Source: http://www.law.cornell.edu/socsec/martin/2socseca.htm
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Martin on Social Security Treatise - Part 2-A
Part 2 � Topics
� A 100. The Need to File an Application � Social Security
Filing an application is a precondition to Social Security benefit entitlement and also to recognition of a period of disability which will later be considered in benefit calculations.� There are only two situations in which the Act does not require an application.� One is where a person who is receiving one type of Social Security benefits becomes eligible for another.� A person who applied for and was receiving disability insurance benefits need not, when he or she reaches the Act�s �full retirement age,� apply again for old-age benefits; a person receiving spouse benefits on the account of a retired worker need not apply for widow or widower�s benefits if that worker dies.
The Act provides a second exception; it operates when misleading information received from the Social Security Administration causes a person not to apply.� A later application by that person can be dated from the earlier contact.� Previous law was to the contrary.� In Schweiker v. Hansen, 450 U.S. 785 (1981), the Supreme Court held that the Agency was not estopped from denying benefits to a claimant who failed to file an application even though her failure to do so was the result of an erroneous statement by Agency staff.
An applicant for Social Security benefits of any kind must furnish satisfactory proof of an existing Social Security number or apply for one.
Eligible claimants can in many cases elect to have benefits paid for a period of months (6 months or 12 months depending on benefit type) prior to the month of application.� Generally this election is not available when payment of benefits for the prior period would, because of the claimant�s age, give rise to a reduction in the monthly benefit amount.
[Supporting and Elaborating References] [Related Sections: Part 1 - Part 2] � A 200. Insured Status � In General
All Social Security benefits, whether old-age, disability, or family benefits, require some person (either the claimant or the relative on whom benefits depend) to have sufficient covered wages or self-employment income to qualify for �insured status.�� Different benefits require different types of insured status, but all require some type.� The tests of insured status are expressed in terms of quarters of coverage, requiring a certain number of such quarters altogether or a certain number during a specified period of time.� The three principal insured status tests are: fully insured, currently insured, and insured for disability benefits.
[Supporting and Elaborating References] [Related Sections: Part 1 - Part 2] � A 210. Insured Status � Fully Insured
Old-age or retirement benefits and family benefits for survivors require �fully insured� status.� (In addition, the insured status test for disability insurance benefits is, in part, derived from the �fully insured� concept.)� The test for fully insured status contains a sliding scale requiring more quarters of coverage of successive cohorts of beneficiaries.� The sliding scale stretches between a minimum of 6 quarters of coverage and a maximum of 40.� No one, except those in a few special classes dealt with specifically by Congress, can qualify for fully insured status without having 6 quarters of coverage (the equivalent of a year and a half of covered work).� And anyone with 40 quarters of coverage (the equivalent of 10 years of covered work) has such insured status.� Whether someone with fewer than 40 quarters meets the test depends on date of birth and the basis of their claim.
For all individuals reaching 62 in 1991 or thereafter and claiming old-age or retirement benefits, the full 40 quarters is required.
The sliding scale applies to those born prior to 1929, requiring one quarter of coverage for each year falling after 1950 (a year in which the program�s coverage was dramatically increased) but before the year the person becomes 62.� This formula, for example, requires 37 quarters for individuals who turned 62 during 1988 (having been born in 1926), 38 quarters of coverage for those born in 1927 who turned 62 during 1989.� In the case of a deceased individual on whose account survivors benefits are claimed the full 40 quarters is not required if the deceased has one quarter for each year after the age of 21 before the year of his or her death.
[Supporting and Elaborating References] [Related Sections: Part 1 - Part 2] � A 220. Insured Status � Currently Insured
Currently insured status is based on recent work rather than a long period of covered work.� A worker with 6 quarters of coverage out of the last 13 quarters prior to death, disability, or entitlement to old-age benefits is currently insured.� Benefits available on the basis of currently insured, as distinguished from fully insured, status include survivors benefits for children, survivors benefits for a younger spouse caring for eligible children, and lump sum death benefits.
[Supporting and Elaborating References] [Related Sections: Part 1 - Part 2] � A 250. SSI � The Need to File an Application
Otherwise eligible individuals will not receive Supplemental Security Income (SSI) benefits without filing an application.� For those who can qualify for benefits delays in filing an application, thus, translate directly into benefits lost.
Some written and even some oral contacts with the Agency can, if followed up promptly by an application, establish an earlier date for the application.� The regulations provide detail on such �protective filing date� situations.� Upon receipt of a written statement that can qualify, the Agency is supposed to send a notice of the need to file an application.� To qualify for the earlier date, the claimant must file the application within 60 days of that notice.
As with Social Security benefits, a failure to file because of misleading information received from the Social Security Administration receives special treatment.� A later application by the person misled can be dated from the earlier contact.
[Supporting and Elaborating References] [Related Sections: Part 1 - Part 2] � A 260. SSI � Categorical Eligibility � In General
The Supplemental Security Income program (SSI) provides cash benefits to individuals whose income and assets fall below set national standards, but not all individuals.� SSI�s �need-tested� benefits are provided in rough but not precise parallel to Social Security benefits being limited to three categories � the aged, blind and disabled.� Those within the SSI categories must meet certain other eligibility tests and qualify by virtue of low income and limited assets.� Individuals and families with insufficient income who fall outside the SSI categories must turn to other programs for assistance.
SSI, established in 1974, replaced state programs, supported in part by Federal funds.� To ease the transition special eligibility rules and certain related provisions applied (and still apply) to individuals who were receiving benefits under the predecessor programs.� These provisions, still part of the law, apply to relatively few recipients.
[Supporting and Elaborating References] [Related Sections: Part 1 - Part 2] � A 270. SSI � Categorical Eligibility � 65 or Older
While Social Security old-age benefits can be begun at age 62 and widow or widower benefits at age 60, SSI benefits based on age require that the individual be 65 or older.� Persons already eligible for SSI by virtue of blindness or disability may be subject to slightly different rules upon turning age 65.
Since establishing age can be critical to eligibility, proof of age is addressed in detail by the regulations.� The regulations spell out the Agency�s preferred types of age evidence starting out with a public birth record.� The regulations also provide for reliance on a state�s report of age, in the absence of evidence to the contrary, and for less rigorous documentary evidence when the individual claims an age of 68 or more.
[Supporting and Elaborating References] [Related Sections: Part 1 - Part 2] � A 280. SSI � Categorical Eligibility � Blind or Disabled
An individual is eligible for SSI based upon blindness if (i) with a correcting lens, his or her vision in the better eye is 20/200 or less, or (ii) he or she has tunnel vision of 20 degrees or less.� Under Social� Security Disability Insurance, a claimant qualifies as disabled on the basis of blindness with vision falling below this same standard.��� The SSI disability category is also defined in terms largely identical to those governing Social Security Disability Insurance.
It should be noted that for SSI purposes blindness is set apart on its own, rather than being swallowed up by the disability category.�� Two important differences between Social Security and SSI blindness claims emerge as a result of this separation.� First,� SSI�s blindness test has no duration requirement.�� Under Disability Insurance, blindness, like any other form of disability, must last for at least 12 months.� Secondly, under SSI, �Substantial Gainful Activity� is not at issue for those eligible by virtue of blindness, as it is in Social Security.� After demonstrating categorical eligibility based upon blindness, an individual needs only to meet the SSI income and resource limits.
[Supporting and Elaborating References] [Related Sections: Part 1 - Part 2] � A 300. Covered Work
Earnings from nearly all work performed within the U.S. are covered by Social Security. This includes work performed for others as an employee (wages) and also work done within an individual�s own business or partnership (net earnings from self-employment). In addition some work performed outside the U.S. by U.S. nationals is covered.
Work that is covered by Social Security is subject to a special Social Security tax (the F.I.C.A. tax if the work is done as an employee, the S.E.C.A. tax if it is self-employment). And earnings from work that is covered figure into the Act�s eligibility requirements and benefit calculations.
Work done within a family has raised special issues for Social Security which have been the subject of an evolving set of rules. Some work that would otherwise qualify for coverage will not if done for certain relatives.
The coverage of domestic work, including baby-sitting by teen-agers, long an area of significant non-compliance, received Congressional attention in 1994. Amendments to the Act increased the threshold amount for coverage based on domestic labor to $1,000 per employer per year (with that figure subject to subsequent annual adjustment) and excluded part-time domestic work by those under 18, altogether. The threshold for 2008 is $1,600.
For individuals who are receiving benefits, earnings from covered work (and other work as well) can lead to a reduction in benefits under the excess earnings test. If those benefits are based on disability, the earnings can lead to a conclusion that the person is engaged in substantial gainful activity and is, therefore, not disabled.
[Supporting and Elaborating References] [Related Sections: Part 1