Social Security Administration

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Social Security denied my Child-in-Care claim because my disabled daughter attends day program - is this correct?

I'm so frustrated with Social Security right now! I had my phone appointment yesterday to apply for Child-in-Care benefits since I care for my adult daughter who has autism, intellectual disabilities and seizures. The claims rep shut me down almost immediately when I mentioned my income (I make about $84K per year). I understand there's an earnings limit, but after pushing for more explanation, I realized I might actually qualify next year when I reach my FRA since the earnings test works differently then. But here's what really bothers me: When I explained that my daughter needs substantial care (I help her with medications, appointments, daily living tasks, etc.), the rep said I couldn't qualify because my daughter attends a day program 3 days a week. The rep literally said I would need to be with her "24/7" and that "the person has to practically be an invalid" to qualify! That can't be right? My daughter needs continuous supervision and substantial assistance even though she can do some basic tasks. She can't be left alone safely due to her seizures. The day program actually has medical staff on site for her seizure management. I've looked at some POMS guidelines online and they don't seem to require 24/7 care to qualify. Has anyone successfully gotten Child-in-Care benefits while their disabled adult child attended a day program or school? Am I misunderstanding the rules here? I feel like the rep was just looking for quick reasons to deny me without fully understanding my situation.

One more thing I forgot to mention - when you call back, try to use their exact terminology. Instead of just saying your daughter "needs care" or "has disabilities," be specific about the "exercise of parental control and responsibility" and that you "provide personal services, supervision and direction" - those are the exact phrases from their policy manual that they're trained to look for.

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That's incredibly helpful! I'll make sure to use those specific phrases. I wasn't prepared for how technical the conversation would be last time.

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good luck!! update us after u call again! my aunt might be in same situation soon

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they asked me for a letter from his doctor about his care needs and why he cant be left alone. i also gave them his guardianship papers and IEP from when he was in school showing his severe disability. and my work schedule showing i only work part time now to care for him

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does anyone know if this works if youre the grandparent? my daughter passed and i take care of her disabled son who gets her survivor benefits...

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To answer the recent question - grandparents can qualify for this benefit in place of parents if they are the legal guardian providing care for a disabled individual receiving survivor benefits. The same criteria apply regarding care requirements and work limitations. One important note for everyone: If approved, the Mother's/Father's benefit is generally 75% of the deceased person's primary insurance amount, but may be reduced by the family maximum benefit limit if multiple people receive benefits on the same earnings record. This is something to be aware of when calculating potential benefit amounts.

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That's good to know about the 75% amount. In our case, it's just my son and potentially me receiving benefits on his father's record, so hopefully we wouldn't hit the family maximum. I'm going to gather all our documentation and try to get an appointment at the local office.

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Just my 2 cents - everybody's situation is different. My wife and I decided I'd file at 62 and she'd wait til 70 since her benefit was bigger. Worked great for us, we're 15 years into retirement and no regrets. Health problems can change everything tho so dont just think about the math, think about QUALITY OF LIFE!!

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That's a good perspective, thank you. Were there any unexpected issues you ran into with your strategy that I should be aware of? Did your wife's larger benefit at 70 end up being worth the wait?

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Absolutely worth it! Her benefit at 70 was nearly DOUBLE what it would've been at 62. The only surprise was Medicare premiums - they're higher than we expected and keep going up every year. But having one bigger check helps with that.

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Has anyone mentioned survivor benefits yet? This is HUGE in your planning! When one spouse dies, the surviving spouse basically continues with the HIGHER of the two benefit amounts. So if you delay till 70 and get say $4200/month, then pass away, your husband would get that $4200/month for the rest of HIS life (assuming it's higher than his own benefit). So even if you delay and don't live super long, your husband could benefit from your higher amount for DECADES, especially with that 3 year age difference. This is especially important with his WEP situation limiting his own benefit.

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This is so important! My friend's husband delayed till 70 then died at 74. She was devastated BUT she's now getting his maximum benefit at age 82 and will for many more years. His delaying ended up being a gift to her.

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My friend's husband died last year and she got survivors benefits at 60 without any earnings test! why is that different from retirement?

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Survivor benefits and retirement benefits have different rules. While survivors can claim as early as age 60 (with a reduction), they're still subject to the earnings test if they're working and under their FRA. However, the reduction formula is different for survivors than for retirement benefits. If your friend isn't working or earns under the limit, she wouldn't see any withholding due to the earnings test.

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When I had to figure out my strategy, I made a spreadsheet comparing different scenarios. Have you run the numbers for: 1) Claim at 62 + part-time work, 2) Work full-time until 63 or 64 then claim, and 3) Work until FRA? Each year you delay claiming increases your benefit by about 7-8%. It's really a math problem specific to your situation.

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That's a smart approach. I'll definitely make a spreadsheet comparing the different options. I'm still hoping to find a new full-time job, but at my age that's uncertain. At least now I understand how the earnings limit works if I do need to claim early and work part-time. Thanks for the suggestion!

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My sister went thru this with my mom. The caregiver payments were a problem during Medicaid application cuz they didn't have a formal agreement. They ended up having to pay back some money to qualify mom for Medicaid. Make sure you're charging a fair market rate. In our area agencies charge like $25-30/hr for similar care, so document your hours to show you're not overcharging.

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That's helpful context - thank you. I'm probably providing 20-25 hours of active care weekly, plus being on-call constantly. So $375 is probably around $15-18/hour which seems reasonable. Did your sister have to repay everything or just the amount that exceeded market rates?

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Since everyone's focused on Medicaid, I want to address your Social Security question specifically: When someone needs a nursing home, their Social Security benefits typically continue but may be used differently: 1. If she goes on Medicaid, most of her Social Security check will go to the facility as her "patient responsibility" contribution, with a small personal needs allowance (usually $30-60/month depending on state). 2. You should become her representative payee with SSA before facility placement to ensure proper handling of benefits. 3. The caregiver payments won't affect her Social Security benefits directly, but will be scrutinized during Medicaid application. Call SSA directly about the rep payee process - it requires specific forms and sometimes an in-person interview.

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Good luck reaching an actual person at SSA! I tried for weeks before using Claimyr. The rep payee process also requires form SSA-11 and they usually want medical documentation about why the beneficiary can't manage their own benefits. Get a letter from her doctor about the dementia diagnosis to speed things up.

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