Most of us usually rely on the experience of others to understand how to deal with similar situations. The real problem with this is that benefits are person-centered. Benefit programs fit each individual differently, based on a variety of facts and conditions, such as:
your work history;
how much you earn;
what you own;
how disabling your condition is;
how clearly you report the details of your condition to your medical provider;
how well your medical provider understands or documents these details;
what benefits an employer provides; and
what benefits you have purchased individually.
Acting on Bad Information
It can be difficult to find accurate and complete information about Social Security programs. Some social workers and advocates may have limited knowledge or training about the variety of benefits you may have available through Social Security and how work could impact such benefits. Many representatives of federal and state agencies may be experts in a particular field of benefits but may not be trained on other benefit programs. It is important for you to verify that the information you have is accurate and complete.
Misunderstanding Acronyms
SSA - Social Security Administration, the federal Agency that administers all Social Security programs.
SSI - Supplemental Security Income, the program that supplements low income of the aged, blind, and disabled with limited resources.
SSDI - Social Security Disability Insurance, the program that provides a benefit for people with disabilities paid through FICA taxes of the primary wage earner in the family.
Not Knowing Which Social Security Program You Are Enrolled In
You may be eligible for Supplemental Security Income (SSI) or for Social Security Disability Insurance (SSDI). Some individuals are eligible for both programs. Understanding which program you are enrolled in can be confusing because of the many benefit program acronyms used. Although both programs use the same definition of disability, the rules governing each are different. Misidentifying these programs is common. Make sure you know exactly which program is being discussed.
Working In The First Year Of Receiving Social Security Disability Benefits
Social Security defines disability as an inability to work due to a disabling condition that will continue for at least one year. If you work or return to work (even if only part time) within the first year of disability, Social Security may re-determine your disability status.
Underreporting Your Earnings
Underreporting earnings to Social Security may result in overpayment where the beneficiary will be responsible to pay back those benefits. Make sure to report all of your gross income. Gross income is the amount you are paid before taxes are deducted from your paycheck. If you are self-employed, you can report earnings based on your most recent IRS tax return. To avoid overpayments report earnings to the Social Security Administration at 800-772-1213 (voice) or 800-325-0778 (TTY).
Not Keeping Complete Earnings Records
It is your responsibility to maintain accurate and detailed records. The earnings you report to Social Security will be verified. Clearly document all communication with Social Security. Make copies of letters and keep records of phone conversations, including the date and time phone calls take place and the name of the individual who was assisting you. These steps can help you avoid pitfalls during the application process and while maintaining eligibility for benefits. Many people keep a journal of Medi-Cal contacts in a spiral notebook.
Not Understanding the Underwriting Process
The underwriting process means providing medical proof of good health. This process can be complex and intrusive, including review of your medical records for the previous 10 years, a physical examination and other tests to determine eligibility for coverage.
Not Understanding the Importance of the Initial Enrollment Period
The initial enrollment period is the first time the employer-sponsored policy is offered to you. If you choose to wait until a future open enrollment period to enroll in employer-sponsored health coverage, exclusionary periods for pre-existing conditions may be longer.
Missing Premium Payments
Cancellation notices will be sent to you if premium payments are delinquent. It is important to know that the law mandates a 30 day grace period after cancellation of a policy, allowed once every 12 months. If payments are made within those 30 days, the policy will be re-instated.
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