Social Security Administration

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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.

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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.

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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.

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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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wait i just thought of something - doesnt this affect medicare premiums too? like if u show too much income don't they charge u more for part b or something?

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Yes, that's called IRMAA (Income-Related Monthly Adjustment Amount). If your modified adjusted gross income from two years prior exceeds certain thresholds, you pay higher Part B and Part D premiums. So income reported in 2024 would affect your 2026 Medicare premiums if you're enrolled by then. It's another factor to consider in your calculation.

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Oh wow, I hadn't considered the Medicare angle. I need to check those IRMAA thresholds too. This is getting complicated!

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just wondering why worry about this at all? social security is going bankrupt anyway lol

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That's a common misconception. Social Security is not going bankrupt. According to the 2023 Trustees Report, even if Congress does absolutely nothing (which is unlikely), the trust fund would be depleted in the 2030s, but ongoing payroll taxes would still fund approximately 80% of promised benefits. And Congress has always acted to shore up the program before significant cuts would take effect, as they've done several times over the program's 89-year history.

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I HATE the windfall elimination!!!! Its so unfair to teachers!!! We work our whole lives and then get penalized for choosing a public service career?? Make it make sense!!!

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The rationale behind WEP is that Social Security benefits are designed to replace a higher percentage of income for lower-wage workers. Since teachers with non-covered pensions appear to Social Security as "low-wage workers" (because their teaching earnings don't show up in SS records), WEP was created to adjust for this. I agree it feels unfair, but that's the current policy logic. There are ongoing efforts to reform it.

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Just to add to my earlier comment: When you suspend benefits, you continue earning delayed retirement credits until age 70, which will permanently increase your benefit by about 8% per year. So suspending from FRA (67) to 70 could increase your benefit by around 24% for the rest of your life. Also, regarding WEP - if you have 30+ years of "substantial earnings" in Social Security-covered employment, WEP doesn't apply at all. If you have 21-29 years, the WEP reduction is lessened. Might be worth checking your earnings record to see where you stand.

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I just checked my SS statement online and I only have about 15 years of substantial earnings under Social Security. Most of my career has been teaching. So I guess the full WEP will apply to me regardless. Still, getting that 24% increase by waiting until 70 seems worthwhile.

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One more thing to be aware of - if you want to set up or modify your tax withholding by phone instead of online, be prepared for extremely long wait times (often 1-2 hours). The

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Thanks for the heads up! I'll definitely stick with the online method whenever possible. The thought of being on hold for 2 hours is not appealing at all.

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KEEP IN MIND that if you work while collecting survivor benefits before your FRA, you'll be subject to the earnings test!!! In 2023 you could only earn $21,240 before they start taking $1 for every $2 you earn above that limit. They don't tell you this stuff upfront!!! I learned the hard way when they reduced my checks because I was still working.

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Thank you for this warning! I'm still working full-time and plan to continue for several more years, so this earnings limit would definitely affect me. I had no idea they would reduce the benefit that much if you're still working.

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also look into if ur eligible for that $255 death benefit payment, its not much but its something

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Yes! That death benefit is automatic if you were living with your spouse when they passed away. Though honestly, $255 barely covers any funeral expenses these days... my dad's funeral was over $12,000 😢

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Thank you everyone for the responses! I called SSA this morning (waited 2 hours!) and finally spoke to someone who confirmed what many of you said. My estimated benefit at FRA will be about $3,850 based on my earnings history. They also mentioned I could get approximately $4,775 if I wait until 70. Definitely gives me something to think about as I finalize my retirement plans.

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Glad you got through! Next time save yourself the 2-hour wait and use Claimyr. The 15 minutes I spent on hold was SO much better than the usual SSA wait times.

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Jabari-Jo

One more thing that's important - once your wife starts receiving the increased spousal benefit, be aware that this might affect her Medicare Part B and D premiums if your combined income crosses certain thresholds. The additional income could potentially push you into a higher IRMAA (Income-Related Monthly Adjustment Amount) bracket. Just something to plan for when budgeting for next year.

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I hadn't even thought about the IRMAA implications. We're already paying a bit higher due to our income, but this is a good reminder to check if the additional spousal benefit might push us into the next bracket. Thank you!

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One question nobody's asked - have you made sure the $390 increase calculation is correct? Remember that spousal benefit is 50% of your FRA amount (not your age 70 amount) minus her full retirement benefit. A lot of people get confused and think it's 50% of whatever you're actually receiving.

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Have you run the numbers on what the financial difference would be? Sometimes it helps to see it on paper. If your survivor benefit is $2000/month and you'd lose it by marrying 2 years early, that's potentially $48,000 you'd be giving up. Everyone has to make their own choice about whether that's worth it, but having the actual figure helps with the decision.

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That's a good point. I'm getting about $2,250/month, so that would be around $54,000 over two years. Seeing that number definitely puts it in perspective. Might need to have a difficult conversation with my partner about possibly postponing our plans.

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My neighbor said you can just not tell Social Security you got married and keep collecting! But that sounds like fraud to me??

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That is absolutely fraud and a terrible idea. SSA can and does check marriage records, and the penalties for deliberately concealing information to collect benefits you're not entitled to can include fines, having to repay all benefits received fraudulently, and even criminal prosecution in serious cases. Never risk it.

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Mia Green

my sister went through this last year and she said one thing nobody tells you is that after you convert to retirement you start getting those COLA increases every january! her first one was like $125 more per month

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Just to clarify - SSDI recipients also receive the annual COLA increases, just like retirement beneficiaries do. The COLA applies to all Social Security benefits, including disability. So this wouldn't be a new thing after conversion.

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Thank you all for the helpful information! It's a relief to know I don't need to do anything special for the transition. I think I'll still try to contact SSA just to make sure everything is set up correctly in their system. Better safe than sorry!

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That's a good approach. While the process is automatic, it never hurts to verify. If you do contact them, make sure to have your Social Security number, birthdate, and any recent correspondence from SSA handy - it'll help the conversation go more smoothly.

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The most important thing your sister needs to know is that for ESRD patients, Medicare covers dialysis at 80% with NO CAPS. Most private insurance has annual or lifetime maximums that she could hit quickly with ongoing dialysis. If she has Part A already, adding Part B would mean Medicare could cover her dialysis treatments regardless of her employment status. Also, make sure she looks into Medicare Advantage plans that might have better coordination of care for her complex conditions. With both kidney disease and arthritis requiring regular treatments, she would benefit from a plan that helps manage multiple specialists.

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careful with advantage plans tho!! my mom switched to one and they wouldnt let her see the specialists she wanted. regular medicare let her go to ANY doctor that takes medicare. advantage plans have networks just like hmos

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That's a fair point. Traditional Medicare with a good Medigap/supplemental plan might be better for someone with complex conditions who needs specific specialists. The tradeoff is that Advantage plans often include prescription drug coverage and sometimes extras like transportation to medical appointments, which can be valuable for someone getting regular dialysis. It really depends on whether her preferred providers are in-network with available Advantage plans in her area.

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Thanks for all this helpful information everyone! I spoke with my sister and we've decided that she's going to talk to the social worker at her dialysis center first thing tomorrow. She's also going to check with her HR department about exactly what kind of health coverage she has now and what her STD/LTD options look like. We now understand that switching to SSDI isn't an option at her age, but the information about Medicare's special provisions for kidney disease patients is a game-changer. I'm going to help her enroll in Part B right away to avoid any future penalties.

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That sounds like an excellent plan. One more tip: make sure she gets the Medicare coverage to start before ending her employment if possible. There's a special form her employer needs to fill out (CMS-L564) to verify she had creditable coverage through work, which will help her avoid any Part B penalties. Wishing her all the best with her health challenges.

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