being deemed aged consists of attaining the age of 65 or older.^[4] The Social Security Administration, like the United States Government in general, follows English common law and considers a person to attain an age the day before their birthday.^[7]

Disabled – Being deemed disabled consists of meeting the general disability definition used by the Social Security Administration to be eligible for Social Security Disability Insurance:

“Disability means inability to engage in any SGA [substantial gainful activity] by reason of any medically determinable physical or mental impairment which can be expected to result in death, or has lasted or can be expected to last for a continuous period of not less than 12 months.”

“The 1967 amendments specified that workers shall be determined to be under a disability only if the physical or mental impairment or impairments are of such severity that the individual is not only unable to do his previous work but cannot, considering his age, education, and work experience, engage in any other kind of substantial gainful work which exists in the national economy. This is regardless of whether any of these are true:

Such work exists in the immediate area in which the claimant lives.
A specific job vacancy exists.
The claimant would be hired if they applied for work.

“The statute also specifies that ‘work which exists in the national economy means work which exists in significant numbers either in the region where such individuals live or in several regions of the country.'”^[8]

Substantial gainful activity (SGA), for the year 2015, is the ability to earn $1,090 gross income in a month’s period for most disabled individuals, and $1,820 for those whose disability includes blindness.^[9]

In addition, children under the age of 18 can be determined to be disabled for SSI purposes “if the individual has a medically determinable impairment or combination of impairments that causes marked or severe functional limitation(s), and can be expected to result in death, or has lasted or can be expected to last for a continuous period of not less than 12 months.”^[10]

Blind – Being deemed blind consists of meeting the following definition:

“central visual acuity of 20/200 or less in the better eye with the use of a correcting lens. An eye which has a limitation in the field of vision such that the widest diameter of the visual field subtends an angle no greater than 20 degrees should also be considered as having a central visual acuity of 20/200 or less.”^[10]

In addition, for SSI purposes, an individual is considered blind regardless of the period of time they are expected to be blind or if they are performing a substantial gainful activity.^[10]

Income

One of the requirements to receive SSI is that the individual’s income must be below certain limits.^[11] These limits may vary based on the state in which the individual lives, living arrangements, the number of people living in the residence, and the type of income. The limit varies on all of these factors and is described below in the section on benefit computation.

Resources

Another requirement for SSI is that the individual’s resources be below a certain limit. This amount is $2,000 for an individual and $3,000 for an individual and their spouse (whether the spouse is eligible for SSI or not), $4,000 for a child applicant with one parent living in the household, and $5,000 for a child applicant with two parents living in the household.^[12] However, conditional benefits may be paid if a substantial portion of the resources are considered non-liquid, resources that cannot be sold within 20 working days,^[13] if they agree to sell the resources at their current market value within a specified period and repay the money after the non-liquid property is sold.^[14] However, not all actual resources are counted in calculating an individual’s or couple’s resources for SSI purposes.^[15]

The resource limits were originally set at $1,500 for an individual and $2,500 for couples in 1974,^[16] and were not linked to inflation. In 1987, the limits were raised to $1,800 and $2,700, in 1988, to $1,900 and $2,850, and, in 1989, to $2,000 and $3,000.^[17] Under current law they will remain at present levels indefinitely.

There will soon be one exception to the general asset limit. On December 19, 2014, the ABLE Act of 2014 (standing for Achieving a Better Life Experience Act) was signed into law, creating a new tax-advantaged account under the newly added Section 529A of the Internal Revenue Code.^[18] Details of the new ABLE accounts, which will officially come into effect once the Treasury Department issues enabling regulations and states pass legislation regarding account administration, are:^[19]

Accounts can be established by or on behalf of a disabled person, provided that the beneficiary’s disability began before age 26.
Annual contributions to an account are limited to the same amount as the gift tax exclusion for an individual ($14,000 in 2014). The upper limit for lifetime contributions is the same as that for a 529 educational plan in the disabled person’s state of residence. Contributions are not tax-deductible, but income earned in an account is not subject to tax.
Tax-free withdrawals can be made for “qualified disability expenses”, including but not limited to education, housing, transportation, employment-related expenses, assistive technology, and healthcare.
There are special statutory rules regarding the accumulation of ABLE account assets for individuals on SSI and Medicaid. The first $100,000 in an ABLE account is not counted as an asset for purposes of SSI eligibility. Once an ABLE account balance exceeds $100,000, the beneficiary’s SSI payments are suspended until the account balance drops below $100,000. However, the beneficiary remains covered by Medicaid regardless of the account balance.

Residency

SSI benefits are not paid solely to US citizens, but may also be paid to aliens legally residing in the United States.^[4] Conversely, citizens may find themselves ineligible because they do not currently reside within the United States;^[20] exceptions apply for children of military parents who were born overseas, were disabled or became blind overseas, or first applied for benefits overseas^[21] and for students studying abroad who were eligible for SSI in the month prior to leaving the US, whose absence will be for less than one year, and who are studying to enhance their ability to perform substantial gainful activity, sponsored by an educational institution in the US, and would not be available to the individual in the US.^[22] Several restrictions apply to the eligibility of aliens however. These include being in a “qualified alien” category and meeting an exception condition.^[23]

There are seven categories of qualified aliens based on Department of Homeland Security (DHS) immigration statuses. This includes:^[24]

those admitted as Lawfully admitted for permanent residence (LAPR)
those granted conditional entry pursuant to section (a)(7) of the Immigration and Nationality Act (INA)
those paroled into the US under section 212(d)(5) of the INA for a period of at least one year
those who are refugees admitted to the US under section 207 of the INA
those granted asylum under section 208 of the INA
those whose deportation is being withheld under sections 243(h) or 241(b)(3) of the INA
Cuban/Haitian entrants under section 501(e) of the Refugee Education Assistance Act of 1980.

There are five exception conditions. These include:^[25]

having already been receiving SSI on August 22, 1996
having 40 qualifying credits (using SSI as a supplement to Retirement or Disability Insurance Benefits) when in LAPR status
being a veteran, active duty member of the U. S. military service, or being the spouse or dependant child of an individual who is
having been lawfully residing in the US on August 22, 1996 and being blind and disabled (excluding aged individuals)

Collateral consequences of warrants, parole, and probation

Since Congress enacted “fugitive felons” and parole/probation violation provisions in 1996, the Social Security Administration has suspended benefits and charged overpayments to individuals receiving SSI on the basis of outstanding warrants.^[26] Enforcement of the provisions greatly increased in 2000, as SSA reached agreements with local law enforcement to match databases.^[26]

Individuals who are fleeing to avoid prosecution or incarceration for a felony or violating probation or parole are statutorily prohibited from receiving SSI or Title II Social Security benefits.^[27]

The Social Security Administration interpreted the statutes broadly to include individuals whose names were matched against a warrant database.^[26] Some individuals lost benefits even though the warrant in question was for a different person.^[28]^[29] For others, the presence of a warrant did not necessarily mean that an individual was “fleeing,” or that the individual had violated probation or parole.^[28]

As a result of two legal cases (Martinez v. Astrue and Clark v. Astrue), the SSA may not suspend benefits based merely on the evidence that a warrant had been issued.^[30]^[31] Back benefits were owed to hundreds of thousands of recipients.^[29]^[32]

Benefit details

Payments for SSI are made on the first day of the month unless that day is on a Weekend or legal holiday, in which case the payment is made on the first day prior that is not a weekend or legal holiday. The minimum benefit is one dollar.^[33]

The SSI program (or Title XVI of the Social Security Act 1611) provides monthly federal cash assistance of up to $771 for an individual and $1,157 for a couple (as of 2019)^[34] to help meet the costs of basic needs of food, shelter, and clothing. In most states, SSI eligibility usually assures concurrent access to important medical coverage under the various state Medicaid programs and sometimes access to Section 8 housing benefits. In some states, supplemental payments are made by the state, increasing the cash assistance available through SSI. For example, the state of California (through its State Supplementation Program or SSP) increases the cash assistance, making the total 2015 SSI benefit $889.40 per month.^[35]

SSI takes the income and resources of the applicant or recipient into consideration. People who have qualified for Social Security disability benefits may receive SSI during the five-month waiting period if they meet the income and resource requirements. The resource limit for single individuals is $2,000 and for married individuals is $3,000. Resources include anything that is cash or can be turned into cash, such as art, mineral rights, stocks or other investments, and real property. In some situations, however, these resources can be excluded. SSI benefits are generally reduced dollar-for-dollar by any unearned income, such as TANF, alimony, unemployment insurance, Social Security Disability or Retirement benefits. Earned income from wages or self-employment is treated more favorably; e.g., a person who earns a wage of $750 per month may still be eligible while someone who receives $750 per month in alimony may be ineligible. It is permissible, subject to regulations, to be employed and continue to receive SSI. Even if a person no longer receives SSI due their wage or self-employment income being too high, they may still be eligible for Medicaid benefits under what are referred to as 1619 provisions. An examination of eligibility for SSI also considers the income of “deemors,” e.g., a spouse who lives with the recipient, a parent or parents who live with a child recipient (recipient under the age of 18) or, in some cases, the sponsor of an alien.

Social Security determines the first month of potential eligibility for SSI by the date of the intent to file an application for benefits as expressed to the Social Security Administration, and an application is filed within 60 days of the date of that expressed intention. To begin the process, people wishing to be considered must contact Social Security (there is a toll-free telephone number) to set up a disability interview. No online application for SSI is currently available; however, one may apply for Social Security Disability or Retirement benefits online and add the application for SSI via a telephone-scheduled interview. Calls placed on the last day of the month, where the interview is scheduled for the second week of the following month, will result in SSI eligibility being retroactive to the month in which the call was made to set up the appointment, although the first check will not be received until the next month. For example, a person calls on 31 January to set up an appointment for February. January will be the month-of-application for determination purposes, but the first benefit check will be issued in February. Medicaid benefits usually begin the first month in which medical and financial requirements are met.

In order to qualify for SSI, an immigrant must have been a legal resident of the United States before the Welfare Reform Act of 1996 took effect (August 22, 1996). Those who arrived after that date may be denied SSI benefits. However, the regulations governing alien eligibility for SSI are complex and contain many exceptions; for instance, asylees, refugees, spouses of a member of the U.S. military, and some LAPR may be qualified aliens. A person who has been in LAPR status for at least five years, has a valid I-551^{[clarification needed]} issued by the Bureau of Citizenship and Immigration, and has been employed in the United States, may qualify. People wishing to learn whether they might qualify for SSI should contact the Social Security Administration to schedule an appointment for an interview.

A person who is incarcerated for a calendar month is ineligible for benefits. If the person is in a medical facility where at least 50% of their costs are paid by Medicaid, their benefit may be reduced to $30.

Calculation

Calculation of an SSI benefit begins with the Federal Benefit Rate (FBR). The FBR for 2015 and 2016 is $733 for an individual and $1,100 for a couple.^[34]

The initial benefit levels for SSI in 1972 was the same as the average monthly benefit as a retired worker under the Social Security retirement benefits program. In August 1974 Congress established legislation to automatically increase SSI benefits by the same percentage and at the same time as Social Security retirement, survivors, and disability benefits.^[36]

The benefit payable to a couple is smaller than the combined benefits payable to two individuals in order to take account of the fact that two people living together can live more economically than if each lived alone. However, the reduced SSI couple benefit applies only to those who are legally married, which gives beneficiaries an incentive not to marry.^[36]

An issue of importance has been additional household costs caused by the disability of a beneficiary. The original concept of SSI was to ensure a minimum income. Research on household needs includes examining potential options to meet those needs.^[36]

A major purpose of allowing a certain amount of assets was: to cover major costs of an urgent nature, such as to replace a furnace or another essential appliance. The costs of such items have increased considerably since 1989.^[36]

Federal living arrangements

There are four living arrangements for SSI: A, B, C, and D. Living arrangement A is for an individual that has rental liability or buys their food separately from the rest of the household. Living arrangement B is for an individual that has no rental liability and does not buy their food separately. This is the most disadvantageous living arrangement. An individual will have a minimum charge of income deducted from their check. This is done because it is considered that an individual is being given income in the form of free housing and food. An individual in living arrangement B will also be subject to more periodic reviews called redeterminations. This is done because it is common for a person in living arrangement B to eventually obtain rental liability or buy their food separately. Living arrangement C is for children living with at least one of their parents. In some cases, it may be possible that a child has another living arrangement. This happens when the child does not live with either parent. Living arrangement D is for individuals in the facility where the Medicaid pays over fifty percent. A person is only due a check of fifty dollars per month. This is because it considered that the individual has all his basic needs met.

Beneficiaries by age

Age 65 or older – 2,051,848
Between ages 18–64 – 4,691,651
Under age 18 – 1,258,533

Total Beneficiaries 8,002,032

Payee assignment

Generally, the person qualifying for benefits is determined to be capable of managing their own financial affairs, and the benefits may be disbursed directly to them. In the case of persons who have a diagnosed mental impairment which interferes with their ability to manage their own finances, the Social Security Administration may require that the person assign someone to be their representative payee. This person will receive the benefits on behalf of the disabled individual, and disburse them directly to payors such as landlords, or to the disabled person, while providing money management assistance (help with purchasing items, limiting spending money, etc.). The representative payee generally does not charge a fee for this service, especially if the payee is a friend or relative. Social service agencies who are assigned as payee are prohibited from charging a fee, though some private payee agencies do provide the service for a small fee. Some states and counties have representative payee agencies (also called substitute payee programs) which receive the benefits on behalf of the disabled person’s social worker, and disburse the benefits per the social worker’s instructions.