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Based on what you've shared, here's what I recommend as your next steps: 1. Help your daughter create a my Social Security account at ssa.gov to check her work credits. 2. Gather comprehensive medical evidence: - Clinical records from therapists/doctors - Psychological evaluations if available - Prescription medication history - Treatment notes documenting symptoms and limitations - Any hospitalizations or intensive outpatient treatment 3. Document how her conditions affect daily functioning: - Failed work attempts with specific details - Difficulties with daily activities - Social functioning limitations - Episodes of decompensation (periods when symptoms worsen) 4. Apply for both SSDI and SSI simultaneously online or by calling SSA. 5. Consider getting a disability attorney if initially denied (most work on contingency). The combination of multiple mental health conditions plus asthma could strengthen her case, especially if you can document how they interact to further limit her functioning.
This is incredibly helpful, thank you! I'm going to start gathering all this documentation right away. One more question - she's currently on my health insurance (thankfully). If she gets approved for disability, would she eventually qualify for Medicare or Medicaid? I'm wondering how her healthcare would work long-term.
With SSDI, she would get Medicare after 24 months of receiving benefits. With SSI, she would likely get Medicaid immediately in most states. Either way, she would eventually have health coverage, which is important for maintaining the treatment she needs. One thing I haven't seen mentioned yet: make sure her doctors are specifically documenting how her conditions limit her ability to work. Many doctors focus on symptoms and treatment but don't explicitly address work capacity in their notes. You might want to ask her providers to complete a Medical Source Statement or Residual Functional Capacity form that specifically addresses work-related limitations. Also, if she's denied initially (which is common), don't give up! Request reconsideration within 60 days, and if denied again, request a hearing before an Administrative Law Judge. Success rates increase significantly at the hearing level, especially with proper representation.
Thank you for this information about healthcare coverage - that's been a major concern. I'll definitely talk to her therapist about documenting work limitations specifically. Would it be helpful to get statements from previous employers about the accommodations they tried to make for her and why they weren't sufficient?
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This thread has been such a lifesaver! I'm dealing with the exact same issue - filed my W-4V twice by mail with zero results. Reading about everyone's experiences has convinced me that going in person is definitely the way to go. One question for those who've successfully done this - do you recommend bringing any additional documentation besides the W-4V form itself? I have my Social Security card and driver's license, but wondering if I should bring anything else like a copy of my award letter or recent benefit statement? Also, has anyone noticed if certain days of the week or times of day are better for shorter wait times at the local offices? I'm retired so I have flexibility in when I can go, and would love to avoid the longest lines if possible! Thanks again to Emma for sharing her successful experience and to everyone else for all the helpful tips. This community is amazing!
Hey Liam! Based on my experience and what others have shared, bringing your Social Security card and driver's license should be plenty - that's exactly what I brought when I went. I don't think you need the award letter or benefit statements, but it certainly wouldn't hurt to have them just in case. As for timing, I went first thing in the morning (got there 30 minutes before opening) and while there was already a line, it moved pretty quickly. From what I've observed and heard from others, early morning seems to be the sweet spot - later in the day tends to get busier. Tuesday through Thursday might be your best bet to avoid the Monday rush and Friday crowds. One tip I'd add - make sure you have a clear, legible copy of your completed W-4V form. Double-check that your SSN is clearly written at the top and that you've selected one of the standard percentages (7%, 10%, 12%, or 22%). And definitely ask for that receipt! Good luck with your visit!
Thanks for sharing this detailed experience, Emma! I'm in a very similar situation - started receiving benefits in February and have been trying to get withholding set up ever since. I've mailed the W-4V twice with no luck, and like you, I can never get through on the phone. Your success story gives me hope! I'm planning to visit my local office next week. A couple of quick questions for you or anyone else who's done this: 1. Did you need to fill out any additional paperwork at the office, or was just bringing the completed W-4V sufficient? 2. How long did you actually wait in line once they opened? 3. Did they give you any estimate on when you might see the withholding start showing up? I'm also going to look into those quarterly estimated payments that others mentioned as a backup plan. Really appreciate everyone sharing their experiences here - it's so much more helpful than the vague information you get from the official SSA website!
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One important clarification about dependent grandchildren: SSA has specific requirements about the status of the natural parents. Generally, for a grandchild to qualify: - Both parents must be deceased or disabled, OR - You must have legal adoption, OR - You must have legal guardianship AND prove the child was dependent on you Since you have legal guardianship, you'll need to address the status of the biological parents. For the unknown father, SSA will likely require some documentation stating he's not in the picture (your guardianship papers may cover this). For the mother, having court documents showing she's legally barred from contact will help your case. When you apply, bring: 1. Your grandson's birth certificate 2. Legal guardianship papers 3. Court orders regarding the biological mother 4. Any documentation about the unknown father 5. Proof of living arrangements (school records, medical records, etc.) 6. Proof of financial support (tax returns, expense records) Applying at your local SSA office in person is usually more effective for complex cases like this.
This is incredibly helpful - thank you! We do have court documents clearly showing the mother's situation and explaining that the father is unknown. I'll gather everything you listed and try to make an in-person appointment. Would it be better to bring our grandson with us to the appointment, or is this something we can handle without him being present?
You shouldn't need to bring your grandson to the appointment. The documentation is what matters most. However, make sure you have his Social Security number and any other identifying information they might ask for. I'd recommend calling ahead to schedule an in-person appointment rather than walking in, as these complex cases can take time to review.
I work as a benefits advocate and see these cases regularly. Your grandson should absolutely qualify based on what you've described. The key factors working in your favor are: 1. You've had legal guardianship since birth (well before your husband's disability) 2. You've provided 100% financial support 3. The biological parents are effectively out of the picture legally A few practical tips from my experience: - When you apply, emphasize the TIMELINE - that your grandson was living with and dependent on you BEFORE your husband became disabled in 2022 - Bring bank statements or receipts showing you paid for his expenses (medical, school, clothing, etc.) - If you have any old tax returns where you claimed him as a dependent, those are gold - Consider bringing a letter from his school or doctor confirming your role as his guardians The process can take a few months, but with your documentation it should go smoothly. And yes, you should get some retroactive benefits - likely 6 months back from your application date, possibly more depending on when SSA determines he became eligible. Don't let the horror stories discourage you. Well-documented cases like yours get approved more often than not.
This is exactly the kind of expert perspective I was hoping for! Thank you so much for breaking this down so clearly. I feel much more confident about moving forward now. We definitely have all the documentation you mentioned - tax returns going back to 2013, medical records, school enrollment forms, everything showing we've been his primary caregivers and financial support. The timeline aspect is really reassuring since we've had him for 9 years before my husband's disability started. I'm going to organize all our paperwork and call to schedule an in-person appointment this week. It's so helpful to hear from someone who actually works with these cases regularly rather than just guessing about the process. One quick question - should I mention that he also receives some Medicaid benefits currently, or could that potentially complicate things?
@Chad Winthrope Question if anyone is still here. I am currently on my Dad s'benefits as a DAC. He has never been in my life except at birth when he signed my birth certificate. I only qualify because around two years ago he was approved. I am also collecting SSI in the amount of $297 so supplment my dad s'DAC because his DAC is lower then the federal max of SSI. I want to know if I can be switched to my deceased grandfather s'benefits since his would be higher. I was born in march of 1990. I lived with him until 9 years old when he died in june of 1999. He was collecting both social security and military benefits years before I was even born. He also provided financial support for me the entire 9 years. His benefits paid the entire rent, utilities, and food for the entire household. My mom wasn t'able to because she did not make enough. I was on SSI for that time because she could not afford to pay for me. She was also on Welfare too. I have my DIBWIZ report that shows the address of the apartment I lived with my grandfather at the time of his death. And his last address that we lived at together is on his birth certificate. My grandmother was also receiving his benefits at the time of his death as well. Do I qualify for his Survivor Benefits? Or able to switch to his benefits from my dad s?'My mother and father were NOT receiving their own benefits at the time because they did not qualify. Dad was not even in the picture. Dad only recently around two years ago got benefits and he s'still not in the picture. Mom is still working because she still can t'receive her benefits. So, given my situation and in the past, Would I qualify to be switched to my grandfather s'benefits? Or is it not even worth calling the SSA about it?
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I'm 65 and planning to file at my FRA next year, but after reading this entire thread I'm now wondering if I should delay even further! It sounds like the system is really set up to favor January filers. One thing I'm curious about - for those who experienced the January adjustment, did you receive any kind of written notice beforehand explaining that your benefit would be increasing? I'm the type of person who likes to have documentation of everything, and I'm worried I might not realize the adjustment happened or might think there was an error if I'm not expecting it. Also, does this same timing issue affect divorced spousal benefits? My ex-husband delayed his filing and I'm wondering if his DRC timing could affect when I'd see the full spousal benefit I'm entitled to. This community has been incredibly helpful - thank you all for sharing your real experiences!
Welcome to the community! Regarding documentation, I didn't receive any advance written notice about my January adjustment - it just appeared in my payment with a brief note on the deposit slip. I'd recommend setting up a my Social Security account online if you don't have one already, as you can track your payment history there (though as others mentioned, it updates slowly). For divorced spousal benefits, the timing can be tricky since your benefit is based on your ex-husband's PIA plus any DRCs already included in his current benefit amount. If he's experiencing the same January adjustment issue, it could potentially delay when you see the full spousal benefit amount you're entitled to. I'd strongly suggest calling SSA to get specific guidance on your divorced spousal benefit timing - those calculations have so many variables that general advice might not apply to your situation. One tip: when you do call, ask them to document your conversation in your file and get a confirmation number if possible!
This has been such an informative discussion! I'm 67 and was about to file next month, but now I'm seriously considering waiting until January. One thing I haven't seen mentioned - does anyone know if the delayed processing of current-year DRCs affects the taxation of Social Security benefits? I'm wondering if getting a lower initial payment followed by a lump sum adjustment in January could impact which tax year that extra income is reported in, or if it might push me into a higher tax bracket unexpectedly. Also, for those who received the January lump sum adjustment, did it come as a separate payment or was it just added to your regular monthly benefit amount? I want to make sure I plan properly for the tax implications of either filing approach. Thanks to everyone who has shared their experiences - this is exactly the kind of real-world insight that helps us make better decisions!
Great question about the tax implications! From my experience, the January adjustment typically comes as a lump sum added to your regular January payment, not as a separate payment. For tax purposes, all Social Security benefits are reported in the year you actually receive them, so the retroactive adjustment would be taxable income in the year it's paid (January 2026 in your case), not spread back to the months it represents. This could definitely affect your tax situation - that lump sum might push you into a higher bracket or make more of your benefits taxable if you're close to the income thresholds. I'd strongly recommend talking to a tax professional about this timing issue. Some people I know have actually chosen to delay filing until January specifically to avoid this tax complication and have more predictable monthly income for tax planning purposes.
Isabella Costa
Adding to what others have shared - I went through this exact same confusion when I first started Medicare two years ago! One thing that might help future newcomers is knowing that the 1095-B form is actually pretty basic - it just shows your name, coverage dates, and confirms you had qualifying health coverage. The most important info is really just when your Medicare coverage began, which you can find on your Medicare card or welcome packet if the form gets delayed. I keep a simple spreadsheet now with all my Medicare dates and key info as a backup. The first year is definitely the hardest as you figure out all these new processes!
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Benjamin Johnson
•That's such a smart idea about keeping a spreadsheet with all the Medicare dates and info! I wish I had thought of that from the beginning. You're absolutely right that the first year is the hardest - there are so many new systems and processes to learn. I'm definitely going to create a simple tracking document like you suggested so I'm better prepared next year. Thanks for the practical tip!
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Lily Young
Just wanted to chime in as someone who went through this exact same experience! I turned 65 last year and had the same panic about finding the 1095-B form on the SSA website. Like everyone else mentioned, it definitely comes in the mail from CMS, not through your MySocialSecurity account. One thing I'd add is that if you're worried about missing the form in your mail, you can also sign up for Informed Delivery through USPS - it sends you previews of your incoming mail each morning so you won't accidentally throw away important tax documents. I started using it after almost tossing my 1095-B because the envelope looked like generic government mail. Also, don't stress too much if it's delayed - my tax preparer said the IRS is pretty understanding about Medicare forms arriving late since it's such a common issue. The most important thing is having your Medicare start date, which should be on your Medicare card or in your welcome materials. Glad you got yours sorted out!
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NeonNebula
•That Informed Delivery tip is brilliant! I had no idea USPS offered that service. I'm definitely signing up for it right away - would have saved me so much stress this year wondering if I missed important mail. You're also right about not stressing too much if the form is late. My tax preparer actually told me the same thing about the IRS being understanding with Medicare-related delays. It's reassuring to hear from someone who went through this exact same experience last year. Thanks for sharing these practical tips!
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